[Editor’s note: Today’s blog comes from Health Network intern, Shilpa Rumalla. Shilpa is a fifth-year student at the University of Texas at Austin, where she’s currently pursuing degrees in Human Biology and Human Development and Family Sciences. Her interests include the medical humanities and health equity; in particular, she is interested in applying the arts towards engaging patient communities. After her internship and graduation, Shilpa will continue her studies as a medical student in the fall.]

Concern and uncertainty overwhelm the lives of many migrating communities. Following traumas experienced during their resettlement journeys, asylees may experience multiple harms to their physical and/or emotional well-being. Given these challenges, a source of consistency, empathy, and guidance for these communities is critical.

Migrant Clinicians Network (MCN) is a non-profit organization that addresses this need through various initiatives promoting community engagement, health justice advocacy, and more. One such initiative, Health Network, is a virtual case management program that connects migrants to health care services, both during and post-migration. Specifically, MCN’s Health Network assists migrants in identifying accessible clinics, scheduling appointments, transferring medical records, and securing the necessary follow-up services. Critically, Health Network also removes the substantial barriers to access care that migrants encounter, by providing support like finding transportation to the clinic, ensuring translation or interpretation, or helping patients sign up for sliding scale fees.

Undeniably, the program owes its success to the dedicated case managers who work tirelessly to further MCN’s mission. Promoting communication and collaboration among Health Network Associates is critical for ensuring the program’s continued progress, a coordinated effort made possible by the Health Network’s huddle meetings.

The program’s huddle meetings, occurring three times every week, consist of an interdisciplinary MCN team, including a medical officer and medical director, a program officer, a data specialist, a prenatal coordinator, and Health Network Associates. Collectively, the team discusses current patient cases and associated updates. Importantly, members also review the risks of onboarding and securing care for particular patients, all while deliberating ways of circumventing such challenges. The benefits attained from these meetings prove numerous; however, three gains are noteworthy: knowledge dissemination, identification of needs, and peer support.

Knowledge dissemination is a key component for ensuring effective and targeted care. When connecting migrant communities to care, Health Network Associates are faced with multiple barriers. For example, securing necessary follow-up services may require Health Network Associates to contact multiple health care clinics until one agrees to provide a referral. Additionally, certain medical conditions often require specialty care, services with which Health Network Associates, as non-medical professionals, may not be familiar. While collaborating with MCN’s experienced staff physicians, Health Network Associates learn the clinical interventions necessary to address particular medical concerns, thus promoting efficient health care access for their patients. Additionally, MCN’s staff clinicians also learn important information from the Health Network Associates. By understanding the steps required to follow up with patients, arrange appointments, and the associated obstacles, these physicians are recognizing the challenges that accompany case management. By creating a shared understanding of the case management process from both sides, the Health Network team is learning how to better collaborate with and support one another towards the goal of providing equitable health care access.

Additionally, conversations among all Health Network Associates reveal new needs of care, thus providing opportunities for program adaptation and innovation. For example, while discussing case details during one meeting, the Health Network team realized the multitude of patients that were traveling within the United States, rather than migrating internationally. This recognition encouraged the team to connect with different US-based health centers to discuss ways of focusing on and supporting patients traveling intra-nationally. Further, while discussing a number of patients who were lost to follow-up, conversations arose regarding the different socio-cultural barriers that may contribute to this outcome. Subsequently, different Associates suggested that the team speak with providers who shared the same cultural backgrounds as these patients, in hopes of understanding how to support the cultural needs of these patients.

Lastly, the huddle meetings provide a fundamental source of peer support. Throughout their pre- and post-resettlement journeys, migrant patients face a number of challenges that severely compromise their well-being and make it difficult to access quality care. Additionally, contacting patients to ensure provision of secondary follow-up services proves challenging, with some Health Network Associates eventually losing contact with these individuals. Working with vulnerable populations can be incredibly stressful and may lead to secondary trauma -- that is, harm that may follow upon exposure to another individual’s own traumatic exposure. Considering this, it’s essential that Health Network Associates have access to a reliable support system to help navigate and process their experiences. When sharing challenges faced throughout the week at huddle meetings, Health Network Associates consistently remind one another of the impacts they are able to make, while providing gentle reminders that they are not responsible nor expected to redress all the difficulties that a patient is navigating. Further, Health Network Associates regularly check-in about each other’s work loads and offer to help other Associates complete their cases. In addition, the team validates the difficulties that Health Network Associates face during their case management (such as maintaining follow-up contact), and provides praise and recognition of their efforts.

Together, the Health Network team is addressing the critical need to provide comprehensive and targeted medical care for migrants. To learn more, read about the services that Health Network provides or read stories detailing the Health Network team’s provision of care.