HeRMES
	Structure

HeRMES operates as a partnership with area health centers which serve the underserved and uninsured of the region. The closest analogy is one of a physician staffing group. The partner clinic provides the physical space, equipment, supplies, medication/referral network, and the infrastructure to advertise, schedule and screen patients. HeRMES provides the health care expertise which lies at the heart of any clinical encounter: medical students and licensed supervising physicians to perform intake, history taking, physical exam, diagnosis, and treatment or referral as appropriate. We also provide other professional and clerical expertise to manage the majority of each patient's time at the clinic.

This model works well in our setting. As a small site of a large medical school (only 50-75 third and fourth year students are here any given year), the manpower for students to obtain a physical space, equipment and the like is simply not available, unlike many other student-run free clinics. At the same time, local free clinics have more patients than they can handle at given time — the limiting factor is often not material resources, but the availability of health care providers to evaluate patients.

By operating as a "clinic within a clinic", HeRMES allows for local clinics to see more patients than they might otherwise, and for medical students to gain valuable experience working with underserved populations — an experience which does not exist in the curriculum except as incidental encounters. HeRMES benefits by not having to take on the burden of creating and maintaining a clinic from scratch, while the clinic benefits by allowing HeRMES to handle the work of screening, accepting, and scheduling the students.

Currently, HeRMES is active at one location with a second partnership about to be initiated. Another site was also a partner early on, but had to be dropped due to logistic issues. (See our Partners for more details.) Our current strategy is to schedule one three-hour evening clinic once a month at each partner site. During this time, 3-4 "senior students" (qualified third and fourth-years) and 1-2 "junior students" (who have completed the history and physical diagnosis course) students work at the clinic in conjunction with a volunteer supervising physician. The junior students perform intake duties including vital signs and medication lists while the senior students take the full history, perform a physical exam, formulate a diagnosis and treatment plan and then present it to the physician for discussion, modification and implementation.

The supervising physician is a volunteer to HeRMES, although he or she may also volunteer at the partner clinics at other times. Additionally, undergraduate students from the Illini Health Coalition serve in other non-clinical capacities to help move patients efficiently and courteously through their visit. (Some have professional training such as EMTs and LPNs, and help with some clinical duties as well.) Plans to incorporate other professions such as nursing, social work and librarians are at various stages of implementation.

The record-keeping and other administrative rules are no different than that of the partner clinic — their policies and procedures apply, and patients may be seen either under the rubric of HeRMES or of the partner clinic in order to assure appropriate followup, although some effort is made to ensure continuity of care by the same students whenever possible.

To learn more about HeRMES, please explore other areas of this site or contact us.