Taking the capabilities of a state-of-the-art hospital exam room and cramming them into a van: That’s essentially the idea that a team of local collaborators – including Munson Healthcare, Traverse Health Clinic, and Goodwill Northern Michigan – have been working on in recent years. The result is a fully-equipped “mobile medical unit,” which deployed in Traverse City last July with the goal of providing better care to the local homeless population. A year later, leaders from all three organizations say the initiative is having a transformational impact – not just on the local fight to end homelessness, but also on broader conversations around healthcare access in the region.

Meet Traverse City Street Medicine, an initiative meant “to connect with people experiencing homelessness wherever they are and provide medical care.” Working together, Munson, Traverse Health Clinic, and Goodwill Northern Michigan turned a box truck into a fully-equipped mobile medical unit, which Mi Stanley – director of special projects and communications for Traverse Health Clinic – describes as “an exam room on wheels.” Two days a week, the truck visits places where people experiencing homelessness tend to congregate – “So, we go to community meal sites, to shelters, and to encampments,” Stanley says – and provides the healthcare services those individuals need.

“[The mobile unit] is basically an extension of Traverse Health Clinic,” says Dr. David Klee of Munson Healthcare, a key figure in the partnership. “On the truck, we’re able to do most of the things that we can do in the clinic. We can provide individual care in a private setting. We have EMR [electronic medical record] access. We have internet access on board. We're able to do point-of-care testing, check people's vital signs. We can do treatment of injuries. We do a lot of wound care on the truck, for instance. The unit gives us the ability to take a clinic setting and move it to where the patients are – therefore, getting better access to the people.”

Per Dr. Klee, street medicine isn’t a new thing in Traverse City, but the mobile medical unit has made it more efficient, effective, and consistent. Prior to the deployment of the vehicle, Klee says Munson and Traverse Health Clinic would often provide care to people experiencing homelessness separately, creating situations where a patient might have an EMR with both entities – neither of which was comprehensive. Not having a true mobile exam room also meant that doctors and nurses were forced to go a lower-tech route. Less than two years ago, Klee notes, street medicine workers “were using a three-ring binder and writing on 9x11 pieces of paper and then faxing those handwritten notes between clinics.”

Now, Klee says instead of a patient having multiple EMR files across different providers, Munson and Traverse Health Clinic have streamlined operations to make sure each patient’s EMR is accessible wherever they receive care. Whether the patient is seening a doctor out in the field, going to a local clinic, or visiting the emergency room, Klee says the the provider caring for them will have the most up-to-date information possible.

Ryan Hannon, community engagement officer for Goodwill Northern Michigan, says the evolutions of the street medicine program are already making a difference among the local homeless population. People in that community, he says, have historically not sought out recurrent medical care due to barriers both real and perceived. Lack of health insurance; difficulty making it to doctor’s appointments; distrust in the healthcare system in general. These issues and others, Hannon explains, have long meant that people experiencing homelessness in the region were neglecting their health.

With the mobile medical unit, Klee says one of the big goals is to bring access to primary care medicine back to the local unhoused population. Under the old model, he tells The Ticker that people experiencing homelessness most often sought out care in an emergency room setting. “Now, we’re starting to track primary care measurements,” Klee says. “We’re making sure their blood pressure is being monitored. We're screening for cancers. We’re administering immunizations. There are so many different things that we're able to provide when we're able to come right to the people.”

That focus on primary care, Stanley says, has far-reaching benefits. People experiencing homelessness are getting better preventative care, which not only helps minimize high-severity situations that can be debilitating or life-threatening, but also keeps unhoused individuals out of the region's already-strained emergency rooms.

"So this is something that is good for our entire community, not just for the people receiving the care," Stanley says.

According to Munson, since the mobile medical unit launched, the team has recorded nearly 500 patient visits from approximately 250 individuals. Doctors have treated injuries, managed pregnancies, provided mental health services, helped patients in the throes of addiction, and triaged patients to help identify those most in need of immediate housing.

Hannon has no doubt that the initiative has improved the health of a community he’s become closely familiar with over years. More than just improving the medical situation, Hannon believes the program – and the investment in the mobile medical unit in particular – represents a big step forward in the fight to end chronic homelessness in northern Michigan by 2028.

“Having healthcare professionals see the value of housing as healthcare and then advocating for it as well, that is a huge thing,” Hannon says. “It's one thing for me to be out there saying, ‘Hey, we need to help these people.’ But now, you literally have doctors seeing the same thing, and caring, and telling that story. It's just amazing.”

Klee concurs, saying it’s virtually impossible to work on the front lines of street medicine and not become an advocate for addressing homelessness.

“Being homeless decreases your life expectancy by 30 years,” he says. “When you’re trying to figure out where you’re going to get food or water, or how you’re going to keep yourself safe, it’s very hard to work on your health. If we can get people out of that survivor mentality, then it’s a lot easier to achieve and maintain health. Our program here is basically a stopgap. So, we’re all very supportive of the Housing First initiative locally, and of developing housing that's affordable so that we can get people adequately housed.”