Carl Maronich (Host): Welcome to Wellness First, a St. Joseph Hospital Podcast, where we hear and learn directly from experts on all things health and wellness. I'm your host, Carl Maronich. And joining me today is Rosemary Ford, Director of the St. Joseph Hospital Mobile Health Clinic. Welcome, Rosemary.

Rosemary Ford, MBA: Nice to be here.

Host: Great to have you here.And today, we're going to be discussing mobile health and how it's bringing care to the community. So, let's jump right into that topic. And I'll ask what inspired the launch of the mobile health clinic and what community need does it really address?

Rosemary Ford, MBA: Well, the Mobile Health Clinic came about because working with our community partners, looking at our community needs assessment, we identified opportunities to better serve our community in particularly vulnerable populations. We know that there are certain populations that have barriers to accessing quality healthcare are more prone to different types of illnesses and diseases. So, the birth of the Global Health Clinic came about. And here we are, out in the community providing excellent care.

Host: What types of care and services are available in the mobile health clinic?

Rosemary Ford, MBA: Well, we offer non-urgent walk-in care. So, what that means is basically we're set up just like a doctor's office. Our mobile health clinic actually has two exam rooms. One we have set up where we can provide vaccines and it also doubles as a lab for point-of-care testing. We can offer anything from pregnancy testing to STI, hepatitis, respiratory illness, blood glucose, the list goes on.

And our other room we have is set up just like a doctor's exam room, that's where we see a majority of our patients. And besides the point-of-care testing, we also provide an array of vaccines. As you can imagine coming up to the flu season, that's going to be very busy for us. But we also provide different vaccines such as hepatitis vaccines, Tdap, shingles vaccines. We carry what the needs are in the community. And then also, we're able because of the staffing with our RN and nurse practitioners, we're able to provide wound care, write prescriptions when needed and general health-related visits.

Host: Yeah, pretty all encompassing it sounds like, and it may seem obvious since it's a mobile unit, but maybe you could speak a little bit to what makes it easier for patients to access care in the mobile unit compared to a traditional hospital?

Rosemary Ford, MBA: Well, due to different socioeconomic issues that people do face, having access to a brick and mortar facility to access healthcare just isn't an option for some folks. So, the beauty of the mobile health clinic is we're meeting people where they are and providing that care. And if it wasn't for our community partners, we wouldn't know where to meet people. And many times, we're working with folks who are transient, so our populations may move. So, it's so important for us to have a pulse on where are the communities, where can we best provide that care to our communities and to adjust our schedule to make it as accessible as possible to all of our community members.

Host: Yeah. You talk about community partners, I'm sure in the lead up to the establishment of the mobile clinic, you worked with a lot of folks to, exactly as you said, determine where the need was and how to serve that need. Is that an ongoing process now that the mobile unit is out in the communities?

Rosemary Ford, MBA: It sure is. Like they say, it takes a village. And we're fortunate enough in the greater Nashua area to have community partners who offer all different types of services that address food insecurity, shelter needs, clothing, hygiene. The list goes on and we do meet monthly. And we are one of our closest partners, which is Nashua Public Health. They actually report out on the communities that we're serving, where they're populating, what are the current needs that they're seeing. And through those meetings, we're able to make a game plan with our partners and provide our services where we could make the biggest impact.

Host: Yeah, helping a lot of people. And maybe you could speak to who benefits most from the mobile health clinic and maybe share a story if you have one.

Rosemary Ford, MBA: Well, really, I think everyone benefits. We're seeing folks from all different walks of life. And a greater majority of folks that we do provide care to are homeless or at risk of being homeless. And we've built relationships over the years, which of course takes time. Building that trust and rapport is so essential to the services so that people have a place where they feel comfortable to receive their care and know that they can go to if they're experiencing a health condition or a concern.

And as far as stories go, there's so many. But one in particular I'd like to share is with a patient that we saw at one of our regularly scheduled locations. And this particular patient met with our nurse practitioner and had a severe burn on the lower half of his body. This individual has been homeless most of their life, substance abuse, mental health issues personality disorder. Very challenging as you can imagine. And although it was highly recommended that this individual seek care at a hospital, the patient refused. They were not going to do this and was insistent on receiving the care through the clinic.

