By Julie Walker After two decades of providing care in the Sinai-Grace emergency room, nurse Josephine Quaye-Molex has embraced a new way of connecting with patients. In late July, the venue was a van parked outside Immanuel Grace AME Church on Conner. Quaye-Molex joined the Wayne Health Mobile Unit about a year ago and said the ease of access has been reassuring for those who often have felt dismissed or mistrustful of doctors in traditional healthcare settings. The mobile units, she said, are meeting residents where they are and, in turn, building trust in the community. The setting also gives Quaye-Molex a chance to offer more feedback than the hospital’s ER might typically allow. “I get a lot more time to be able to sit and talk with my patients, or whoever it is that has approached,” she said. “They don’t necessarily have to get services, they just may have questions, and I’m able to answer those questions now.” Born out of necessity during the early peaks of the pandemic, some of the most vocal advocates behind mobile health said they are hopeful that the concept will alleviate barriers to healthcare access and increase trust in underserved communities like Detroit. Dr. Phillip Levy, who practices emergency room medicine at DMC Sinai-Grace Hospital and leads the WSU and Wayne Health Mobile Unit program, is hopeful that they will help revolutionize medicine in at least two ways; easing access to care and preventing serious diseases before they start. Levy says five factors – high blood pressure, diabetes, smoking, high cholesterol and obesity – contribute to 80% of chronic illnesses in the country, especially heart disease. Levy’s findings resulted in a grant and Wayne State University supported efforts to turn that data into a tool. The tool, coined PHOENIX, is intended to be used by community members and healthcare professionals to identify and curb risk factors before they turn into deadly disease. “At the end of the day, we’re going to affect the most people by screening for the most common disorders and diseases and fixing those problems,” Dr. Levy said. 

By Kristen Jordan Shamus  Even though 60% of the people who have gotten monkeypox in Michigan so far are Black, 70% of the doses of the vaccine that can prevent infection or limit symptoms after exposure have gone to white Michiganders. Black residents have gotten just 17% of the doses administered so far in Michigan, new state health department data shows. And when the first doses of Tecovirimat, the antiviral treatment more widely known as Tpoxx, arrived in Michigan, Oakland and Washtenaw counties got them – not Detroit, a majority Black city that has 38% of Michigan’s known monkeypox infections, said Dr. Shira Heisler, a Wayne Health physician and medical director of the Detroit Public Health Sexually Transmitted Diseases Clinic. In those early weeks of the monkeypox outbreak, Heisler said she fielded calls from people concerned they might have the virus. Because her clinic was so short-staffed, she didn’t have anyone else to pick up the phone. She was also testing and treating patients with the virus and administering vaccines. Doses of Tpoxx were “only physically available in two neighboring county health departments,” said Heisler, whose STD clinic is the largest in the state. “I had a patient who was immunosuppressed, HIV-positive, was in significant pain from monkeypox…However, there was no way to physically get the Tpoxx to the patient. I physically couldn’t get it for him,” she said. The patient didn’t have access to transportation and no courier service was available. “So I was going to drive there. Me and the epidemiologist were on the phone int the wee hours of the evening to figure it out…There’s no infrastructure, organizational infrastructure to be able to do this.”   

By Robin Erb   Death comes early to Detroit, killing residents in some neighborhoods 12 to 15 years earlier than Michiganders elsewhere. Thickening heart muscles, narrowing arteries and cholesterol deposits are hallmarks of the heart disease silently afflicting Detroiters and building toward life-threatening heart attacks or strokes. Dr. Brian O’Neil, chair of emergency medicine at Wayne State University’s School of Medicine, said that young doctors arriving in Detroit are often blown away by patients’ blood pressure readings. The coronavirus has exacerbated chronic conditions, increased the number of deaths of preventable diseases because people skipped regular check-ups, and disrupted transportation options for those seeking to get to doctors. As a result, more people who suffered heart attacks or strokes died because they laced swift medical intervention. The pandemic also proved the nimble nature of mobile health. Dr. Phil Levy, an emergency medicine doctor at Detroit’s Receiving and Sinai-Grace hospitals and a researcher at Wayne State University, was positioned to act because he and his team had gathered and arranged data for years to map out hypertension rates in the Detroit area. Their data tool, called Population Health OutcomEs aNd Information Exchange (PHOENIX) revealed neighborhoods strained by high blood pressure and stress based on social vulnerability index factors. Even in the earliest days of the pandemic, the parallels between COVID and heart disease in Detroit were obvious, Levy said. “We started seeing everything that was happening with the brown and Black communities in Detroit and around Detroit – especially around the Sinai Grace area – and the increased caseload and death rate that was occurring in Detroit,” Levy said. In April, the Wayne Health mobile health fleet began with a single van. By the end of this year, it will consist of ten vans that visit schools, churches, festivals and neighborhood parking lots.   

