ISSUE 03, JUNE 2019
UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE
A Year in Review
Mitchell Wolfson Sr. Department of Community Service (DOCS) Annual Report 2018 - 2019
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Table of Contents Our Mission..........................................................................................................................6 Message from Dean’s Office..................................................................................................7 Our History...........................................................................................................................8 Alumnus Feature: Dr. Sibi Krishnamurthy...............................................................................10 Annual Data........................................................................................................................12 Clinics.............................................................................................................................16 Reginal Medical Campus Projects....................................................................................... 24 Alumna Feature: Dr. Morgan Sendzischew........................................................................... 30 Almunus Feature: Dr. Rimsky Denis.......................................................................................31 Health Fairs........................................................................................................................32 Community Partner Feature: Dr. Larry Pierre........................................................................38 Medical Student Feature: Madeleine Hindenlang.................................................................39 Community Health Leadership Conference..........................................................................40 National Health Leadership Consortium...............................................................................42 Innovations to Public Relations Strategies........................................................................... 44 Longitudinal Access............................................................................................................46 Emergency Preparedness...................................................................................................48 Medical Informatics............................................................................................................50 Research and Quality Improvement......................................................................................51 Resident Feature: Dr. Mousa Botros....................................................................................54 Behind the Scenes.............................................................................................................56 Contact Information............................................................................................................58
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Thank you from DOCS We are incredibly grateful for the support of the donors, patients, healthcare providers and students who make our work possible. We are tremendously proud of the goals that we were able to accomplish this year. The raw numbers are encouraging; we have served a large and ever-expanding group of patients through our health fairs, clinics and community outreach efforts, and our volunteer engagement is stronger than ever. However, these data points provide only a limited perspective on the work that we do. The true beauty of DOCS is in the individual stories of the patients we serve and the volunteers with whom we work. In this year’s annual report, it is these stories that we wish to highlight, for woven together they create the rich tapestry that truly defines our organization and gives meaning and context to the work that we do. Through these stories, we hope to provide a personal perspective on the motivations, impact and aspirations of those who have chosen to make DOCS a part of their lives. We are so fortunate for the tremendous generosity of the Mitchell Wolfson Sr. Foundation. Through the ongoing support of the Wolfsons, DOCS is able to provide innovative and meaningful solutions for patients throughout South Florida who face innumerable barriers to care. We are able to train the next generation of physicians to develop a lifelong commitment to working with and understanding the needs of underserved patients. In addition to the Wolfsons, we would like to thank the numerous other donors whose gifts have enabled us to successfully carry out our mission this year. As an organization, we believe that no one understands the needs of a community better than its throughout South Florida who face innuown members, and we are humbled to work with sopatients many incredible communities throughout South We are incredibly grateful for the support of the domerable barriers to care. We are able to train Florida. We are cognizant of the fact that it is our patients and community partners who enable us to the nors,identify patients, andand students next generation physicians to develop a lifelong and healthcare address theproviders unique social healthcare challenges of of each neighborhood. As healthwho make our work possi commitment to working with and understanding care providers, we must always seek to meet the needs of communities as defined by their members, the We are incredibly grateful forown thepreconceived support of thenotions do- needs patients. In be addition rather than based on our of whatofa underserved certain population should offered.toIt the nors,is patients, healthcare providers and students Wolfsons, we would like to thank the numerous other through our community partners and exhibitors that we are able to truly serve such a diverse set of whopopulations make our work possible. donors whose gifts have enabled us to successfully in our community, and we are so grateful for their ongoing support. carry out our mission this year. We are tremendously proud of the goals that we were We would like to express our gratitude to the healthcare providers who have dedicated so much time ableand to accomplish this year. The Our rawvolunteer numbers physicians, are As andentists, organization, we believe that no one underenergy to DOCS this year. audiologists, nurses, physical therencouraging; we have served a large and ever-exstands the needs of a community better than its apists and public health professionals model what it means to provide excellent and compassionate own panding group patients through oura health fairs, service members, we arebut humbled to workdedicated with so many patient care.ofThey not only provide tremendous to ourand patients, are incredibly clinics and community outreach efforts, and our incredible communities throughout South Florida. to teaching students and improving our processes to ensure that we are constantly improving our servolunteer engagement is stronger than ever. HowWe are cognizant of the fact that it is our patients vices. We are grateful to the leaders of the Medical Parents Association for their generosity in supportever,ing these data points provide only a limited per-fueland partners who enable us to for our organization and providing the literal that community enables us to serve so many patients at identify our spective on the work that we do. The true beauty of and address the unique social and healthcare fairs and clinics. Thank you to our faculty advisors Dr. Amar R. Deshpande and Dr. Julia L. BelkowitzchalDOCS in the individual of the patients we oflenges each you neighborhood. As healthcare providforisnurturing