07Feb

Mobile Clinics for Disaster Zones and Low Resource Communities: Interview with CEO of World Housing Solution

World Housing Solution, based in Florida, specializes in rapidly deployable buildings. Recently, they have focused on providing fully-equipped mobile clinics that can be fabricated and installed very quickly in disaster zones. The clinics are conceived as serving patients who can’t reach a hospital or medical facility.

So far, the company has sent clinics to Houston when Hurricane Harvey struck and to Puerto Rico after Hurricane Maria. As the clinics can be towed by a standard pickup truck, they can serve patients in difficult to access areas. The units are customizable, with specialized units including dental, pediatric, and OBGYN clinics. By daisy-chaining several units together, rescuers can create small but autonomous power, water, and communication grids.

The company also offers larger units that can be rapidly assembled onsite. A standard urgent care clinic contains four procedure rooms and an operating suite, and the units have the capacity for telemedicine, allowing clinicians onsite to access online resources.

The company has recently set up a new division called Mobile Response Units to focus on producing and delivering the clinics. These units could also be useful in providing routine healthcare for isolated and low-resource rural communities.

Medgadget had the opportunity to ask World Housing Solution CEO, Ron Ben-Zeev, some questions about the concept.

Conn Hastings, Medgadget: Please give us an overview of the types of structures World Housing Solution provides, and their applications.

Ron Ben-Zeev, World Housing Solution: We produce Rapidly Deployable Shelters (RDS). These prefabricated quick-deploy buildings use our proprietary panels and leveling foundation systems. We build buildings and when you think about it, every building can become homes, offices, clinics, schools, latrines, barracks, dorms and I could go on. However, our value is not in what our buildings become, but how we make our buildings. For eight years WHS has been designing and manufacturing structures that can be rapidly deployed and re-deployed as needed. Think of us as Ikea meets construction. Imagine the materials for a 5000 square foot building arriving on site and moving in the next day. In addition, our buildings have superior insulation over traditional construction and are far superior to container or tent solutions. Our shelters are resistant to mold, mildew, fire, pests, insects, and high winds. Then you cap that off with the fact that for every 25 watts of energy it takes to operate a one square foot of a tent you can operate an equivalent size WHS building for 5 watts per square foot. A 7 to 1 energy efficiency makes it easy to understand our value. Finally, our buildings can be taken down without leaving a foot print moved and set up somewhere else.

We also manufacture Mobile Response Unit (MRU). This brings a brand-new tool in the fight for quick disaster response or long-term prepositioning of assets that can be easily deployed. These are for the rapid response community. They provide almost 200 square feet of clean, air-conditioned space that can be towed with a pickup truck and brings their own utilities with them. They are the perfect solution for any austere environment like we’ve all seen left behind in the wake of a disaster. Water, power, communication, can all be part of our Elastic Grid™ allowing the Mobile Response Units to share resources. This means a response camp can easily increase or decrease capacity as you add or remove MRUs.

Medgadget: How did the idea for mobile clinics come about? Was there one incident that inspired the idea or highlighted the need for mobile healthcare?

Ron Ben-Zeev: Our buildings have always had the ability to become clinics and when the latest challenges in deploying sustainable, off the grid, ADA compliant clinics that can be moved simply came along, we worked with a subject matter expert. He spent over 30 years developing, amongst other things, hundreds of Ambulatory Surgery Centers and published articles on emergency response. In 2014, we worked together to develop an Ebola Response camp using our buildings and a solution he was developing for the medical surge community. In January of this year he came to WHS with a significant challenge. FEMA and the Puerto Rican Department of health responded to a white paper he wrote and was requesting a solution that given the current technology in mobile medical response was not possible. The design build team of WHS brainstormed with Tony Cowan and what we produced was Clinics on Wheels. We made Tony an offer to come on board with us and he is now our Director of Emergency Response Technology.

The lessons learned from Clinics on wheels gave us a set of skills that produced our new divisions called Mobile Response Units (MRUs) which can cover a wider array of services beyond medical. Now Clinics on Wheels is strictly for medical clinics and MRUs are mobile communications centers, command centers, housing, latrines, or any other non-medical resource a response camp could need.

