MedStar Health blog : MedStar Health

MedStar Health Blog

Featured Blog

  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

All Blogs

  • August 06, 2020

    By Jessica S. Wang Memoli, MD, Pulmonology

    African Americans are disproportionately affected by diseases that affect the respiratory system. When it comes to lung cancer, sarcoidosis, and asthma, statistics are quite revealing. African Americans are:

    • More likely to get malignant lung tumors than any other population group in the U.S.
    • Three times more likely to develop sarcoidosis than Caucasians in the U.S.
    • Three times more likely to die from asthma than other groups

    Lung Carcinoma and African Americans

    This is the second most common cancer in African Americans. African American men are 37% more likely to be affected by the disease and 22% more likely to die from it than Caucasian men—even when accounting for smoking rates. African American women, on the other hand, develop the condition at about the same rate as Caucasian women.

    A variety of factors can increase risk for the disease:

    • Smoking: This is the most important risk factor associated with malignancies of the lung and the leading cause of death from this condition. Vaping and marijuana use also affect the lungs. Any time you inhale anything into your lungs, there’s a potential for damage.
    • Second- and Third-Hand Smoke: According to the American Lung Association, African Americans are exposed to more second-hand smoke than other groups. Third-hand smoke refers to the oils and fumes that can remain on a smoker’s clothing and skin and affect other household members and close contacts. There’s evidence that this exposure may increase risk as well.
    • Family History: If you have a first-degree relative who has had lung tumors, that’s a risk.
    • Environmental Factors: You may have a higher risk depending on your exposure to various air pollutants and radon, which is a colorless, odorless radioactive gas found in higher concentrations in some homes. Radon is the second leading cause of malignancies of the lungs.
    • Primary Cancers: Having cancer in other parts of your body increases the risk of lung tumors. 

    At MedStar Washington Hospital Center, we target tumors on an individual basis through programs such as Lung Cancer Screening, Smoking Cessation Counseling, and Thoracic Oncology services. Over the last five to ten years, medicine has gained a better understanding of molecular markers and immunotherapies in lung cancer treatment. It’s become more important to know the tumor type and genetics involved so we can choose an appropriate therapy. Regardless of your race, gender, or age, we look at the genetics of each patient’s individual tumor type because that helps us understand which therapy to choose.

    African American men are 37% more likely to be affected by #lungcancer—and 22% more likely to die from it—than Caucasian men. #riskfactors https://bit.ly/2WRVSGt via @MedStarWHC
    Click to Tweet

    Sarcoidosis and African Americans

    Sarcoidosis is an inflammatory disease that can develop when the immune system creates an overgrowth of cells called granulomas in various organs throughout the body. We see it commonly in the lungs and lymph nodes, but it can occur anywhere in the body—eyes, nerves, heart, gut, liver, kidneys, even on your skin.

    In the United States, African Americans are three times more likely to develop the disease and 16 times more likely to die from it than Caucasians. African American women have the highest incidence in the nation and tend to be more severely affected.

    This increased rate of death in the African American population is due to the disease affecting multiple organs. Unfortunately, the reason for more extensive disease is unknown since we haven’t pinpointed what causes sarcoidosis to begin with.

    The data shows that sarcoidosis probably has a genetic component as well as an environmental component. Interestingly, during my pulmonary training in Charleston, South Carolina, which is a coastal city, we saw a lot of sarcoidosis—yet the further inland we went, the less we saw.

    People with this disease can present in a multitude of ways, including shortness of breath, coughing, wheezing, palpitations, and even skin lesions. Some people may not feel anything at all depending on which organ systems are involved. It is different for everybody.

    When someone is diagnosed, we perform a slew of tests to determine which organs may be involved. If the patient is short of breath, or their pulmonary function test reveals that their lung function is not what it should be, or they have other organs involved, the first-line treatment is prescribing a systemic corticosteroid like prednisone. Depending how effective this first-line treatment is, the patient may not need another treatment after a short course of these steroids.

    If symptoms recur when we stop the prednisone, other immunosuppressive medications—many of which are used in rheumatology, such as methotrexate, azithromycin, and cyclophosphamide—can be used.

    The good news is that sarcoidosis can be managed. Long-term damage can be minimized the sooner you seek medical care. To treat my patients, I give them breathing surveys every year. I look at their CT scans. I make sure they see their ophthalmologist and get an EKG to ensure they don’t show evidence of disease involvement in another organ.

