U.Va. Health System's New Club Red Clinic Pioneers Innovative Approach to Preventive Heart Care for Women

December 10, 2009 – When the University of Virginia Health System's new Club Red Clinic was on the drawing board, its organizers envisioned creating an innovative, cost-effective model for health care delivery. In a bold move, they decided to meld two timely health care concepts – prevention and shared medical appointments, or "SMAs" – into a unique clinical offering that has garnered overwhelmingly positive feedback from patients.

Since opening its doors in late 2008, Club Red Clinic has specialized in providing preventive heart care for women at all stages of life. Its emphasis is on reducing risk factors by empowering patients to adopt heart-healthy lifestyles. While the clinic offers traditional one-on-one medical appointments, its staff has focused on developing new forms of shared medical appointments, or group visits, tailored to patients' needs.

"We believe that aggressive prevention is the most important treatment option for women who have heart disease risk factors," said Dr. Amy Tucker, a cardiologist and the clinic's co-director. "In addition to medical oversight, our SMAs are designed to motivate and support patients in making permanent, sustainable lifestyle changes. We are constantly revising and improving SMA content to empower and encourage women."

Club Red Clinic's emphasis on prevention stems from studies that show healthy lifestyle habits may prevent 80 percent of heart disease and 90 percent of type 2 diabetes in women.

Other studies indicate that hospital readmissions and overall health care costs decrease when patients with chronic conditions have frequent contact with their providers and take accountability for their health.

"We have those bases covered. Wait times for SMA openings are minimal, giving patients ready access to care. Plus, the sharing that occurs during SMAs really helps to instill a sense of personal accountability among participants," Tucker said.

Patient feedback indicates that Club Red Clinic's innovative approach is on target. Ninety-seven percent of SMA participants would choose a group session over an individual appointment for their next clinic visit. All would recommend an SMA to family members and friends.

In use for two decades but not widely available, the shared medical appointment is a health care delivery model in which a physician treats a group of patients simultaneously, thus achieving greater productivity and minimizing wait times for appointments.

Typically, sessions run for 90 minutes and give patients an opportunity to receive medical care and education from their physician while interacting with and learning from each other. Offered by appointment or on a drop-in basis, most SMAs are led either by specialists who focus on a chronic health issue – such as asthma or diabetes – or by primary care physicians who treat a wide range of patients.

At Club Red Clinic, instead of a chronic condition, SMA participants share common interests: reducing their cardiovascular risk factors and improving their heart health. During sessions, patients receive care from members of the clinic's interdisciplinary team, which includes cardiologists, endocrinologists, nurse practitioners, cardiovascular nurses, an exercise physiologist, registered dietitians, certified diabetes educators and a registered pharmacist.

In another innovative change, the clinic offers different types of SMAs. Some focus on medical concerns and are led by a cardiologist; others concentrate on lifestyle support and are run by nurse practitioners.

According to Anne Hedelt, a nurse practitioner and clinic co-director, the SMA curriculum is expanding to include hands-on experiences, like using exercise equipment, learning dance steps or participating in cooking demonstrations.

"We are moving beyond just telling patients about changes they can make to giving them a direct experience of the new behaviors or skills we're suggesting," she said.

The clinic's staff encourages SMA participants to develop a "community of support" and "accountability partners." They are welcomed to bring a female family member or friend with them to group visits. To ensure privacy and create a sense of safety in the group, everyone signs a confidentiality agreement at the start of each session.

At Club Red Clinic, SMAs typically begin with blood pressure checks and other individual exams. These usually take place in the group setting, but are done privately when requested. During each 90-minute session, patients receive medical care, have prescriptions changed or refilled, obtain answers to their questions and concerns and discuss treatment options as well as various health and lifestyle topics. The cost of attending an SMA is equal to a regular office visit. Typical insurance co-pays apply.

"First-time participants are generally surprised at how comfortable and supported they feel in the group and how much individual attention they receive," Hedelt said. "Patients appreciate the new ideas and reinforcement offered by the group, the sharing and laughter that occurs, and the camaraderie they develop with others who have the same risk factors."

Another way that Club Red Clinic is leveraging its expertise and specialized services is through collaborations with primary care physicians. "We can provide an extra level of support that patients may need but PCPs cannot offer," Tucker said. "By helping patients make and sustain heart-healthy lifestyle changes, we supplement the work of their primary care physicians."

More information about Club Red Clinic can be obtained online at www.clubreduva.com or by calling 434-243-1000 or (toll-free) 800-251-3627.