Medgadget: Where have the clinics been deployed so far? How did the operations go?

Ron Ben-Zeev: WHS Clinics have deployed to Texas during Harvey, running off the grid on batteries and solar, then back to Florida for Maria and Irma and of course the island of Vieques, Puerto Rico. Most recently we are working with the resiliency efforts in the Carolinas supporting non-profit groups in delivering supplies. WHS maintains an inventory of available buildings and MRUs that can be requested by FEMA or municipalities as needed. For Puerto Rico, our fellow Americans on the Island of Vieques received three Clinics. One included an OB-GYN room with pediatric care. The second was a general exam room with mobile x-ray and telemedicine. The third was a dentist office with two dental surgery chairs. They all can run off their own solar and battery power and are ADA compliant. They were delivered over “OFF ROAD” conditions with a simple pickup truck. The level of gratitude the people showed was indescribable. We are currently working to find funding solutions for the mountainous regions of Puerto Rico as we have received many requests for more Clinics on Wheels. We are constantly looking for ways to improve the next set of clinics and already produced a version 1.5 of the clinical platform. That MRU will be going on tour stopping in Quantico and DC over the next month. Finally, we are developing version 2.0 that will be even lighter and stronger allowing us to put in more power, water and communications and get those resources to even harder to reach places.

Medgadget: What was the biggest challenge in designing the units? Was it difficult to balance their small size and need for rapid fabrication with the need to include a variety of bulky medical equipment and supplies?

Ron Ben-Zeev: Some of the hurdles we had to overcome were significant. The medical response industry is full of RVs, buses, re-built containers and tractor trailers. Not one of these options could have been deployed to the area of need in Puerto Rico in the time required. People think about mobile and do not realize most mobile response requires a significant amount of logistical support. That is a big deal when you think about the fact that in emergency response one of the first breakdowns is logistics. MRUs can go off road and be pulled by a pickup because they are rugged and light. We had to keep the weight under 10,000 pounds so pickups driven by a volunteer could deliver our assets. We were able to do that because our team has a dynamic set of skills; Paul Cairney our VP of Operations worked for one of the leading trailer manufacturers in the world and that insight was key to creating a light ADA compliant platform. The integration of equipment is really about utilities and weight management. Composite materials and smart space design are the secret sauce that make the MRU possible.

Medgadget: Please elaborate on the telemedicine aspect of the units. How does this expand the options available to clinicians?

Ron Ben-Zeev: There is no doubt that Mobile medicine is now a growing industry both in the US and abroad. It reduces the burden placed on our over taxed emergency rooms and provides care in underserved communities. Healthcare deserts exist in the US as well. With Telemedicine and our MRUs or Clinics on Wheels, you have the ability to bring specialists into our mobile response units as needed. With Telemedicine it really does not matter how far an individual needing care is from the hospital, they can look into the eyes of a doctor like they are in an emergency room, and that doctor can see the patient and share diagnostic information like they are there in the MRU. For instance, Florida Hospital through the Nicholson Center, was invaluable in providing the knowledge and expertise to make telemedicine possible for the clinics in Puerto Rico. They not only provided the equipment but are currently funding the satellite link that connects the CDT on the island of Vieques to the Centro Medico Hospital in the city of San Juan.

Medgadget: The units also have potential for routine healthcare in underserved and isolated communities. Are there any plans to apply the units in this context?

Ron Ben-Zeev: Ten years ago, the idea of a Doctor making a house call ever again was unimaginable, but telemedicine makes all the benefits of a house call possible virtually. The MRU is designed to make it easy for this technology to get out to the people who can benefit the most from it. As hospitals implement telemedicine overtime, there will be a dramatic increase in health care availability and decreases in cost. To help hospitals and the Health Department make this happen we have created a lease program for the MRU and Telemedicine. This will dramatically reduce the upfront cost to acquire this life changing technology, stretching the cost out over a longer period, allowing the MRU to generate the revenue to pay for itself.

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