Wayne State University and Wayne Health, its affiliated physician practice group, have received a $900,000 grant from Bank of America to strengthen the Wayne Health Mobile Unit (WHMU) program. The innovative fleet of health delivery vehicles was established in partnership with Ford X in April 2020 to deliver COVID-19 testing, education, and vaccinations to underserved populations in Detroit. The support from Bank of America will provide two fully outfitted electric vehicles from Ford Motor Company that will bring preventative health care to Detroit workers in an environmentally sustainable way. The new electric Ford Transit vehicles will make regular site visits to an estimated 16-20 small- and medium-sized businesses in Detroit through partnerships between Wayne Health, the businesses, and their health insurance providers – offering comprehensive or preventative health care services to thousands of workers. Each mobile unit will function as a mobile clinical setting with an examination and consultation area and a telehealth component. The funding from Bank of America will support the purchase of the vehicles, along with three years of personnel, medical supplies and vehicle maintenance. “We are helping businesses help their workers and with these new electric vehicles, we are doing so with a small environmental impact,” said Phillip Levy, M.D., M.P.H., project lead for the WHMU program as well as Wayne Health’s chief innovation officer. “Healthier workers mean healthier business, which translates to greater economic health for the Detroit region. We are grateful to Bank of America for helping us move from crisis response to destination care, and for giving these businesses the capacity to offer high-quality, affordable health care for their workers.”  

The team at Wayne Health knows to break the cycle of health disparities in Black and brown communities, they must take their tools on the road. For more than a year, the Wayne Health mobile unit has broken down the barriers to healthcare access in Detroit's Black neighborhoods, providing COVID vaccines, heart health awareness, and other services. Dr. Philip Levy, a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne State and chief innovation officer for Wayne State University Physician Group, said that his team has noticed that nearly 7 out of of every 10 visitors has elevated blood pressure. "Most of the folks have pretty profound hypertension, and a lot of them fall into the category of stage 2 hypertension, which is advanced hypertension that we need to do something about as soon as possible," said Dr. Levy. This summer, Wayne Health will officially being its Achieve Greater initiative, which will provide Detroiters with the resources to manage their health. After one visit with the mobile health unit, all other follow ups are done remotely. Wayne Health is partnering with a number of church groups, recreation centers, and other community groups to connect with more residents. Dr. Levy said the life expectancy of a Detroiter is up to 15 years less than Michigan's average life expectancy of 77.7 years, and that deaths linked to heart disease jumped 25-30% during the pandemic. Wayne Health wants to help future generations of Black families live longer. "Ultimately, we want everyone in the state, and especially in the City of Detroit and the Black community, to live as many years as everyone else," Dr. Levy said. 

Health care disparities in Black, Brown and impoverished populations are well documented, but the outcomes have never been as obvious as during the pandemic. For instance, in 2020, Black people were 2.1 times more likely than white people to die from COVID-19 in the U.S. In Michigan last year, roughly 30 out of every 1,000 Black people living in Michigan could expect to die from COVID-19, according to data published by Brookings Institution last March. To improve access to health care, the system must go mobile, said Dr. Philip Levy, professor of emergency medicine at Wayne State University and chief innovation officer for Wayne Health. Levy's practice is attempting to reinvent the model by putting primary preventive care on wheels and meeting patients where they live in an attempt to overcome systemic problems by treating chronic conditions like high blood pressure. The pandemic has also led to the most critical staffing crisis the industry has ever faced. Nationally, roughly 30 percent of nurses have either quit or been terminated during the pandemic. 

