VerticalChange for Street Medicine

Meeting people where they are at, living in parks, under bridges, on sidewalks, and providing medical care for free is in many ways very simple and pure. Street medicine in particular provides us with a unique perspective on homelessness because unlike a traditional health care setting, we are meeting people on their turf, and we intentionally ditch the power imbalances that dominate relationships in health care. Getting to know people who are living unsheltered is a privilege and we have a responsibility to honor that privilege by advocating for them in the community to the best of our ability. That’s where technology like VerticalChange can help.

Street medicine data is gold.  

The information you collect while providing street medicine is incredibly powerful and valuable. You will be among the first people to know when community health risk factors such as hepatitis A outbreaks or fentanyl-laced drugs are hitting the street. You will hear stories about people suffering with infected wounds living in bushes, or slowly dying while hidden in urban jungles, and you will be able to bring help to them immediately, preventing a life or limb threatening emergency. You will know where the camps at risk of flooding during storms are, which emergency shelters are having problems with scabies or bed bugs, and you will know why people avoid certain neighborhoods. All of this knowledge can be used to advocate for the health and safety of people who are living unsheltered, you just have to capture it in an electronic record system like VerticalChange so that the stories are not lost.

Data silos are the enemy.

People experiencing homelessness often interact with a variety of service providers and multiple health care settings. Data sharing between street medicine programs, partner social service agencies, and the health care system in a community provides the best available information about a patient for all parties involved. VerticalChange is built to share data securely between community partners. When street medicine programs can share information with social services, public health nurses, or an emergency department for example, it helps everyone take better care of their patients and the unsheltered population as a whole.   

Don’t ask the question if you aren’t going to do anything with the answer.

It is an unfortunate reality that a lot of nonprofit social service providers ask for a tremendous amount of personal information from people that just gets filed away somewhere and never looked at again. Some of that burdensome data collection is funder-mandated, some of it is just legacy “we have always done it that way” rationale, and sometimes it’s just because too many stakeholders added questions without looking at the big picture or the workflow. Regardless of the reason, it’s wasteful and can even be unethical to collect data from people if you aren’t going to do anything with it. Street medicine programs have used VerticalChange to carefully structure and customize their data collection forms to only ask questions that have a clear purpose. Redundancy is eliminated and everyone involved understands why each question is being asked. VerticalChange forms are simple to change without any outside assistance, so continuous data collection quality improvement is easy to do, even for volunteers.

Having the information available when you need it and where you need it is mission critical for street medicine.

The fundamental nature of street medicine is mobile, in the field, adaptable, and flexible. To empower street medicine, the data needs to be accessible from anywhere, 24/7. In technology terms, that means the electronic record system should be cloud-based like VerticalChange. As a street medicine team member, you could be sitting in a community care planning meeting and log in to VerticalChange from your phone to double check when a patient’s upcoming appointment is. You could be in a park using an iPad to take a patient history, or sitting on a sidewalk logging medication that you just dispensed. Using VerticalChange, leadership can access reports and always up to date dashboards that are presentation ready for board meetings from their laptop. Street medicine is mobile, and your data needs to be too.

VerticalChange works well as an electronic health record for street medicine, if you would like to talk about how your street medicine program could get started, please contact me.

Luke Barrett, MSW, MPA

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