Tuesday, December 5, 2017

NIH Building a Local Clinical Research Network?

On Friday I attended an exciting meeting at National Institutes of Health (NIH) exploring the possibility of building a local clinical trials network.  The NIH leadership wanted to explore the interest of regional healthcare research leaders, from Virginia (UVA and VCU), DC (Georgetown, MedStar, GW, Childrens, Howard, USUHS/Walter Reed), Baltimore (Hopkins, U of MD, MedStar) to Philadelphia (HUP and CHOP).  I was very pleased that MedStar was 'at the table' with these other great medical research organizations.

The day started out with Francis Collins (NIH Director) welcoming us and setting the stage of possibilities.  Then John Gallin (Chief Scientific Officer) and James Gilman (CEO of the Clin Center at NIH) explained how the NIH hospital, the largest hospital in the U.S. dedicated to research, has enormous resources that could potentially be shared with regional investigators.  Furthermore, the NIH could facilitate other types of peer-to-peer research organizational collaboration.

Then we heard about the challenges for building a clinical research network from Rob Califf, the former FDA Commissioner (who currently spends half his time as Vice Chancellor for Health Data Science at Duke and half his time at Google spin-off Verily Life Science) which set the stage for a robust discussion of 'what is possible together.'

At the end of the day, we all agreed that there is potential for such a regional network and committed to continue to work on it together.

Monday, December 4, 2017

Stepping Away from the Routine

Below is my monthly message for the December 2017 edition of the MHRI newsletter, Focus. You can view Focus online at MedStarResearch.org/FOCUS.

Friends and Colleagues,

I hope everyone had a great Thanksgiving and you are now getting into the end-of-year holiday spirit.

Along with the holiday celebrations, the season is a wonderful reprieve from the routine. It’s a chance to take a breath and relax. It is also a chance to reflect and appreciate.
I recently took a BIG step away from the routine, which gave me an unprecedented chance to reflect and appreciate. It has been a long-time desire of mine to do volunteer work in a medically underserved area. I wanted to be able to use my experience in cardiac ultrasound to make a difference. After realizing that I could keep putting this off forever, I finally decided to do it.

Last month I went to Africa to volunteer with Team Heart. Team Heart is a non-profit organization dedicated to increasing access to medical care in Rwanda. In a country with only two cardiologists (yes, only two in the entire country!) where rheumatic heart disease (a consequence of untreated strep throat) remains rampant, there is a big need for volunteers with cardiac expertise. My job was to help train the nurses, doctors and staff physicians how to use cardiac ultrasound to identify rheumatic heart disease and other disorders of the heart. With support from the Rwanda Ministry of Health, our volunteer team brought new, laptop-sized cardiac ultrasound machines to four hospitals.

Having worked in healthcare for over 30 years and seen many clinical situations, I was amazed by the clinical staff’s level of dedication, creativity, and resourcefulness. They did whatever was needed to care for their patients. Despite knowing what was possible in places with modern healthcare (because of online textbooks and other tools), they never got discouraged. This is often despite not having basic things we take for granted all the time—and I am not only referring to materials like antibiotics, ECG leads or IV saline. Basic things we never think of, like electricity, would routinely go out each day for a few minutes! Nonetheless, each patient, every day was approached with a ‘can do’ attitude utilizing whatever was available. On top of it all, everyone I met was so incredibly nice and grateful for what they had. It is true: when you have little, you really appreciate the things you do have so much more.

While they were appreciative of our time and expertise, I feel that I received far more than I gave. It’s just like tonight’s supermoon (when the moon appears larger-than-usual), using the time to reflect as you step away from the routine showed me things in my life “larger-than-usual”.
The 2016 supermoon
by David Zvonaƙ on Unsplash
Let me take this end-of-year opportunity to also thank you – thank you for taking the time to read this monthly column and for your frequent comments. It’s great when a message resonates or touches someone else. Thank you also for the privilege of working with you each day on our meaningful work here at MedStar.

If you want to see some pictures from Rwanda, they are posted on my blog, Notes from Neil.

Very best wishes for a joyful and healthy (and reflective) holiday season! I look forward to working with you in 2018 to advance health for our community today and tomorrow.  Enjoy this month’s FOCUS e-Newsletter below.


Read Focus at MedStarResearch.org/FOCUS.

Tuesday, November 21, 2017

Happy Thanksgiving

In the spirit of the season, and in the spirit of gratitude, thank you all for advancing health through research at MedStar.  We have had a great year and none of this would have been possible without you!

Enjoy the Thanksgiving holiday with your family and friends.  I hope you have a chance to take a moment during your festivities to reflect and be grateful for what we have and what we are doing each day to advance health.

Happy Thanksgiving Day to you and your loved ones.

Saturday, November 18, 2017

Sharing My Mission Experience with Team Heart

We all work very hard and every now and then, it is good to step back and put it all into perspective.

Last week, I took a week off from work to fulfill something I have wanted to do for a long time -  I went to Africa to volunteer with Team Heart.  Team Heart is a non-profit organization dedicated to increasing access to medical care in Rwanda. In a country with only 2 cardiologist (yes, only 2 in the entire country!) where rheumatic heart disease (a consequence of untreated strep throat) remains rampant, the need remains great for volunteers.

With support from the Rwanda Ministry of Health, our volunteer team brought new (laptop size) cardiac ultrasound machines to four hospitals and spent time working with the staff to train them to do echocardiograms to diagnose rheumatic heart disease and other cardiac abnormalities.  The clinical staff was amazing - they were so knowledgeable, dedicated and extraordinarily nice, all in the face of remarkably restricted resources - even things like uninterrupted electricity should not be taken for granted!

While they were very appreciative of my time and teaching, I feel that I received far more than I gave. 

