Central Appalachia residents present unique healthcare challenges. This vulnerable population fac... more Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work of the Health Wagon has broken down a financial barrier to healthcare access and offers unique and profound opportunities to improve health and expand health care in rural Central Appalachia.
Background: The Health Wagon, a free 5013c clinic, was awarded a HRSA Affordable Care Act in 2010... more Background: The Health Wagon, a free 5013c clinic, was awarded a HRSA Affordable Care Act in 2010 to form an academic partnership with the University of Virginia and other community agencies in Southwest Virginia (SWVA) Appalachia. The 4 counties targeted by the grant have almost 43% of residents below 200% of the federal poverty level, with 25% reporting no health insurance. Age-adjusted mortality rates in some of the counties are as much as 70% higher than the rate for the state of Virginia. Description: The primary goals of the grant are 1) to expand access to comprehensive health care with a public health focus on prevention, 2) to expand the number of clinical training opportunities for nurses, 3) to improve access to care and become a patient-centered family home for those without insurance or ability to pay, and 4) to improve clinical services and data collection ability by implementing an electronic medical record (EMR). Lessons Learned: Up-front training of all involved in ...
The purpose of this project was: 1) to expand clinical training experiences for undergraduate, gr... more The purpose of this project was: 1) to expand clinical training experiences for undergraduate, graduate and advanced practice nursing students at a rural free clinic, 2) to test the feasibility of developing a model training and practice internship for undergraduate, graduate and advanced-practice nurses as part of a Health Resources and Service Administration (HRSA)-funded academic-community partnership to encourage nurses to consider future employment in rural Appalachia and 3) to determine the successes and challenges of this endeavor. This paper reports the successes and challenges of this partnership. Data were collected from nursing students attending the University of Virginia through self-reported student information forms. A total of 145 students (56 advanced practice, 19 graduate and 70 undergraduate nursing students) successfully received scheduled clinical training experiences at three rural clinic sites operated by the Health Wagon (HW), a free clinic in rural Southwest Virginia. It is feasible to develop and implement a long distance academic and community-based partnership to provide real life experiences for undergraduate, graduate and advance practice nurses, including nurse practitioners, in rural settings. Success depends on the commitment of both the academic and free clinic staff to the program, excellent on-site clinical supervision of students, and a source of revenue to cover both on-site and travel related expenses for students and preceptors.
Central Appalachia residents present unique healthcare challenges. This vulnerable population fac... more Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work...
Central Appalachia residents present unique healthcare challenges. This vulnerable population fac... more Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work of the Health Wagon has broken down a financial barrier to healthcare access and offers unique and profound opportunities to improve health and expand health care in rural Central Appalachia.
Background: The Health Wagon, a free 5013c clinic, was awarded a HRSA Affordable Care Act in 2010... more Background: The Health Wagon, a free 5013c clinic, was awarded a HRSA Affordable Care Act in 2010 to form an academic partnership with the University of Virginia and other community agencies in Southwest Virginia (SWVA) Appalachia. The 4 counties targeted by the grant have almost 43% of residents below 200% of the federal poverty level, with 25% reporting no health insurance. Age-adjusted mortality rates in some of the counties are as much as 70% higher than the rate for the state of Virginia. Description: The primary goals of the grant are 1) to expand access to comprehensive health care with a public health focus on prevention, 2) to expand the number of clinical training opportunities for nurses, 3) to improve access to care and become a patient-centered family home for those without insurance or ability to pay, and 4) to improve clinical services and data collection ability by implementing an electronic medical record (EMR). Lessons Learned: Up-front training of all involved in ...
The purpose of this project was: 1) to expand clinical training experiences for undergraduate, gr... more The purpose of this project was: 1) to expand clinical training experiences for undergraduate, graduate and advanced practice nursing students at a rural free clinic, 2) to test the feasibility of developing a model training and practice internship for undergraduate, graduate and advanced-practice nurses as part of a Health Resources and Service Administration (HRSA)-funded academic-community partnership to encourage nurses to consider future employment in rural Appalachia and 3) to determine the successes and challenges of this endeavor. This paper reports the successes and challenges of this partnership. Data were collected from nursing students attending the University of Virginia through self-reported student information forms. A total of 145 students (56 advanced practice, 19 graduate and 70 undergraduate nursing students) successfully received scheduled clinical training experiences at three rural clinic sites operated by the Health Wagon (HW), a free clinic in rural Southwest Virginia. It is feasible to develop and implement a long distance academic and community-based partnership to provide real life experiences for undergraduate, graduate and advance practice nurses, including nurse practitioners, in rural settings. Success depends on the commitment of both the academic and free clinic staff to the program, excellent on-site clinical supervision of students, and a source of revenue to cover both on-site and travel related expenses for students and preceptors.
Central Appalachia residents present unique healthcare challenges. This vulnerable population fac... more Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work...
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Papers by Paula Meade