When a 10-Minute Drive is an Ocean Away

Last week I paid a visit to the University of Miami’s Pediatric Mobile Clinic (UMPMC). The 40-foot bus was parked outside the Center for Haitian Studies in Miami’s Little Haiti neighborhood as usual – the big blue bus took over the parking lot, with staff, interns, residents and volunteers providing care both in the mobile unit and throughout the Community Center. The services provided to the children visiting the clinic are highly integrated and holistic, ranging from sports physicals and immunizations to specialty care in cardiology, dermatology, endocrinology, hematology and nutrition. How does one mobile clinic possibly provide this breadth and depth of care?

Telemedicine. And an innovative medical director committed to serving her young patients with the highest level of continuous care.

The Pediatric Mobile Clinic provides live interactive videoconferencing consultations in which young patients and/or their care givers interact directly with a specialist off site. As Dr. Lisa Gwynn, clinic director explained, “There are major barriers to the 10-minute drive to the closest hospital, from transportation costs and cultural barriers to fear of a bill and inability to pay.” Telemedicine removes those barriers by bringing a specialist right into the clinic with a portable videoconferencing tool that allows patients to interact directly with a provider in the comfort and convenience of their medical home. Gwynn notes she saw the clinic’s patient compliance rate sky-rocket with the integration of this technology in 2013, with 35% of her patients following through and meeting with their specialists to now over 90% of her patients meeting with their specialists.

The neighborhood of Little Haiti is home to one of the largest populations of Haitian immigrants in the country, with the majority of its residents of Haitian origin or descent. It is also an area of high levels of poverty and a lack of primary care providers. 45% of the residents of Little Haiti earn less than $12,000 a year and 40% of its residents have no insurance, compared to 16% of all Floridian residents that live below the poverty line and 20% across the state that have insured.  These demographics and a shortage of providers make it the ideal neighborhood for the Pediatric Mobile Clinic, which rolls out of its parking spot at the University of Miami 5 days a week to park in different high need neighborhoods throughout the city.

On my visit last week, I watched as Gwynn photographed the back of an infant’s head on her cellphone. She then uploaded the photo to an app on her phone which pushed the photo to a pediatric dermatologist for her diagnosis. This store-and-forward technology is yet another telemedicine tool used by the clinic to ensure continuity of comprehensive care. “Telemedicine is absolutely critical for compliance,” Gwynn explains. “My main concern is quality care for patients and their safety.”