our ideas stories and supporting the growth DOCS.ofThank to Raysa Cristodoulou for her serveencouragement, and the volunteers with whom we work. In this ers, we must always seek to meet the needs of patient advocacy and longitudinal unifying vision that enables DOCS to build on thecomyear’s annual report, it is these stories that we wishof prior munities success years.as defined by their members, rather than to highlight, for woven together they create the rich based on our own preconceived notions of what a tapestry thatthe truly defines our supporters, organization certain population be offered. is through Through kindness of our we and were able to pursue manyshould new initiatives this It year. We givesopened meaning and context to the work that we do. our community partners and exhibitors that we are a new weekly free clinic at the Center for Haitian Studies, expanded the scope of our emerThrough these stories, we hope to provide a personal able to truly serve such a diverse set of populations gency preparedness efforts, streamlined and refined our triage process at health fairs and expanded perspective onofthe impactWe and aspirain our community, and we are so grateful for their the scope ourmotivations, patient navigation. are looking forward to another incredibly rewarding and humtions of those who have chosen to make DOCS a part ongoing support. bling year of fairs, clinics and new initiatives in 2019-2020. of their lives. We would like to express our gratitude to the healthWe are so fortunate for the tremendous generosicare providers who have dedicated so much time Sincerely, ty of the Mitchell Wolfson Sr. Foundation. Through and energy to DOCS this year. Our volunteer physithe ongoing support of the Wolfsons, DOCS is able cians, dentists, audiologists, nurses, physical therVedant, Leah, and Lindsey to provide innovative and meaningful solutions for apists and public health professionals model what 5
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Mission DOCS is dedicated to providing preventive, primary, and subspecialty healthcare to the medically underserved populations in South Florida in collaboration with medical students, physicians, as well as allied health students and professionals at the University of Miami Miller School of Medicine through:
> Leadership
Fostering students’ leadership abilities among peers, patients, and the community
> Training
Providing formal training and practical experience, allowing students to hone essential clinical skills
> Education
Realizing the importance of not only educating ourselves but also our patients and the communities in which we live
For more information, please visit us online at: https://umdocs.mededu.miami.edu/ http://udocs.med.miami.edu/ 6
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From the Dean’s Office
“The DOCS program represents one of the Miller School’s most fundamental and essential missions: service to our community,” said Henri R. Ford, M.D., M.H.A., dean and chief academic officer of the Miller School of Medicine. “Our students and faculty bring medical care to neighborhoods whose residents often have no other way of getting this care. The patients’ gratitude and their hope for good health in the future are an inspiration to all of us.” “It is a privilege to be the dean of a medical school whose students are so committed to providing help to every member of our community who needs it.” Henri R. Ford, MD, MHA Dean and Chief Academic Officer University of Miami Miller School of Medicine
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Our History Since the inception of the first health fair in Big Pine Key in 1971, the students of the University of Miami Miller School of Medicine have made access to care for the medically underserved a top priority. In 2001, the health fairs formalized into DOCS, a student-run, non-profit organization endorsed by the medical school under the direction of Dr. Mark T. O’Connell. As DOCS gained recognition, a generous donation was received in 2006, endowing the service organization as the Mitchell Wolfson Sr. Department of Community Service. In the 2018-2019 Academic Year, DOCS brought screening and educational services through its health fairs and clinics to over 2,000 patients thanks to the volunteer efforts of over 500 medical students and 250 physicians. Currently, DOCS holds 8 annual health fairs in undeserved areas in Miami-Dade, Monroe, and Broward counties to screen for the most prevalent health problems in our community, including: hypertension, diabetes, dyslipidemia, obesity, vision loss, glaucoma, osteoporosis, fall risk, oral health, dementia, depression, HIV and Hepatitis C, as well as colon, breast, cervical, and skin cancers. In addition, DOCS also partners with local efforts to bring awareness about community resources in mini-health fairs and exhibitions. DOCS has also expanded to operate 4 free student-run clinics that provide treatment in both primary care and specialized services through the San Juan Bosco Clinic, the IDEA Needle Exchange Clinic, Cardiad Center Clinic and the newly founded Center for Haitian Studies DOCS Night Clinic. Using a referral system from our health fairs to free and reduced-cost clinics, we are able to provide continuity of care and follow-up services by acting as a portal of entry into the healthcare system for at-risk patients.
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Alumnus Feature: Sibi Narayana Krishnamurthy, MD Class of 2016
What is your current position and role in your professional life? I’m finishing my last year of internal medicine residency at the University of Miami Hospital & Jackson Memorial and will be starting Cardiology fellowship here this summer. What is your role in DOCS now? I volunteer at health fairs and at SJB clinics on Internal Medicine and Cardiology nights. At the health fairs, I help out mostly at the final doctor evaluation station, working with students to review results from the day and counsel patients on how to improve their health. SJB resembles a more traditional clinic model and allows me to work in an attending-like role with medical students who get to formulate their own assessments and plans. How has volunteering at DOCS as a medical student impacted your current practice of medicine? DOCS was the earliest experience I had taking care of patients in medical school (in my third month right after Anatomy). Doing those health fairs early gave me a big focus on preventative care and screenings in healthcare, which has been important in my continuity clinic at UM. When you work in the hospital and finally see just how costly healthcare is you want to try to do as much as you can to prevent a rise in disease burden and hospitalizations in the area. What do you think DOCS has to offer to patients, medical students, and physicians? DOCS provides medical students the ability to start taking care of their own patients and learning how to obtain and disseminate information to them. They also get exposure to multiple specialties, from Ophthalmology and Dermatology at health fairs to Cardiology, GI, and Urology at the SJB clinics. For physicians, this is a great opportunity to provide medical education in a hands-on manner to students, which is usually not possible until their third and fourth years of medical school. And ultimately, the biggest benefit is for the patients, many of them who have had little to no access to healthcare their entire lives. The biggest change I’ve noticed in health fairs over the past few years is the referral station and how we’re able to get patients connected to healthcare in the community at a more effective rate with good continuity.
