California Health Care Improvement Projects (CHIPs) are designed by CHCF Health Care Leadership Program participants with the goal of addressing meaningful challenges or opportunities in health care.
Street medicine is the delivery of individually tailored health and social services to people experiencing unsheltered homelessness (PEUH) in their own environment. Because Street Medicine has historically existed on the margins of the medical field – run as part time teams with volunteer staff - and because of that individually tailored approach, the field lacks universally recognized measures of success.
This CHIP developed five Health Maintenance Screenings as initial Street Medicine core metrics to partially answer the question “how do you know when you’re doing a good job?” Interviews of stakeholders at USC, other Street Medicine providers and patients identified Healthcare maintenance screening as a key gap in Street Medicine. Key tasks addressed by the CHIP included: selection of the screening tests, choosing laboratory testing over Point-of-Care testing, exploring the feasibility of non-blood specimens, improving integration of the lab system and electronic medical record, and implementing new Street-based treatment options for the conditions diagnosed by the new screenings. Four of the five screenings (HIV, Hepatitis C, Syphilis and Colorectal Cancer) have been successfully implemented. The fifth screen (Cervical Cancer) is still in the planning stage.