Health professionals gather at Pitt, discuss future of healthcare

Health professionals from Pittsburgh and around the world may be trying to change what happens during your visits to the doctor.

Ben Reynolds, director of UPMC’s Office of Advanced Practice Providers, which advances education at UPMC, said this weekend that “interprofessional education” will mean changing the way medical students are taught, primarily in the emphasis on teamwork among various specialties.

Reynolds spoke at the seventh biennual All Together Better Health conference, which focused on interprofessional practice and education in health care and concluded on Pitt’s campus on Sunday. This year’s conference was the first of its kind held in the U.S. and the largest one so far, according to Susan Meyer, associate dean of Pitt’s School of Pharmacy. It drew about 880 people from 27 countries, including Canada and Scotland.

Meyer, also one of the event organizers, said interprofessional education is having “students from two or more health professions learning from, with and about each other for the purposes of improving patient care outcomes.”

“It’s learning how to work together and having common goals for the patients and the communities that they serve,” Meyer said.

The problem, Meyer said, is that in practice patients may go to different health care providers to treat different ills, and none of the doctors will have the complete picture of the patients’ health. Costs from visiting various doctors then accumulate and can negatively affect patients.

Though the idea of interprofessional collaboration has been around for several decades, Meyer said it is gaining traction now.

“Patients aren’t as healthy as they should be and we’re spending way too much on healthcare, and there’s evidence out there that shows that when different healthcare professionals work better together, people are healthier, communities are healthier and they save money,” Meyer said.

Reynolds said the push with interprofessionalism is to use small interventions to prevent large spending. The end goal of this movement, he said, would be for an assistant physician to conduct initial visits with patients and then direct them to a specialist if necessary.

But this year’s conference was not all about theory.

Meghan Bastin, a graduate student studying dental medicine, Cara Mazzarisi and Ryan Winstead, both graduate students studying pharmacy, presented at the conference on Saturday morning about a case study in a Rwandan hospital.

The trio presented on a case study by Dr. Patrick Lee, Volunteer Clinical Mentor at Newton-Wellesley Hospital in Newton, Mass. Lee, a graduate of Harvard Medical School, conducted research in 2007 at Kirehe Hospital in Rwanda, a place that, according to the case study, had low staff morale and no consistent information recording.

For the first two weeks of his 18 months in Kirehe, Lee observed the hospital and took notes on needed improvements. He spent the rest of his time training the staff on how to implement better systems, such as setting a goal of 95% compliance with nurses checking vital signs and administering medications — basic practices the nurses were not doing, according to Lee’s observations.

In the case study report Lee said he noticed “major gaps” in the care available at Kirehe, such as lack of essential medications or lab tests — common conditions in impoverished areas.

“If you tell the audience that Rwandans make less than one U.S. dollar a day that gives them an idea of the extreme amount of poverty in the area,” Bastin said. “They can relate even if they haven’t been to Rwanda. There are aspects of their culture that they can have some ideas about and not be afraid to speak up or participate.”

Eric Johnson, an assistant professor and director of Interprofessional Education at the University of North Dakota, said he learned new information from the presentation on the Lee case study.

“It was interesting to hear about this resource allocation and quality improvement things in an environment that obviously has a lot of deficits,” Johnson said.

The three-day conference included lectures, workshops, roundtable discussions and 524 oral, panel and poster presentations, according to the official event website.

The final day closed with a plenary session about global interprofessionalism, and a major theme emerged: There is a high need to gather more evidence for the effectiveness of the interprofessional approach and use such evidence to influence policymakers to make changes within the healthcare system.

In his closing remarks, John Gilbert, Professor Emeritus at the College of Health Disciplines at the University of British Columbia in Vancouver, Canada and the panel’s moderator, noted how the conference has grown since its first meeting in 1997.

“It’s clear that we have come a great distance from [the first conference],” Gilbert said.

The next All Together Better Health conference will take place in September 2016 in Oxford, England.