An initiative designed to transform health care that was once led by First Lady Michelle Obama on Chicago’s South Side has linked more than 5,600 largely low income patients to a medical home in five years, but has faced challenges in helping these people maintain a relationship with a doctor or clinic, executives at the University of Chicago said today.

Five years after the Urban Health Initiative was launched by executives at the University of Chicago Medical Center and its then vice president of community affairs Michelle Obama as a way to educate patients on the best use of the emergency room, the effort has grown into a network of 25 community-based clinics and other providers of medical-care on a budget of more than $6 million a year. It is now poised to escalate research initiatives and teaching opportunities for physicians in hopes of becoming a national model for medical care in urban areas of the U.S.

Those involved in a key part of the initiative known as the South Side Health Collaborative say the number of appointments made at clinics through the U of C referral system have jumped nearly 50 percent to 3,649 in the year ended Jan. 31, 2010 compared to the same period ending Jan. 31, 2006. On average, those keeping their appointments has grown to 1,386, or 38 percent of those referred to clinics, from 884 patients five years ago or 34 percent five years ago.

The effort has been controversy in its early years because some critics both inside and outside the University of Chicago Medical Center and surrounding community in part because some see it as an effort to boost profits and shirk responsibility to poor in the Hyde Park. Critics take particular issue with the redirecting of patients from the U of C emergency room to other medical-care providers, some several miles from their homes.

But the U of C officials maintain 40 percent of the more than 55,000 patients who come to its emergency room each year could be better and more efficiently served in a physician’s office or a clinic. In addition, the U of C, like other academic medical centers, says its costs are 30 percent to 40 percent higher than community hospitals, which are better positioned to treat a variety of patients.

It has gained national attention in part because of the high-profile people involved but also because it has been controversial and also because it is unique. Dr. Eric Whitaker, who heads the Urban Health Initiative, is one of Michelle and President Barack Obama’s closest friends and has attended White House functions promoting the Obama administration’s health reform plan.

U of C and clinic officials involved bristle at the attention critics and members of the press have put on the patient referrals from the emergency room.

“If we do our job right, we will have an impact nationally in education,” said Dr. Eric Whitaker, who heads the Urban Health Initiative at a briefing with reporters this morning..

“This is an ambitious project,” Whitaker added. “The emergency room is not where the action is. It’s in people’s homes. . and communities. This is a hard thing.”

And their briefing with reporters was in part designed to highlight other facets of the Urban Health Initiative such as its research on health disparities and its educational efforts for U of C medical students and residents.

Whitaker acknowledged the Urban Health Initiative has much work to be done. Not only is it a challenge to get patients to see physicians on a regular basis, officials said residents on the South Side are often skeptical of the University of Chicago and studies it conducts.

But studies nationally show people of all income groups don’t see a doctor regularly and in low income neighborhoods generally, health care is far down the list of priorities. “It has to be cool to go to the doctor,” said Warren Brodine, chief executive officer of the Chicago Family Health Center, located at 9119 S. Exchange Avenue, where leaders from the U of C and the Urban Health Initiative addressed the media.