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.

Wednesday, November 1, 2017

Protecting Future Patients through Research

Recently in Focus, we highlighted a project from A. Zach Hettinger, MD, MS, Medical Director and Director of Cognitive Informatics at MedStar Institute for Innovation (Mi2). The work was funded by a grant from the Agency for Healthcare Research and Quality (AHRQ). 
Much like the airline industry uses HRO as a safety net, “Context is Critical: Understanding When and Why EHR-Related Safety” will test the feasibility of using a black box methodology tied to EHRs. The official public profile has gone live on the AHRQ website!
This research has great potential for future patients, as it hopes to create evidence-based recommendations for safer EHR design that may be useful to all stakeholders, including healthcare teams. Congratulations to the research team and I look forward to seeing the results of this great work!
Airline black boxes are actually orange! Image from How Stuff Works

Tuesday, October 24, 2017

Fall Town Halls: Investing In MHRI

Thank you to all who were able to join us at a town hall! With so much going on in our business lives, it’s nice to be able to take some time and touch base on the progress we are making as a whole.

Each town hall, we try to include a safety moment that reflects MHRI as a whole. It was great to be able to open our town halls recognizing the great work of some of our associates. The following HeRO Awards were presented at the town halls. Thank you all for your commitment to HRO and patient safety, no matter your role at MedStar.

  • HeRO Good Catch Award: Ron M. Migues
  • Safety Coach HeRO Award: Rachel Campbell, RN
  • HeRO Non-clinical Award: Sarah Wright-Gaul
  • Nursing HeRO Award: Jean Flack, RN
  • Team HeRO Good Catch Award: Research Development, Planning, and Communications
Mary Anne Hinkson and Allison Keuthen were on hand to present the status of OnCore implementation and why it is so important to our associates. Thanks to those associates who shared why OnCore is helping them with their day-to-day. I was pleased to share the progress we are making in implementing a clinical pharmacy system and a new IRB program. These investments in our IT infrastructure may not affect your role specifically, but they will allow for MHRI associates to run more smoothly and efficiently.
Across the system, the first two weeks of October are the Power to Heal campaign. Thank you to all of you who have donated and thank you ALL for being ambassadors of research. We were joined by Dr. Avi Giladi and Dr. Jessica Galagarra, who shared the impact of the New Investigator fund on their research.
There were lots of updates, so be sure to check for the email that went out from Eva Hochberger for the details on the following items: CMS training, open enrollment, year-end celebrations, and flu shots.
If you have any additional questions or feedback, please contact me or use the 2-Way Communication feature on StarPort. We look forward to seeing you all in the spring!


Thursday, October 19, 2017

Sharing the Power to Heal

At UTC, we are joining in the larger MedStar initiative to create a gratitude banner. Associates have been sharing what they are grateful for over the past few weeks and it’s clear that there is an underlying theme: associates are grateful for their fellow associates.


Many of the messages on the banner highlight the great team of associates at MHRI, from those who see patients every day to those who support those teams. For the first time this year, during our associate giving campaign, you are now able to donate in honor of another associate. Please take some time this week to make an impact on the future of research and share your gratitude with a fellow associate.
Visit MedStarResearch.org/InspireHealing to make your donation today.
If you'd like to hear about the impact of the New Investigator fund, which is supported by the Power to Heal campagin, take a moment to hear from a 2016 fund recipient, Dr. Avi Giladi, research director of the Curtis National Hand  Center at MedStar Union Memorial Hospital.

Tuesday, October 17, 2017

Awarding a HeRO

Guest Blogger: Colleen A. Kelly, CCRC, CIM
Manager, Clinical Trials
Baltimore Cardiology

Joan Bardsley, MBA, RN, CDE, FAADE, Assistant VP Special Projects, presented Rachel Campbell, RN, Baltimore Cardiology Research Nurse Coordinator, with the MHRI Safety Coach HeRO Award at the MHRI Town Hall meeting.

Rachel has demonstrated exemplary commitment as the MHRI, Baltimore Cardiology Safety Coach. She is vigilant in recognizing potential safety catches and uses the HRO principles on a daily basis.  She consistently reports her safety observations every week and provides timely feedback.