    Asthma and African Americans

    Although Puerto Ricans in the United States have the highest rate and prevalence of asthma, African Americans are three times more likely to:

    • Have a fatal asthma attack (especially women) than other ethnic groups
    • Be hospitalized due to asthma

    African American children have the highest prevalence of asthma, with roughly 13.4% compared to approximately 7.4% of Caucasian children.

    The burden rests heavily on African Americans for many reasons, including genetics, socioeconomics, educational awareness, access to insurance, and exposure to allergens and other environmental factors.

    Can allergies cause asthma? Yes, there certainly can be an allergic component to asthma. One of the areas currently being studied in asthma care is the body’s immune response to allergens. That means evaluating antibodies and other signs of inflammation the body has against the multiple possible allergic insults. A lot of allergists will actually treat asthma because it’s considered an allergen-mediated disease for some people. Some of the new medications for chronic and severe asthma work to modify your immune system to help it fight off allergens.

    To determine if you have asthma or allergies, have a doctor listen to you breathe. Symptoms of asthma include:

    • Wheezing
    • Shortness of breath
    • Chest tightness
    • Inability to do everyday activities

    The doctor may give you a breathing test called the Pulmonary Function Tests (PFT) with a methacholine challenge. During this study, we irritate your lungs to see how difficult it is to pass air through them. But this test can be negative, even in people who have asthma, which makes it difficult to diagnose definitively. Diagnosis often involves testing, clinical suspicion, and looking for other causes of respiratory symptoms. Other allergy symptoms typically involve sinusitis, rhinorrhea (runny nose), and nasal congestion.

    During an asthma attack, part of the allergic response occurs within the lungs themselves. With asthma, the airways leading to the air sacs in your lungs get inflamed, so moving air in and out of those air sacs is harder. To reduce inflammation, you must either avoid your asthma triggers or use an inhaler.

    Education and tracking are really important if you have been diagnosed with asthma. You can do simple tests at home such as using a peak flow meter, which is a small device that measures how well you can get air in and out of your lungs. It can reveal if your lung function is impaired or headed in the wrong direction.

    Being aware of your peak expiratory flow (how fast you exhale) can help you know when to use your albuterol inhaler, call your doctor, or go to the hospital. At MedStar Washington Hospital Center, we can help you learn about the condition and work with you to create an asthma action plan. It’s about working together to learn about your body and what you can do to stay healthy.

    What You Can Do

    Although lung cancer, sarcoidosis, and asthma affect African Americans at higher rates, know that you can take steps to advocate for your own health. Learning about the data, understanding your family history, and assessing lifestyle choices are good first steps.

    Our goal at MedStar Washington Hospital Center is to do everything we can to relieve your symptoms and improve your airways, so you can get back to your family and the activities you enjoy.


    Breathe easier.

    Our specialists are here to help.

    Call 202-644-9526 or Request an Appointment

  • August 05, 2020

    By Glenn W. Wortmann, MD

    While we continue to learn more about COVID-19, there’s still a lot we don’t know. But it’s important to stay up-to-date on basic information related to COVID-19 symptoms so that you know if and when you need to seek medical care. 


    Is sore throat a common COVID-19 symptom?

    A sore throat can be a sign of COVID-19, but it’s not common. A study in China reported that only l4 percent of 55,000 patients with confirmed cases of COVID-19 experienced a sore throat. Everyone’s body reacts differently to the virus, so while it’s possible to have a sore throat as a symptom of COVID-19, it’s more likely that you’ll have other symptoms.

     
    While sore throat can be a symptom of #COVID19, it’s uncommon. Infectious disease specialist Dr. Wortmann shares what you need to know about COVID-19 and sore throat: https://bit.ly/3d0jSPv.
    Click to Tweet

     

    What are common COVID-19 symptoms?

    COVID-19 is a respiratory illness so it commonly results in symptoms similar to that of the common cold, such as:


    • Fever
    • Cough
    • Fatigue

    Unlike the flu, COVID-19 symptoms appear gradually, according to the World Health Organization (WHO). Many people who become infected have mild to moderate symptoms that last around a week. And, some people with COVID-19 don’t experience any symptoms at all. 


    Aging adults or those with underlying health conditions are at a greater risk of experiencing more severe COVID-19 symptoms, but anyone can become seriously ill—even younger people. Severe COVID-19 symptoms include:


    • Shortness of breath
    • Difficulty breathing
    • Loss of smell or taste

    As we continue to learn more about COVID-19 and it’s symptoms, we may discover new information about what symptoms develop and when. 


    Related article: Learn how COVID-19 compares to the flu.

    When do COVID-19 symptoms appear?

