Mobile Health Units Aim to Close Gaps in CKD Screening Access

Mobile health unit–based screening programs are emerging as a strategy to address gaps in chronic kidney disease (CKD) detection, particularly among populations without the access to routinely engage with traditional healthcare systems.

In Detroit, Michigan, investigators developed a community-based screening model aimed at reaching individuals at elevated risk for cardiometabolic disease who may not otherwise access preventive care. The population-wide screening program, found 11-13% had CKD ≥ stage 3, double the US population’s 6% reported national average.

“We provide care in a community that suffers disproportionately from early onset of things like heart disease and kidney disease and strokes secondary to poorly controlled risk factors like high blood pressure, diabetes, hyperlipidemia,” study investigator, Phillip Levy, an Assistant Professor of Emergency Medicine and Assistant Professor of Physiology at Wayne State University and the Assistant Vice President for Research at Wayne State University Department of Emergency Medicine, shared in an interview with HCPLive. “There are high rates of smoking and obesity as well in the community, low rates of physical activity, socioeconomic challenges, and environmental exposures, all of which create outsized risk for the population we serve.”

Addressing Gaps in Preventive Care Access

The initiative reflects a broader shift in care delivery, informed in part by frontline experience treating advanced disease in acute care settings. Rather than continuing to intervene at late stages, the program was designed to move upstream and engage individuals earlier, particularly those who do not routinely seek care in traditional settings such as emergency departments or outpatient clinics.

To guide deployment, investigators developed geospatial analysis tools to identify high-risk communities using county-, ZIP code–, and census tract–level data, incorporating both clinical and social risk factors.

From Pandemic Response to Community-Based Screening

The model expanded during the COVID-19 pandemic, when mobile units were initially deployed for community-based testing. High levels of engagement, particularly willingness among community members to undergo blood-based testing, highlighted an opportunity to broaden screening beyond infectious disease.

In response, the program incorporated additional testing for hemoglobin A1c, kidney function, and lipid levels, using the point of community engagement to identify cardiometabolic risk earlier.

This evolution led to the development of a “portable population health” model, which integrates blood pressure screening using gold-standard triplicate protocols, laboratory testing, social determinants of health assessments, and coordinated linkage to follow-up care through community health workers.

Shifting Toward Population-Based Screening Models

Findings from the initiative support a broader reconsideration of how preventive screening is delivered, particularly in high-risk communities where clinic-based models may be insufficient.

“What we’re really striving toward… is the idea that prevention should be community-based, not office-based,” the investigator said. “Prevention screenings shouldn’t require a doctor to say that person needs to be screened for kidney disease, because we all need to be screened.”

The model emphasizes bringing screening directly to communities, reducing reliance on patient-initiated engagement with the healthcare system and addressing barriers such as transportation, time constraints, and competing life demands—even among insured populations.

Barriers to Scaling Community-Based Models

Levy noted that scaling this approach will require rethinking how care is delivered and reimbursed. Current healthcare models are largely structured around clinic-based services and physician-led encounters, which may not align with community-based, team-driven prevention strategies.

Expanding reimbursement pathways for services delivered in nontraditional settings, as well as supporting team-based care models, may be critical to broader adoption.

Editor’s Note: Levy report relevant disclosures with Cielo Foundation.

References

1. Brook RD, Korzeniewski SJ, Foster B, et al. Screening for Chronic Kidney Disease by Mobile Health Unit Outreach. JAMA Network Open. 2026;9(3):e262312. doi:https://doi.org/10.1001/jamanetworkopen.2026.2312

2. This City’s CKD Stage ≥ 3 Incidence is Double The US National Average. HCPLive. Published 2026. Accessed April 20, 2026. https://www.hcplive.com/view/city-ckd-stage-3-incidence-double-us-national-average