The following blog has been co-authored by the CareForward Team of Senthil Rajasekaran, Lauren Mazzurco, Christine Matson, Don Robison, Anca Dobrian, Marta Ambrozewicz, Raja Koteeswaran, Mekbib Gemeda, Cindy Cadieux, Carrie Elzie, Arun Mohanram and April Pace
It seems like American Healthcare has been in “crisis mode” since 1900s. Despite so many advances, little has changed in controlling cost and improving value and health outcomes. Even though there is plenty of evidence to suggest that clinical care at its best contributes to only 20% of patient health outcomes and a whopping 80% is determined by socioeconomic and behavioral factors, little is done in medical education to address the 80%. Recently we are witnessing a welcome trend, where undergraduate (UME) and graduate medical education (GME) are seen as part of this solution. At Eastern Virginia Medical School (EVMS) we have implemented our new CareForward curriculum to teach cost, value, and health system sciences in the UME. Realizing the challenges in effectively integrating these complex topics in UME, our team at EVMS has created a set of virtual families, members of which will be represented in the clinical cases that are used in the UME curriculum. These virtual families represent diverse patient populations (e.g., age, gender, sexual orientation, ethnicity, race, culture, belief system, literacy level, socioeconomic status and geography), and introduce variables such as veteran affairs, family dynamics, financial turbulence, health equity/disparity, roles within a care delivery team, access to community resources, interactions of organizations and complexities of care in specific patient populations. Each organ system module and clerkship will use longitudinal clinical cases that are drawn from the virtual families.