Hear our ECHO by Gila Hoffman

Hear our ECHO

Spring2014 2014 Winter

Linking ECHO patients to primary care providers Access to continuous and consistent primary care treatment drastically improves medical outcomes. Patients who visit primary care providers are more likely to receive regularly scheduled preventative screening tests, for example. Unfortunately, access to continuous care is limited in low-income areas like the Bronx. Thankfully, increasing the number of patients with primar care doctors, arguably one of Take Care New York’s (TCNY) most essential goals, has also been one of the most successful. In only the first couple of years since its inception, the number of patients without continuous care in New York has decreased by over 350,000 and the percentage of low-income adults with-

Daniel Santos ‘17 Weekly Coordinator

out continuous healthcare has dropped from 15.8% to 13.2%. The ECHO Free Clinic played a large role in this endeavor. One of the clinic’s primary objectives has been to link its patients with regular healthcare providers. For years ECHO has provided free, comprehensive health care to the uninsured population of the Bronx. In recent years, in concordance with the aims of TCNY, ECHO has focused primarily on helping to link its patients with primary care doctors while still providing quality free care. Patients at ECHO are offered two free visits at the clinic, providing for any acute medical needs while emphasizing preventative care. Patients with chronic illnesses are allotted two extra visits, for a total of four, due to the complicated nature of their disease. ECHO volunteers HEALTHCARE, 2

Alumni Spotlight: The ECHO journey of Dr. Juan Robles Pooja Sheth ‘18

Community Outreach Volunteer

Dr. Juan Robles, an alum of the Albert Einstein College of Medicine, has been an avid contributor to the ECHO Free Clinic ever since he was a pre-medical student in 2005. Dr. Robles is an ideal example of how the ECHO Free Clinic has a major impact not only on those it serves, but also the students and physicians who volunteer for the clinic. Dr. Robles is a chief resident and is in the process of credentialing to become a preceptor at ECHO. Dr. Robles was born in Honduras and moved to the Bronx at the age of

13. He graduated from Einstein in 2011 and has been completing his residency in Family and Social Medicine at Montefiore Medical Center. While serving as Co-Chief Resident of his program at Montefiore Hospital, Dr. Robles also sees patients at The Family Health Center where he continues to see patients in the underserved populations of the Bronx. In 2005 Dr. Robles had his first encounter with the ECHO Free Clinic as a pre-medical student, when he volunteered as an interpreter for Spanish-speaking patients. Since he grew up in close proximity to the clinic, he felt this to be an opportunity to give back to his community. ALUMNI, 2

In this Issue:

ECHO 5K: 4-5

Volunteer Spotlight: 6

Cancer Education: 7

Dr. Juan Robles got his start at ECHO as a pre-medical volunteer and now serves as a CoChief Resident of the Family and Social Medicine at Montefiore.

ECHO transitions patients to continuous healthcare providers are then trained to identify, support, and help transition patients from their final free visit to primary care healthcare providers. These providers include, but are not limited to, the Walton Family Health Center, other New York primary care clinics associated with the Institute of Family Health or primary care clinics in the greater New York Area. These clinics operate daily on an income based sliding-scale fee system. In this way, ECHO not only provides initial free care for a large number of patients, but also increases the number of patients who have access to primary care doctors. Successful transitioning of our patients requires the cooperative efforts of every volunteer. Our front desk volunteers are essential in initiating the task. They register and identify patients during their final visit, ensuring that the clinical teams are aware of their transitioning status. Patient advocates speak with and educate these patients on the importance of maintaining continuous care. They then guide patients through the process of transitioning to the weekday Walton Family Health Center clinic before the end of their HEALTHCARE, 1

visit. If specialty care is needed, the referral volunteers guarantee that these patients schedule appointments at the appropriate clinics. Finally, the Walton staff and social workers who see ECHO free clinic patients on Saturday are critical in completing the process. They confirm that these patients are successfully transitioned and help them enroll in a health plan if they qualify for insurance. Thanks to these unified efforts, nearly 100% of ECHO patients were successfully offered the opportunity to transition to regular healthcare provid-

ers after their final visit last year. We continue to strive toward improving our patients’ access to continuous care. Recent advancements help ensure that our patients are provided quality care after their time at ECHO. New volunteer positions have been created specially to look out for transitioning patients and new protocols are being placed to make regular follow-up phone calls to recently transitioned patients. ECHO has become a stepping stone for access to high-quality care in the Central Bronx, and we are dedicated to supporting all of our patients.