 So, knowing that the patient most likely won't go to a brick and mortar location for about five weeks, every single Wednesday, this patient came to the clinic, received care, had their burns cleaned, freshly wrapped, and we also provided this individual with clean bandages. And different types of cleaning agents so that when we weren't there, they were able to care for their wounds. And week after week, the nurse practitioner steadily saw an improvement in the wounds on his lower body. And the nice outcome of this was, about a month or two later, she overheard him speaking to his friends and sharing about his great experience with the clinic and how he and the nurse practitioner healed his wounds together.

Host: And that comes back to something you said a minute ago, trust and developing those kinds of relationship allows the public to trust the organization and be more comfortable should they need to go to the brick and mortar hospital, but that trust has been established. That's so important.

Rosemary Ford, MBA: Absolutely.

Host: Maybe you could speak a little to the team that's involved in the mobile health clinic and the variety of providers. As you said, it takes a village, so there are a number of people that get involved, I'm sure.

Rosemary Ford, MBA: There sure are. Well, first off, it is an RV, so we have to have someone who can drive our vehicle. So, we do have a driver. We also staff with either an RN or a nurse practitioner. We have a patient service rep. So, we are fully integrated into our electronic medical record, which is Epic. And every patient that we do see and treat gets registered, and we build a medical record for them so that staff can reference it and the patient can as well if they need that information for a followup. With that team of three, we're out on the road providing care. And at times, we're actually partnering with public health who may join us on the clinic as well, providing a service that we may not be particularly offering at that time.

Host: There aren't appointments necessary or are there? How does that work if someone wants to use the clinic?

Rosemary Ford, MBA: No appointments necessary. It's walk-in care. We do have a little bit of a waiting area in the event that we have more than one person who needs to be seen at the same time. But we try to make it as flexible as possible.

Host: How do you determine where the mobile unit is going to go?

Rosemary Ford, MBA: Really based on the populations and where they're congregating at the time. So if we're doing specific outreach to homeless or unsheltered individuals, we will know where these populations are currently residing. And a key part to providing care to folks is having a consistent schedule. And we learned this through years of trials and tribulation. Just being at one location one time a week during the month, it's hard for people to keep track. So, we have our schedule set up four months at a time. And we're consistently at these locations on a weekly basis.

The only time we don't go out is if it's extreme inclement weather, and it would just be too dangerous to drive. So even in the winter, the clinic is out. And one of our policies is to keep the door wide open to make it accessible and welcoming to everybody.

Host: I'm sure that consistency is very important, being there when folks expect you to be. What's on the horizon, if you will, for the mobile health clinic? You've done a lot of things. You've had a time to understand the needs? Are there some new things on the horizon that we can look forward to?

Rosemary Ford, MBA: Well, I'd love to share that one of the newest things that we've added to the clinic is being able to offer over-the-counter medications to our patients. So as you can imagine, many people face financial constraints that don't allow them to get the simplest things at a local pharmacy, such as if there's a recommendation for Tylenol or an Icy Hot patch for back pain. A greater majority of the time, we hear from folks that they just don't have the money and they don't have the transportation to buy those luxuries. So, we now carry an array of medications over-the-counter on the clinic that we're able to provide in real time to our patients. So, that could be anything from an allergy med to an anti-inflammatory or an antacid.

 We are continuing to grow those types of offerings based on what we're seeing because, as you can imagine, we're constantly learning and we're encountering new things on the clinic. And my hope in the future is to be able to have some prescription medications on the mobile health clinic because, as you can imagine, we see folks that need that next level of care and a prescription medication, which can again, of course, be a barrier for folks. So, that is hopefully in the horizon in something we're working towards.

Host: Rosemary Ford, Director of the Mobile Health Clinic at St. Joseph Hospital, you've been a wealth of information. Anything else you want to add?

Rosemary Ford, MBA: I just want to add that we would love to see anyone and everyone at our clinic. Our motto is everyone is cared for here, and we have an open door policy. So, stop on by and check us out.

Host: Very good, Rosemary. Thanks so much for being with us today. And for more information, visit stjosephhospital.com. If you enjoyed this podcast, please share it on your social channels and explore all the other podcast in the podcast library. I'm Carl Maronich. This has been Wellness First. Thanks for listening.