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A Chronic Disease Management Student–Faculty Collaborative Practice: Educating Students on Innovation in Health Care Delivery

Remus, Kristin E. DO; Honigberg, Michael MD, MPP; Tummalapalli, Sri Lekha MD, MBA; Cohen, Laura P. MD, MPP; Fazio, Sara MD; Weinstein, Amy R. MD, MPH

doi: 10.1097/ACM.0000000000001147
Innovation Reports

Problem: In the current transformative health care landscape, it is imperative that clinician educators inspire future clinicians to practice primary care in a dynamic environment. A focus on patient-centered, goal-oriented care for patients with chronic conditions is critical.

Approach: In 2009, Harvard Medical School founded the Crimson Care Collaborative, a student–faculty collaborative practice (SFCP) network. With the aim of expanding clinical and educational opportunities for medical students and improving patient control of chronic disease (i.e., hypertension, obesity, and diabetes) in an innovative learning environment, in 2012, the authors developed a novel SFCP at their hospital-based academic primary care practice. In this SFCP, students learn to explore patient priorities, provide focused counseling and education, and assist patients with self-management goals during clinical visits.

Outcomes: From 2012 to 2014, 250 student volunteers participated in the SFCP as clinicians, innovators, educators, and leaders, with between 80 and 95 medical students engaging each semester. Between January 2012 and March 2014, there were 476 urgent care or chronic disease management visits. Patients with chronic diseases were seen at least twice on average, and by 2014, chronic disease management visits accounted for approximately 74% of visits.

Next Steps: Work is under way to create assessment tools to evaluate the practice’s educa tional impact and student understanding of the current health care system, develop interdisciplinary care teams, expand efforts in registry management and broaden the patient recruitment scope, further emphasize patient engage ment and retention, and evaluate chronic disease management and patient satisfaction effectiveness.

K.E. Remus is instructor of medicine, Harvard Medical School, faculty, Division of General Medicine, and codirector, Crimson Care Collaborative, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

M. Honigberg is a graduate, Harvard Medical School, and internal medicine resident, Brigham and Women’s Hospital, Boston, Massachusetts.

S.L. Tummalapalli is a graduate, Harvard Medical School, Boston, Massachusetts, and internal medicine resident, Icahn School of Medicine at Mount Sinai, New York, New York.

L.P. Cohen is a graduate, Harvard Medical School, Boston, Massachusetts, and internal medicine resident, NewYork–Presbyterian/Columbia University Medical Center, New York, New York.

S. Fazio is associate professor of medicine and advisory dean, Harvard Medical School, and faculty, Division of General Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

A.R. Weinstein is assistant professor of medicine and director of student education, Harvard Medical School, faculty, Division of General Internal Medicine, and former faculty director, Crimson Care Collaborative, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Funding/Support: This project was funded by the support of Harvard Medical School and Beth Israel Deaconess Medical Center, both in Boston, Massachusetts. All patients described in this report have health insurance as required by Massachusetts state law; patient visits to the SFCP are billed to health insurance, and all co-pays are collected by office staff in the usual manner. The medical center provides all patients visiting the SFCP with free parking.

Other disclosures: None reported.

Ethical approval: The Committee on Clinical Investigations, the appropriately authorized institutional review board and privacy board appointed to review research involving human subjects at Beth Israel Deaconess Medical Center, has approved the use of material presented in this report.

Previous presentations: Portions of this work have been described locally and nationally in the form of abstracts and posters at the following conferences: Harvard Medical School Medical Education Day (2012–2014), Harvard Medical School Center for Primary Care Conference (2012–2014), Society of Student Run Free Clinics Annual Meeting (2012–2013), and Society of General Internal Medicine Annual Meeting (2013).

Correspondence should be addressed to Kristin E. Remus, Beth Israel Deaconess Medical Center, Healthcare Associates, 330 Brookline Ave., Boston, MA 02215; telephone: (617) 754-9600; e-mail: kremus@bidmc.harvard.edu.

© 2016 by the Association of American Medical Colleges