Clinical Excellence Case Set
Aquifer High Value Care
The 12 cross-disciplinary virtual patient cases and introductory principles module in the High Value Care course explore the fundamentals of providing value in health care, adopted from the American College of Physicians (ACP) and the Alliance for Academic Internal Medicine’s (AAIM) High Value Care Resident curriculum.
Aquifer High Value Care teaches students how their decisions about diagnostic testing, care management, and other interventions affect the costs and efficacy of care. Including this curriculum in every healthcare professional’s education is a step toward making high value care a reality in clinical practice.
Aquifer High Value Care is part of Aquifer’s Clinical Excellence Case Set, which includes 52 cases covering Palliative Care, Trauma Informed Care, Diagnostic Excellence, High Value Care, Social Determinants of Health, and Telemedicine.

Just in Time Coverage of High Value Care Embedded in Select Courses
In addition to the stand-alone cases on High Value Care included as part of this Clinical Excellence Case Set, select core cases in Pediatrics, Family Medicine, Internal Medicine, Geriatrics, Neurology, and Radiology now have brief teaching on High Value Care embedded right into the case in the form of a clinical decision making question.
Together the just-in-time curricular threads combined with the deeper principles and application cases provide a strong foundation in High Value Care across the curriculum without adding faculty time.
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Key Features
- Part of Aquifer’s Clinical Excellence Case Set, included with Curricular Partner subscriptions and available by subscription to Limited Subscribers
- Created for educators, by educators, from the ACP-AAIM’s High Value Care Resident Curriculum
- Ready-made cases to support self-directed learning, appropriate to supplement pre-clinical or clinical learning
- Cases take approximately 15-20 minutes to complete.
- Appropriate to support pre-clinical or clinical learning.
- Can be combined with other cases in a custom course to meet the needs of your specific curriculum.
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Course Content
Aquifer High Value Care consists of innovative, cross-discipline, case-based modules that begin teaching the fundamentals of value in health care. The modules include short interactive virtual patient cases, brief instructional videos, key teaching points, and embedded links so that students can apply principles from the HVC modules to other cases. Topics include: making your diagnostic testing count, adult preventative care, insurance, statistics and clinical decision making, and more.
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Course Structure
All Clinical Excellence Case Sets, including High Value Care, now include:
- Principles module: covers key definitions, epidemiology, explanations of key principles and why they are important for patient care, and a harm statement that makes it explicit what harm can come to the patient if the principle is not incorporated into practice.
- Application Cases: Brief, realistic case scenarios that focus on one area of a patient encounter, and are centered around asking students to make important clinical decisions. Content models evidence-based best practices and communication strategies, exploring the real-world impacts on care and potential harm. At the end of each case, a reflection question asks the students to consider key takeaways, implications for their future practice, or personal wellness. Each application case also includes self-assessment questions that extend the learning to other scenarios.
The cases illustrate how trauma-informed care can improve patient-provider rapport, increase patient engagement in preventive care, and facilitate integrated, patient-centered treatment plans.
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Development Process
After the grant award in 2020 from the Arthur Vining Davis Foundations, Aquifer established a Palliative Care Leadership team, a group of interprofessional clinician-educators and content experts representing schools around the US.
In the absence of clear national curricular standards on palliative care in medical and health professions education, the Leadership Team then completed a needs assessment (stakeholder surveys and focus groups) and literature review. After completing the research activities, the leadership team held a consensus conference, synthesizing the literature review and needs assessment findings into a vision statement and key guiding principles.
Using the vision and principles as a framework, the Leadership Team developed a national palliative care curriculum to be delivered through the Aquifer course. Learning objectives were identified, and development work on virtual patient cases began in late 2021. Case development used varied pedagogies to ensure that learners are equipped with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities.
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Curriculum Integration
Aquifer High Value Care is designed for any level student in a medical school or health professions program. The course is an ideal assignment for students to complete as preparation for clinical experiences that include telemedicine. Cases also serve as valuable reference material for students to return to as they need to refresh their knowledge during clinical rotations.
