Eric Young, the director of operations at Sentara Leigh Hospital in Norfolk, Va., oversees the Sentara Mammography Mobile Van, a 38-foot long RV. This mammography suite on wheels is fully equipped with two dressing rooms and a complete digital mammography unit, just like you’d find in a brick and mortar facility.
“We drive it and set it up. Patients come in, get greeted by a registrar, get changed and get their mammography,” Young says. “A lot of times it’s more convenient because breast centers are not near them. For example, in Portsmouth, there are access issues.”
Having the mammography van means ready access to mammograms for large concentrations of women who need it. Young says that screenings like these are so important because many women would not take the time to make the appointment and go get one. So they look for areas where they can serve a group of people by bringing the van to them.
“We are constantly looking for areas to provide access, where there is a concentration of people who need access to the service. The mobile van is a great way to do that,” he says.
The van visits around 60 different sites a year, including large employers in the area. Young says that human resources departments announce the date to staff and offer online registration to save a time slot.
“We often heard that women don’t think they have time to do it. So we take the mammogram to them,” Young says.
The van provided screenings for 4,000 women last year, primarily in South Hampton Roads, but also in, Hampton, Newport News and Williamsburg. In addition, women visiting the mammography van get information on self-screening, the importance of annual mammograms and follow-up care as needed.
At the end of the day, the mammography van plugs in back at the hospital and all of the images are securely transferred to each patient’s electronic medical record so that their individual doctors can follow up as needed.
It’s a testament to the advances in technology that this is even possible. Many people remember when doctors made house calls, but the portability of technology has made many more services possible. A Richmond-based company, Dynamic Mobile Imaging, has based their entire business model on it.
With a fleet of 30 vans equipped with radiography (X-ray machines) and other portable technologies, like ultrasound, Doppler, echocardiogram, EKG and halter monitors, they serve a large area of Virginia and Maryland, including the Eastern Shore.
“The technology was the tipping point,” says Dean Berger, chief operating officer of DMI. In 2005, other mobile businesses existed, but DMI launched as 100-percent digital, and that made the quality of the images and the ease of transmitting them much more feasible.
The company serves people in nursing homes, jails, assisted living facilities, adult day care centers and their own homes. There are many reasons to take the technology to the patient rather than transporting the patient.
“For some people, being transported to and from the ambulance is traumatic, and when the weather is bad, it can be even more difficult. It’s quicker to take it to them, and when time is of the essence, it can really help,” says Debbie Berger, the president and CEO of DMI.
For example, elderly people are susceptible to lung infections like pneumonia. Rather than lifting them from bed, down the stairs to an ambulance, in bad weather, to go and wait in an emergency room, they can have what they need come to them. Having the X-ray machine make a house call is more comfortable for them, and their doctor can review the X-ray and treat them accordingly. They may be prescribed antibiotics and get started on treatment in the same amount of time it would have taken to get to a hospital for an X-ray.
At jails, many of the chest X-rays are to screen for TB, if skin tests have come back positive. This avoids the cost of transportation and additional security for prisoners. Another potential situation is the swallowing of foreign objects, and mobile radiography can quickly identify whether an item was ingested or not.
The company started as a family business, with Debbie, her husband Dean and her mom Clara Burrows, who are all radiology techs. “We understood the ins and outs of radiology,” Burrows says.
Her husband was the one who thought the family should jump into the mobile X-Ray business because he was excited about the new technology. The old process involved chemically developing X-Rays, and that meant same-day results weren’t possible. Other advantages that come with the new technology include seeing the image immediately, and if it’s not good quality, the tech can retake it right away. They can also send the files wirelessly so no time is wasted in transit.
Mobile services are growing, mainly because of the advances in technology, but also because of a growing awareness of the lack of access for people living in rural areas. One of the leaders in this push for improved rural health care access is the U.S. Department of Veterans Affairs. According to the department, about 41 percent, or 3.3 million veterans enrolled in the Veterans Affairs Department health system live far from a VA hospital. They have a fleet of more than 70 “mobile vet centers” to bring mobile technology and other services to rural veterans. There are satellite systems installed in every mobile unit to allow remote access to a range of the department’s medical and benefit systems, including referrals, stored medical records and counseling.
In addition, mobile services may be shared by facilities to cover the far-reaching areas of a metropolitan area. Sharing a resource helps provide coverage and increase access because the equipment is a significant investment and one location may not have the volume to make it worthwhile. Another use is taking mobile technology to locations in need of disaster assistance.
Other types of services that are offered on the road: lithotripsy, which uses sound waves to break up stones in the urinary system (such as kidney, bladder or ureter), and PET/CT scans. The PET/CT is to help diagnose a number of different diseases including brain disorders and cancers. By comparing images from the scans, the spread of cancer and the effectiveness of current therapy methods can be determined.
With all of these options, people who are short on time, need to remain where they are or who live in rural areas can be helped. Whatever the need, medical technology is more likely to be where it’s needed than ever before.