Outsiders help solve health care access problems in Charlotte - North Carolina Health News
By Yen Duong
If you lack health insurance and have a medical problem, there are many people in Charlotte who can help you.
The problem: You need to know about them.
And if you only know about one provider, you might travel half the city before learning there’s a free clinic around the block. Since the early 2000s, members of the safety-net provider consortium MedLink have wrangled with how to get residents to services they need the first time before patients appear at a less-appropriate clinic’s doors.
Last month, outsiders helped solve that problem in one night.
“We get a lot of orthogonal thinkers, people who aren’t necessarily familiar with health care,” said Brittany Box, the chief administrative officer at Tresata, a tech company which organizes the annual hackathonCLT. “If you’re looking at the patterns in the data, sometimes you find these things that end up being really helpful even if you don’t have that industry expertise.”
One evening in March, around 600 tech-savvy problem-solvers barricaded themselves in the Discovery Science Center for a night of coding. Teams of up to three programmers had 12 hours to parse through anonymized data from six MedLink member clinics alongside the national databases 500 Cities and AIDSVu to come up with a technological solution for helping people gain access to the right care.
The winning solution had two parts. MedLink providers will use a health “heatmap” to see the issues in any census tract, such as diabetes or high blood pressure, and what services to treat them are available in those areas to plan their deployment of new services. Clients will input their health issues, location and insurance information into a mobile app, which will output which provider could best serve them.
“We’ve needed this kind of perspective for a long time,” said Don Jonas, executive director of Care Ring, a Charlotte-based nonprofit which runs a low-cost clinic and connects uninsured or undocumented people with health care. “We have not had that ability to help to direct people to the proper place to go.”
People who are undocumented, uninsured or have limited resources can find help with MedLink providers. The website also includes information on free to low-cost dental clinics. Here are some of the MedLink members:
- Shifa Free Health Clinic: Offers free care twice a month for uninsured people who earn less than 250 percent of the federal poverty line (about $64,375 for a family of four). No residency requirement.
- NC MedAssist: Free prescription medication for uninsured North Carolina residents at or below 200 percent of the federal poverty line ($50,200 for a family of four).
- RAIN: Support for people living with HIV and their families.
- Project 658: Runs a clinic for uninsured and underinsured Mecklenburg County residents, which offers medical, counseling, dental and vision care.
- Charlotte Center for Legal Advocacy: Offers a variety of legal services for Mecklenburg and surrounding county residents who make less than 200 to 300 percent of the federal poverty level, depending on the service.
- The Atrium Community Resources Hub: Website allows search by ZIP code or need.
Binding a patchwork system
About 12 percent of Mecklenburg County residents lack health insurance, and about 11 percent are in poverty, according to the US Census. That’s the target population for MedLink, which consists of a dozen or so not-for-profit organizations which serve uninsured and underinsured Charlotteans, alongside the public health department and local hospital organizations.
For about 15 years, members from the patchwork system of free or sliding scale clinics, legal aid, support groups and counseling have shared information at monthly meetings open to the public.
MedLink chair Jamie Sunde, who works in community health for Atrium Health, recalled that when hackathonCLT organizers approached MedlLink, the members jumped at the chance for a free application to help their organizations.
“Everyone was like ‘We’re going to get artificial intelligence and machine learning, what even is that?’,” Sunde joked. “We’re still trying to upgrade our rotary phones.”
The scrappy collection of volunteer-based nonprofits stands in contrast to the newly formed ONE Charlotte Health Alliance, a collaboration between hospital rivals Novant and Atrium and Mecklenburg County Public Health which sprouted from city-wide discussions held after a 2016 shooting of an unarmed black man.
That well-funded collaboration, which focuses on Mecklenburg’s six Public Health Priority Area ZIP codes instead of on uninsured or indigent people, already has a functioning website with maps of disparity and health indicator data, toolkits and handouts, and links to six free clinics. Less than a year after being formed, the organization has deployed two mobile health trucks into the community. Meanwhile, the MedLink website lists 20 clinics but little other information for patients.
Read more about nonprofits in Charlotte focused on access to healthy food.
“The idea and hope is for MedLink to plug in and help inform the work of ONE Charlotte Health Alliance,” Sunde said. “And vice versa, making sure that the two hands are talking to one another.
“The main gist is that everyone’s moving in the same direction, really helping to move people upward and improve health outcomes and [economic] mobility.”
What comes next
HackathonCLT began in 2013 as a collaboration by Tresata and the grocery chain Harris Teeter, with hackers delving into retail data. More recent years have focused on applications for nonprofits such as the Charlotte Housing Coalition, Second Harvest Metrolina Food Bank and Big Brothers and Big Sisters.
“Now we’re talking about something impactful, something interesting, amplifying the voice of these nonprofits who are really strapped for resources,” Box said. “We wanted to enable them to have access to these brilliant technology solutions that they previously thought were out of reach.”
This year, half of the prize money is going to the Academy for Population Health Innovation, a collaboration between Mecklenburg County Public Health and UNC Charlotte, to build out the solution into a workable product with the winning team, who won the other $15,000. That application will be demonstrated at next year’s hackathon, which will continue to focus on community health.
“This is a first step to start to address problems around healthcare access,” said Dr. Michael Dulin, director of APHI. “But underneath that, there are lots of other things that need to be addressed: obesity, depression, violence in the community, sexually transmitted infections, access to contraception, tobacco use, [etc.]”
‘Take it one bite at a time’
The prize money to APHI is on top of an earlier $2 million gift to UNCC by Tresata, announced last year, with the goal of making Charlotte “one of the healthiest cities in the world by 2025.”
For now, they have to focus on the smaller picture and tailor the solution from this year’s hackathon to the needs of MedLink. For instance, Don Jonas, executive director of Care Ring, said that over 100 languages have been spoken in Care Ring clinics in the past year, so the app will need to cater to non-English speakers.
Even if the app and program work perfectly, MedLink still has a lot more to do. For one, Sunde wants more clinics, behavioral health specialists and other support services to join the group and coordinate care.
“This is just one tiny angle of the big huge access drama,” Sunde said. “[Access to care] is like the world peace of health care […] We have to take it one bite at a time.”