Programs with a current Aquifer subscription will also have faculty and administrator access to an accompanying educator guide. Subscribers will also be able to view student progress reporting and combine the new cases with other Aquifer content in a custom course.
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Case List
- High Value Care 01: Principles of high value care
- High Value Care 02: 25-year-old patient – Making diagnostic testing count
- High Value Care 03: 65-year-old patient – Adult preventive care and value
- High Value Care 04: 80-year-old patient – Medications and value
- High Value Care 05: 78-year-old patient – High value care in the inpatient setting
- High Value Care 06: 65-year-old patient – Paying for value: Insurance Part 1
- High Value Care 07: 7-year-old patient – Rooting out waste
- High Value Care 08: 5-month-old patient and 4-year-old patient – Value of vaccines
- High Value Care 09: 66-year-old patient – Redefining value at end of life
- High Value Care 10: 16-year-old patient – Statistics and clinical decision-making
- High Value Care 11: 17-year-old patient – High value care reproductive health care
- High Value Care 12: 17-year-old patient – Paying for value: Insurance Part 2
- High Value Care 13: 45-year-old patient – The importance of clinical reasoning
User Story Video
Learn how Aquifer High Value Care—available free of charge—can benefit students and faculty in your program.
Heather Harrell, MD
Aquifer Course Editor
Aquifer Clinical Excellence Course Board
Heather Harrell, MD, FACP
Course Board: Aquifer Clinical Excellence
Role: Editor in Chief
Institution: University of Florida
Institutional Title: Professor of Medicine and Associate Dean of Medical Education
Lauren Azevedo, DO, MS, FAAP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Michigan State University
College of Osteopathic Medicine
Institutional Title: Assistant Dean
Kelsey Dougherty, MMSc, PA-C
Course Board: Aquifer Pediatrics
Role: Associate Editor
Institution: University of Colorado Child Health Associate/Physician Assistant Program (CHAPA)
Institutional Title: Assistant Professor
Patricia Griffith, PhD, CRNP, ACNP-BC
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of Pennsylvania
Institutional Title: Practice Associate Professor, Associate Director AGACNP Program
Jennifer Grumet, MD
Course Board: Aquifer Clinical Excellence
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Institution: Chapman University / PA Studies Program
Institutional Title: Clinical Associate Professor, Director of Admissions, Assistant Clinical Coordinator
Nivedita Gunturi, MD
Course Board: Aquifer Clinical Excellence
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Institution: Rush University Medical Center
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Kathryn Holliday, DNP, CPNP- PC, CNE, CHSE
Course Board: Aquifer Clinical Excellence
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Course Board: Aquifer Clinical Excellence
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Institution: University of Colorado CHA/PA Program
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Townes R. Leigh, Jr., DO, CAQSM, FAAFP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Sam Houston State University College of Osteopathic Medicine
Institutional Title: Assistant Professor of Family Medicine/Sports Medicine, Program Director SHREC Sports Medicine Fellowship
Juan Lessing, MD
Current Role: Associate Editor
Course Board: Aquifer Clinical Excellence
Institution: University of Colorado School of Medicine
Institutional Title: Associate Professor, Medicine-Hospital Medicine
J'Aimee Lippert, DO
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Michigan State University College of Osteopathic Medicine
Institutional Title: Associate Dean of Admissions and Student Affairs
Jamie Macklin, MD, MPH
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: The Ohio State University Wexner Medical Center
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Khiet Ngo, DO, MS
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of California Riverside School of Medicine
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Amit Pahwa, MD
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: John Hopkins University School of Medicine
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Rex Alvin D. Paulino, MD, AGSF
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: Joan and Stanford Division of Geriatric and Palliative Medicine
University of Texas Health Sciences Center at Houston
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Manajyoti Yadav, MD, FACP, FRCP
Course Board: Aquifer Clinical Excellence
Role: Associate Editor
Institution: University of Illinois College of Medicine Peoria
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