Student hotspotting: Teaching the interprofessional care of complex patients

Problem: Individuals with complex health and social needs drive much of the total cost of care. Addressing these individuals' needs and decreasing costs requires interprofessional teams, called "hotspotters," who engage with communities with high utilization. Training health professions students to succeed in the hotspotting approach may benefit trainees, academic health centers (AHCs), and communities.

Approach: The Camden Coalition of Healthcare Providers and the Association of American Medical Colleges launched the Interprofessional Student Hotspotting Learning Collaborative in 2014. The goal was to train health professions students working in interprofessional teams at U.S. AHCs to meet the needs of complex patients, providing home visits and intensive case management for up to five patients over six months. The authors report themes from 20 reflections from the five-student Virginia Commonwealth University (VCU) team.

Outcomes: Across 10 sites, 57 students participated during June-December 2014. The review of the VCU experience demonstrated that the hotspotting program was successful in teaching students how social determinants affect health and the benefits of interprofessional teamwork for addressing the unmet health and social needs of complex patients. Key elements that students identified for improvement were more program structure; protected time for program activities; and formalized processes for recruiting, retaining, and transitioning patients.

Next Steps: Future iterations of the program should strengthen the curriculum on caring for complex patients, provide protected time or academic credit, and formally integrate teams with primary care. A larger study evaluating the program's impact on patients, health systems, and communities should be undertaken.