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What was your fondest memory of DOCS? My favorite DOCS experiences have been the Key West Health Fairs. In addition to seeing 300-400 patients across three sites, the fact that a large majority of the school and residents are together always makes for a fun weekend. What are you most grateful about with regards to DOCS? I’ve met so many people working at health fairs and clinics, some becoming close friends and mentors. DOCS provided me with multiple opportunities to optimize my approach to patient care and even helped fine tune some small procedural skills like venipuncture. Why is it important for medical students to be involved in DOCS? Although a lot of focus of medical school is on exams, it’s important to keep remembering that we are in this for the patients. Our medical school is lucky to have an organization and preventive care model like DOCS. I remember talking with friends at other medical schools and finding it crazy how little patient contact they had in their first two years. I think that experiences like DOCS are a big reason why most Miller graduates are amazing clinicians and patient providers in residency and beyond. Do you have any other comments you would like to share? It’s been interesting watching the evolution of DOCS since I first started medical school. We’ve seen the positive impact of the Affordable Care Act providing healthcare to populations that used to depend on DOCS as their sole medical care. Although this meant some health fairs having a declining patient population, it also forced students to adjust and explore other areas like South Dade and West Kendall which have had high turnouts. The introduction of point-of-care testing for cholesterol levels, Hepatitis C/HIV, and the Septin-9 screening for colorectal cancer are also providing quick results and better response rates than the previous FIT testing. And as I mentioned before, the referral and follow-up station over the past two years has been incredible and ensures that we’re providing more than just a 1-2 hour service once a year. It’ll be important for future medical students and leaders to never get complacent with DOCS. Healthcare is always evolving and a talking point in every political discussion and shifts in population demographics in a growing and international city like Miami requires DOCS to evolve with it if it wants to be at the forefront of providing entry level care and life-changing screenings to those in need in the South Florida area. Sibi Narayana Krishnamurthy, MD PGY-3, Internal Medicine University of Miami Hospital/Jackson Memorial Hospital
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The Year in Numbers > 2,500 physician hours volunteered > 2,200 hours of medical volunteering time at health fairs and clinics
> 1,300 patients seen at health fairs > 600 patients seen at clinics
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Health Fairs
Crockett Foundation’s Back to School Event 08.04.18 Commissioner Edmonson’s Back to School Event 08.11.18 Hialeah/Opa-Locka Health Fair 09.29.18 Little Haiti Health Fair 10.20.18 South Dade Health Fair 11.10.18 Liberty City Health Fair 12.08.18 Jack & Jill Health Fair 01.12.19 Florida Keys Health Fair Marathon Key Big Pine Key Key West 02.02.19 West Kendall Health Fair 02.16.19 Light of the World Health Fair 03.09.19
Clinics
San Juan Bosco Clinic IDEA clinic Caridad Center Clinic Center for Haitian Studies DOCS Night Clinic 13
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2018-2019 HEALTH 1,500
1246
1,000
462
500
237 157
H ent r a P C tea m istit i t n I era apeH fC y o tn lgo ot ioP e la amr socu etn D eD lG cre n a C sm lat xaE cero l o t C iyt s saerB n e y D en o lg o oB uid A
14
406
517 49 584 347
0
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H FAIR SCREENINGS 1339 1246
965
95 494
s t ila V onit a c s udE era m cirta y S pa ideP lgo om P yro laht emM hpO thla e H sm latn xaE eM era elaM fC ec o tnio lne o P sd VIH iV re ipiL
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160 157 231 193 158
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CLIN
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NICS
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SAN JUAN BOSCO
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CLINIC
DOCS
Mitchell Wolfson Sr. Department of Community Service
San Juan Bosco Clinic This academic year, DOCS SJB had a total of 546 patient visits with 182 physician volunteers and 950 student volunteers. San Juan Bosco (SJB) is a student-run clinic that
This year, DOCS SJB also participated in a commu-
operates every Tuesday night and rotates through
nity resource fair which offered information about
eight different medical specialties: internal medi-
the services available through local agencies to
cine, cardiology, psychiatry, neurology, pulmonol-
help patients attain services such as English les-
ogy, rheumatology, gastroenterology, and urology.
sons and technical education.
Our service includes providing laboratory and diagnostic testing at no cost to patients. To qualify for
This academic year, DOCS SJB had a total of 546
our community clinic, patients must be at or
patient visits with 182 physician volunteers and
below 200% of the federal poverty level.
950 student volunteers. More specifically, 13 patients were seen during internal medicine nights,
San Juan Bosco Clinic patients attend the daytime
67 during cardiology nights, 94 during psychiatry
primary care clinic, where they can be referred to
nights, 89 during urology nights, 61 during neu-
one of the DOCS SJB specialty nights. Our stu-
rology nights, 49 during pulmonology nights, 102
dent-run night clinic has continued to grow and im-
during rheumatology nights, and 94 during gastro-
prove in the past year through our new initiatives.
enterology nights.
We are implementing methods to increase the functionality of the Patient Assistance Program (PAP),
The SSJ Health Foundation and main sponsor of
which provides uninsured patients with free or low-
San Juan Bosco honored the DOCS SJB team’s
cost prescription medication. Our staff members
commitment by dedicating a plaque on their Tree
Isabel PeĂąabad and Yanelys Fernandez created a
of Life. We are very grateful for our patients who al-
patient education program teaching basic nutrition,
low us to serve them and would like to thank Berta
banking and credit building, medication safety,
Cabrera, Luz Gallardo, and Marta Villalta for their
child development, and parenting classes.
continued support which enables us to provide the best possible patient care.
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IDEA Clinic
Infectious Disease Elimination Act (IDEA) Wound Care Clinic and Needle Exchange Our clinic works in conjunction with the IDEA Needle
In July, we had a special visit from US Senator Bill
Exchange Program, the first legal syringe exchange
Nelson who came to see the lifesaving work of the
program in Florida that currently serves more than
wound care clinic and needle exchange. Senator
500 people. The goals of our clinic include address-
Nelson was hosted by Dr. Hansel Tookes (founder of
ing patient healthcare needs in a timely and compre-
the IDEA clinic) Dr. Henri Ford, (Dean of UMMSM)
hensive manner, working with patients to increase
and Dr. Edward Abraham (CEO of UHealth).
their trust in the healthcare system, and providing important educational opportunities for medical
We presented our clinic’s work at the 2019 Society
students regarding harm reduction. In addition to
of Student-Run Free Clinics Conference with post-
offering general primary care services, student vol-
ers about Cost Analysis and Patient Nagivation. The
unteers at our clinic work with surgeons, dermatol-
Patient Navigation Program grew out of previous
ogists, and emergency medicine physicians to treat
DOCS infrastructure as well as a Gold Student Sum-
skin infections and abscesses that often occur sec-
mer Fellowship won by one of our student leaders,
ondary to chronic use of injectable drugs.
