“In The Thick of It,” Tennessee’s Biggest Health Center Goes Mobile

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Tennessee

Brittany Carpenter, a medical Assistant, facilitates a telemedicine appointment with patient James Tutwiler inside Cherokee Health’s Mobile Clinic in Knoxville, Tenn. (Donnie Lloyd Hedden, Jr. for Direct Relief)
Brittany Carpenter, a medical Assistant, facilitates a telemedicine appointment with patient James Tutwiler inside Cherokee Health’s Mobile Clinic in Knoxville, Tenn. (Donnie Lloyd Hedden, Jr. for Direct Relief)

Every office has its plum assignment. At Cherokee Health Systems in Tennessee, the largest Federally Qualified Health Center in the state, staff want to get on the mobile unit, which operates in the heart of Knoxville’s homeless community.

“When I got into healthcare, I wanted to help people who fell through the cracks. We don’t have much, but we can help them better themselves and, for instance, when they get set up with an apartment, seeing that, there’s nothing like it,” said Brittany Carpenter, a registered medical assistant and certified phlebotomy technician who snagged a prized spot on Cherokee’s mobile unit.

“There’s a lot of excitement around the mobile clinic,” said Jonathan Johnson, a community education specialist at Cherokee’s Center City location in Knoxville, one of 23 brick and mortar locations in the system, which saw about 70,000 patients last year. “They feel really engaged… like they’re in the thick of it.”

“These are patients who would never get seen or keep an appointment,” he said, referring to the daily challenges of people experiencing homelessness as well as those with mental health conditions.

“With our patients, it’s kind of an on and off thing. They are a transient population. They go through so much tragedy and traumatic events, so seeing them keep appointments is really encouraging,” Carpenter said. The mobile clinic began operating in the spring of 2021 and had seen 215 patients total as of the end of July.

Patients who approach the mobile clinic tend to have one pressing concern, as opposed to patients at the clinic who tend to be more open to general screenings, according to Carpenter. As the mobile clinic is treating a transient population, staff tend to focus on care they can deliver on the spot. The unit is staffed by a family nurse practitioner who conducts telemedicine visits in the mobile clinic, registered nurse, psychologist, recovery specialist, social workers, and administrative staff.

The mobile clinic can offer patients adult primary care, behavioral health, Covid-19 testing and vaccinations, infectious disease testing, and treatment for substance use disorders.

The Cherokee Health Mobile clinic team stands for a photo in front of Cherokee Health’s Mobile Clinic in Knoxville, TN. The Cherokee Health Mobile Unit parked at Volunteer Ministry Center in Knoxville, TN offers medical services to those in need including adult primary care, behavioral health, Covid-19 testing, infectious disease testing, and substance abuse treatment. Many of these services are facilitated and made possible through telemedicine. This mobile-unit driven initiative is part of the Pfizer Infectious Disease Awards program, funded by The Pfizer Foundation and implemented by Direct Relief with the aim to improve access to outreach, education, screenings, testing, and treatment for medically underserved populations across the US. PHOTO: Donnie Lloyd Hedden Jr. 2021
The Cherokee Health mobile clinic team stands in front of Cherokee Health’s Mobile Clinic in Knoxville, Tenn. Jonathan Johnson is farthest left, and Brittany Carpenter is second from left. (Donnie Lloyd Hedden Jr. for Direct Relief)

As part of its primary care mission, Cherokee has been focusing more specifically on sexually transmitted infections, which the FQHC mentioned in its update related to an award from the Pfizer Foundation last year. Cherokee was one of 11 clinics nationally recognized through Pfizer’s Innovation Awards in Community Health: Addressing Infectious Disease in Underserved Communities. Grants totaling $2.5 million went to the clinics.

“We are proud to support Direct Relief and its network of frontline safety-net clinics across the U.S. to break down barriers to good health in underserved communities and increase access to life-saving infectious disease prevention, diagnosis, treatment, and care,” said Caroline Roan, president of the Pfizer Foundation and chief sustainability officer for Pfizer, when the awards were announced last December.

Cherokee used the grant to purchase the mobile clinic and increase STI testing and outreach. The mobile unit is also used to administer Covid-19 vaccines.

“More people than we expected have been vaccinated,” Johnson said. However, the unit does see many people who are vaccine-hesitant. “A lot of people are scared of it still, but people are warming up to it,” he said.

Carpenter said that she tells people she received the vaccine and felt fine besides a headache for a short while.

“Pretty much, I tell them that it’ll keep them, and everyone else around them, safe. I try to answer as many questions as I can, but some people just don’t want it,” she said.

Though the mobile clinic was launched to engage with the homeless population during the pandemic, the value of seeing vulnerable people where they are will continue to be as necessary after the pandemic as it was before, according to Carpenter and Johnson.

Brittany Carpenter, a medical assistant, works with patient James Tutwiler inside Cherokee Health’s Mobile Clinic in Knoxville, Tenn. (Donnie Lloyd Hedden Jr. for Direct Relief)
Brittany Carpenter, a medical assistant, works with patient James Tutwiler inside Cherokee Health’s Mobile Clinic in Knoxville, Tenn. (Donnie Lloyd Hedden Jr. for Direct Relief)

“The pandemic doesn’t affect mobile clinic patients. We adapt to a manner they’re comfortable with… Some of them have to be seen with some physical interaction; they can’t do telemedicine in every case,” said Johnson.

“Our leadership has pushed really hard in that we are still in it [the Covid-19 pandemic], and so we have to be resolved in our safety procedures and protocols,” Johnson said.

Looking towards fall, Carpenter says she feels optimistic, even though she is unsure what’s coming.

“We’re banded together stronger from the pandemic. It’s kind of like going to war together every day,” she said.

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