As first-year medical students, we spend almost all our time reviewing material related to human health, disease, and the management of illness. This foundation is necessary for practicing medicine.
But we want go above and beyond “necessary and sufficient.” We want to work together with our patients, colleagues, and communities to provide the highest quality, safest, and most effective care—every single time. The skills needed to achieve this goal are lacking in the traditional medical school curriculum.
This is where IHI and IHI Open School come in.
From March 18-20, we attended IHI’s 13th Annual International Summit on Improving Patient Care in the Office Practice and the Community in Washington, D.C., and were blown away by the advances being made in building systems where each person has the health care that best fits her/him. We walked away with three major themes:
1. For care to be optimal for each unique person, health care must operate in a people-centered fashion. That means considering an individual’s economic and psychosocial circumstances. We learned, for instance, about different case management models that take these factors into account and in which health professionals work with a panel of patients to help them manage chronic illnesses. Work from other countries (Canada, England, Scotland) was particularly revealing in illustrating how different cultures approach these problems, and how, often times, we in the US can be narrow-minded in our thinking of how health care functions and the interactions it can have with other community institutions. On the other end of the spectrum, from large government driven programs, we heard practical advice from leading US solo/small practice physicians in how they achieve high quality care in their relatively resource-limited settings. Seeing how their passion for quality was intertwined with relationships they had formed with their patients over decades was extremely inspiring.
2. We learned that the pace of research on how to improve care is increasing. We live in an era of active research and increasing knowledge on best practices for improvement gaps, such as chronic disease management and avoidable hospital readmissions. As future health care professionals, we need to remain aware of these advances (they may be just as important to our future practice as a drug discovery) and possibly consider becoming involved in health services research ourselves. The panels on the Triple Aim and PDSA were particularly good at illustrating how quality improvement work occurs.
3. Technology provides the backbone to improvement. The process of incorporating technology is cumbersome—both in terms of time and resources. We heard from hospital systems that are using Meaningful Use regulations as a jumping board to achieve higher quality of care. We also learned about the use of mobile apps for individuals to better manage illness. Electronic health records, databases, patient portals, and other technology advances, when used meaningfully, allow health providers and patients to achieve better results. Examples of health data in action from overseas (England, Scotland) offer exciting ideas for how we can also meaningfully use similar data here.
In all, IHI’s 13th Annual International Summit reminded us once again of the tremendous challenges, but more importantly, exciting opportunities we—as only beginners in our medical journey—will face as we enter the health care field. It is an exciting time. We look forward to staying informed and continuing to work with IHI to build on the great improvement work already being done.
Parastou Fatemi, Medical Student, Duke University School of Medicine and President, Duke IHI Open School Chapter
Marisa Dowling, Medical Student, Duke University School of Medicine and Vice President, Duke IHI Open School Chapter
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