Hardik Patel, and an integrated multi-disciplinary collaboration with the School of Nursing.
We have been able to reach a variety of patients with primary care and wound care needs in the Overtown
In addition, we now have the Department of Health’s
Community. Our physician volunteers educated
STI Testing Van in our IDEA parking lot every other
both students and patients not only in the principles
week, increasing our patients’ access to these ser-
of harm reduction and methods to encourage his-
vices.
torically marginalized patient populations to access healthcare, but also in the execution of necessary
This academic year, we were able to serve over 71
procedures such as abscess care and prevention.
patients with the help of 24 doctors and 95 volun-
We also provided free point-of-care HIV and
teers.
Hepatitis C screenings to our patients.
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In early May, a bill passed both the Florida House and Senate to expand the Miami-Dade pilot needle exchange program spearheaded by Dr. Tookes to allow additional counties to participate after approvied by their county commissions (pictured right with Dr. Tookes, Rep. Rene Plasencia, Rep. Shevrin Jones, and student Tyler Bartholomew at the state House.) We would like to thank Dr. Hansel Tookes, Emy Martinez, Carlos Padron, David Forrest, Annie Liu, Eddy Suarez, and Elisha Ekowo for their support and guidance.
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CENTER FOR HAITIAN STUDIES
DOCS NIGHT CLINIC
Center for Haitian Studies DOCS Night Clinic We saw this space as a potential to fill a gap in primary care and women’s health services in the community. The creation of the Center for Haitian Studies (CHS)
The CHS DOCS Night Clinic has been running ev-
DOCS Night Clinic was inspired by the desire to
ery other Monday evening since February. We
expand healthcare access to our community after
have been able to provide our patients with prima-
the previous DOCS Lotus Wellness Center Clin-
ry care services, health screenings, routine labo-
ic was replaced by a day clinic. We have a strong
ratory evaluations, and valuable patient education
relationship with the Little Haiti community through
and counseling. The partnership between CHS and
the DOCS annual health fairs at the CHS as well as
DOCS has led to an increased access of care for
through other UM initiatives in the community in-
those in the Little Haiti community who are unable
cluding screening and education services through
to make it to the day clinic. We have been working
the Sylvester Game Changer Vehicle and Pediatric
with community partners at local events to ensure
Mobile Clinic.
that patients are aware of the services we provide at our new clinic.
Upon visiting CHS to discuss the potential partnership, we visited a portion of their building that
Since our grand opening on February 11, 2019, we
served as an obstetrics and gynecology clinic in
have seen 27 patients with the help of 5 doctors, 7
the past. We saw this space as a potential to fill a
clinic staff, and 38 medical students during our 9
gap in primary care and women’s health services in
primary care nights.
the community. Additionally, we hoped that through partnering with CHS, we could create more conti-
We are very grateful for our patients who allow us
nuity for the patients who we see at the health fairs
to serve them and would like to thank Dr. Pierre, Dr.
each year.
Metellus, Gina, and Sonida for their support in making this clinic a reality. 22
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Regional Medical Campus (RMC) Projects 24
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CARIDAD CENTER Caridad Center is the largest free clinic in South Florida, which provides care to uninsured and low-income patients. DOCS partners with Caridad Center in order for UM faculty and students to provide free primary care appointments to Caridad Center patients on select Saturdays. This year DOCS hosted five clinic dates at Caridad and participated in their Family Festival and Health Fair in November 2018. Five students along with Dr. Harris, Dr. Lichtstein, and Dr. Agarwal provided primary care services to approximately 20 patients.
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CHRISTMAS STORE With the help of six student volunteers, RMC DOCS participated in a holiday event hosted by Urban Youth Impact in West Palm Beach called the Christmas Store in December 2018 where 500 families from the area came to celebrate the holidays, get free gifts for the children, play games, and more. DOCS volunteers spoke with parents and children in attendance and provided nutrition education, healthcare access information, and healthy recipes with ingredients to the attendees.
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GUATEMALAN-MAYA CENTER The Guatemalan-Maya Center is a non-profit community organization located in Palm Beach County that serves the immigrant population in South Florida. DOCS holds health workshops throughout the year focusing on community education topics such as diabetes, physical activity, nutrition, and utilizing the healthcare system. This year, we expanded the project to include classes discussing safety in the workplace, healthy cooking classes, and mental health and mindfulness, as well as incorporate more interactive learning with the goal of empowering community members. Based on feedback from our community partner, we also implemented a simultaneous pediatric program, complementing the adult curriculum to engage the children and encourage families to come together. In March 2019 we presented this community initative at the Society of Student-Run Free Clinics Conference.
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HEALTHCARE ACCESS The RMC Healthcare Access Project aims to educate students regarding the health insurance and healthcare resources options in Palm Beach County in partnership with the Health Council of Southeast Florida (HCSEF). We represented HCSEF and other organizations at two community events this year, during the summer and early fall, where we talked about health insurance options for children and adults, and handed out bilingual flyers on health insurance and health literacy workshops. We also created a resources map with a list of free and reduced clinics and other healthcare resources provided by HCSEF, which is being used by medical students, residents, attendings and case managers at JFK hospital. In July 2018, we helped to host a community back to school fair at BRIDGES West Lake Worth, where we advised over twenty families on health insurance and free/low-cost healthcare options in the community. In September 2018, we helped to host a community event at a church in east Lake Worth, again interacting with over 20 families and also networking with other community organizations. Students also volunteered with the Health Council of Southeast Florida at community events to educate and help community members navigate the healthcare system. We have created a GIS resource map for Palm Beach and Broward Counties, utilized by students, physicians, and other healthcare providers to personalize counseling on healthcare resources for patients. In March 2019 we presented our work on the GIS resource map at the Society of Student-Run Free Clinics (SSRFC) Conference.
