Overview

• Between March 26, 2020 and April 3, 2020, general practice (GP) trainees implemented a telephonic outreach intervention targeted to support a rural and vulnerable patient population during COVID-19.

Organization Name

West Oxfordshire General Practice

Organization Type

• Academic Hospital
• Rural health system

Tech Involved

• Electronic medical record
• Email
• Telephone
• Video conferencing

Team Members Involved

• Clinical Trainee or Student
• Physicians

Workflow Steps

• GP trainees (residents) at West Oxfordshire General Practice mentored 13 medical students in a week-long telephonic outreach intervention to support individuals at elevated-risk for COVID-19 living in rural areas.
• GP trainees identified over 1,400 patients who would benefit from the intervention using health records and students contacted 878 patients in total. During the calls, students fielded questions on COVID-19, explained key prevention practices, and assisted patients struggling to refill prescriptions for pre-existing conditions. 
  • A separate team of students conducted a qualitative review of the intervention, including collecting patient feedback through remote interviews.

Outcomes

• Innovators qualitatively evaluated the program by soliciting feedback from participating students and patients. Students anecdotally reported gaps in patient knowledge pertaining to social determinants of health and access to care. Patients valued the extended care the students’ calls provided, specifically the ability to have key questions about COVID-19 answered.
• Innovators recorded high response rates and access to internet and cellular services in the rural population they served. 80% of patients targeted responded to telephone calls and consulted with the medical students. In conducting the calls, students discovered that a majority of patients vulnerable to COVID-19, 55%, had internet access and cellular connection. 
• This initiative demonstrates one way to engage medical students during a pandemic.

Unique Challenges

• Because innovators were responding to an ongoing pandemic and delivered the intervention in a one-week time frame, no pilot was performed prior to the program. The students used up-to-date information to answer patients’ questions but were limited by rapidly changing national health guidelines.  
• 20% of the patients innovators fitting National Health Service (NHS) categories for elevated COVID-19 risk lacked internet and cellular connectivity and could not be reached to participate in the intervention. A lack of updated health records also resulted in phone calls to households where patients no longer met criteria for inclusion.

Sources

• Hughes T, Beard E, Bowman A, Chan J, Gadsby K, Hughes M, Humphries M, Johnston A, King G, Knock M, Malhi K. Medical student support for vulnerable patients during COVID-19–a convergent mixed-methods study. BMC Medical Education. 2020 Dec;20(1):1-9.