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

History of the Crimson Care Collaborative at Beth Israel Deaconess Medical Center

According to a 2009 MMS Physician Workforce study, patients are now waiting an average of 82 days to see their primary care physicians. With the wait times increasing, many patients who may want to spend more time with their family doctor now resort to the costly option of the emergency room.

Started by Harvard Medical students in 2010, the Crimson Care Collaborative (CCC), a student-faculty clinic, addresses this gap in the healthcare system. At the Beth Israel Deaconess Medical Center (BIDMC), CCC provides specialized care after normal operating hours. CCC-BIDMC focuses on chronic disease management and partners with primary care providers and specialists to serve patients with hypertension, diabetes, and obesity. Every Tuesday evening students and faculty see patients, either recruited or referred by their primary care physician, for their chronic care and various episodic needs.

Students are involved in every step of the practice and develop valuable skills in health care and research. As of 2013, students work in committees ranging from chronic care innovation, which educates patients with chronic diseases, to research, which compiles data on the clinic. In addition, students who are either junior or senior clinicians work with patients directly. Pharmacy students and faculty also counsel patients and make recommendations on their medications.

Look at our website for more about this student-faculty clinic: http://www.crimsoncare.org/