    COVID-19 symptoms typically appear two to 14 days after you are exposed to the virus. Because it can take up to two weeks for symptoms to appear, many people may not realize they have it. And, some people don’t experience any symptoms from COVID-19. That’s why it’s so important to self-quarantine if you think you may have been exposed, even if you don’t feel sick. The Centers for Disease Control and Prevention (CDC) recommends staying home for 14 days to minimize the risk of spreading the virus to others.   


    How do I know if my sore throat is related to COVID-19?

    It can be hard to determine what is causing a sore throat. A sore throat could be a symptom of lots of other illnesses, including allergies, strep throat, or other infections. The best way to know if your sore throat is related to COVID-19 is to be on the lookout for more common symptoms of COVID-19, such as a fever, cough, or shortness of breath.


    How can I treat a sore throat at home?

    Whether or not your sore throat is a symptom of COVID-19, there are a few things you can do at home to ease your pain. To relieve irritation due to a sore throat, you can try:


    • Gargling warm salt water
    • Drinking warm tea
    • Sucking on throat lozenges
    • Using a humidifier 
    • Taking over-the-counter medicines (e.g. Tylenol)

    When should I seek medical care for a sore throat?

    In some cases, you may need to seek medical attention for a sore throat. If you have a severe sore throat that worsens or makes it challenging to swallow, consider using MedStar eVisit to talk to a doctor virtually. During a virtual visit, a doctor will ask you questions about your sore throat to determine when and where you should seek in-person medical care.


    What should I do if I suspect I have COVID-19?

    According to the WHO, most people can recover from COVID-19 at home. In fact, 80% of people who become infected with the virus recover without needing medical care in a hospital. 


    If you have mild symptoms, such as a light cough, you can probably ride out the virus at home. Be sure to quarantine, taking precautions to limit exposure to family members in the same household. Even if you don’t have symptoms, if you think you have COVID-19 or were exposed to the virus, the Center for Disease Control and Prevention (CDC) recommends:

    • Staying home
    • Avoiding any public area or transportation
    • Drinking water to stay hydrated
    • Resting and taking over-the-counter medication, such as Tylenol, to reduce discomfort
    • Separating yourself from family members by staying in a separate room
    • Wearing a facemask over your nose and mouth if you are around anyone in your home
    • Washing your hands often
    • Cleaning high-touch surfaces every day
    • Monitoring your symptoms
    If you have shortness of breath or difficulty breathing, you should seek medical attention immediately.


    Find care now.

    Click below for more information on our services.

    Urgent Care

    MedStar Health Telehealth

  • August 05, 2020

    By The MWHC Blog Team

    More than two decades ago, Ariam Yitbarek came onboard at MedStar Washington Hospital Center as a nurse in the Cardiac Surgery Step-Down Unit and loved that patient population. She had ambition to move up, however, and was always ready to take advantage of educational opportunities. 

    “I loved how supported I was and appreciated that MedStar Health offers a lot of development opportunities,” said Ariam. 

    After a year and a half in her first position, she became a clinical manager in the same department. Five years later, Ariam moved up to the position of nursing director on the heart failure unit. She says she kept an eye out for how she could be of service, helping to provide interim coverage on other units in cardiac services. This was around the time she completed her master’s degree in Health Care Administration from George Mason University.

    In 2009, Ariam began serving as interim senior nursing director of surgical and oncology services, which became permanent nine months later. “I took on roles where I was learning a lot about service lines I had no clinical experience with,” said Ariam. “I also looked to leaders and peers whom I learned from and who have guided me throughout my career. And I took full advantage of tuition reimbursement.”

    Excelling in that position, Ariam then transitioned into a position created for her: senior nursing director for ambulatory services and women’s and infants’ services. From 2013 to 2017, Ariam covered other service lines as well, and added emergency services to her portfolio. In mid-2019, Ariam was promoted to her current position, vice president of nursing operations. She says she appreciates the encouragement she has received from Chief Nursing Officer Tonya Washington, who is a mentor and a trusted friend. This gives Ariam the motivation to mentor others. She sees her role as having an impact and leaving a legacy wherein those she leaves behind have the tools to seamlessly succeed her. She says it is important for leaders to provide tools, knowledge, and resources, and to let people learn from their decisions.

    Finally, Ariam believes the key to success is looking at each of our roles as being a part of One Team.

    Regardless of your role in this hospital, we all impact patient care,” said Ariam. “At any level throughout the organization, we can tarnish the reputation of the hospital or we can look at ourselves as representatives of the hospital and say ‘My success is its success’ and be mindful of how we’re adding to that. I am truly proud to be part of this amazing organization. One Team!”


    Looking for a new career opportunity?

    Join our team.