Patients without a regular doctor are less likely to receive vital exams and preventative care than patients who do visit a doctor regularly. Source: NYC Community Health Survey

Alum Dr. Juan Robles recounts his time with ECHO The feeling persisted as he started at Einstein. Dr. Robles continued to stay involved in ECHO as a medical student. “I have so many memories of wonderful patient interactions, working with medical students, and working with Dr. Cortijo,” Dr Robles said. It is no wonder that Dr. Robles continues his involvement at ECHO as an attending physician today. He believes that while ECHO enabled him to give back to his community, he himself has also gained and ALUMNI, 1

been influenced through his experiences at the clinic. “ECHO considerably shaped the doctor I am today: social medicine oriented, advocating for the underprivileged, and making a difference in the youngsters through mentorship.” Dr. Robles, reflecting on his experiences, offers guidance for what he believes would strengthen the ECHO Free Clinic even more. “I definitely want ECHO to continue its mission to care for the uninsured and underserved individuals in our community. I also envision ECHO partnering up with other com-

munity organizations and to expand on women’s health services.” As an advocate for helping underserved populations, Dr. Robles would very much like to see ECHO expand its reach and capabilities. And of course, Dr. Robles would also like to impart his encouragement to those students and physicians who currently volunteer with ECHO. “I encouraged every volunteer to enjoy this wonderful opportunity to make an impact in the lives of others. This is what medicine and service to the community are all about it!”

ECHO takes the Colon Cancer Challenge Melissa Bhikham ‘17

Community Outreach Coordinator

To promote colon cancer awareness in the Bronx, on June 11, 2014, Michael Tseng, Nico DelPiccolo, Jessica Faiz, and Melissa Bhikham (pictured) volunteered with the Colon Cancer Challenge Foundation (CCCF) at the Owen F. Dolen Park. CCCF is a non-profit dedicated to a world without colorectal cancer through awareness, prevention, screening, and research. For this organization, taking “the challenge” is a five step process: get the facts about colorectal cancer, talk to your family, discuss it with your doctor, get screened, and spread the word about colon cancer and how to prevent and treat it. Throughout the day, ECHO volunteers along with Catherine Montaldo, the Executive Director of CCCF, and

Marcline Saint-Germain, an employee for the charity handed out free giveaways, brochures, and pamphlets outlining treatment and prevention methods to those at the event. The CCCF also brought the Rollin’ Colon, a 20-foot long, 12-foot high inflatable human colon. ECHO volunteers gave tours through the exhibit to inform the local community about signs and symptoms of colorectal cancer as well as other diseases, such as Crohn’s Disease. Catherine Montaldo said, “Access to quality health care and health information is such an important issue in the Bronx and we appreciate all the help they gave us in getting the word out about the need to get screened.” Through the Colon Cancer Foundation ECHO is able to provide all non-symptomatic patients free screening colonoscopies.

ECHO Continuity Chair: Marika Osterbur ‘19 Where are you from? Arlington, Massachusetts Where did you go to undergrad? University of Rochester What is your favorite thing about ECHO: As a first year Medical Scientist Training Program student, volunteering at ECHO was a great way to acquire further patient experience and to meet my medical student classmates. As I’ve progressed in my medical training, I have loved playing a role in how the clinic runs. Being a part of ECHO continually teaches me about medicine, leadership and the importance of being open to new ideas. I am a better person and will be a better doctor because of my in-

volvement with the clinic. If a million dollars was given to ECHO what would you do with it? I would want to create an ECHO scholarship fund aimed at helping underserved students from the Bronx pursue careers in healthcare. What do you hope to leave with ECHO? First, I hope that ECHO never loses the sense of community amongst the board and volunteers. Second, I know that people sometimes get caught up in the improvements they have planned for the clinic that they forget to appreciate every Saturday in clinic. If patients receive care that they would not have been able to access otherwise, it is a great day. Everyone should be proud of their accomplishments and the effort they put into serving our patients.

