Mobile Services Improve Access to Preventive Care, Cancer Screening: Constance Blunt, MD

The mobile health care initiative represents a innovative model of community-based health care that addresses systemic access challenges by bringing services directly to those who need them most, explains Constance Blunt, MD, medical oncologist, Mary Bird Perkins Cancer Center.

This transcript was lightly edited; captions were auto-generated.

Transcript

When patients know that certain screenings are free, does it make a difference in their willingness to be screened?

On the clinical side of things, I have patients all the time that will come and they'll say—I do a lot of breast cancer—“Hey, I felt a lump in my breast 6 months ago, but I didn't have insurance," or "I haven't met my deductible, and I couldn't afford the co-pay.” And so they will wait until they either have the finances or have that insurance company coverage to come in to even start that process. Not having coverage, not having the financial stability or the financial freedom to be able to pay for a co-pay, even if it's just a small financial inconvenience, it can really limit people's ability to come in and get preventative care.

Can you discuss how the mobile units work through the Prevention on the Go program?

We rely on physician and nurse volunteers to help us. We have some nurse practitioners and some trained nurses that are there to do skin exams, prostate exams, breast exams, and so we're bringing these services directly to the patient with these mobile units, and so, no, they don't have to make a doctor's appointment. We are the first step. Then with that, you're kind of left with, “I need to do A, B, C and D.”

We have navigators that will take a patient. Say you come to our health fair and your mammogram screening is abnormal. Well, at that point, you're handed off to our navigator, who works to pair you with a provider so that you can continue your diagnostic process and get set up for your evaluation and treatment. Now, if the patient happens to be diagnosed with a cancer, and say they get funneled to me, well, when the baton is handed to me, I take care of taking the cancer, and then I'm also looking back. Do you have a primary? Have you done this? Have you seen a dentist?

With Mary Bird, we recently hired a dentist, so when patients are seeing me, if they are not caught up on their oral care, I'm referring them to our dentist if they need a primary care provider, I'm letting my navigators know, “Hey, can we get this patient set up with a PCP [primary care physician]?” And so, from one screening event, this patient has now been plugged into primary, they now are getting caught up on their dental screenings, and so it's an easy way to take a process that's very overwhelming and we kind of consolidate it for the patient.

If you're behind on your health care or you don't have an established provider, to have a network that can kind of take some of that leg work out from you, increases their compliance and likelihood that they're going to follow-up reliably.