By Anthony Vecchione
The demand for mobile vans in occupational health is on the rise.
Growing concern over lost productivity, liability, and administrative hassles are the forces behind a new interest in mobile vans for delivering the scope of services––from drug testing to routine physicals.
Mobile vans deliver a range of health and safety products and care, including immunizations, pre-placement exams, drug testing, hearing evaluation, lab work, and injury management.
The Occupational Health & Safety Administration (OSHA) regulatory screenings for spirometry and audiology are frequently conducted in mobile vans as well. The use of mobile vans for corporate health services is not limited to rural areas. Large cities are also prime locations for mobile van utilization. The sight of a mobile van pulling up to a skyscraper where employees can avail themselves of a hearing test or lab work during their lunch hour is not uncommon.
According to the Centers for Disease Control and Prevention (CDC), bringing mobile screening services on-site is an effective way to reduce out-of-pocket expenses. The CDC also says that an on-site mobile screening service reduces structural barriers that keep many women from getting regular mammograms.
The CDC reports that on-site interventions such as these vans help reduce access barriers that prevent employees from receiving other preventive services—including distance to a screening facility, hours of operation, and lack of childcare. Just how valuable are the services provided by mobile vans in terms of cost-effectiveness and efficiency? Industry insiders say the value is best measured in the time saved when an employee does not need to leave the workplace to get an education, screening, inoculation, or other kinds of care. And the further away a company is from its healthcare provider, the more pronounced that value becomes.
Donna Lee Gardner, R.N., M.S., M.B.A., senior principal with RYAN Associates, said that in markets where access is a key problem for wellness services, functional evaluations and primary care, the need for mobile vans is increasing.
“Vans used in occupational health programs are a service delivery option when you want to provide on-site services to employers yet they don’t necessarily need an on-site clinic,” said Ms. Gardner.
“The employer doesn’t have to send employees to your clinic. They can process a lot of people in a short amount of time without taking time away from work,” she said.
So far, said Kim Bradberry, director of practice operations for Self Medical Group, the feedback has been positive. “These companies did not have enough space to set up medical offices. The main advantages are cost-effectiveness and access by keeping employees from leaving the job site,” said Ms. Bradberry.
What are some of the economic advantages of utilizing a mobile van?
“Access, access, access, and employer productivity,” said Ms. Gardner. “If you have to send 100 employees out one at a time and schedule them at a clinic 15 to 20 minutes away––which is going to take an hour’s worth of productivity for a screening evaluation––it’s great to have the van there. It takes the employee 15-20 minutes for most regulatory screenings and they’re back at work.”
Ms. Gardner added many places do volume discounting; when you go into the clinic it might cost $12 to $20 for a screening evaluation, but some vans do them for $9.
STAFFING REQUIREMENTS
Staffing at U.S. Mobile Health Exams depends on the type of services the client needs. “If we are conducting audio testing for a hearing conservation program, we send a CAOHC-certified technician. If we are conducting physicals for a medical surveillance program, we send a physician with another medical technician such as a paramedic, EMT, or RN,” said Mr. Hassan.
At Unity Point Health, on-sight nurses do drug tests, blood draws, and flu shots. “That gives us two levels of service to provide either on-site in the mobile unit or on-site in the workplace,” said Mr. Schmidt.
The design of a mobile van staff depends on the market, said Ms. Gardner. “For exams, you might want to use a physician or an NP with an MA or an LPN. If you’re just doing drug screening, all you would need on the van is a certified drug screening collector.”
For regulatory screenings like audiology, Spirometer, and DOT substance abuse screening, Ms. Gardner recommends an appropriately trained tech. Cost is a factor with staffing, so the best-qualified person who has the right competencies for the screenings is essential. For examinations, the use of an NP with a CNA or LPN for the tech roles would be cost-effective.
BRIGHT FUTURE
“The need for mobile vans is dependent on ease of access to services in the market. It is projected that the decreasing number of primary care providers will result in employers seeking care from occupational health programs. Contracted services via the van model may be the option,” said Ms. Gardner.
For employee wellness screenings, there are many personal health insurance providers that reimburse for a variety of prevention services and many of these vans are paid not by the employee or employer, but by the health plan provider” added Ms. Gardner.
“I see more occupational health programs going to mobile because it makes them more comprehensive,” said Mr. Schmidt. “I get calls two to three times a year from companies who’ve learned about our mobile service and want to come and look at our unit.”