New initiatives in peer-to-peer education Alyssa Liguori ‘18 Labs Volunteer

Wayne Cohen-Levy, a fourthyear medical student, was inspired to create and introduce the concept of teaching modules at ECHO clinic after noting the positive impact that great educators had in his own medical training. He recalls specific interns and residents who dedicated time to help him improve his clinical knowledge and sought to bring that same spirit of teaching and learning to ECHO. Cohen-Levy’s first push was to work with a team of other fourth and second year students to determine specific topics relevant to family medicine and the patient population at ECHO. The team decided on topics such as hormonal contraception, thyroid disorders, and anemia that affect many of the patients seen at clinic. Then, they developed materials including information sheets and sample cases that would be used by third and fourth year medical students to educate first year medical students and pre-health volunteers. As Cohen-Levy continues to develop the implementation, he hopes the teaching modules will serve two main purposes. First, he would like for the modules to help the firstyear student volunteers connect basic science coursework to clinical care in the area of family medicine. Second, he hopes that the modules will allow third and fourth-year students to gain valuable experience as educators. Cohen-Levy and the rest of the ECHO team are excited to see the impact that this innovation could have in fostering a culture of education around family medicine at ECHO.

ECHO

ECHO’s annual race draws 7

Melvin Joice ‘18 On the surprisingly brisk morning of August 24, 2014 over 70 students and friends of the Einstein Front Desk Volunteer community joined together for the annual ECHO 5K race. Participants met in the housing courtyard and were greeted with running bibs, electric blue T-shirts specially designed for the event, and coffee donated by the neighborhood Starbucks. Once all the runners registered, race officials directed them to the starting line on Stillwell Avenue where police from the Bronx 49 Precinct Police Department blocked traffic for the race’s start. The race was an outand-back course that began on Stillwell Avenue, continued onto Pelham Parkway, and wound along the Hutchinson River Parkway until the halfway point where runners turned around and ran back to the start. At the end of the race, runners congregated to cheer on remaining participants, take group photos, stretch, and refuel with bananas, coffee and other snacks. Michael Willcockson and Katie Stiles were announced winners and each was gifted, by tradition, a tasteful bottle of red wine.

O 5K

70 runners, raises over $1000

“The most exciting thing about the 5K was seeing how many people came out to support ECHO’s cause. They were all surprised by how fun the event was, and encouraged us to do another one in the Spring.” said Michael Tseng, the ECHO Development Officer and organizer of the race. Overall, said Tseng, the race raised over $1,000 to benefit ECHO. As the first big event of the 2014-2015 year, first-year students perceived the intense camaraderie that characterizes the ECHO and Einstein communities. “I ran because I wanted to support ECHO and because, as a budding first year, I wanted to have shared experiences with school-mates. The run was fun! I ran faster than I usually do and bonded with some classmates,” said first-year medical student Dahlia Norry. Norry’s interest in community was echoed by second-year Aaron Praiss who said, “Just seeing all the people who came out for this event reminded me of what ECHO is all about – community – and made me smile.” Photos taken by David Molho Design by Olivia Low and Melvin Joice

A message from Sarp Aksel ‘15, Executive Clinic Chair For many Einstein students, the icated their time at Einstein remains an Einstein Community Health Outreach on-going priority. (ECHO) Free Clinic embodies one of At ECHO, we are constantly lookthe most formative expeing to improve the clinic riences of their medical experience for patients education. and student volunteers As the first student-run alike. Ensuring that the free clinic in the New York changes we implement are metropolitan area, ECHO thoughtful, goal-directed offers a dynamic environand measured with approment where high-quality priate outcome measures patient care and unparalis always a priority. Trainleled medical education ing student researchers is exist in harmony. one way that we are workIn efforts to anticing to improve clinic Sarp Aksel is a fourth year, ipate changes in our while educating our pursuing residency in OB/GYN field, the clinic’s student volunteers, as it develleadership is prepared to tackle oppor- ops individuals versed in formal quality tunities and challenges with equal zeal assessment and quality improvement to ensure growth in the quality of ser- protocols. vices we provide our patients and comWhile patient satisfaction and health munity. outcomes are ultimate goals, many inOur focus on relationship building termediate checkpoints are being efwith community supporters and in- fectively utilized to create systems for creasing buy-in from local stakeholders monitoring and adjusting clinic flow, is instrumental in continuing the clin- programming efficacy and community ic’s growth and success. Specifically, interventions. we are looking to connect with local While the Affordable Care Act has partners in order to expand ECHO’s been instrumental in reducing the outreach. Strengthening the clinic’s re- number of uninsured adults in commulationships with the community that we nities across the country, there are paserve and the volunteers who have ded- tient populations that remain without

access to health insurance. For those patients, ECHO serves as a bridge to reliable, high-quality care. As part of our efforts to provide comprehensive care to our patients, on-going assessment and appropriate expansion of referral services is a must. A careful review of the most highly utilized referrals, as well as those services that are necessary but difficult to provide at ECHO is an important way to begin this expansion. In today’s environment, success for non-profits and social justice organizations hinges on the appropriate use of social and web media platforms for advertising and marketing purposes. Establishing a distinct position for a communications director was a necessary step we have taken in order to further a comprehensive development strategy. We are confident that a concerted focus on ECHO’s increased visibility will contribute positively to its continued growth. It is this long-standing success that we hope to build on in the year to come. Through the dedication of its volunteers and generosity of its alumnae and donors, ECHO looks forward to continuing to serve the needs of our patients and community.

