Facing Healthcare Access Challenges With Specialty Care Clinics in Central Appalachia

Abstract

Access to specialty care and diagnostic services in rural healthcare settings are required to achieve quality healthcare outcomes. St. Mary’s Health Wagon network of free clinics, established in 1980, serves a region with an array of health disparities and poor social determinants of health. In 2018, the administration envisioned implementation of an interprofessional team to deliver diagnostic services targeting healthcare access challenges in southwest Virginia, which is historically unprecedented. The cost of diagnostic services in the area was not equitable for the poor, uninsured, and underinsured. Many patients had to use the emergency department for radiologic exams, incurring more debt that cannot be afforded or paid or simply forgoing needed diagnostic services. The leadership team applied for and secured a United Health Foundation Grant that fulfilled their vision, employing ultrasound, diagnostic x-ray, mammogram, telecystoscopy, telecolposcopy, and dental visits into the network of clinics. To date, St. Mary’s Health Wagon has performed 3,587 exams (342 ultrasounds, 282 x-rays, 273 mammograms, 21 telecystoscopies, 16 telecolposcopies, and 2,669 dental visits) free of cost for the patients. While there were some challenges with the implementation of these services, the benefits yielded quick diagnosis and treatment, leading to optimal patient outcomes.