**7. Examples and opportunities for improved pandemic responses with Mobile clinics**

A recently published commentary shared the findings of a webinar co-hosted by the Harvard Medical School's Family Van together with the Mobile Healthcare Association to gain an understanding of the current state of efforts by the clinics, discuss best practices, and exchange ideas [20]. Several mobile clinics in the United States offered services to different populations during the early stages of the COVID-19 pandemic, and still continue to do so. Examples highlighted in the commentary include the Parkland Health and Hospital System, which had staging areas at COVID-19 testing sites, or triage locations in the parking lots near hospital emergency departments. Another was a federally qualified health clinic in Austin, Texas, conducting outdoor testing. Nurses at the clinic triaged patients in their vehicles and not the mobile van, and then patients drove around to a doctor to get tested. Finally, Cincinnati Children's used the mobile clinic to test employees using an algorithm for employees to call a centralized number for a referral [20]. Mobile clinics are an essential aspect of our healthcare delivery system with innovative and adaptable approaches to problem-solving. Mobile clinic programs repurposed their operations to serve other dire needs of their patient populations, and communities. For example, the Harvard Medical School's Family Van hosted call-in hours, contacted clients directly, and distributed handouts put together with the COVID-19 Health Literacy Project [22]. The vans for the Vision to Learn program were used to take food and household supplies to seniors in East Los Angeles in a partnership with the Weingart East Los Angeles YMCA, University of Southern California Keck School of Medicine, Adventist Health White Memorial, and the American Heart Association. Other programs also used their vans to distribute food, and supplies to families in public housing [20].

In order to efficiently leverage the adaptable and community-based approach to healthcare delivery that mobile clinics provide, especially as an avenue to improve pandemic responses, there is a need to consider moving beyond the grant-based model of funding to create sustainable mobile clinic programs [20]. We need to be asking health policy questions about how we can leverage innovation in mobile healthcare delivery to help enhance efforts to narrow the widening gap in disparities that have resulted from this pandemic. For example, mobile clinics can be used in case management approaches similar to the model used by Uber Technologies,

*Mobile Clinics in the United States and the COVID-19 Pandemic: A Response Strategy Model DOI: http://dx.doi.org/10.5772/intechopen.98692*

where mobile clinics can be requested on-demand to address localized and contextualized needs in areas where there are increases in reported cases of health conditions during a pandemic.

Additionally, as part of the National Emergency Preparedness Strategy, mobile clinics can play a pivotal role in the deployment of health resources to areas with the direst need. The model can serve to provide trained medical professionals, the use of the actual vehicles for triage and isolation units, temporary housing, and sourcing additional medical equipment. Integrating mobile health clinics in our national healthcare delivery systems in a comprehensive way will create an existing structure of collaboration with stationary facilities, and an innovative infrastructure that aims to address the underlying disparities in healthcare access and geographic barriers to care. With the evidence around costs, their geographical influence, and populations served, healthcare policies and funding models that support mobile clinic programs and their integration in our healthcare delivery systems will ensure improved responses during pandemics and other health crises.

National funding programs that expand the use of technology can also provide the opportunity to establish close collaborative involvement with other stakeholders in the healthcare system. As the nation grapples with logistical challenges and other gaps in current vaccination efforts, more critical attention needs to be given to the long-standing community model of healthcare delivery with mobile clinics, and their capability to refer and navigate patients in a comprehensive real-time manner. This will not only support the success of current efforts in response to combating the COVID-19 pandemic but other potential future pandemics in an equitable fashion.

#### **8. Conclusions**

Mobile clinics are both effective and efficient in ensuring populations have access to equitable healthcare. They have been shown to be a sound complement to stationary clinics. In order to better leverage, their critical role in addressing health disparities that have dramatically worsened throughout the COVID-19 pandemic, significant shifts in healthcare reimbursement policies will need to occur. With national efforts to combat health disparities by addressing social determinants of health, there is now more than ever the need to consider cohesive funding for mobile health clinics, as well as a comprehensive approach to incorporating mobile clinics in our entire health system. These efforts will not only be effective for improving health outcomes of under-resourced populations but will also play a role in contributing to the success of the current national pandemic response, and future health crises.

### **Acknowledgements**

The authors acknowledge the Mobile Healthcare Association, and the Mobile Health Map, a program of Harvard Medical School's Family Van for their contributions with access and insights into mobile health programs.
