Page 16 - 2021 MHA Start-up Guide

Creating a needs assessment
Your first step, therefore, should be a needs assessment, which will identify the gaps in local
healthcare and the reasons they exist. The process of creating one will not only help you find your
role within the healthcare system, but will provide a critical benchmark against which you can
measure success (more on that later) .
Start by answering the following:

• What are the most important morbidities (diseases or symptoms of disease) and most
common causes of mortality in your target community?
You may have a passion for diabetes prevention, but if it’s not a leading problem in local com-
munities — or if it is, but it’s being addressed for all clients by the local health system — it may
not be the right choice for your service model . Learn what the biggest unaddressed problems
are, and tackle those first.

• Is there opportunity for prevention awareness?
Many mobile healthcare programs focus on prevention rather than treatment. By offering
screenings and education on your vehicle and referring clients out to local doctors and health-
care centers, you can profoundly impact public health in your area . According to a 2014 study
in The American Journal of Managed Care, clients with high blood pressure who utilized
screenings at the Family Van clinic in Boston lowered their relative risk of heart attack and
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stroke by 32% and 45%, respectively .

• Are there disparities of service within the community? If so, what are the causes?
That is, are some people being left out of the health system for lack of access, insurance,
education or trust in that system? Frequent use of hospital emergency or urgent care services
can be especially telling here; EDs and urgent care centers are often the first and last line of
defense for the uninsured or otherwise vulnerable. They’re also a major financial burden on
the entire healthcare system . A 2013 study of 10 large U . S . mobile clinics estimated these
clinics saved nearly $7 million in avoidable ED visits over just one year .
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Sources of data for needs assessment
To answer the questions above, you’ll need information, and lots of it. Community health needs
appear in a variety of forms . The obvious signs are clinical in nature, like a high rate of chronic
disease . But they can also present in the way community members engage, or fail to engage,
with the healthcare system — for instance, a low rate of immunization or preventative screening .
According to a recent report by The Advisory Board’s Population Health Advisor, gaps in care can
be recognized in three different ways :
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Non-clinical signals: logistical obstacles to healthcare, transportation limitations, lack of spe-
cialty care or under-utilization of primary care, dependence on housing services or other public
benefits, and demonstration of mistrust between clients and providers.

3 Hill, Caterina, et al . “Mobile Health Clinics in the Era of Reform .” American Journal of Managed Care. 20 .3 (2014): 261-264
4 Mobile Health Map . Mobile Health Clinics in the United States. 2013. (Retrieved from https://www.mobilehealthmap.org/sites/default/files/
Mobile_Health_Clinics_in_the_United_States_March_2013 .pdf
5 Advisory Board, Population Health Advisor . Mobile Health Clinics: Improving Access to Care for the Underserved . Washington, D .C .: Advisory
Board, 2017. Retrieved from https://www.mobilehealthmap.org/sites/default/files/uploads/PHA_Mobile%20Clinic%20Brief_0317_General.pdf

14 MOBILE HEALTH CARE PROGRAM STAR T-UP GUIDE