Saturday, June 21, 2014

The Crimson Care Collaborative: Reviving the Pipeline for Primary Care


Christine Bishundat
Med Ed Committee

            The Benjamin Lipson Memorial Lecture was held at the Simches Research Center on June 19. The speakers included Marya Cohen, MD, MPH, Jessica Zeidman, MD, Talia Kraower, MD, Charlotte Ward, MPH, and medical students Tomi Jun, Simin Lee, and Katherine Schiavoni, who each addressed different aspects of the CCC model at HMS.
            Simin Lee's talk described the founding and evolution of CCC at HMS. In 2006, universal healthcare coverage became law in Massachusetts, transforming the landscape of healthcare and medicine in the state. While the number of uninsured patients has fallen following healthcare reform, there remains an insufficient number of primary care providers to meet the growing need.  In addition, between 1999-2009 the number of medical students matching into primary care dropped substantially [1]. 

            Recognizing the need for more primary care providers in Massachusetts, a group of students at HMS sought to expand primary care opportunities by creating the first CCC site at MGH IMA in 2010. The CCC mission emphasized a desire to provide excellent care while developing the next generation of primary care leaders. Currently, five CCC sites exist, treating a variety of patients including immigrants, refugees, youth, and those with chronic illness.
            Charlotte Ward, a researcher at the Stoekle Center and Benjamin Lipson Memorial Lecture speaker, analyzed data on the relationships between CCC and primary care match rates. She published an article in the New England Journal of Medicine in 2010 suggesting that CCC at HMS had, in fact, increased the number of graduating students matching into primary care.

The remaining speakers highlighted additional projects underway at CCC which are summarized here:

Interprofessional Education (IPE): Since modern medicine requires working in a team, CCC has nurse practitioner students, pharmacy students, medical students, interpreters, social workers, faculty preceptors, and undergraduates provide care as a unit. The students and faculty address medical concerns as well as social needs.
Longitudinal mental healthcare: A care manager enhances communication between the patients and PCPs around issues related to mental health.
Patient-reported outcomes: iPads are distributed to patients at their appointments to assess what outcomes are important to them and how well CCC addresses these needs.
Longitudinal care teams: CCC hopes to follow-up with patients and build lasting relationships through phone calls, text messages, and home visits.
Patient outreach: CCC is posting information in the communities it serves regarding workshops on nutrition labels reading and exercise habits.

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1. Ganguli, Inshani. The Case for Primary Care- A Medical Student’s Perspective. NEJM. Available online at: http://www.ishaniganguli.com/pdfs/GanguliPerspectiveNEJM.pdf

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