UNE Interprofessional Community Health Rotations: Training medical students in team-based rural primary care

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August 13-19, 2017 was recognized as National Health Center Week, celebrating the work of Federally Qualified Health Centers (FQHCs) in providing comprehensive, coordinated health care to rural and urban underserved communities throughout America. This event drew attention to Maine’s network of mostly rural FQHCs, some of which have begun to serve as training sites for UNE College of Osteopathic Medicine (COM) students as part of an Interprofessional Education Community Health Rotation (IPE CHR) experience.

While UNE COM’s four-week CHR has traditionally addressed not only patients’ clinical needs, but the socioeconomic and cultural factors that shape health outcomes, the IPE CHR was created in 2016 to help COM students apply their on-campus interprofessional training to team-based primary care practice. The IPE CHR includes four to eight hours per week of engagement with non-medical health professionals, providing a profound awareness for COM students of the value of collaborative care. According to Dora Anne Mills, MD, MPH, FAAP, Vice President for Clinical Affairs and Director of UNE’s Center for Excellence in Health Innovation (CEHI), “Maine’s FQHCs are ideal settings for introducing UNE COM students to interprofessional care, as the one-stop shop FQHC care model often includes behavioral health, dentistry, care coordination, and assistance with community resources, effectively meeting patients’ and families’ complex care needs.”

As a foundation for clinical IPE training in rural Maine, the UNE CEHI created the Clinical Interprofessional Curriculum (CIPC) in 2016, which introduces COM students to the national Patient Centered Medical Home (PCMH) model of care now in place at the majority of Maine’s FQHCs. The CIPC’s three-pronged emphasis on team-based care, care management, and population health now guides UNE students in practice-based IPE CHR activities including: student engagement with specialists (podiatrists, optometrists, psychiatrists, etc.) as well as engagement with pharmacists, clinical care managers, behavioral health providers, diabetes educators, case managers (addressing social service needs), dentists, and more. COM students have also worked within interprofessional teams addressing care planning, quality improvement, post-discharge care, and palliative care.


IPE CHR Spotlight: Nasson Health Care, Sanford, Maine

Samuel Wood, OMS-III, UNE College of Medicine

Samuel Wood, OMS-III, UNE College of Medicine

Sam Wood, a third-year COM student and Care for the Underserved Pathway (CUP) scholar with a specific intent to serve vulnerable populations, recently completed his IPE CHR at Nasson Health Care, an FQHC serving rural, low-income communities in southwestern Maine. Following a wide range of team-based care experiences at Nasson including a home visit to a patient with terminal kidney disease, participation in a Cooking Matters nutrition class for food stamp program enrollees, and an unscheduled intake for an opioid-dependent patient, Sam observed that “every link in the chain matters” in meeting patients’ complex needs. At the close of his IPE CHR, Sam reflected that his opioid-dependent patient had “walked in helpless, alone, and without any resources, but roughly one hour later, she emerged with confidence, a plan, and a team to help her implement it.” –Samuel Wood, OMS-III, UNE College of Medicine

Mary Jeralds, RN, Clinical Nurse Manager at Nasson Health Care, also noted at the close of Nasson’s first IPE CHR that her team “feels very fortunate to have had an opportunity to provide a medical student with a rural health rotation. [Sam Wood] was able to participate in providing comprehensive and integrated care in a Patient Centered model of care.”


To date, students have completed IPE CHRs at Nasson Health Care/Sanford, Penobscot Community Health Care/Bangor and Brewer, MDI Hospital/Hancock County* , Swift River Family Medicine/Rumford*, Greater Portland Health/Portland (serving a large refugee/immigrant population). Future IPE CHRs are also planned at Health Access Network/Lincoln, Sacopee Valley Health Center/Porter, Harrington Family Health Center/Harrington, Islands Community Medical Services/Vinalhaven, and DFD Russell Medical Center/Leeds and Monmouth.

* rural practice network; not FQHC

 

FMI: contact MaryFrances Smith, AHEC Clinical Coordinator, msmith4@une.edu or Ian Imbert, Clinical IPE Project Coordinator, iimbert@une.edu

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