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Alumna Feature: Morgan Allyn Sendzischew Shane, MD Class of 2012
What is your current position and role in your professional life? Graduating gastroenterology chief fellow, T-32 research grant recipient Are you currently active in DOCS? What is your role now? I volunteer at SJB on GI night and health fairs when my schedule allows. How has volunteering at DOCS as a medical student impacted your current practice of medicine? DOCS has had a profound effect on my career trajectory. For one, the Flexible Sigmoidoscopy fair we conducted first in 2010 and then again in 2012 was my first exposure to GI. Without those fairs I may have ended up being a surgeon--gasp! What do you think DOCS has to offer to patients, medical students, residents, and physicians? That’s the beauty of DOCS. There is something that is offered to everyone participating. Patients get vital screenings in health fairs and follow up in clinic that would not be available to them for a variety of reasons, be it insurance status, legal status, or simply just not having the freedom to take time off work for medical appointments for fear of losing their job. Medical students get to see early on the magic of becoming a physician and helping others in that capacity. Most students have spent their lives in the classroom, and DOCS gets students out of the chair and into clinical practice. Residents get to work in a supervisory role, and for some that is the first time they get to practice teaching skills that need to be honed to be successful attendings. And for attendings, I think working with students in DOCS renews the sense of idealism that is sometimes lost along the way in medical training. What was your fondest memory of DOCS? Definitely eating pizza and hand-processing scopes for the Flex Sig fair at midnight in the kitchen of the clinicturned-GI station. Seeing the attendings (including Dr. Deshpande--current faculty advisor!) donating their free time for a cause they truly believed in--and better yet, having fun while they did it--really motivated me toward GI, and continued service. What are you most grateful about with regards to DOCS? The experience and the mentorship. I worked my way from assistant project manager of a health fair up to Executive Director ultimately in charge of all student volunteers and a large budget. That kind of exposure to leadership really can’t be found at the medical student level anywhere else. The skills I learned in DOCS helped me ultimately become chief resident and chief administrative fellow. Dr. O’Connell, who was the faculty advisor at the time, was the best mentor who helped to show me which battles were worth fighting, and when to let it go. Morgan Allyn Sendzischew Shane, MD PGY-6, Gastroenterology University of Miami Hospital/Jackson Memorial Hospital
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Alumnus Feature: Rimsky Denis, MD Class of 2014
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What is your current position and role in your professional life? I’m currently a cardiology fellow at the University of Miami Hospital & Jackson Memorial Hospital with one year of training remaining, a PGY-5. How has volunteering at DOCS as a medical student impacted your current practice of medicine? My volunteering has tremendously impacted my training by providing me with a broad lens through which I view medical cases. My experience with DOCS reinforced my desire to provide health services to individuals in underserved communities. What do you think DOCS has to offer to patients, medical students, residents, and physicians? I think DOCS has a lot to offer. DOCS definitely provides students with the skills necessary to develop into a better clinician. For physicians and residents, DOCS give them an opportunity to give back to the community. For patients, I think DOCS provides free quality services for people who otherwise would not be in a position to receive those services What was your fondest memory of DOCS? As a first year at my first health fair, I remember just seeing the overwhelming amount of need and really understanding how I could have an impact in the lives of people who desperately need the care. That initial recognition that I could actually do something to help someone as a first-year medical student was inspiring to me. As a medical student, you don’t really get an opportunity to get involved in clinical/patient experiences early on, but in DOCS, you get a taste of that as a first-year medical student. What are you most grateful about with regards to DOCS? I’m most grateful about the opportunities that I received to serve as a medical student, and the opportunity to develop my leadership skills in medical school. Are you currently active in DOCS? What is your role now? Yes, I’m a Monday night preceptor at the DOCS Center for Haitian Studies Clinic. As a premed student, I worked with an organization that worked with DOCS and we always talked about having a clinic in Little Haiti but we were never able to bring that to fruition. It was actually one of my biggest regrets that we were not able to accomplish it as a medical student, I feel really rewarded that it has finally come to reality now. Why is it important for medical students to be involved in DOCS? I think it’s important because medical students need to be able to understand some of the social issues to providing health and seeking health (in addition to the medical skill benefits). There are factors associated with cost, transportation, social/cultural barriers. It’s not simply diagnosis, treatment, and medications; it really sets you up for a holistic understanding of medicine. What we learn in school can truly be implemented in a holistic way to help the truly disadvantaged. How do you think DOCS contributes to medical care in the community? For many people in the community served by DOCS, this is literally the only form of access they have to medical services. DOCS really provides the medical opportunity that many patients, hundreds of patients, would not otherwise have. Rimsky Denis, MD PGY-5, Cardiology University of Miami Hospital/Jackson Memorial Hospital 31
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Health Fairs
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CROCKETT FOUNDATION’S BACK TO SCHOOL EVENT MINI HEALTH FAIR @ BLANCHE ELY HIGH SCHOOL This was our second year participating in the Crockett Foundation’s Back to School Extravaganza in Pompano Beach. We offered services including vitals, POC glucose and lipids, and pediatric education resources. We look forward to returning to this event and serving this community in the future.
COMMISSIONER EDMONSON’S BACK TO SCHOOL EVENT MINI HEALTH FAIR @ OLINDA PARK/OVERTOWN This was our second year participating in the District 3 Commissioner Audrey Edmonson’s Annual Back to School Fun Day/ Health and Information Fair in Overtown. We offered services including ophthalmology, vitals, POC glucose and lipids, and pediatric education resources in this miniature health fair. A special appearance was made by Commissioner Edmonson herself, pictured in purple with the Bascom Palmer ophthalmology team and our faculty advisor Dr. Deshpande (far right). We hope to return to this event so that we may continue to serve this community.
