MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Preparing Physicians Who Thrive in the 21st Century:

Deciphering SI2025Mammen Puliyel, MD, PD PediatricsAmy Zack, MD, PD Family Medicine

Abdulla Ghori, MD, DIO, The MetroHealth SystemAPPD 2019 Spring Meeting, New Orleans

March 28, 2019 1:30-3 PM

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Disclosures

The following speakers have no relevant financial relationships with commercial interests to disclose

Mammen Puliyel, MDAmy Zack, MDAbdulla Ghori, MD

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Objectives

• Understand the current and projected views proposed in SI2025 and recognize the responsibility of medical educators in addressing the projected views

• Sketch a plan to address the future challenges in graduate medical education imminent by 2025 in one’s institution and program

• Compose strategies feasible at institutional and program level to address the future challenges in selected but prioritized thematic categories

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Objective 1

• Understand the current and projected views proposed in SI2025 and recognize the responsibility of medical educators in addressing the projected views

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Genesis of SI2025

• Project commissioned by ACGME in June 2015• To develop a future vision for Sponsoring

Institutions (SI)• 19 member task force• Met with 1065 diverse participants• Potential structures and functions of SIs to

produce the future physician work force• Discussion around 3 fundamental questions

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Fundamental Questions

1. Identify up to 4- aspects of health care delivery in the US in the year 2025 that are most likely to impact GME

2. How will these aspects of future health care delivery affect the GME needs of residents and fellows?

3. How will these aspects of future health care delivery affect the organization of residency and fellowship training?

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Outcome

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

“Findings” – 8 themes (52 findings)I. Changing Health Care NeedsII. Changes in Health Care DeliveryIII. Evolution in Health Care SystemsIV. Evolution in the Role of the PhysicianV. Evolution in the Role of Other Health Care ProfessionalsVI. Evolution in Graduate Medical EducationVII. Uncertainties in the Models for GME FundingVIII. The Role of GME in the Continuum of Medical Education

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Three Major Drivers of Change

1. Rapid Democratization2. Increasing Commoditization3. Advancing Corporatization

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 10

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Concern for Preserving Professional Attributes and Other Aspects of the

Profession of MedicineI. Health Care Professionals as HealersII. Face-to-Face Clinical EncountersIII. Bedside InteractionsIV. Physician WorkforceV. Readiness for Unsupervised PracticeVI. Delineation of Different Types of Health Care

Professionals

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Reflecting on these concerns…….

• HEALERS who are able to make effective use of technology and information systems to enhance their healing relationship with patients

• SERVANT-LEADERS who collaborate with others and prioritize the needs of others in decision-making

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Reflecting on these concerns…….

• ADVOCATES who promote patient-centered care, who meet the needs of the populations they serve, who recognize and address social determinants of health, and who recognize and address disparities in health care

• TEAM MEMBERS who work and communicate with health care professionals toward effective coordination of patient care

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Evolution of the Roles and Responsibilities of the Sponsoring Institution, 2016-2025

Journal of Graduate Medical Education Supplement, December 2017

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Potential Values of SI2025 program

The program should be designed to:• Encourage SIs to excel in providing high-quality GME• Encourage SIs to innovate in areas not currently

addressed by accreditation• Identify successful GME practices and innovative GME

ideas for dissemination• Create a national cohort of SIs interested in collaborative

improvement in GME

Source- ACGME presentation

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Potential SI2025 Program Criteria

• Demonstrating excellence in patient care• Optimizing health systems for learners• Advancing educational innovation and

performance

Source- ACGME presentation

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Objective 2

• Sketch a plan to address the future challenges in graduate medical education imminent by 2025 in one’s institution and program– Dr. Amy Zack– Dr. Mammen Puliyel

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Amy Zack, MD

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

How do I apply SI2025 to my learners?

• Break down the SI2025 topic for a better understanding

• Identify how this type of goal applies best to your setting

• Create a plan that addresses your goals within the SI2025 targets

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

How do I apply SI2025 to my learners?

• Template developed to assist with this process• Maybe molded to fit any level of educational

program and any SI2025 view

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Example of residency program goal

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 22

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 23

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 24

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Faculty Technology Learners

Clinic Patients

Time

KnowledgeInvestment

Software

Training

Access

Didactic Time

Investment

Clinical Time

Staff

Rooms

Continuity Panel

Access to appointments

ACGME

Expectations

Feedback

Use of practice data to improve patient care and inform learning goals

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 26

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 27

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Mammen Puliyel, MD

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Theme: Evolution in the Role of the Physician

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 30

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 31

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 32

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Faculty Technology Learners

Administration Patients

Time

Knowledge

Investment

Technology

Training

Access

Didactic Time

Investment

Investment

Support

Demand for current information

ACGME

Expectations

Feedback

Use of outcome data to continually improve the curriculum

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 34

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching. 35

MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Objective 3

• Compose strategies feasible at institutional and program level to address the future challenges in selected but prioritized thematic categories

– Audience participation

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Small Group Work

• Choose a topic as a table (or in a small group)

• Work through worksheet• Present your ideas to the whole group

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MetroHealth and Case Western Reserve University, affiliated since 1914, partners in advancing patient care through research and teaching.

Thank you

• Mammen Puliyel, MDmpuliyel@metrohealth.org

• Amy Zack, MDazack @metrohealth.org

• Abdulla Ghori, MDaghori@metrohealth.org

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