1. Development of the Evaluation of an Interprofessional Hotspotting Curriculum Charles Baron BA, Lauren Collins MD
Background
Evaluation Development
Super-utilizers
Top 1% of patients account for 22% of spending
Typically complex patients with multiple chronic conditions
Underlying struggles with social determinants of health
Interprofessional Education (IPE)
Occurs when 2+ professions learn about, from, and with each other
IPE well integrated into preclinical years
Increasing need in clinical education and practice
Hotspotting
Patient-centered interprofessional intervention
Patients work with teams to identify healthcare goals and barriers to care
Created by the Camden Coalition of Healthcare Providers (CCHP) based on data driven observation that small subset of patients drive massive amounts of healthcare spending
CCHP has trained students in hotspotting through the Interprofessional Student Hotspotting Learning Collaborative (ISHLC) since 2014
Iterative Process
Logic Models, Program Theories (CIPP, 3P)
Early focus on inputs and outputs allowed for understanding of existing resources
Evaluation Structure
Areas of impact emerged: Students, Advisors, Patients, Systems
Mixed method investigation
Qualitative components include interviews and focus groups
Quantitative components are prospective investigations including short and long term outcomes
Evaluation Plans
Patient
Multidimensional locus of control, health outcomes, patient experience
Student
Knowledge, Skills, Attitudes, Beliefs
Empathy
Teamwork
Advisor
Burnout
System
Patient healthcare utilization
Curriculum Integration
Funding: Protected time for faculty/staff, fellowships
Program
Satisfaction survey, interviews, interest in primary care/complex care
Program Outline
Iterative evaluation process, current plans in front
Intervention
Potential patients identified from insurance claims data
Enrollment in conjunction with patient’s PCP
Intervention focused on care coordination, patient advocacy, and patient goals
Curriculum
6 month intervention with concurrent video curriculum, in person team meetings, and online case presentations and skills workshops
Focused on social determinants of health rather than clinical care
Scaling Up at Jefferson
Next Steps
Participated in ISHLC since 2014
1 team of 6 students per year (n =18 total over 3 years)
Jefferson becomes National Hub
Jefferson selected as 1 of 4 national hubs for the ISHLC (selected May 2017)
Responsible for training 8 internal teams and 12 external teams
Coordinate curriculum, communication, kick off and wrap-up for external teams
Program Expansion at Jefferson  Scaling up
5 colleges, representing 9 health professions, and 6 clinical departments expressed interest in a scaled up hotspotting program
Increased from 1 to 8 teams, with 43 student participants
Increased from 4 to 34 total advisors
Introduced formal application process, with sponsorship from each student’s dean
Students eligible for formal transcript recognition, in most professions
Independent study/capstone available
Continue Program integration
EMR Integration to improve patient outcome tracking
Optimize patient identification
Opportunities for students to assist with program research
Funding
Pursue protected time for involved staff
Investigate creation of possible superutilizers fellowships
Evaluation Expansion
Dearth of evidence regarding IPE and care coordination in multi-center studies
Role as hub ripe with opportunity for partnerships:
External teams
Fellow hubs
CCHP
Current program theory