A5010302798- Emergency and Acute Care Studies
- Healthcare Policy and Management
- Trauma and Emergency Care Studies
- Patient Satisfaction in Healthcare
- Acute Myocardial Infarction Research
- Primary Care and Health Outcomes
- Cardiac Arrest and Resuscitation
- Healthcare Systems and Technology
- COVID-19 and healthcare impacts
- Advanced Battery Technologies Research
- Legal principles and applications
- Law, Economics, and Judicial Systems
- Disaster Response and Management
- Heart Failure Treatment and Management
- Palliative Care and End-of-Life Issues
- Energy and Environment Impacts
- Artificial Intelligence in Healthcare and Education
- Telemedicine and Telehealth Implementation
- European and International Contract Law
- Social Media in Health Education
- Innovations in Medical Education
- Health Literacy and Information Accessibility
- Healthcare Operations and Scheduling Optimization
- Opioid Use Disorder Treatment
- Electronic Health Records Systems
Massachusetts General Hospital
2015-2024
Mass General Brigham
2024
Harvard University
2015-2023
Lemuel Shattuck Hospital
2017-2022
Harvard University Press
2020
Harvard Affiliated Emergency Medicine Residency
2017-2019
Cerner (United States)
2018
Emerson (United States)
2017-2018
Brigham and Women's Hospital
2017-2018
Vanderbilt University
2014-2016
Various initiatives are using emergency medical service personnel to address critical problems in local U.S. delivery systems, such as insufficient primary and chronic care resources, overburdened EDs, costly, fragmented urgent networks.
The COVID-19 pandemic pushed hospitals to deliver care outside of their four walls. To successfully scale virtual delivery, it is important understand how its implementation affects frontline workers, including teamwork and patient-provider interactions. We conducted in-depth interviews 17 clinicians staff involved with the Virtual Observation Unit (CVOU) in emergency department (ED) an academic hospital. program leveraged remote patient monitoring mobile integrated health care. In CVOU (vs....
Objective Understanding the pattern of population risk for coronavirus disease 2019 (COVID-19) is critically important health systems and policy makers. The objective this study was to describe association between neighborhood factors number COVID-19 cases. We hypothesized an disadvantaged neighborhoods clusters Methods analyzed data on patients presenting a large care system in Boston during February 5–May 4, 2020. used bivariate local join-count procedure determine colocation census tracts...
Background ST-segment elevation myocardial infarction (STEMI) guidelines recommend screening arriving emergency department (ED) patients for an early ECG in those with symptoms concerning ischemia. Process measures target median door-to-ECG (D2E) time of 10 minutes. Methods and Results This 3-year descriptive retrospective cohort study, including 676 ED-diagnosed STEMI from geographically diverse facilities across the United States, examines alternative approach to quantifying performance:...
Abstract Objectives Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury ( TBI ) with an intracranial hemorrhage ICH ). The purpose of this study was to evaluate the effects implementing protocol department ED observation unit and . Methods This retrospective cohort approved by institutional review board. Study subjects were ≥ 18 years age International Classification Diseases code corresponding admitted EDOU...
Patients with cancer constitute a large and increasing segment of patients who receive unscheduled hospital-based care due to treatment-related symptoms disease progression. The initial touchpoint for these hospitalizations is often the emergency department. Traditional models department inpatient are saturated incapable scaling accommodate future, increased needs projected this population. New necessary address gap. Acute home-based promising tool potentially providing patient-centric,...
We performed a retrospective cohort study of patients admitted to novel, home-based COVID Virtual Observation Unit (CVOU) from an urban, university-affiliated emergency department with ∼112,000 annual visits. Telephone-based survey questions were administered by nursing staff working the program. Of 402 enrolled in CVOU, 221 (55%) able be contacted during period; 180 (45%) agreed participate telephone interview. Overall, 95% (169 out 177) surveyed reported 8 10 on likelihood recommend CVOU...
Background: Measurement of biological indicators physiological change may be useful in evaluating the effectiveness stove models, which are intended to reduce indoor smoke exposure and potential health effects.Objectives: We examined changes exhaled carbon monoxide (CO), percentage carboxy-hemoglobin, total hemoglobin response installation a chimney model by Juntos National Program Huayatan, Peru 2008.Methods: Biomarkers were measured convenience sample comprising 35 women who met...
Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal all patients. In addition, degree which screening and diagnosis are associated improved time intervention postpercutaneous coronary outcomes, under more contemporary practice conditions, known....
Introduction: Under regulations established by the Affordable Care Act, insurance plans must meet minimum standards in order to be sold through federal Marketplace. These become a qualified health plan (QHP) include maintaining provider network sufficient assure access services. However, complexity of emergency physician (EP) employment practices – which EPs frequently serve as independent contractors departments, independently establish contracts, etc… and governing repayment may hinder...
Recent news stories have explicitly stated that patients with symptoms of COVID-19 were "turned away" from emergency departments. This commentary addresses these serious allegations, an attempt to provide the perspective academic departments (EDs) around Nation. The overarching point we wish make is EDs never deny care any person. All receive payments Medicaid and Medicare. Under Federal Emergency Medical Treatment Labor Act (EMTALA), no ED receives funding or Medicare can "turn patient. In...
The Society for Academic Emergency Medicine Board of Directors convened a task force to elucidate the current state workforce, operational, and educational issues being faced by academic medical centers related advanced practice providers (APPs). surveyed emergency department (ED) chairs residency program directors (PDs).The survey was distributed Association Chairs (AACEM)-member their respective PDs in 2021. We 125 with self-identified PDs. sampled hiring, state-independent laws, scope...
Obstet Gynecol Surv 2016;71(2):82–83 Nearly 12 million Americans are enrolled in health care coverage through the insurance marketplaces set up by Affordable Care Act. Despite a “reasonable access” standard that has been applied to ensure access of covered individuals specialty care, there concerns about network adequacy.
Abstract Objectives Earlier electrocardiogram (ECG) acquisition for ST‐elevation myocardial infarction (STEMI) is associated with earlier percutaneous coronary intervention (PCI) and better patient outcomes. However, the exact relationship between timely ECG PCI unclear. Methods We quantified influence of door‐to‐ECG (D2E) time on ECG‐to‐PCI balloon (E2B) in this three‐year retrospective cohort study, including patients from 10 geographically diverse emergency departments (EDs) co‐located a...
394 Background: Home hospital provides hospital-level care for acutely ill patients in their homes as a substitute brick-and-mortar hospitals. Since the Centers Medicare and Medicaid Services’ acute at home waiver November 2020, 330 hospitals have received approval to launch programs. Prior research has shown that cared improved physical activity, lower mortality readmission rates. However, many of these programs exclude with cancer, data describing outcomes cancer are limited. Methods: We...
Background: AHA/ACC/ESC practice guidelines advise an ECG within 10 minutes for all patients with symptoms suggestive of ST-segment elevation myocardial infarction (STEMI). This facilitates early diagnosis and timely treatment. Earlier treatment, particularly percutaneous coronary intervention (PCI), has been associated better clinical outcomes. Our objective was to quantify the impact delayed screening on treatment determine if there may be race, sex or presenting complaint disparities....
The growth in emergency department (ED) utilization has fueled speculation that uninsured patients, acutely ill Medicaid and patients without primary care providers seek from EDs at disproportionately high levels. As such, who use levels well above the general population are commonly categorized as a single group - super users. Previous studies seeking to analyze user patient have predominantly used metric of ED visits per unit time define this population, usually with threshold ranging 2 12...