Service orientation activities include food distribution, shelter volunteer, job/tax preparation, legal support, transportation services, and housing rehabilitation. It appears you have zero such activities, and it's unclear that the design-build club satisfies this category (more like teaching/mentoring). Consequently, your application may be at risk of getting screened out at most programs where you do not demonstrate a very strong mission fit with your purpose.
I don't think it's a big deal to have the bulk of your shadowing and clinical experience in acute care so far. Your approach to observe hospital/internal med is reasonable.