In January 2017, Rachel reported a Safety Coach observation which featured her co-worker’s (Judith Raqueno, RN, BSN, Research Nurse and Heart Valve/TAVR Study Coordinator) observation.  They determined that there was a discrepancy in a subject’s final catheterization report and brought it to the attention of the Principal Investigator. The discrepancy was determined to be a dictation error and, as a result, all clinical and study documentation was immediately corrected.

The Good Catch was featured by Seth Krevat, MD and disseminated to thousands of MedStar associates across the MS system.

In addition, Rachel is an experienced Research Nurse Coordinator who cares deeply for each of her research patients and their families.

We are grateful to Rachel for her dedication to the MedStar HRO principles!

Note from Neil: In addition to Rachel, the following MHRI associates were also presented with HeRO Awards at the Fall town halls. Thank you all for your continued commitment to patient safety!
  • HeRO Good Catch Award: Ron M. Migues
  • HeRO Non-clinical Award: Sarah Wright-Gaul
  • Nursing HeRO Award: Jean Flack, RN
  • Team HeRO Good Catch Award: Research Development, Planning and Communications

Monday, October 16, 2017

Boss's Day

Who knew!  Since when did someone make up 'Boss's Day'?

So, you can imagine how surprised I was this morning to see a new plant and a fancy balloon in my office! Karen Wade was also the recipient of a great balloon for Boss’s Day today.  Thank you to such a great team - you made my day!

Friday, October 13, 2017

The Ultimate Fan

Late last night, as thousands of devastated fans left Nationals Stadium after a hard fought, but ultimately futile fight to stay in the playoffs, there was at least one MHRI associate celebrating her Cub's victory.  All right Michelle, good thing you are so beloved at work!

Wednesday, October 4, 2017

Contributing to Advance Health. It all Contributes to The Power to Heal.

On Monday, Oct. 2, MedStar Health launched the 2017 Power to Heal Campaign: Gratitude has the Power to Heal. This initiative, which runs through Friday, Oct. 20, invites you to further your positive impact on patient experience at MedStar Health Research Institute.

Guest Blogger: Kristi Rasmussen, CFRE
Director of Philanthropy
MedStar Good Samaritan Hospital and Research at MedStar Health

In the simplest definition, the Greek word “philanthropy” means the love of humankind. Across MedStar Health, gratitude and philanthropy go hand in hand - a natural extension of the caring and compassionate work we do every day at MedStar Health. Philanthropy is the result of the desire to do more…to make a positive impact on the lives of others from the gratitude we feel.

We celebrate our growing culture of gratitude by creating awareness about philanthropy and how it can be meaningful to our patients and families. Research shows that expressing gratitude can make people feel more positive and happy - and can deepen our relationships with one another. The great research taking place at MedStar Health improves patient safety, patient outcomes, patient care; therefore impacting the overall patient experience.  Gratitude for research is growing, and our patients and their families  want to be engaged with important people doing important work.

We are grateful to everyone who participated in last year’s Power to Heal Campaign by supporting research at MedStar Health.  Your gifts helped to establish the careers of five new investigators who advanced the health for patients resulting in better outcomes, patient safety, and quality. Research from these investigators included:
  • Mitigate physician and nurse error in the emergency room; ultimately improving patient safety and quality
  • Provide a body of evidence on significant research on transplant recipients, which will ultimately improve transplant outcomes
  • Evaluate payment reform on patient care and quality which could impact healthcare policy going forward
Learn more about the campaign
and download the flyer here.

Again, this year, commitments designated to Research at MedStar Health will support the New Investigator’s Grant Fund. Five new investigators will be selected.  I encourage you to join me during the three-week campaign and discover your Power to Heal. Remember – every level of participation is valued; it’s about choosing to invest and choosing to make a difference.

Visit MedStarResearch.org/InspireHealing to learn more and chose to make a difference.

Monday, October 2, 2017

Our Power to Heal Together

Below is my monthly message for the October2017 edition of the MHRI newsletter, Focus. You can view Focus online at MedStarResearch.org/FOCUS.

Friends and Colleagues,

Last week, an MHRI Board member from Houston shared his personal experience and his hospital’s response in the days following Hurricane Harvey as the safety moment.

