URI’s Academic Health Collaborative: ‘A new approach to educating health professionals’

E. Paul Larrat, dean of URI’s College of Pharmacy and the first coordinating dean of the Academic Health Collaborative executive committee, discusses key elements of the new initiative. / COURTESY NORA LEWIS/URI
E. Paul Larrat, dean of URI’s College of Pharmacy and the first coordinating dean of the Academic Health Collaborative executive committee, discusses key elements of the new initiative. / COURTESY NORA LEWIS/URI

SOUTH KINGSTOWN – Collaboration was the watchword of the day, when officials from the University of Rhode Island announced a new Academic Health Collaborative intended to foster multidisciplinary health care learning, teaching and research within URI and far beyond its campus walls.

“Health really is a team sport; we have ample evidence … that health teams provide better care, more efficient care,” said E. Paul Larrat, dean of URI’s College of Pharmacy, at the March 28 press conference. With the AHC, we want to “make sure that every single one of our graduates in the health disciplines at URI is health team ready on ‘Day One’ of their employment. That’s not only to benefit the students and the organizations that employ them, but also to benefit our ultimate stakeholders – the patients that we all serve.”

The College of Pharmacy and the College of Nursing will be part of the AHC, which also establishes a new College of Health Sciences. With that, seven different disciplines currently scattered across different colleges – communicative disorders, health studies, human development and family studies, kinesiology, nutrition and food science, physical therapy and psychology – and nursing and pharmacy will be part of the College of Health Sciences, said Larrat. The AHC includes an Institute for Integrated Health and Innovation, designed to facilitate multidisciplinary collaboration among faculty, students and community professionals and serve as a locus of health services research and outreach for Rhode Island’s residents to access. Finally, a shared services office will facilitate and coordinate accreditations, professional education, communications and development, grant funding and information technology. While the AHC is a major initiative, it required only a limited financial investment, said Larrat, noting that the provost is committed to hiring a director of the Institute for Integrated Health for the next academic year.

Donald H. DeHayes, URI provost and vice president for academic affairs, said that the AHC, with approximately 160 full-time faculty and staff, will serve some 5,000 students, about 500 of whom are graduate students. Larrat will serve as the initial coordinating dean of the AHC’s executive committee, which also includes deans of AHC’s other two colleges. The AHC, “a work in progress,” is expected to be up and running for the fall semester of 2016, reported a university spokesperson.

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The AHC will facilitate professional education and practice, said Phillip Clark, director of both the Program in Gerontology and the Rhode Island Geriatric Education Center at URI. No single health care professional has all the perspectives, he said before the press conference, so it’s important that patients have a team of people working together. “Many health professionals have little training in how to work as a team member in a collaborative setting, and one goal of [the AHC] is to give students an opportunity to collaborate more effectively and work in teams.”

We hope that this new initiative will attract more students, draw in more grants and other external sources of funding and spur more collaboration with other academic institutions and health care providers, said Clark, of the AHC, which is expected to be fully up and running this fall.

Fox Wetle, dean of the School of Public Health at Brown University, calls the AHC “a win-win,” which offers opportunities for collaboration on several levels. Given Brown’s very strong research activity in evidence-based medicine and health care research, including in pharmacoepidemiology (the study of the uses and effects of drugs in specific, defined populations), pharmacoeconomics (the scientific discipline that compares the value of one pharmaceutical drug or drug therapy to another) and health data sets, Wetle said after the conference, “We see a natural connection [with the AHC] for external funding, but also for training doctoral students.”

DeHayes said the AHC represents recent societal shifts in issues of health and health care: Not only is there a movement away from the traditional university-based medical center to a model of collaboration built upon partnerships, there is also a shift from medicine to health as the central focus. Recognizing the greater emphasis on the health of populations, not just individuals; the need for integrated and coordinated approaches to health care delivery; and an acknowledgement that health reform and health policy bring changes to cost structures and payment reform models, DeHayes said, “We saw an opportunity to be in the forefront of leading that change.”

Under URI’s earlier approach, URI pharmacy students training in a hospital would pass URI nursing or nutrition students and not know that the other discipline was right there, said Larrat, after the press conference. “That’s not how health teams work and that’s not how education should work.” Through the AHC, the university will endeavor to create multiple opportunities for students from these different disciplines to study and work together.

Deborah Riebe, chair of the Department of Kinesiology, explained how interdisciplinary training of health care professionals supports the goals of disease prevention and health promotion (throughout a person’s life span) at the AHC and throughout the nation’s health care system. Seven of every 10 deaths in the United States are due to chronic disease and 50 percent of the country’s adults have at least one chronic disease, many of which are preventable or at least manageable, she said. According to Riebe, 25 to 33 percent of cancer cases are due to poor nutrition, physical inactivity, excess weight or obesity. We know that if we prevent disease, it increases productivity; high blood pressure, smoking and obesity each reduce annual productivity between $200 and $400 per person.

A patient with a heart attack is routinely seen by pharmacy and nursing professionals, but other health professionals promote better long-term outcomes, she said. A clinical exercise kinesiologist supervises the patient’s cardiac rehab program, a registered dietician recommends nutrition and diet changes, and a psychologist or other health behavior professional helps guide the patient through behavioral changes needed for improved health. “Teaching students within disciplines and across disciplines … has a lot of potential to change the way we promote health and prevent disease,” said Riebe.

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