Innovative Program at Local Clinic Promises to Improve Outcomes for Students and Patients

By Nancy Dockter, MPH
Diversity Process Coordinator
Center for Diversity Affairs

Anjali Saxena
COM class 2014

A band of dedicated COM students is working hard to establish a program which will link HHC patients to needed services and resources. The intent is to help patients improve the conditions of their lives, and in turn, their health. Patients will identify their needs and be referred to agencies that can help them obtain safe and affordable housing, jobs training, the nearest food pantry, reliable transportation … the kinds of things most of us take for granted.

The effort is led by third-year medical student Anjali Saxena, who has volunteered at the clinic since her first year in medical school. She calls her time at the clinic “a vital part of my education.”

Saxena feels that connecting with low-income patients in that setting encourages students to have a less judgmental attitude towards those who are having a hard time living a healthy lifestyle. “It helps you understand what the struggles are in the community,” she says. Also, the experience improves students’ communication skills. “They know what to ask their patients.”

The referral process will be facilitated by the database software Online Advocate, which was developed at Boston’s Children’s Hospital. The hospital has offered the clinic use of the software at no charge.

Saxena’s goal is to have Online Advocate up and running at HHC by early 2013. Patients will have the option of completing a needs assessment and being referred to local service providers.

This fall, medical students are conducting an assessment to get a perspective on what the greatest needs are among HHC patients, and students from the University of Arkansas are logging some required volunteer hours by entering information about local social services into the database.

Harmony Health Clinic opened in 2007 and is run almost entirely by volunteers, many of whom are affiliated with UAMS. Students and physicians donate their time to see patients by appointment on Thursday evenings and Saturday mornings. Outpatient preventive and acute care, management of some chronic conditions, and prescription assistance are free to individuals who meet eligibility requirements. A free dental clinic is on Friday mornings.

Saxena would also like to see systems in place at HHC that would enable the COM student volunteers to stay with the same patient over time. A stronger provider-patient relationship would improve continuity of care and mean better patient outcomes. It would also deepen the learning experience of students, as they gain perspective on how economic and social conditions set the context for life choices and affect health.

“Many people in health care, including myself, often feel frustrated when patients are ‘non-compliant’ and do not take care of themselves in the way that we want them too – it feels like it is out of control,” Saxena said. However, by digging deeper into the social needs of our patients, we will be able to design better treatment plans that fit the social circumstances of our patients. By doing so, we can impact health, patient satisfaction, and job satisfaction.”

* The social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics. ~ World Health Organization. Social Determinants of Health: Final Report.