Labs and imaging procedures
• The mobile health program should provide a range of diagnostic laboratory tests appropriate to the care provided by the van. All laboratory specimens obtained on the mobile unit should be handled according to the highest standards and processed by the clinical partner’s regular laboratory services, according to the partner’s laboratory procedures policy.
• When possible, providers should complete lab
requests electronically.
• CLIA-waivered tests should be provided directly. Non-CLIA waivered tests should be provided through an arrangement with the clinical partner’s regular laboratory.
Examples of laboratory services offered include the following:
– Blood glucose (fingerstick)
– Rapid strep test (throat swab)
– Fecal occult blood
– HCG (urine)
– HIV and HCV (blood)
– Toxicology (buccal and/or urine
– Other blood tests as determined by patient need
and test availability
• Patients who require imaging should be referred
according to the clinical partner’s imaging procedures.
• Lab results and imaging should be entered into the
patient’s EHR. Results should be reviewed by the
provider who will discuss the results with the patient
during follow up.
Abnormal labs and imaging
• When the laboratory reports and/or the provider notices
abnormal results:
– The provider should contact patients with a follow
up plan and to inform them of any need for further
intervention. If urgent, an on-call provider should be
notified. The on-call provider should give the patient
instructions on actions to be taken immediately.
– If the patient cannot be located, this should be
documented in EHR along with the steps taken in
attempt to locate the patient.
Medications
• Policy
– The mobile health program should maintain procedures
to properly store and maintain any medications used on
the van, noting that medications are not to be stored on
the unit when the unit is not in operation.
– Medications for MOUD (i.e., buprenorphine and
naltrexone) are never stored on the unit.
• Procedure
– The mobile unit should utilize emergency drug kits
(EDK) to keep a limited number of medications onhand for use during emergencies. The emergency
response medications will include:
» Naloxone, intranasal and intramuscular
» EpiPen, intramuscular
» Aspirin, oral
» Nitroglycerin, sublingual
» Glucagon, intramuscular
» Diphenhydramine, oral
» Glucose gel, oral gel
-During mobile health unit hours of operation, all clinic
Schedule VI medications will be stored in a sealed
EDK container on the unit and may include albuterol,
lidocaine (for incision and drainage procedures which
may require local anesthesia) and limited count of
frequently needed antibiotics (bactrim, doxycycline
and/or clindamycin, PrEP/PEP).
Referrals to outside care
• Staff should make referrals to health care or addiction providers and other health care specialists via electronic referrals whenever possible. Referrals can also be made via telephone call and should be done directly from the mobile unit.
• Providers should make initial referrals to schedule outside agency specialty appointments electronically whenever possible.
• If possible, the clinical provider should implement a policy where available referral coordinators are activated in the event of a referral. Referral providers should be responsible for ensuring the accuracy of referral details and notifying the providers and patients as needed.
• The patient or referral coordinator should report any difficulty securing an appointment within a reasonable amount of time to the provider and follow up