A clinic on wheels. A paradigm shift in the provision of care and the challenges of information infrastructure

The implementation of nontraditional healthcare delivery increases the need for information technology innovation, not only in use of computer-based patient records, but also in enabling infrastructures to support health information exchange. This is very apparent in mobile health clinics where care is provided to vulnerable community populations at locations far removed from academic and tertiary care settings. Several challenges of designing a computerized system for the University of Maryland School of Nursing's Wellmobile will be addressed in this article, as well as possible solutions to these challenges. It is the authors' belief that implications for further study will become apparent as these constraints and challenges are described.