Attached are a few pictures from my time in Butare University Hospital, a hospital in the southern part of Rwanda in which I spent most of my time.  In these pictures, you can see the hospital inpatient wards (typically with 8-10 patients per room).  The hospital (below) looks like a typical community hospital from the outside but has about 800 beds inside!  Below is also a picture of me with Dr. JP Sibomana, the internal medicine physician who is single handedly starting an echo service for the hospital.

Once a week physicians from across the hospital come together for a multi-disciplinary grand rounds.  In this photo, I was one of 3 lectures (involving internal medicine, ENT and Ob/GYN) on how to manage rheumatic heart disease and prosthetic valves in a women who is pregnant and in heart failure.

And it was not only about medicine.  The country is beautiful and full of life.  We took one day to drive through one of the national parks where there are all types of animals freely roaming, just as you would expect in Africa!


Thursday, November 16, 2017

Investigator Orientation

Twice a year, we welcome MedStar investigators at the UTC offices for a full day of Investigator Orientation. Hosted by our Office of Research Development, Planning and Communications, the day is packed full of information to help investigators make the most of their work at MedStar.

The day covers the importance of research at MedStar to the structure of our Scientific Centers. Time is devoted to the proposal development stage and resources that MHRI has to offer investigators. We also cover how the EHR can be used to support your research.

It’s always a great day to meet other investigators and the team that MHRI has to support research. Thank you to our planning team and those who were able to attend. If you are interested in attending our spring orientation, contact Research@medstar.net.

Monday, November 13, 2017

Asking Questions

Guest Blogger: Eva HochbergerMarketing & Communications Coordinator, Office of Research Development, Planning & Communications

I was invited to attend the 2017 Mi2 Forum recently, and it always covers lots of ground in one day. This year’s event, called “Framechangers” gave me lots of food for thought in terms of what we can bring to the table in the future. There was an underlying theme of asking questions. Working for the research institute means that I work with associates and investigators who have made their career out of asking questions.

Donna Harris

What makes the Mi2 Forum stand out from other events is that they invite associates from every level and entity of MedStar Health. My table included a resident at MWHC (who does research!), a coordinator on our Health Services Research team, a member of the Organizational Effectiveness team, two outside guests and a lawyer. Bringing together all these perspectives to listen to speakers on topics ranging from neurosurgery and horses to interviewing on CNN or where we can get good ideas allows for all of us to grow.

So, what questions did I walk away with?
  1. Don’t only ask what’s the best way to do something, ask why are we doing it at all? (Donna Harris)
  2. How can we combine both intellect and imagination? (Frank Sesno)
  3. What are the coffee houses of the future? How do they foster collaboration and development? (Steven Johnson)
  4. Is there a way to think more like prey than a predator? (Allan Hamilton)
  5. Why is the Singularity always named Bob? (Michael Gilliam)

A "fireside chat" with Frank Sesno and Mark Smith
The event is also live-streamed and recorded, if you want to take some time and work on your professional development. The the livestream videos are available now, and fully polished videos will be coming soon at https://mi2.medstarhealth.org/hub/forum/

Monday, November 6, 2017

How Do Lobsters Grow?

Below is my monthly message for the November 2017 edition of the MHRI newsletter, Focus. You can view Focus online at MedStarResearch.org/FOCUS.

Friends and Colleagues,

Do you have any idea ‘How Do Lobsters Grow’?

This odd question was put forward at a physician leadership development course earlier this year and has stuck with me ever since. Many don’t realize this, but lobsters are soft, mushy creatures that live in a rigid, hard shell. The shell, obviously, can’t be too big nor too small, so this naturally begs the question...how do lobsters grow?

In a short, compelling video by Rabbi Dr. Abraham Twerski, he explains that as the shell starts to become confining, the lobster feels increased pressure and grows uncomfortable. This stimulates the lobster to crawl under a rock, cast off the shell and produce a new one. The lobster will keep repeating this routine whenever the constraint of the hard shell causes discomfort and stress. He effectively makes the point that the stimulus for the lobster to be able to grow is that it feels uncomfortable. That means that times of stress are also signals for times of growth.

Wow…That is a powerful message and has stayed with me. We all experience times of stress. Stressful experiences are often painful, frustrating and disheartening. They can bring out the worse in us, even when we don’t want it to. However, what if you keep Dr. Twerski’s lobster story in your head and recognize that these stressful times are actually times of growth? Wow, that changes everything!

I was thinking of Dr. Twerski’s video over the last few weeks as we finished our MHRI Fall Town Halls. A major portion of the meeting was dedicated to the IT investments MHRI is making to enhance our infrastructure for clinical trials across the system. In the last few months, we have: 1) gone live with OnCore, a clinical trial management system which handles all aspects of a trial from patient enrollment to sponsor billing, 2) started the installation of PowerTrials, a new feature in the Cerner EHR that will allow for viewing of clinical research information within a patient’s health record, 3) disseminated Vestigo, an IT platform for research pharmacists, across the system and 4) decided on a new IRB electronic system which we will install with our partners at Georgetown so all investigators, at Georgetown and MedStar, can use one IRB system.

That is a lot of change happening in a short period of time and will undoubtedly stress all members of the research team. While the implementation and roll-out of these systems has taken substantial planning with roadblocks along the way, it is the change that is necessary for us to keep growing as an organization. Times of stress are also the signals of growth. I am excited to think about our future-state when all of these IT platforms are fully implemented with automatic interfaces allowing for efficient management, improved communication and enhanced utility of clinical trials for all our patients. It hasn’t been easy, but we can at least thank lobsters for showing us how to grow!

Enjoy this month’s research e-newsletter and thank you for contributing to our growth!


Read Focus at MedStarResearch.org/FOCUS.