HIALEAH/OPA-LOCKA HEALTH FAIR @ ROBERT B INGRAM ELEMENTARY SCHOOL The Hialeah/Opa-Locka Health fair provides screening services to the medically underserved communities in the adjacent communities Hialeah, Opa-Locka, and West Miami-Dade County in general. This population comprises a diverse mix of underserved communities who do not have health insurance nor access to quality medical care. We partnered for the second year with Dr. Robert B Ingram Elementary School as the location of the health fair to empower patients through community partnerships with local organizations and churches.
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LITTLE HAITI HEALTH FAIR @ CENTER FOR HAITIAN STUDIES
LITTLE HAITI
The Little Haiti Health Fair is hosted at the Center for Haitian
DOCS
Studies, a non-profit organization that works with local members of the large Haitian community living in Miami. This year the Little Haiti Health Fair was able to expand our impact by providing fresh vegetables and dairy products to patients after their final doctor assessments. The ability to partner with and serve the Haitian community make this fair a unique and exciting fair. Based off our long-standing relationship with the Center for Haitain Studies, we were able to build our community efforts and create a new primary care clinic.
HEALTH FAIR
24th Annual Little Haiti Health Fair FREE!
Health insurance not required Saturday, October 20th 9 AM - 2 PM Center For Haitian Studies 8260 NE 2nd Ave Miami, FL 33138
Mitchell Wolfson Sr. Department of Community Service
Screening Services: Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø
Blood Pressure Blood Glucose (Diabetes)*** Cholesterol*** Skin cancer and Dermatology Eye Exam Pediatrics Women’s Health (Pap Smear and Breast Exam) Men’s Health (Prostate Exam) Mental Health Counseling Bone Density Dental Exam
*These stations are subject to change
***For glucose and cholesterol exams, please do not consume any food or drink for 8 hours before the fair. You may take your medications and drink water. *Children must be accompanied by adults at all times *Anyone needing special assistance, please make arrangements prior to the fair by calling 305-243-4898 or visiting www.umdocs.org
TRANSLATORS NEEDED! Get service hours! Email docs.translators@gmail.com
DOCS Mitchell Wolfson Sr. Department of Community Service
UNIVERSITY OF MIAMI MILLER SCHOOL of MEDICINE
SOUTH DADE HEALTH FAIR @ BRANCHES COMMUNITY CENTER The South Dade Health Fair aims to provide medical care to uninsured, low-income, and migrant worker families in the Florida City and Homestead areas. This year, we reached out to factories and farms to engage those populations who may otherwise lack access to routine health screenings. We look forward to returning to this event and serving this community in the future and increasing our aid to an even larger population of those in need.
LIBERTY CITY HEALTH FAIR @ HOLMES ELEMENTARY SCHOOL Liberty City has been a vibrant and growing community in our own backyard. Despite its proximity to a large hospital system, the community continues to face challenges in healthcare access. Through our efforts at the Liberty City Health Fair, we aim to address the health needs of our patients while also linking them to invaluable community resources. This year, we had a special family of volunteers, the Turner family: emergency medicine physician Dr. Turner, medical student Darren, Mrs. Turner, and Mrs. Turner’s mother. Born and raised in Liberty City, Mrs. Turner and her mother were particularly excited that their family was able to give back to the community by volunteering at the fair. 35
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JACK AND JILL HEALTH FAIR @ JACK AND JILL CHILDREN’S CENTER The Jack and Jill Health Fair is held in Broward County at the Jack and Jill Children’s Center, which provides childcare and parenting classes to underserved populations in Fort Lauderdale. In partnering with this community center, we were able to serve parents and children who attend the center as well as the surrounding community. This year, we also had the opportunity to work with a large patient cohort from Pompano Beach, expanding our services to reach more underserved individuals in Broward County.
FLORIDA KEYS HEALTH FAIR: MARATHON HEALTH FAIR @ MARATHON MIDDLE HIGH SCHOOL
The Marathon Health Fair was held at a new site this year, Marathon Middle High School. With our community partner, AHEC, we were able to provide healthcare services to around 100 patients in an area that is still recovering from the effects of Hurricane Irma. We look forward to continuing to provide care for this community in the years to come!
FLORIDA KEYS HEALTH FAIR BIG PINE KEY HEALTH FAIR @ BIG PINE UNITED METHODIST CHURCH AND FIRST BAPTIST CHURCH The Big Pine Key Health Fair is the oldest DOCS health fair, operating since 1971. For over 40 years, our program has provided screening services and medical care to the Keys’ various populations. Volunteers from the local community assist in our fair, many of whom have worked with us for more than 40 years. They provide unique insight into how far these fairs have progressed. This year we were able to see growth in our fair’s attendance, showing that Big Pine Key is beginning to recover from the aftermath of Hurricane Irma.
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FLORIDA KEYS HEALTH FAIR KEY WEST HEALTH FAIR @ KEY WEST HIGH SCHOOL Our largest site in the Florida Keys, the Key West Health Fair this year served almost 160 patients. Thanks to our community partners AHEC and Key West High School, we are able to provide annual care to a patient population that is rebounding from the devastation of Hurricane Irma. We plan to continue serving this community well into the future while partnering with local providers to make year-round healthcare more accessible for our patients.
WEST KENDALL HEALTH FAIR @ CAPILLA DEL REY West Kendall Health Fair provides health screening services to a community that primarily consists of Hispanic immigrants. This year we moved to a new location and established a strong community partnership with Capilla Del Rey, a church that is located in the heart of the community. This had a positive impact on patient access and turnout, and our future teams will continue to lay the groundwork and build community partnerships in the area that has a clear need for quality medical screening services.