“All of a sudden, there were just two types of people: Those that needed help and those that were providing help.”
What a statement. I suspect a similar thing is also happening right now in Puerto Rico, Florida, and Mexico.

From the Wall Street Journal
Last month, I wrote about confronting challenges together. To me, the key part of that is “together”. Together we can do much more than we can as individuals. During a natural disaster, that concept becomes eminently obvious. However, this concept should not be forgotten in our day-to-day activities.

The MedStar Power to Heal philanthropy campaign is an opportunity for us to do something together that none of us can do alone. This campaign, which runs through Friday, Oct. 20, encourages associates, clinicians and those in our broader MedStar community to come together and collectively help strengthen our future. If you decide to select “Research at MedStar” then your donation will go towards the “New Investigator Grant” fund. These grants supports scientific research by new MedStar investigators so they can launch their academic career at MedStar, get pilot data and better position themselves to become an independent investigator competitive for external grants.

With last year’s donations, we were able to fund five new investigators in research ranging from transplantation to breast cancer and from emergency medicine to neonatal stress. In fact, one of our new investigator grant recipients used the pilot data and already successfully secured his first R01 NIH grant!

Please take a moment to read how YOU have made a difference and consider giving once again to the Giving: The Power to Heal campaign by visiting MedStarResearch.org/InspireHealing and selecting “Research at MedStar” in the drop-down menu.

Research is a team sport. Yes, that certainly includes the investigators, coordinators and others on the MHRI research and administrative team. I feel it is a gift to work with such dedicated and talented people. Now it is time for you to receive that same gift and join the research team by giving. We all understand the value of advancing health through research and want you to ‘jump on board’ and join the team by visiting
MedStarResearch.org/InspireHealing today….. and thank you!


Read Focus at MedStarResearch.org/FOCUS.

Friday, September 22, 2017

Sailing into a MedStar Teaching and Research Scholars Retreat

Well, this was a first for me! Soon after arriving at a conference center in Wye River (just over the Chesapeake Bay Bridge) for the MedStar Teaching and Research Scholars off-site meeting, we were asked to gather up for a "team building" experience. We were then led down to the dock where a sailboat was waiting to take us out on the calm waters. It was a perfect evening and a great way to kick off a 2-day educational conference. If only all meetings could start like this!

After we came back in from sailing, we got down to work with presentations and conversation about educational scholarship. Then the first year Teaching Scholars presented their work in progress for feedback. It should be a great few days!

Wednesday, September 20, 2017

Georgetown Med Student Summer Research Capstone

Tuesday night marked the closing of another successful summer of research for many of our rising second-year medical students at Georgetown.
Between MHRI, MedStar Health Academic Affairs, and Georgetown University, nearly 75 students received the opportunity to conduct research over their 8-week summer break between the first and second year of medical school. This research culminated in a capstone event at the French Embassy, with MedStar and Georgetown leadership in attendance.

I was honored to introduce the speakers who presented their research to the group in the auditorium. Each time they shared their summer research experience, I was reminded of my first forays into research between my first two years of medical school and how much it impacted the rest of professional life.

Congratulations to all students on a successful research project and I hope that this summer opened the door for all of you into fulfillment of research and scientific inquiry that will carry with you throughout your careers.

Saturday, September 16, 2017

The Monthly MCCRC Staff Meeting

I had the pleasure of attending the monthly MedStar Community Clinical Research Center (MCCRC) staff meeting this week. While I was invited because there was a recent change in principal investigator, I also wanted to answer questions about the day-to-day issues at MCCRC.  What I was not expecting was for people to ask me how I ended up in research and at MedStar.

While that sorry is too long for this blog, I enjoyed sharing it - my travels as a clinician, an educator, an investigator and now in administration. Since MCCRC does outpatient research, one highlight in my career that seemed to resonate with the group was my wild 'ride' when I got involved in a diet pill study (20 years ago!) that went from first patient enrolled to New England Journal of Medicine in just one year! 

Becky K. Montalvo, Executive Director of MCCRC, brings together her associates from Baltimore, UTC and Capital Hill each month to not only share administrative updates with her team, but also to bring in another MHRI associates to share how they developed into their current role. It’s a great view of professional development from the ground up. Thanks for the invite and it was great to share!