The Life Bus Project: How two MCW Medical Students engaged in Social Innovation

From the 9/18/2020 newsletter

Student Perspective

The Life Bus Project: How two MCW Medical Students engaged in Social Innovation

Medical Students Kelli Cole & Gopika SenthilKumar describe how they partnered and utilized their passion, ingenuity, entrepreneurial mindsets, and community support to design a real-world public health solution which gave them a transformative learning experience.

We remember March 2020 clearly. The two of us, were looking forward to getting started on our Kern Institute TI2 project and finalizing our summer lab rotations. Suddenly, there were constant news updates about rising death tolls around the world and an incoming sense of doom as the pandemic spread to the US. As we watched the initial responses, we could not help but notice all the ways that our healthcare systems were not prepared - personal protective equipment (PPE) shortages, disproportionate impact on vulnerable and low-income communities, intensifying health disparities, fear amongst frontline healthcare workers. In an effort to help, we put together a grassroots team of students, physicians, scientists, and engineers for the Johns Hopkins COVID19 Design Challenge held in early April. Life Bus, the solution that sprouted from the competition and evolved since, has not only allowed us to persist towards improving healthcare delivery and access starting in our own MKE community, but has also been an incredible opportunity for growth and reflection.

In this article, we hope to share our story and reflect on our key takeaways/learnings thus far.

During the competition, our team (click our link here) conducted a rapid needs assessment and identified three key needs:

1. Protecting frontline healthcare providers 
2. Reaching vulnerable populations
3. Conserving PPE

Our solution was designed to meet all three of those needs by temporarily repurposing city buses into mobile COVID19 testing and triage centers. Life Bus incorporated key design solutions (physical barriers with gloves to overcome PPE shortage, indoor/outdoor models, creative vital sign collection, existing infrastructure/routes of city buses) that were truly made possible because of the multidisciplinary nature of our team and mentors. The 5-day challenge opened our eyes to the impact of the pandemic on various aspects of our society and uncovered avenues for improvement/change.

The Kern Institute provided invaluable support and local connections to further the project.

After the competition, we showed our idea to front-line providers, healthcare administration, and the Kern Institute. Given the overwhelmingly positive response and incredible support from the Kern Institute, our team decided to continue working on Life Bus. For the rest of the spring semester, we improved our design, added valuable team members, and identified other key stakeholders who could help refine and implement Life Bus. Balancing our roles as early-career professionals in this project while also juggling medical school courses challenged us to improve practice in these areas that we may not have otherwise gotten this early in our medical education.

Over the summer and at the beginning of our second year of medical school, the two of us participated in the National Science Foundation I-Corps program to develop a sustainable business model for Life Bus. We conducted 50 interviews with community partners, Wisconsin’s COVID19 testing committee, students, physicians, transit companies, outreach organizations, manufacturers, and private and public health systems. We are beyond grateful for the time and advice from everyone we interviewed and are honored that many of them are still involved and supportive of our initiative. Our conversations helped confirm the need for sustainable (i.e. not depleting PPE or straining our healthcare workforce) mobile healthcare and highlighted the feasibility of our project. Through this process, we developed entrepreneurial skills such as hypothesis-driven interviewing, synthesizing subjective feedback into tangible ideas, and asking for buy-in from higher-level executives. This opportunity taught us how to vet an idea based on customer discovery and pivot based on the information learned to create a refined solution. Moreover, we were mentored by inspiring local entrepreneurs who continue to provide us with constructive feedback and guidance as we move forward.

Life Bus is addressing ‘real-time’ issues from the pandemic in Milwaukee

All through this project, a common theme that kept arising was how ‘healthcare access has been a long-standing challenge in the Milwaukee community, and the pandemic merely intensified the problem.’ It became clear to us that Life Bus needed to not only provide COVID19 testing and triage but also focus on addressing basic health needs, building sustainable mobile care, and establishing a model for long-term continuity of care. This way, Life Bus is not just a “band-aid” for the time being, but rather a solution to the underlying etiology. We now envision our work as a necessary extension of our current healthcare delivery model, and we view it as a sustainable method for bringing care to the patients rather than relying on their ability to come to us.

There is still a lot of work to be done before Life Bus becomes a reality in MKE and beyond, but we are excited to see what the future holds. Our work has further exposed us to the innovation, engineering, public health, and business sides of medicine. It has allowed us to integrate our individual backgrounds (in basic science and education for Kelli, and in engineering and design thinking for Gopika) as well as our passion for medicine and public health, into a cohesive initiative that has the potential to tackle some of the challenges in healthcare delivery that have been exacerbated by the COVID19 pandemic. Someday, we hope contributing to real-world challenges becomes a part of our medical education. Not only does it expand our understanding of the numerous aspects of healthcare and its impact on our patients, but it also allows us to hang on to a sense of meaning and purpose even when feeling overwhelmed with coursework.

These few months have opened our eyes to the extent of health disparities and access deserts plaguing the Milwaukee community. As we move forward in our medical education, we plan to do our part in helping increase sustainable healthcare access in our community - through Life Bus and beyond. We would like to thank everyone who has contributed to our work thus far; it truly takes a village! This project would not be possible without all of your hard work, support, and mentorship! Please visit our website for more information on the project and team: https://covidlifebus.wixsite.com/website.

Kelli Cole & Gopika SenthilKumar are both M2 students in MCW’s MD/PhD Program.