    Visit our Jobs Portal

  • August 04, 2020

    By Ron Waksman, MD

    The thin, delicate tissues of the valves in the human heart may be small—but they have a big job to do. They keep the blood flowing forward in your body. If they malfunction, they need to be repaired or replaced

    At MedStar Heart & Vascular Institute, we are well equipped to restore optimal quality of life to patients requiring valve repairs or replacements. The good news for patients is that many of these procedures are minimally invasive, which means the patient can go home the following day.

    The good news for patients is that many heart valve procedures are minimally invasive. https://bit.ly/2D2Zqia via @MedStarWHC #ValveDiseaseAwareness
    Click to Tweet

    One Heart, Four Valves

    The human heart has four valves: the aortic, pulmonary, tricuspid, and mitral valve. Each can have its own problems, and each issue can manifest at a different age in patients. Some people are born with abnormal valves. Some develop malfunctioning valves through infection or as a result of aging.

    How Does a Valve Malfunction?

    Patients might experience two main issues with their valve, both involving the valve’s leaflets—thin flaps of tissue that open and close to allow blood flow.

    • First, the valve can become leaky, which means that the leaflets are not closing and operating well and there is a leakage of blood. Instead of just flowing forward, the blood also moves backward
    • Another problem is that the valves may develop stenosis, which is when the opening of the valve becomes narrowed and the leaflets don’t open enough. The result is that the ventricles, or lower chambers of the heart, don’t pump out enough blood

    Symptoms Can Be Silent, Sudden, or Gradual 

    Symptoms of valve disease depend on the degree of the disease. Some people—those with a mitral valve prolapse, for example—might have no symptoms, or the symptoms may go away.

    When something goes wrong with any of the valves, patients usually experience shortness of breath as well as weakness. The symptoms can be new to the patient—in other words, not previously experienced.

    Because the onset of symptoms can be gradual rather than abrupt, the patient may not necessarily notice their symptoms. The intensity of symptoms depends on the cause and degree of the valve malfunction.

    Patients with valve disease may also experience palpitations, a kind of fluttering of the heart. Some palpitations, especially involving the mitral valve, could spur atrial fibrillation, an irregularity of the heart rate. Occasionally, palpitations may also cause some chest discomfort or chest pain (this is most likely with mitral valve prolapse).

    A Simple Test to Diagnose Valve Disease

    It is very easy to diagnose problems of the heart valves or heart muscle with an echocardiogram—basically, an ultrasound of the heart. The ultrasound is a very simple procedure, not that costly, and is free of any risks or side effects. The results will give you an accurate answer to whether or not you have valve disease, and you can be diagnosed after one visit.

    It’s important not to delay diagnosing valve disease. When the heart valves are not functioning properly, you may feel weak or have shortness of breath. The abnormal flow of blood may cause the heart muscle to start to behave differently.

    Home of Pioneering Medical Advances

    The team at MedStar Heart & Vascular Institute treats valve disease with an array of innovative, minimally invasive techniques, meaning we no longer have to perform traditional, open-heart surgery. Today, many patients can go home the next day with a repaired valve.

    Some technologies were implemented at MedStar Heart & Vascular Institute before they were well known within the United States. For example, we were first in the country to use heart valves in patients diagnosed with severe aortic stenosis but who had a low risk of death.

    We are now among the first to treat a mitral valve regurgitation with innovative technology started by some of our investigators, who also work at the National Institutes of Health. MedStar Heart & Vascular Institute can now offer this pioneering approach to its heart health patients.

    Repair or Replacement?

    Other than maintaining good dental health and living a clean lifestyle, there’s not much we can do to prevent heart valve disease. And once it occurs, it cannot be reversed. So, if a degenerative problem in the valve is diagnosed, it should be addressed, because it will not improve on its own.

    If the existing valve can be repaired, we do so. Some cases are beyond repair—for example, when there is a severe narrowing of the valve. In a case like this, we have to replace them with a new valve.

    A patient may be able to compensate for symptoms by using medication for some amount of time; however, this plan of care calls for the supervision of a cardiologist, as well as repeat ultrasounds of the heart to ensure no further deterioration of the valve conditions or the muscles.

    Do Right by Your Valves

    MedStar Heart & Vascular Institute, we’d like to underscore the critical importance of healthy heart valves.

    Patients should be aware that valve disease can be easy to understand and easy to diagnose. And, in most cases, it’s not difficult to treat. Early diagnosis can help. A recommendation: at age 50, arrange to have an ultrasound of your heart—even if you don’t have obvious issues or symptoms.