LIGHT OF THE WORLD HEALTH FAIR @ CORAL RIDGE PRESBYTERIAN CHURCH The Light of the World Health Fair is led by Regional Medical Campus DOCS in collaboration with Light of the World Health Clinic in Ft. Lauderdale, FL. Each year, the Clinic hosts a Health Expo that connects nearly 500 attendees to many health and social services throughout South Florida, hosting 40-60 vendors each year. As the sole health fair vendor this year, DOCS provided health screenings to over 140 patients at the Expo and connected them to care at the Light of the World clinic. Our goal is to reach the uninsured as well as people who do not have access to longitudinal primary care. We hope to continue to solidify our partnership with the Clinic and the UM IM Residency Program at Holy Cross. 37
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Community Partner Feature: Larry Pierre, MD, MPH Center for Haitian Studies
What is your current professional role? My current professional role is two-fold, that of Executive Director of the Center for Haitian Studies, Inc. and also the President and CEO of the Greater Miami Health Education and Training Center, Inc. Please tell us a little bit about the Center for Haitian Studies. Founded in 1989, The Center for Haitian Studies, Health and Human Resources, Inc. (CHS) is a not-for-profit community organization which provides primary healthcare and health education services to underserved members of the communities of Little Haiti/Little River and North Miami. In partnership with the Jackson Health System (JHS) and University of Miami Miller School of Medicine (UMMSM), CHS also serves a training site for medical students, medical residents and fellows, as well as for students in nursing and other allied medical fields. How does the work of DOCS fit into the goals and vision of the Center for Haitian Studies? DOCS fits perfectly in the vision of CHS by: 1) providing members of the community with an opportunity to access specialty care, which otherwise would not be readily available to the target population, and 2) attracting and pre paring the next generation of physicians to the practice of community-based and culturally competent medical care. DOCS provides direct patient care resources through its annual community health fair at CHS, and by adding professional staff to allow the clinic to expand into the evening hours. This provides greater healthcare accessibility to the working poor. Why do you think that it is important for medical professionals and students to be involved in the community? Practicing medicine at the community level is key to the provision of effective medical care services to underserved populations. Community settings a) offer easier access to members of the community, b) facilitate better understanding of health problems, c) optimize disease prevention measures and d) reduce the costs of healthcare. Community settings complement the knowledge acquired by medical professionals, residents and fellows, and medical students in academic settings. In addition, the exposure of medical professionals to the needs of minority and economically challenged populations contributes to the formation of providers and the provision of optimal care. There is evidence that medical students and residents who train in community settings are three times as likely to serve as physicians in these types of settings than those who did not receive such training. How do you envision the relationship between DOCS and the Center for Haitian Studies evolving in the future? It is our mission to have DOCS become an integral part of CHS in the delivery of primary healthcare to largely underserved populations of Miami-Dade County by continuing to increase the services provided. This contributes to the full formation of future generations of UMMSM medical professionals, as well as expands access to primary and specialty healthcare to those who would otherwise go without. This type of community-medical school partnership can serve as a model for other communities with large disenfranchised populations. Larry Pierre, MD, MPH Executive Director of the Center for Haitian Studies President and CEO of the Greater Miami Health Education and Training Center, Inc.
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Medical Student Feature: Madeleine Hindenlang Class of 2021
How did you first become interested in being involved with DOCS? My decision to attend medical school at the University of Miami was heavily influenced by both the option to pursue an MD-MPH dual degree and the wide range of community service opportunities available. We have one of the most diverse and robust student-run departments of community service of any medical school. Throughout the past two years, I have been able to take part in longitudinal patient care by volunteering at SJB and providing screening and preventative care at health fairs. Participating in DOCS has been one of the most rewarding parts of my medical school experience. Please tell us a little bit about your role this past year as the station manager for the Women’s Health Station. This year, I had the privilege of serving as the Women’s Health station manager at seven health fairs throughout Miami and South Florida. The primary purpose of this station is to provide pap smears to screen patients for cervical cancer. Miami has a higher rate of cervical cancer than the rest of Florida and the United States a whole. Many patients lack access to regular care. As station manager, I was responsible for ordering supplies, setting up the station, training my peers, and work ing alongside students and physicians to provide these services to patients. Why do you believe that it is important for medical students to be involved in serving the community? Much of medical school primarily take place inside the walls of a classroom or a hospital but participating in community service connects us to the people around us and the city we’re calling home for four years. It can be challenging to meet the demands of medical school, but at the end of the day we’re here because we want to help people – and learning more about the people who are your patients makes you a better doctor. How do you hope to use what you have learned in your role within DOCS in the future? Working as the Women’s Health station manager in DOCS has provided me with a number of tangible skills I hope to carry with me in my medical career. My role as a station manager has strengthened my leadership, communication, and organizational skills. DOCS has taught me how to better advocate for patients with limited access to healthcare. I believe that improved access to health education, screening, and treatment are essential for reducing health inequities and empowering our patients. These experiences have laid a foundation for my future as a physician. Madeleine Hindenlang Women’s Health Station Manager MD, MPH Candidate Class of 2021
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Community Health Leadership Conference Disseminating the Model
The third annual DOCS Community Health Leadership Conference (CHLC) was held on December 7th and 8th, 2018 with a total of 53 participants from more than 8 medical schools throughout the country. The conference aims to be the premier annual event connecting student leaders in various community health endeavors to share ideas, successes, and newfound needs seen in their student-run free clinics, health fairs, and healthcare service organizations. This year, we had the pleasure of hearing from Dr. Hansel Tookes discussing Miami’s pilot needle exchange program. We had three oral presentations discussing the assessment in quality of global healthcare in rural areas of the Dominican Republic, coordination and implementation of hand surgery outreach in underserved populations, as well as design and implementation of an interdisciplinary free women’s health student-run clinic. Afterwards, CHLC hosted a poster session for all conference participants to present their work to fellow medical students and judges. Students were also invited to workshops hosted by the National Health Leadership Consortium, our longitudinal team that helps schools develop sophisticated community health initiatives, and the DOCS Patient Navigation Care Access Coordinators. Students enjoyed a conference gala and awards session that recognized the wonderful initiatives presented to the group. Conference participants had the option of participating in our Liberty City Health Fair during the same weekend, giving them an opportunity to volunteer alongside our students and physicians to understand how the logistics of DOCS health fairs can be applied to their home institutions.
