During summer 2015, a patient walked into the Emergency Department at University of Colorado Hospital only to hear very bad news. This patient needed a 30-day supply of a medication immediately —not in two weeks or seven days—but immediately. The drug was very expensive and the patient, who didn’t have insurance, could not afford it.
Within 48 hours, the patient had the medication in hand, thanks to the intervention and quick action of CU Denver junior Scott Cao, a biology major in the College of Liberal Arts and Sciences. The situation, which might have seemed hopeless at first glance, was business as usual for Cao in his summer internship working as a “Hot Spotter” at the hospital on the CU Anschutz Medical Campus.
“It was a fantastic experience,” Cao said. “It changed my perception of people who have chronic illnesses. I now look at them and realize many different factors could be affecting their health.”
The Hot Spotters
Hot Spotters is a summer experiential learning program developed by Roberta Capp, MD, MPH, assistant professor of Emergency Medicine. It teaches students from a variety of disciplines about the needs of underserved populations with the goals of improving access and quality of care for these patients and reducing their reliance on the Emergency Department for care. During summer 2015, the Hot Spotter program helped more than 3,500 patients address their health needs.
Cao found the internship through Charles Fergsuson, PhD, director of CU Denver’s Health Professions Programs. One of 19 Hot Spotters, Cao joined small Hot Spotter teams staffing the Emergency Department 24 hours a day, seven days a week. He was working side-by-side with students in medicine, nursing, pharmacy, public health and sociology. All were trained to identify resources available to high-risk patients who had come to the Emergency Department multiple times in a short period.
“Many patients come in with something manageable, like type 2 diabetes, but after they get discharged they don’t get the correct follow-up care,” said Cao, sounding more like a medical student than an undergrad. “They don’t have insurance, or they don’t have a pharmacy, or they do have Medicaid but they don’t have a primary care physician, or they don’t have transportation. Some are homeless.”
After these patients were treated, a physician or nurse would call in a Hot Spotter to help the patient navigate the health care system and receive follow-up care from a primary care physician. The students also assessed the patients’ barriers to accessing health care and provided resources to overcome those barriers, including health insurance enrollment, housing, transportation to appointments, medication and food pantry services.
“Our mission was to make sure we provided patients with enough resources and information that they did not have to come back to the Emergency Department unless they had life-threatening injuries,” Cao said. “We cut through red tape, sometimes making calls while the patient was still in bed.”
After Hot Spotters
In the months after his summer internship, Cao compiled and analyzed data he had collected from patients who had completed a medical screening survey. He turned his internship into a research project looking at the demographics of patients, their access to a car, whether they were homeless, had chronic illnesses, knew a primary care physician, could access prescription medication. He is hoping that the research could lead to the creation of more patient navigator programs like Hot Spotters.
He credits Capp with doing a “tremendous job” training the Hot Spotters to engage with patients. “She taught us to look at the big picture,” he said.
In the case of the patient who needed help paying for medication, Cao picked up the phone and reached an insurance enrollment specialist. Two days later, the patient was enrolled in an insurance plan that would cover the medication immediately—a singular example of how Hot Spotters, even when they are juniors in college, can change lives.