A5017043766- Palliative Care and End-of-Life Issues
- Patient Dignity and Privacy
- Childhood Cancer Survivors' Quality of Life
- Cancer survivorship and care
- Patient-Provider Communication in Healthcare
- Ethics in medical practice
- Electronic Health Records Systems
- Economic and Financial Impacts of Cancer
- Telemedicine and Telehealth Implementation
- Colorectal and Anal Carcinomas
- Medical and Health Sciences Research
- Digital Mental Health Interventions
- Youth, Drugs, and Violence
- Innovations in Medical Education
- Biosimilars and Bioanalytical Methods
- Migration, Health and Trauma
- Educational and Social Studies
- Radiomics and Machine Learning in Medical Imaging
- Healthcare Systems and Public Health
- Adolescent and Pediatric Healthcare
- Multiple and Secondary Primary Cancers
- Literary and Cultural Studies
- Health, Nursing, Elderly Care
- Mobile Health and mHealth Applications
- Clinical Laboratory Practices and Quality Control
Memorial Sloan Kettering Cancer Center
2018-2024
National Center on Addiction and Substance Abuse at Columbia University
2017
Columbia University
2016
Universidad Santo Tomás
1988-1990
Prior work to integrate early palliative care in oncology has focused on patients with advanced cancer and primarily consultation. We developed this outpatient clinic initiative for newly diagnosed at any stage, emphasizing primary (nonspecialist) by teams, enhanced access specialists.We piloted the project two medical specialty clinics (for myelodysplastic syndrome GI cancer, respectively) establish feasibility. On a visit-based schedule, systematically reported symptoms,...
Improving care transitions for patients with cancer discharged from the hospital is considered an important component of quality care. Digital monitoring has potential to better delivery transitional through improved patient-provider communication and enhanced symptom management. However, remote patient (RPM) interventions have not been widely implemented oncology after discharge, innovative setting in which apply this technology.
The COVID-19 pandemic has shined a harsh light on critical deficiency in our health care system: inability to access important information about patients' values, goals, and preferences the electronic record (EHR). At Memorial Sloan Kettering Cancer Center (MSK), we have integrated systematized health-related values discussions led by oncology nurses for newly diagnosed cancer patients as part of routine comprehensive care. Such conversations include not only patient's wishes at end life but...
Advance care planning, the process through which patient values and goals are explored documented, is a core quality indicator in cancer care. However, predominantly elicited at end of life; earlier serious illness not clearly delineated. The objective this analysis to assess content patient-verified summaries health-related among newly diagnosed outpatients order develop theoretical framework guide future discussions optimize person-centered oncologic care.Values patients with...
Laparoscopic cholecystectomy plays a central role in the treatment of patients with gallstones and is gold standard for management. Total situs inversus (TSI) rare congenital anomaly which there transposition thoracic abdominal organs, resulting mirror-image left-right configuration normal anatomical placement organs. TSI affects less than 0.01% population. We present case 68-year-old male cholelithiasis TSI, managed laparoscopic using American mirror technique such patients, reporting...
While there is a growing body of literature on medical mistrust and its relevance to public health, research formerly incarcerated Black Latino men their perception toward providers institutions remains scant. Very little known about whether clinical given previous experiences with the criminal justice system. It important determine play key role in health behaviors released men. The purpose this study validate assess psychometric properties Group-Based Medical Mistrust Scale for use among...
Goals of care (GOC) documentation is important but underused. We aimed to improve oncologist GOC and end-of-life (EOL) care.In April 2020, our cancer center launched a note template, including optional fields for documenting discussion with the patient about: natural history, goals, and/or EOL (resuscitation preferences, hospice receptivity). Associations between notes were evaluated.Among 1721 patients dying June 1, 2020 30, 2021, median days from first (± discussion) death was 92, whereas...
Brazil has a sizable alcohol and substance use disorder (ASUD) population, yet there are considerable gaps in treatment access retention. ASUD, chronic medical condition, is highly comorbid with behavioral health disorders. This indicates need for more targeted interventions order to achieve care integration (a major goal of Brazil's system). Care management - that is, the organization patient by an institution viable strategy engage individuals ASUD who might benefit from but not aware or...