Wayne State University is incentivizing students to receive the COVID-19 vaccine by offering free laptops, bookstore vouchers, and even an entire semester of classes. From now through Aug. 29, students, faculty, and staff can submit proof that they have gotten at least one dose of the vaccine to be entered in a drawing. Prizes for students include $100 bookstore vouchers, $100 OneCard vouchers, a free semester of parking, laptops, a free semester of on-campus housing, and a free semester of classes. Prizes for faculty and staff include gift cards, TVs, laptops, and free parking. Wayne State has not mandated the COVID-19 vaccine for students and staff like some colleges have, including the University of Michigan and Michigan State University. However, the university said it is implementing a targeted mandate for students living in university housing for the fall 2021 semester.

The Office of Women’s Health at Wayne State University, in partnership with the Wayne Health Mobile Unit program, will introduce Well-Woman Wednesdays, bringing free mobile health screenings and health education to the community at a variety of locations beginning July 14. The first Well-Woman Wednesday will take place from 2 to 6 p.m. at the headquarters of Alternatives for Girls. The project seeks to educate and empower women to achieve better health by providing them with screening, resources and connections to health care providers on their journey to improved wellness. “With Well-Woman Wednesdays, the Wayne State University Office of Women’s Health aims to expand health care to vulnerable communities impacted most by health disparities and lack of access to health care, thus improving the health of women overall,” said Sonia Hassan, M.D., associate vice president and founder of the Office of Women’s Health and a professor of Obstetrics and Gynecology at Wayne State University. “The development of a women-focused mobile health unit aiming to improve health literacy and provide reliable methods and resources for the establishment and pursuit of care will improve accessibility of health care to women and eventually narrow the gap in health disparities.” The Wayne Health Mobile Unit program began in April 2020, bringing COVID-19 testing, and later vaccinations, to tens of thousands of people across Michigan. “This latest project is an extension of our initial testing and vaccination efforts,” said Phillip Levy, M.D., M.P.H., a WSU professor of Emergency Medicine and chief innovation officer for Wayne Health. “It makes perfect sense to expand the array of health care and health care education services that our mobile units can provide for communities, assisting people in the comfort of their own surroundings.”

There is plenty of excitement from people who are taking advantage of free COVID-19 vaccines offered through Wayne Health from Wayne State University and their mobile medical units. On Monday people pulled up to the New Bethel Baptist Church and they didn't even have to leave the driver's seat to get their first Covid shot. Others will get a chance to get theirs as Wayne Health visits neighborhoods as part of a new pilot program. "This is what is needed for us to get beyond on the pandemic," said Dr. Phillip Levy, Wayne Health. "We have to wear masks we have to continue to social distance. But the more people that can get vaccinated the sooner we can reach herd immunity." For months Wayne State University and its physician group Wayne Health, have taken vehicles across Detroit where they've done Covid tests and other health screenings. Now they are part of a statewide pilot program to make sure everyone has access to the vaccine. Levy, the chief innovation officer, says it's especially important to meet Detroiters where they're at. because while most drove up to Monday's clinic- not everyone has a car. "There's a lot of transportation challenges despite it being 'The Motor City,'" he said. "A lot of people don't have cars and a lot of people can't get ready access to public transportation. And they have to rely on somebody to drive them to existing vaccination sites."

The Michigan Department of Health and Human Services (MDHHS) is partnering with Wayne State University and Wayne Health to provide mobile COVID-19 testing. The partnership comes in an effort to reach more Michiganders in need of COVID-19 testing and other public health services. This new program allows three mobile units to move between sites and serve communities at the highest risk. Locations are chosen in part to help address racial and ethnic disparities that had existed prior to the pandemic and were exacerbated by the virus – a focus of the Racial Disparities Task Force. Wayne Health’s Mobile Health Unit offers an array of health care screenings, including COVID testing, flu shots, blood pressure screening, HIV testing and on-site referrals for public benefit programs such as Medicaid and unemployment assistance and emergency food and shelter services addressing social determinants. “Partnering with the state will expand our efforts to bring these vital services to more Michigan residents who need them,” said Phillip Levy, M.D., M.P.H., who leads the Mobile COVID Testing Program for Wayne Health and is WSU’s assistant vice president for Translational Sciences and Clinical Research Innovation. “This work is a key element of who we are as a university and as a practice group. Meeting people and providing services where they live is critical not only to containing the COVID-19 pandemic, it is essential to improving health in general.”