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Mitchell Wolfson Sr. Department of Community Service
UNIVERSITY OF MIAMI MILLER SCHOOL of MEDICINE
CONFERENCE ATTENDEES
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Collaboration NATIONAL HEALTH LEADERSHIP CONSORTIUM The DOCS National Health Leadership Consortium (NHLC) aims to be a national springboard for discussion and collaboration among medical students seeking to serve their communities, in addition to aiding students in creating and realizing meaningful community health initiatives at their own institutions. The initiative continues to evolve with the goal of involving more students, organizations and institutions nationally. Our information-sharing model has already had several successes, including:
{
{
{
Nova Southeastern University Patel College of Medicine
NHLC is actively advising a group of interested students at the newly founded Nova College of Medicine in how to start a free health fair and clinic in the setting of a new medical school. NHLC hopes to help Nova College of Medicine identify a health fair site and scope of services in a way that is sustainable for a newly founded organization and establish their inaugural health fair by Fall 2020. For a longer term impact in the community, NHLC is also assisting Nova College of Medicine in identifying resources necessary for developing a free clinic.
University of Central Florida College of Medicine (UCF)
Initiated by contact established at the annual DOCS Community Health Leadership Conference, UCF expressed significant interest in establishing their own needle exchange clinic, modeled after what currently exists in DOCS. NHLC facilitated a video conference between the UCF student group and Dr. Hansel Tookes, founder of the Miami IDEA Clinic, and discussed issues such as navigating the current political landscape and engaging key community leaders such as local police, mayors, and religious leaders. We are also assisting UCF in expanding the current level of services offered by their free clinics, such as adding HIV/hepatitis C screening services and creating a more sophisticated electronic medical record.
Florida Clinics Collaboration
In a partnership with University of Florida, DOCS NHLC has formed a Florida Clinics Collaboration that includes the medical schools of the University of Miami, University of Florida, Nova Southeastern University, Florida International University, University of South Florida, University of Central Florida, and Florida State University. Year-round, the Florida Clinics Collaboration exchanges documents and ideas for collaboration using the platform of a closed Facebook group and scheduled conference calls. On April 5-6, 2018, NHLC attended the first Florida Clinics Collaboration Conference hosted at University of Florida to help disseminate the DOCS model, discover potential areas of collaboration between clinics, and troubleshoot existing problems organizations are facing.
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}
}
}
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NATIONAL HEALTH LEADERSHIP CONSORTIUM TEAM
WORKSHOP AT DOCS COMMUNITY HEALTH LEADERSHIP CONFERENCE HELD BY NATIONAL HEALTH LEADERSHIOP CONSORTIUM TEAM, FEATURING THE IDEA ORLANDO NEEDLE EXCHANGE CLINIC DURING A PRACTICE PITCH COMPETITION COMPOSED OF TEAMS OF STUDENTS FROM DIFFERENT MEDICAL SCHOOLS
WINNERS OF THE MOCK PITCH PRESENTATION AT THE NATIONAL HEALTH LEADERSHIP CONSORTIUM WORKSHOP DURING THE COMMUNITY HEALTH LEADERSHIP CONFERENCE 43
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Innovations to DOCS Community Engagement Strategies With the changing landscape of healthcare needs and access to health insurance, DOCS needs to be innovative in our ability to recognize which populations would most benefit from our free health services. This year, we began a formalized three-pronged protocol for gathering the most reliable information and input to help identify each population’s unique needs and promote our services to the populations who require our help the most. With the help of the newly developed positions of Longitudinal Public Relations Coordinators, each health fair’s public relations team identifies key community leaders and stake holders in governmental, religious, and non-governmental sectors. By expanding our pool of advisors, we are able to gather more objective information about the community and increase our understanding of what DOCS is able to provide to surmount what is currently lacking. In addition, we wanted to increase patient familiarity with DOCS and trust in our organization with our direct engagement of community leaders. This approach has proved to be fruitful in fostering strong relationships with health fair hosts and advisors. Perhaps most importantly,
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there was an increased emphasis during team meetings to elucidate the effectiveness of individual in-person advertising efforts in order to brainstorm productive and efficient means of advertising. Other changes to our public relations strategies include an increased emphasis on media advertisement of our services to better reach the modern audience through platforms such as Facebook and Instagram, QR codes, implementation of yard signs and large banners to help guide patients to the location of health fairs to prevent confusion when the hosting location may be difficult to find, and a collaboration with the Miami-Dade Public Libraries (MDPL). We partnered with the library system by having them host our flyers in libraries near upcoming health fairs. In addition, our Longitudinal Public Relations Coordinators and health fair teams gave Health Literacy presentations in nearby libraries prior to health fairs to interested audiences on topics such as nutrition, cardiovascular health, and healthcare access.
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Governmental Partner
PR Protocol Keystone: Formally Identify and Engage Reliable, Influencial Community Stakeholders Early
Religious Partner
Non-Governmental, Service-Oriented Partner
OLINDA PARK DOCS VOLUNTEERS WITH COUNTY COMMISSIONER EDMONSON
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WEST KENDALL HEALTH FAIR TEAM WITH PASTOR DIAZ AT CAPILLA DEL REY
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Longitudinal Access
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Patient Navigation Our patient navigation project was born three years ago and has now grown into a large, essential program for DOCS. We train about 50 patient navigators each year to provide longitudinal follow-up for patients after each fair. