NCT04375189

High Risk Outpatient Intern-led Care (HeROIC) Clinic Initiative

Impact of a Novel Complex Outpatient Clinic Setup on Patient Outcomes and Intern Education

• Status: Withdrawn
• Phase: N/A
• Study type: Interventional
• Enrollment: 0 (actual)
• Sponsor: Johns Hopkins University · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Background: A small subset of the patient population is responsible for a significant proportion of healthcare expenditures. These patients are cared for in academic medical centers by internal medicine residents however there has been no research to date about the education or the management of patients with complex multimorbidity in the outpatient setting. Objective: To evaluate the impact of the High Risk Outpatient Intern-led Care (HeROIC) Clinic on internal medicine interns' perceived ability to manage complex outpatients as well as pre and post intervention total patient healthcare cost. Methods: The investigators created the HeROIC outpatient clinic environment to comprise longer visit time slots, "bedside" presentations, and team-based care (one intern primary care provider, one secondary intern, and one longitudinal attending). All non-preliminary interns based at one primary care site participated in the intervention while interns at a second site continued to practice in the usual outpatient clinic environment. The interns in the HeROIC clinic arm assumed the roles of primary care providers for 34 complex patients in total. The primary outcome was the perceived confidence in the management of complex outpatients as assessed by a survey. Secondary outcomes included perceptions about the ability to provide high-quality outpatient and evidence-based outpatient care, as well as statewide pre-post patient healthcare cost data.

Conditions

• Comorbidities and Coexisting Conditions
• Risk Reduction
• Emergencies

Interventions

Type	Name	Description
OTHER	High Risk Clinic	Subgroup of primary care clinic where patients have longer time slots, supervision by one longitudinal attending, "bedside" presentations

Timeline

• Start date: 2016-07-01
• Primary completion: 2022-07-01
• Completion: 2022-07-20
• First posted: 2020-05-05
• Last updated: 2022-07-25

Locations

1 site across 1 country: United States