OSF HealthCare recently hosted University of Illinois System President Tim Killeen and leaders from the system universities in Peoria, Chicago, Springfield and Urbana-Champaign to highlight the Equity Innovation Medicine (EquiMED) program and its expanding impact on health care to rural and underserved communities in Illinois. The program exposes medical students to individuals living in medically under-resourced communities in the U.S. and abroad, and it challenges students to come up with sustainable solutions to a health issue.

The four-year program for select medical students is led by John Vozenilek, MD, of OSF Innovation, who says the curriculum and experiences teach innovation through problem solving and provide skills alumni take into their residencies and practices.

“They are using their innovation skillset every single day. She (a former student at a recent gathering) said that she is using these innovation tools when she interviews patients to go deeper into their needs so she can think of new solutions to their problems.” 

Devon Izquierdo, a fourth-year medical student at UICOMP, spent time in the São Paulo area of Brazil meeting with the Guarani people, who have a territory in the northwestern part of the city called Jaraguá. The biggest problems they face are health literacy and mistrust of traditional medicine.

Devon says they decided to focus on a solution that involved children.

“Because they seemed more open and inviting to outsiders and we decided to create an educational game where they would learn how to treat common ailments like stomach aches, not only with their traditional medicine, but also with evidence-based medicine that we use in our Western culture and hopefully disseminate that information to the adult population as well.” 

Izquierdo and other students met with the local shaman and other key stakeholders to get input. They decided the best approach might be to create a game.

“We worked with one of the healers, Sonja Christina, as well as some of the leadership – her son Jefferson – to really get their input on the game and see what kids would really get excited about.” She adds, “So the next step would be to develop a prototype and bring it back to the community to see, does it really work, do they really enjoy it and where can we adjust as needed.”

Izquierdo will work with a team at Illinois State University in Normal, Illinois – an academic partner of OSF HealthCare – that has expertise in game theory and development. Meanwhile, she says the EquiMED program taught her the valuable lesson of listening critically and continuously.

“Continue to have a conversation. Build trust in the community and really come up with a solution together because, ultimately, we want to create a solution that they’re going to use – that really solves the issue that they want. We can always come in with ideas and a high-tech solution but if it’s not feasible and they’re not going to use it, are we really solving the problem that we’re trying to solve?” 

Solutions must be sustainable

Ben Mendez, another fourth-year EquiMED student worked in another region outside of São Paulo, Brazil – an area challenged with having safe drinking water. Mendez says he’s working to develop a water quality monitoring system using sensors and a communication tool to provide alerts when water quality drops to dangerous levels. In that case, private, non-profit organizations could step in to provide safe drinking water.

Mendez says it’s not ideal, but it is the most feasible, sustainable option.

“Instead of completely reshaping the infrastructure that doesn’t exist there, we’re just trying to give them a way to get ahead of a problem before it starts and alert them and give them a fighting chance to not drink this contaminated water essentially.” 

It’s a practical approach and a lesson he’s learned by working in vulnerable communities. Mendez predicts he’ll use that approach as he practices medicine in the future.

“So understanding how to work within the constraints of a financially driven system, which is the reality we’re in, will prepare me better for my residency and helping my career in finding solutions that we can still keep these basic services that we must as providers, but do it in a way that we can justify the cost and keep the lights on essentially.” 

Students also stress importance of developing soft skills, such as listening and collaborating, says Dr. Vozenilek.

“So, this idea of co-design, to really get to the patients’ needs and to really understand them fully and then design with the patient, the solution. Now that’s relevant for very complicated type of treatment paths that require a lot of technology, but it’s also extremely important for the types of simple things we do every day to keep ourselves and our loved ones healthy.” 

At the most recent meeting of collaborative partners, leaders also discussed how in the future they might align EquiMED efforts with national health priorities, such as the Food as Medicine initiative and exploring opportunities for collaboration with agricultural programs.

Dr. John Vozenilek

EquiMED students Devon Izquierdo and Ben Mendez

Like many communities, the older population in Streator, Illinois has grown – so much so that 20% of residents in the north central city are 65 or older. So, it’s no surprise that healthy aging ranked as the fourth-most important health issue in the most recent Community Health Needs Assessment There’s also a big concern about mental health which ranked second for identified health needs in the 2022 survey.

That demographic information and identified health priorities will help guide the innovation sprint by medical students from the University of Illinois College of Medicine, Peoria (UICOMP). They’re part of the EquIMED program – a four-year elective track for medical students. During an innovation sprint, third and fourth year students are challenged with developing an innovative tool or approach to solve a fundamental problem.

Starting February 12, five EquIMED students will be spending a week in Streator to learn first-hand about health challenges for those 65 and older. They will then pair up to develop solutions.

“We have medical providers and social service agencies under one roof at the Center for Health in Streator so there are opportunities for collaborative solutions,” says Community Health Engagement Program Manager Ellen Vogel.

Vogel points out the second-most populous city in LaSalle County, Streator does not have an adult day center or a senior center.

The EquIMED program was developed with an understanding that the challenges facing rural and under resourced communities across the globe are the same as in the U.S. and so solutions developed could help regionally and globally.

“As many as 1.5 million Illinois residents lack access to health care because they live in rural and/or medically underserved communities. We need to come up with solutions that provide more access, but also that can support those residents in between appointments,” says John Vozenilek, MD, vice president for Innovation & Digital Health, OSF HealthCare. Dr. Vozenilek who is also a UICOMP professor and course director adds, “The University of Illinois College of Medicine Peoria EquIMED track offers a four-year curriculum and the opportunity to expose future medical providers to patient populations with unique struggles as well as strategies for how to create innovative solutions for them.”

EquIMED students are learning about innovation through hands-on work, small group sessions, simulations, online lectures, lunch and learns, dinner speakers, as well as from instruction by OSF Innovation experts who work at the Jump Trading Simulation and Education Center, a collaboration between OSF HealthCare and UICOMP.

“The solutions generated by the students have the potential to offer real value, but the real value to the EquIMED students is the journey of discovery and what they learn through an iterative process to advance health equity innovation across environments where health disparities exist. They learn how to ask questions, communicate, document, think critically and research what’s already available and bring the best options forward,” explains UICOMP Program Coordinator Erica Litzsey, MS. “They can use the approach in the future whether they become physicians serving rural, urban or any type of community.”

Additional Background

Some previous solutions from EquIMED students are being developed further in partnership with Bradley University:

• PeoriaFresh! - The software system allows food banks and local gardeners to collaborate and share produce.
• Diabetes and Resourceful Testing (DART) - An app that uses community health workers to increase access to diabetes testing supplies so glucose levels can be measured at least once a week. It will also provide a dashboard with alerts or individual patients better manage their glucose levels. Bradley and OSF are providing additional funding for both efforts through an Innovation for Health grant.

The diabetes management program was a solution proposed by students working in Uganda which has a problem with patients being able to access and afford diabetes testing supplies, particularly in communities with no hospitals or medical clinics. UICOMP has an ongoing relationship with a university in Uganda but due to unrest in the East African country, along with a U.S. travel ban, students won’t be traveling there for their innovation sprint this semester. Erica Litzsey says EquIMED program leaders are looking for another university willing to collaborate to expand the global options for embedding students for future innovation sprints abroad. 

B-roll for EquIMed  program