High-quality cancer care must incorporate patients' personal values in decision making throughout illness. Unfortunately, patient are neither consistently elicited nor easily accessible the electronic health record (EHR). Memorial Sloan Kettering Cancer Center is deploying a major EHR innovation, called Patient Values Tab, which provides ready access to and personhood. To inform Tab's design, we interviewed large, diverse group of institutional stakeholders understand their user needs for...
Abstract Background Goals of care discussions are infrequently documented in the preoperative period. Furthermore, documentation does not consistently address what matters most to patients, although patient values (PV) central person‐centered care. Methods A multidisciplinary working group was formed. An electronic note comprised (1) topics discussion, (2) PV, and (3) advance planning (ACP), created embedded into existing templates for Gynecologic Surgical Oncology. Surgeons advanced...
Abstract Background Assessment of illness and treatment understanding among cancer patients has largely focused on those with advanced disease. Less is known about patient expectations at earlier stages potential modifiers accurate understanding. Methods We assessed accuracy cure in across all gastrointestinal (GI) cancers. Accuracy was determined by independent reviews health records oncologists the investigative team. Impact selected clinical variables health‐information preferences...
Modern cancer care is costly and logistically burdensome for patients their families despite an expansion of technology medical advances that create the opportunity novel approaches to care. Therefore, there a growing appreciation need leverage these innovations make more patient centered convenient. The Memorial Sloan Kettering Making Telehealth Delivery Cancer Care at Home Efficient Safe Research Center National Institute-designated funded Excellence poised generate evidence necessary...
Abstract Time toxicity is a considerable burden for oncology patients. This study evaluated the feasibility and acceptability of integrating mobile phlebotomy into standard care procedures. From September 26, 2022, through December 31, 2023, total 345 patients had 1464 home laboratory test collection visits completed. These occurred in New York (68.6% visits), Jersey (29.9%), Connecticut (1.1%), Pennsylvania (0.5%). Specimen quality surpassed Memorial Sloan Kettering Department Pathology...
To describe the development and implementation of a novel tool designed to enhance nurse-patient communication in major academic cancer center, which nurses can learn quickly, incorporate into their primary palliative care practice, broadly disseminate order improve patient experience.An evidence-based empathic educational program were provide essential skills oncology having discussions with patients about personal values. Evaluation included nurse focus groups, pre- post-course evaluations...
Objectives Evidence-based guidelines call for integration of palliative care within oncology from diagnosis. Misperceptions about have impeded implementation. Prior research has not examined perceptions ‘palliative care’ versus ‘supportive among patients and caregivers to whom this is introduced routinely as part comprehensive cancer care. We conducted a qualitative study with myelodysplastic syndromes (MDS) their informal elicit before after they received integrated primary/specialist...
410 Background: Electronic patient-reported symptom assessment surveys are used in remote monitoring interventions to connect care between the patient and clinical providers through technology with mobile devices portals. Patient responses assessments generate alerts sent clinicians who proactively manage patient’s symptoms at home. This study’s purpose was determine feasibility of implementing a program community-based hospital cancer institute. Methods: We explored models assess...
Remote patient monitoring (RPM) aims to improve access care and communication with clinical providers. Overall, understanding the usability of RPM applications their influence on workflows is limited from perspectives clinician end users at a cancer center in Northeastern United States. This study explore functionality elicit perceptions experiences oncology clinicians using for patients after hospital discharge. The sample included 30 98 (31% response rate) managing least 5 program...
e24146 Background: Patient-reported outcome (PRO) technology offers opportunities to address research questions and unmet clinical needs of cancer patients’ ITU. We tested the feasibility PRO assessment Methods: With same 5-item questionnaire (2 open- [about expectations treatment intent] 3 validated [Weeks JC NEJM 2012] closed-ended items) administered by medical oncology nurses in clinic a previous pilot (Shin P ASCO 2020), we used electronic patient portal our center elicit responses from...