    If you do have to come see us, MedStar Heart & Vascular Institute is well equipped to help restore your valves. We have the capacity. We have the technology. We have the skills. We’ll do our best to bring you back to good health.


    Keep heart valves healthy.

    Connect with a heart valve specialist.

    Call 202-644-9526 or  Request an Appointment

  • August 01, 2020

    By MedStar Team

    As of July 1, 2020, a single COI platform is available to all Researchers employed by MedStar Health (to include those located at MedStar Georgetown University Hospital (“MGUH”) or elsewhere on the Georgetown University campus). With the launch of a single COI platform for MedStar Health employed Researchers, the need for separate submissions through a MedStar Health platform and a Georgetown University platform will be eliminated. Both Georgetown University and MedStar Health have agreed to use the MedStar Health COI Platform for MedStar Health employed Researchers. The Questionnaire will be accessible to Researchers to submit disclosures throughout the entire fiscal year (July 1st – June 30th).

    The COI-Smart platform will meet both organizations’ research COI reporting requirements. This new process will eliminate the Georgetown University COI disclosure for those Researchers who formerly completed a MedStar Health COI questionnaire and a Georgetown University questionnaire. MedStar Health and Georgetown University COI reviewers will have access to the information reported, will review transactions and implement a consolidated research management plan.

    At the onset of a new study routing through MedStar Health/MedStar Health Research Institute or Georgetown University, in accordance with current practices, Researchers must update their COI questionnaire or verify that it is up-to-date. You will access the COI system in the same manner that you have in the past. If you held a research role at MedStar in fiscal year 2020 (FY20), you may have already entered data into the COISmart system during the fiscal year. If you have completed the questionnaire as a researcher during FY20, a link to the conflict of interest disclosure should have been sent to you.

    MedStar Health policies require that all individuals engaged in the conduct of research complete the annual conflict of interest disclosure. The annual research conflicts of interest disclosure process is designed to manage financial and nonfinancial research interests. 

    MGUH Researchers may contact Mary Schmiedel at mary.schmiedel@georgetown.edu to establish a COI-Smart COI account. If you have any questions on the COI-Smart application, please contact Carol Mason at Carolyn.m.mason@medstar.net or 410-772-6607 or Lauren Brummell at Lauren.e.brummell@medstar.net or 410-772-6578.

  • August 01, 2020

    By MedStar Team

    A collaborative team of researchers from across MedStar Health published a case report which examined the need for improved situation awareness of all telehealth operations to effectively monitor and proactively manage patient experience, healthcare provider experience, and platform performance.  The team included investigators from MedStar Health National Center for Human Factors in Healthcare, MedStar Health Research Institute, MedStar Simulation Training and Education Lab, MedStar Telehealth Innovation Center, and Georgetown University School of Medicine.

    “Rapid Development of Visualization Dashboards to Enhance Situation Awareness of COVID-19 Telehealth Initiatives at a Multi-Hospital Healthcare System” was published in Journal of the American Medical Informatics Association.  The COVID-19 pandemic has required the need for prompt acceleration of telehealth programs to lessen community spread while providing safe patient care.  The researchers used a situation awareness model and five-step process to identify operational end-user needs, along with design and develop visualizations to meet those needs.  Three stakeholder groups (healthcare system executives, telehealth leaders, and telehealth managers) were identified and provided with visualization dashboards to seek their relative needs.

    The multidisciplinary visualization team used a five-step process to support the launch and ongoing development of the telehealth program. The five steps were:

    • Subject Matter Expert Interviews to Increase Domain Knowledge
    • User Needs Analysis and Feature Identification
    • Processing Telehealth Data Sources
    • Visualization Design, Development, and Testing
    • Dissemination and Iterative Refinement

    The results show that executive stakeholders needed weekly awareness of high-level metrics and trends to convey telehealth activity across the MedStar Health system. Telehealth leaders requested daily awareness of key operational indicators to monitor telehealth operations.  Telehealth managers and team members needed detailed information about their respective areas with the ability to diagnose where issues such as increased patient volumes, poor patient experiences, or dropped calls were occurring.

    User feedback suggests the visualizations improved situational awareness and may have provided valuable information to better inform operational decisions. In the future, the researchers plan to improve data accessibility and gather more feedback from end-users for dashboard optimization.

    The study team included Raj M. Ratwani, PhD; Ethan Booker, M.D; Ram A. Dixit, M.S; Stephen Hurst, Katharine T. Adams, Christian Boxley, Kristi Lysen-Hendershot, and Sonita S. Bennett, M.S.

    Journal of the American Medical Informatics Association, DOI: 10.1093/jamia/ocaa161/5866982