The cofounder and president of the Children’s Health Fund (CHF), Dr. Irwin Redlener, is one to look up to and admire for his efforts to change the way in which children of underserved populations receive health care. “The Children’s Health Fund (CHF) develops and supports a national network of 22 programs and two affiliates in 15 to 17 states in the United States and the District of Colombia” (Brown and Ryan, 2010, p. 157). The initial focus of the program was on homeless children throughout New York City through mobile medical clinics run by doctors, nurses and other professionals. These mobile clinics “are housed in 36- to 44-foot long blue vans, designed to provide a full range of pediatric primary health care including preventative care (e.g., childhood vaccinations), diagnosis and management of acute and chronic diseases, mental health, dental, and health education services” (Brown and Ryan, 2010, p. 158).
It is implied that the main reason for this operation was to help children and others receive medical attention, especially those individuals that were underserved based on their economic status. This operation was a great idea in order to give back to the community and to help others that could not specifically help themselves. There were also disaster relief efforts that were heightened by this program as well. However, unfortunately, it is implied as well as specifically stated that there were a lot of challenges to be overcome throughout the process for the CHF.
There were many implementation challenges for the many individuals involved with this operation. One of those was the design of the environment. The operation required space and medical equipment that was difficult to get when in a mobile capacity. Another challenge was complying with regulatory standards. There are always regulations in the medical field by HIPPA laws and other acts and these needed to be adhered to no matter what the cost. Another important challenge was that of being able to support the mobile unit and providing computer and communications technology for individuals working on the units and in the stationary clinics (Brown and Ryan, 2010). Record keeping was another challenge for this operation. According to Brown and Ryan (2010), “one of the record keeping challenges faced by all physician practices is the integration of laboratory and imaging results with the rest of the patient’s health record” (p. 161). This is much more difficult to do when the main source of medical attention is within a mobile unit. It also does not help that the majority of the people being served by this operation were homeless and living in poverty. It is much harder to maintain an accurate medical record for these individuals as they frequently move around. In order to trump these challenges, the team attempted using multiple wireless capabilities; some worked, while others didn’t. In 2005, the team attempted using satellite-based access which equipped the mobile units with antenna systems. However, there were structural limitations to the system and though “expensive and designed for mobile operation, they proved to be mechanically unreliable” (Brown and Ryan, 2010, p. 162). In 2007, the team attempted using cellular wireless networks. These were great when it wasn’t critical to have them. However, they did not deliver reliable and dependable coverage when needed and this hurt the individuals working on the MMC’s. Finally, The Asynchronous Multi-Master Database Replication (AMMR) was probably the best solution to the MMC’s problem of record keeping. This solution was adopted to enable “the integration of patient record data collected at multiple sites and provide a backup capability” (Brown and Ryan, 2010, p. 163). This was the most reliable source for a solution to the record keeping dilemma.
Some of the best recommendations for an operation like this include developing better communication and record keeping abilities and focusing on children throughout the whole process in order to not overdevelop the program where management may become difficult unless there is specific ability to do so. The more there is a limited focus and a specific way in which to communicate with other professionals, the better the program will be.
It is safe to say that this is a fabulous program that has helped millions. The need for mobile clinics was continuing to grow in 2010 and seem to be just as needed today. It is also safe to conclude that, with a little more planning and a lot more ways to communicate, this program could help millions more than it already does. There are obvious challenges as have been stated throughout the paper, but the ability to fix problems and work toward creating a solution is something that needs to be valued in an operation such as this. There are newer, more affordable network communications out today, but none that they haven’t really tried. However, I’m sure if they had the right people and the right equipment, other things could help. It is also possible for the federal government’s HITECH stimulus funds and Meaningful Use standards to lead to better software integration solutions. However, the key is to whether they will spend those funds on helping operations on things like this rather than spending them all on other things that are less useful for the community. In addition, many want to make a difference and this is the reason that most of his staff would not leave to go to other physician offices. At least, this is my opinion. This is a great operation and many people want to be a part of something this big. The increase of software adoptions shouldn’t be a huge factor for those individuals who are a part of his team for different reasons. Finally, the only real combinations of conditions that could render the mobile medical clinic model obsolete would be lack of employees, lack of network connectivity, lack of services and equipment and lack of proximity (based on the places in which homelessness takes place). However, all of these have solutions; the team just has to look for them.
Brown, C. V., DeHayes, D. W., Hoffer, J. A., Martin, E. W., & Perkins, W. C. (2012). Managing information technology. (7th ed.). Upper Saddle River, NJ: Prentice Hall.