Cultivating patient advocacy as a pre-medical student Missiel Muñoz

Senior, College of New Rochelle

During my time at ECHO, my primary responsibility was to serve as a Spanish interpreter for patients and their clinical team. I also had the opportunity to assist at the front desk. I was able to rotate through several other clinic positions, and it ended up being the role of patient advocate that impacted me the most. As a patient advocate, I accompanied patients throughout their visit to ensure that all of their questions were addressed. This role pushed me to make sure that I was aware of my patients’ needs and

wonder whether I was being tactful enough to address their confusion. Advocating on behalf of our patients was no longer a clinic role, but a state of mind and a value that I cherished. Recently I had the opportunity to interpret into Spanish the waiting room presentations put on by ECHO community outreach volunteers aimed to engage our patients on an educational conversation about adequate nutrition. This presentation reinforced my understanding that our community is in need of more than diagnoses

and prescriptions. Our community requires care that is sensitive to the social and personal challenges that affect patients’ health. It is not enough to be sensitive to a patient’s pain, we must also be aware of their background and level of health literacy so they can receive the best care possible. My experiences at ECHO have taught me that being a physician entails much more than getting the right diagnosis. Being a physician also entails being an advocate and educator; this is the kind of physician that I aspire to be.

ECHO’s inaugural sexual health day Aneesh Pirlamarla ‘18 Research Volunteer

To commemorate the National HIV Testing Day on June 27th, ECHO held Sexual Health Day to teach patients about sexual health in a fun and easyto-learn manner. ECHO volunteers hosted a Jeopardy game in the waiting room about sexually transmitted diseases, reproductive systems, contraception and other important facts about sexual health. The patients also received free condoms and lubrication as well as pamphlets and brochures regarding sexual health. Aaron Praiss, the HIV coordinator, witnessed the reactions of patients, “Patients loved it! The waiting-room presentation and game were big hits. The

patients would repeatedly say that they never learned any of this information and were too afraid to ask questions. This event comforted them and allowed them to ask any questions they had.” Praiss further noted that the idea was inspired by ECHO’s annual Women’s Health Day, during which patients were offered Pap smears and educated about cervical and breast cancers. Inspired by the positive reception, Praiss hopes to make this a more regular event in clinic. This event is just the beginning of a new initiative. ECHO’s pre-clinical board has been actively working to put more emphasis on sexual health education and HIV screening for patients. The goal is for ECHO to become a place where patients can consistently receive

sexual health counseling, empowering patients of the Bronx community in a much-needed way.

Keneta McKellar, left, Community Outreach Coordinator, with Aaron Praiss, HIV Coordinator, play Jeopardy in ECHO’s waiting room.

Diabetes education at Eastchester Gardens Community Center The community outreach Interpreter Coordinator arm of ECHO allows volunteers to get involved in our Bronx community outside of Saturday clinic day. Two former community outreach volunteers, Keneta McKellar and Jessica Faiz, loved their experience teaching healthy lifestyle classes at a local public middle school during their first year at Einstein. Their passion for the cause drove them to become ECHO board members during their second year. McKeller and Faiz both saw an opportunity to expand our health education to adults. The Neighborhood Initiatives Development Corporation (NIDC), a nonprofit organization focused on neighborhood improvement and youth programs in the Bronx, was looking for support from Einstein/ Montefiore in developing a health education programming for adults. “It was a great opportunity for us that just sort of fell into our laps,” said Faiz. They met with Luna Bella Avila, the Program Facilitator for the Youth Department of NIDC, to discuss topics

