Upstream HeLIX Rotation

Imagine you are an outstanding physician, providing safe care in a way that your patients appreciate. But despite your skill as a physician, you are still frustrated because some problems are bigger than your individual skill. Some of your patients lack healthy nutrition, others are out of work. Often they have a difficult time making it to clinic appointments. A few are homeless. More battle addictions to alcohol or drugs. Your patients describe how they are lonely and socially isolated. These factors have a huge impact on your patients’ health, but you feel powerless to do anything. You can’t write a prescription to solve these tough problems. There was no class in medical school for tackling these complex problems.

But now there is such a class for University of Minnesota Medical Students rotating at Hennepin County Medical Center: the Upstream HeLIX Rotation.

Rotation goals. The goal of the Upstream HeLIX Rotation is to teach medical students how to participate in systems changes to address complex health problems. Students will learn Human Centered Design, the core competency of Upstream Health Innovations, to use as a method to create system changes. During the rotation, the students will continually ask what is the true problem with the system they want to change. They will learn to hold meaningful conversations and perform observations to gather information about a system. Next they will synthesize this information to create insights about the true problem. The students will continually work with people the system serves to coproduce ideas for change. They will then try those ideas, using a process known as prototyping, to learn about potential ways to change a system.

A curriculum based on collaboration. Upstream Health Innovations welcomes the 4 HeLIX students rotating at our innovation center. One essential element of systems change is coproduction, and to teach the importance of this element, students will be coproducting their own curriculum. We are pleased to collaborate with faculty and leaders of Hennepin County Medical Center and the University of Minnesota Medical School to create this rotation for the HeLIX students. We also have many community and industry partners who will participate in discussions and give feedback to students on their projects.

What is innovative about HeLIX? Traditional medical education teaches in isolated blocks of knowledge where, for example, you study surgery in an isolated block for 6 weeks, then you study only pediatrics for 6 weeks, followed by OB/Gyn, then primary care, and so on in continued discreet blocks of learning. This gives time for highly-concentrated study in one area of medicine, punctuated by significant time gaps where you do not study that area at all and forget the knowledge you learned. This also leads to viewing patients from the lens of that specialty seeing only the surgical needs of a patient when you are on the surgery service or only the obstetric needs of a patient when on the OB service; rather than seeing patients as whole persons with complex health needs. A new type of medical education address these educational weaknesses. This new style of education allows the students to study all the areas of medicine at the same time. For a patient who is experiencing depression while pregnant, a traditional medical student would focus on their pregnancy while on their OB rotation, but may not intensely study that patient’s depression unless they rotated onto psychiatry; whereas, the new style of education encourages a student to study both depression and pregnancy at the same time. This new style of education creates fewer gaps where a student can forget valuable knowledge and also allows students to see the patient as a whole person. These new educational experiences are typically called longitudinal integrated clerkships and the longitudinal integrated clerkship at HCMC is called HeLIX (Hennepin Longitudinal Integrated eXperience). To learn more about the HeLIX rotation, check out the program’s site. The Upstream Rotation adds to Hennepin County Medical Center’s longitudinal integrated clerkship by teaching students that patients are essential partners in improving care and introducing them to a method for changing complex systems.

About the Author:

 William E. Walsh, MD serves as the Deputy Chief Innovation Officer at Upstream Health Innovations (UHI). Dr. Walsh leads the Upstream HeLIX rotation for medical students where they learn human centered design and systems improvement for vulnerable patients. In addition to his work at UHI, Dr. Walsh is a practicing Facial Plastic and Reconstructive Surgeon at Hennepin County Medical Center and the University of Minnesota. He serves people who need reconstructive surgery after cancer, Mohs surgery, or trauma. He also helps people born with congenital ear deformities like microtia and anotia. He has a particular expertise in rhinoplasty, nasal reconstruction, otoplasty, and ear reconstruction. He serves people from Minneapolis, St. Paul, the Twin Cities Metro area, and the Midwest United States including Minnesota, Wisconsin, Iowa, North Dakota, and South Dakota. Dr. Walsh’s unique background includes extensive training and experience as an artist. He is a Certified Medical Illustrator and his medical illustrations have been published nationally and internationally.