Virtua Health, the largest not-for-profit health system in southern New Jersey, has a brand promise to be “here for good.” These three simple words shape the organization’s strategic plans and keep staff members mindful of their commitment to the community they serve. The brand promise also informed the health system’s newest mobile health program.
Launched in spring 2023, Virtua’s Mobile Health and Cancer Screening Unit is a 40-foot vehicle designed to empower the health system to provide more than 6,000 appointments per year. Virtua Health sees this program-on-wheels as fundamental to its work to advance health equity. Rather than passively hope patients find their way to the health system, Virtua instead aims to go directly
to the neighborhoods that traditionally lack access to care, forge meaningful partnerships with local leaders and establish trust as a true partner in health.
The vehicle is equipped with the latest mammography equipment and includes a private exam room, an imaging suite, a restroom and a registration area. In addition to mammograms, the program offers screenings for cervical, prostate and colorectal cancer, among other services.
The mobile unit offers free cancer screenings to people who are uninsured or have limited health insurance coverage. The New Jersey Department of Health funds this service as part of its statewide cancer education and early detection program. Additionally, the vehicle makes scheduled visits to community centers, places of worship, area employers and other locations to provide screenings to anyone who would benefit from the convenience of having care come to them, including those with Medicare or Medicaid.
For those who have flexibility in their working hours, a stable place to call home and reliable transportation, it can be easy to forget the challenges other people who are less fortunate may encounter when attempting to prioritize their health and seek needed care. It is easy to imagine, however, that if getting a mammogram required taking unpaid time off work or commuting 45 minutes on two or three bus lines, someone might put off the procedure by a month, a year or more.
This is the sort of candid feedback Virtua’s patients have provided regarding the Mobile Health and Cancer Screening Unit. Many have thanked the health system for acknowledging the competing demands on their time and for simplifying the entry point for receiving care.
As the health system reflects on the program’s journey to this point and maps out its future, some key concepts come to mind. The following lessons learned can be applicable to other healthcare organizations aiming to make meaningful inroads in health equity.
Meet People Where They Are
The Mobile Health and Cancer Screening Unit is not Virtua’s first mobile program. The health system has provided mobile cancer screenings for many years on a vehicle it leased rather than owned. Although the original program was impactful, the on-the-ground team recognized it could do more for the community if the health system had complete oversight. In fact, Virtua is now positioned to quadruple the number of mobile mammograms it provides, from 760 to 3,400 per year. In addition to 3-D mammograms, this vehicle offers clinical breast exams, gynecologic/pelvic exams, pap tests to detect cervical cancer, colorectal screenings via a take-home stool test kit or fast-tracked colonoscopy referrals and PSA tests.
Virtua also has other one-of-a-kind vehicles that bring health services where they can do the most good. A converted cargo van is now the Eat Well Mobile Farmers Market, and a one-time city bus has become the Eat Well Mobile Grocery Store. “Eat Well” is the umbrella term for Virtua’s initiatives to address food insecurity, and both vehicles are familiar sights on New Jersey’s roads and highways.
In 2017, Virtua also launched a Pediatric Mobile Services Unit. This 25-foot van provides developmental and health screenings and vaccines for more than 4,000 children and their families each year.
Although each vehicle has a distinct function, they all aim to bridge the gaps that often prevent people from accessing care. Virtua sees these programs as meeting people halfway; if you want people to take your hand, you first need to extend it.
Establish Care Continuity
Importantly, the health system’s aim for these mobile programs is to serve as a launching point for deeper relationships. If, for example, a child on the Pediatric Mobile Services Unit shows signs of developmental delays, staff members will work to enroll them in Virtua’s early intervention program. Similarly, if someone who shops at the Eat Well Mobile Farmers Market needs support managing a chronic condition like hypertension or diabetes, the team can connect them to a wide range of clinical services.
Inevitably, some percentage of the people who participate in a mobile cancer screening will discover that they have cancer. Virtua wants to support these patients in that moment and guide them through the journey ahead through the health system’s oncology partnership with Penn Medicine.
Show up With Authenticity
Healthcare is all about relationships, and the partnerships Virtua makes with community leaders are fundamental to the organization’s success in reaching prospective patients. In the months leading up to the launch of the Mobile Health and Cancer Screening Unit, as the vehicle was being retrofitted, Virtua staff members began to establish these connections with key players. For example, team members visited local Veterans of Foreign Wars halls and made phone calls to senior centers to raise awareness about the mobile services. These conversations made it clear how much Virtua and its partners could help each other and, therefore, the community.
Health system leadership also assembled a diverse staff that reflects the populations Virtua serves. Currently, there are eight bilingual team members, including someone who speaks Haitian Creole. To nurture relationships among those who exclusively speak Spanish, including migrant farm workers, Virtua leaders fostered what is known as a promotores program. The promotores, the Spanish term for “community health workers,” are well-known figures within their community who connect people to care, many times from within their own family and friend network. In Virtua’s experience, the promotores’ guidance in the community can carry as much weight as that of a clinician because of existing relationships and shared life experiences.
Fuel Your Good Work Through Philanthropy
Virtua Health is extremely fortunate to have a philanthropic community that covered the startup and continues to cover the sustained costs of its mobile programs. This includes kindhearted individuals, grant makers, government agencies and businesses of all sizes. For instance, a $1 million donation from a foundation kick-started the Pediatric Mobile Services Unit. That foundation has made subsequent contributions—as have other private/public donors—to maintain its operations. That program has also been awarded grants for its impact. The approximate cost of the Mobile Health and Cancer Screening Unit—meaning the vehicle itself—is more than $1 million.
Those who dedicate their dollars to the health system’s mobile fleet can feel certain they have made a wise investment, whether that comes from the immediate gratification of providing someone with fresh produce for dinner through the Mobile Farmers Market or the lasting impact of administering back-to-school vaccines through the Pediatric Mobile Services van.
Importantly, at Virtua Health, employees do not consider this work a “side project” that supplements the core functions of a health system. In fact, the team at Virtua applies the same degree of consideration and scrutiny to its community-based programs as it does to its traditional service lines such as cardiology or orthopedics. They are all integral to the organization’s identity and purpose.
In the end, it comes back to being “here for good.” And that feels great.
Stephanie Fendrick, FACHE, is executive vice president/chief strategy officer, Virtua Health, Marlton, N.J. (sfendrick@virtua.org).