MiVIA Program Lets Migrant Workers Access Electronic Health Records From Any Computer

by Candi Helseth

MiVIA Users

MiVIA users fill in health records that are transferred to an electronic resource that can be accessed by providers in various locations.

A mobile medical assistance program is allowing California migrant workers and other transient populations to carry and access their personal health records no matter where they are. The MiVIA program was launched in Sonoma County, Calif., in 2003 for migrant and seasonal workers whose medical care was compromised by the fact that they spoke poor English and moved frequently. In the last two years, the MiVIA concept, and use of its software, has expanded into five more states as well as being used for homeless people in Sonoma County.

MiVIA keeps personal health records stored on remote servers that health care providers can access quickly. Unlike electronic health records, which are owned by the clinic or hospital, the individual owns MiVIA information and it’s accessible at any location with Internet access.

“Electronic health records are great for stable populations, but they don’t work well for mobile populations,” said program co-founder Heidi Stovall. “When farm workers left our community, they left their medical records behind. We built MiVIA (pronounced “mee-vee-ah,” which stands for “My Way” in Spanish) so patients could keep their information with them. They love it because it’s so simple to use. Providers embrace it because it’s such a good way for them to connect with other providers that have taken care of these individuals. It helps providers solve problems they can’t resolve with the patient because of language and cultural barriers.”

MiVIA members carry a photo identification card that lists emergency contacts, medical conditions, medications and allergies, as well as information on how to access the website for their online medical records. The card also helps identify the individual in case of emergency or communication barriers.

MiVIA, California’s Sonoma Valley

MiVIA, an electronic health system, was developed to meet the needs of migrant farmworkers living in California’s Sonoma Valley.

Using a password and login they are given when they enroll in MiVIA, users can access their electronic health record from MiVIA’s secure server wherever Internet access is available. Although most users don’t have personal computers, Stovall said the Internet is easily accessible in public spots.

The individual gives the health care provider access to the secure online patient chart and the provider can view past medical history and then enter current medical information from that appointment. That way, Stovall explained, patients’ health records travel with them to the various locations where they may live. Cards can be updated and reprinted from any computer when changes are necessary.

In Sonoma County, which is wine country, seasonal workers move frequently, are generally uninsured, have incomes below the federal government’s poverty guidelines, and speak little or no English. They are among the more than three million migrant and seasonal farm workers estimated to be in the United States at any given time, according to the National Center for Farmworker Health.

In addition, MiVIA is being used for other populations. St. Joseph’s Health System in Sonoma and the Community Health Resource and Development Center (CHRDC) in San Joaquin are enrolling homeless clients.

MiVIA’s benefits have extended beyond its initial record-keeping benefits, according to Paul Castro, deputy program director of California Farm Worker Services. Castro’s office works with migrants to help them access appropriate care and get screenings and medications. Enrolling in MiVIA has helped workers take more personal responsibility for their health care, and Farm Worker Services has been better able to refer farm workers to proper channels for screenings and diagnoses.

“There is a lot of diabetes among farm workers,” Castro said. “One family, the woman was on three or four meds and she couldn’t keep track of what she was taking. When she got it on her card, she got better because the doctor got the right information when she brought him the card. Another family, when they enrolled, the husband wasn’t getting treated for his diabetes. We helped him get on medications and then he was able to work and even took vocational training.”

When they began developing MiVIA, Stovall said, they involved seasonal workers and family members in preliminary focus groups. Technology was the first barrier; seasonal workers had never used computers.

“The Vineyard Workers Services, our outreach partner, set up computer classes and showed them how easy it was to use,” Stovall said. “For some of these seasonal workers, this email address is their only permanent address. Families really embraced it.”

Migrant workers or family members who didn’t speak English began bringing family members and children, along with all their medications, to the outreach center to be sure their information was entered correctly. While most had never been to the library previously, the classes opened the door for them to use the library for additional resources.

The idea for “follow-me” health records originated out of discussions between Stovall and Cynthia Solomon, a longtime friend who is MiVIA’s co-founder. Solomon’s child was diagnosed 30 years ago with a disease that took the family to many different providers in different locations. Solomon carried her son’s medical records in the back seat everywhere they went.

Knowing they would need additional resources, the women turned to area providers for assistance. Vineyard, St. Joseph’s and CHRDC partnered with them to build MiVIA. The Rural Community Assistance Corporation and the California Endowment funded the program.

In addition to expanding within California, customized follow-me personal health records are being used for projects in Oregon, Minnesota, New York, Iowa and North Carolina.

For more information, contact:
Heidi Stovall
639 Third St. West
Sonoma, CA 95476

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