CARDIOVASCULAR disease-including coronary artery disease, stroke, and hypertension-is responsible for one out of every three deaths in the United States, according to the American Heart Association.1 In 2014, one hospital launched an initiative designed to improve the community's heart health and overall well-being. The Healthy Hub, as it's called, is a free, one-stop screening and referral-to-care kiosk located in the front lobby of West Kendall Baptist Hospital, a not-for-profit, Magnet(R)-accredited community hospital in Miami, Fla. Established with grant and hospital funds, the Hub provides free general preventive healthcare screenings Monday through Friday for adults in the community. Visitors can walk in, have their general health evaluated in about 15 minutes, and speak with a nurse about simple steps they can take to optimize their health. The facility allows visitors to learn if they have a healthy lifestyle and how they can change it for the better, receive a referral for follow-up care if needed, and receive information about free healthy living resources in the community.
The beginning
The Healthy Hub got its start after a community needs assessment commissioned by West Kendall Baptist Hospital in 2013 identified five healthcare priorities for the 300,000 people in the hospital's service area: access to care, availability of primary and preventive care, chronic disease management, cardiovascular disease, and exercise and nutrition. The hospital then led the development of a coalition of community stakeholders and neighbors to support healthy, active lifestyles and address the key factors that influence health. Knowing that prevention is the key to maintaining an optimum state of health and wellness, the coalition planned for a location where members of the community could visit to have their health metrics assessed and receive recommendations to improve their health and well-being.
The technology
The Hub is unique in its use of an electronic health-risk assessment tool that incorporates the American Heart Association's Life's Simple 7 (LS7) assessment and provides real-time education for visitors. The Hub nurse completes the LS7 assessment by entering visitors' responses to lifestyle questions, such as smoking status, activity level, and nutrient intake, into a tablet. The LS7 program generates a health score by evaluating these responses along with information about the visitor's BP, blood glucose and blood cholesterol levels, body mass index (BMI), and body fat percentage gathered by the Hub nurse. The nurse then shares this score with the visitor and gives recommendations for optimizing health via a nonpharmaceutical prescription called the "Journey to Wellness Rx." This "prescription" provides recommendations for specific physical activity to help the visitor manage weight or chronic disease and offers access to community resources that can help the visitor create a healthy lifestyle. Numerous leaflets about nutrition, food labels, BP management, diabetes, and cholesterol levels are also available as educational resources.
The Healthy Hub helps guide lifestyle recommendations to optimize well-being, but this innovation goes beyond technology. Most community health screenings are available during pop-up health fairs at local community events, and help provide a snapshot of health but little opportunity to receive health recommendations and education or a follow-up. Offering free health screenings throughout the week at a set location is what sets the Healthy Hub apart.
In addition, the Healthy Hub offers mobile health screenings to reach members of the community with limited transportation options. These mobile health screenings are provided by the Hub nurse, who goes out into the community twice every other month or during community events.
The results
Since its opening in the fall of 2014, the Healthy Hub has performed 12,000 screenings on more than 9,700 visitors. Of those 9,700, almost 20% didn't have a primary care provider and about 17% had no healthcare insurance. Overall, approximately 1 in 10 visitors reported having been diagnosed with diabetes, while 28% reported taking medication for hypertension, 17% reported taking medications for dyslipidemia, and 87% said they never smoked. Nearly half of visitors reported their health as being very good or excellent, 39% rated it as good, and 11% rated their health as fair or poor.
Every visitor is encouraged to make a return visit every 3 months. Almost 10% have returned for a follow-up visit, and many have seen significant improvements in body fat percentage, BP, and total cholesterol levels (See Percentage of Healthy Hub visitors with abnormal health metrics). Although a 10% return visit rate may seem small, many visitors who are screened don't present with abnormal health metrics necessitating a return visit or aren't from the immediate area. Many also choose to be screened while visiting admitted patients but do not live in the community, making a return visit less likely. However, a return rate of 10% translates to close to 1,000 visitors who took the initiative to improve their health. Besides the quantitative outcomes, we've received numerous video testimonials from visitors who've benefited from the screenings and interventions.
The future
The Healthy Hub has the potential to expand its services. Adding a dedicated mobile van staffed with a dedicated mobile unit nurse and furnished with screening equipment and a full complement of educational brochures could increase its reach. Expanding the concept into not only sister facilities but also other organizations across the US would allow for greater access to preventive health screenings and could help improve health and well-being for generations to come.
As the population ages, having Healthy Hubs across the nation could remove barriers and provide much-needed access to healthcare, potentially increasing the number of those seeking care. By promoting healthy lifestyle habits, many preventable health disorders could be avoided or effectively managed, reducing the economic burden on an already fragile healthcare system.
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