Marie Boller ‘17

that would be of interest to community members. “Diabetes, and specifically nutrition as it relates to diabetes prevention and management was something that came up as an important topic to address,” said Faiz. On a Tuesday night, a group of adults gathered in the Eastchester Gardens community center to participate in the interactive presentation; several were parents of children from the center’s after-school program. Faiz and McKellar began the discussion by having all participants write what they knew about diabetes on a notecard, and then used the cards to guide an informal discussion. “We quickly moved from the script we had prepared to address all the questions that people had,” said Faiz, “It was a lively discussion.” Faiz and McKeller used the discussion to educate the community members on the important aspects of diabetes and prevention while debunking myths that were brought up by the participants. Faiz and McKellar also wanted to demonstrate how to prepare a nutritious and delicious meal using simple

ingredients that be easily purchased at the local Pathmark. When they showed up at the Eastchester Gardens housing development on a Wednesday night, they brought a steaming platter of whole-grain quesadillas made with grilled chicken, roasted red peppers, and low-fat cheese. After the presentation and refreshments, some people lingered to ask for more information. “We should have more events like this,” one community member commented. McKeller and Faiz hope that imparting this knowledge in the community will foster healthier lifestyles and help better manage and prevent chronic illnesses such as diabetes. Community Outreach at ECHO returned to the community center in November to educate residents on the topic of cancer screening and another future session will cover sexual health. We look forward to strengthening our relationship with NICD and broadening the impact of ECHO as we promote health and wellness in our community.

Letter from the Editor I have had the privilege Session Coordinator Clinic Chair of watching ECHO extend its reach into the Bronx and grow as a family over the past few years. Since I began volunteering at ECHO in 2010, our organization has made tremendous strides towards helping the uninsured and underserved. We have closely observed our patient demographic, listened to their particular needs, and evolved to meet those needs. A student-run organization has matured to handle an ever-growing, diverse patient population. It has been a pleasure to sit in on board meetings, listen to student leaders collaborate on ideas and projects, and see those efforts manifest into tangible improvement. We have advanced sexual health awareness, management of chronic disease, avenues to consistent care for patients, affordable or free referral services, fundraising, community outreach programs and a medium by which ECHO members can be continually updated. Over the years, students have received grateful feedback from patients, further validating our efforts and serving to fuel our passion for helping those in need. Our impact on the community and the patients we have supported will forever shape who we are. It takes a special kind of person to volunteer his/her energy towards the betterment of other; I am proud to be working with such a special family. I hope this newsletter continues to serve as a testament to our efforts in the years ahead and as a humble reminder of our impact on the many lives we’ve touched.

Matthew Barbery ‘15

Above: ECHO 2014-2015 Pre-clinical Board Members Below: ECHO 2014-2015 Clinical Board Members Clinical Board Executive Clinical Chair Sarp Aksel Session Coordinators Chair Wayne Cohen-Levy Matthew Barbery Clinical Teams Chair Arvind Badhey and Fa’iz Bayo-Awoyemi Continuity Chair Marika Osterbur SC Flow Director Jessie Liu SC Back of House Director Laura Hawks SC Board Alison Schmitzler Abtin Farahmand Brandon Adler Cindy Martinez Megana Ballal Mohana Roy Newton Phuong Pratistha Koirala Stacey Stauber Tony Bowen Wanda Lam Medical Director Dr. Amarilys Cortijo Assistant Medical Director Dr. Sarah Nosal

Pre-clinical Board Project Director Annemieke Wilcox Weekly Coordinators Daniel Santos and Viraj Patel Communications Officer Jessica Faiz Development Officer Mike Tseng Financial Officer Sean Hickey Referrals Coordinators Alex Petti and David Levitz Patient Advocate Coordinators Carly Hirschberg and Dordy Sugano Women’s Health Coordinator Elise Rosenthal HIV Counselor Coordinator Aaron Praiss Labs Coordinators Gila Hoffman and Nico Delpiccolo Front Desk Coordinators Lilly Zhao and James Yuan Interpreter Coordinator Marie Boller Pre-Clinical and Scheduling Coordinator Hope Williams Quality Improvement Coordinator Liz Clain Community Outreach Coordinator Keneta McKellar and Melissa Bhikham

Editorial Staff

Left to Right, starting at the Back: Melvin Joice ‘18, Aneesh Pirlamarla ‘18, Gila Hoffman ‘17, Aaron Praiss ‘17, Jessica Faiz ‘17, Matthew Barbery ‘15, Elizabeth Guevara ‘18, Dahlia Norry ‘18, Alyssa Liguori ‘18, Pooja Sheth ‘18, and Olivia Low ‘18. Not Pictured: Hasan Safiuddin ‘18. Chief Editorial Staff: Jessica Faiz, Aaron Praiss, Gila Hoffman, Matthew Barbery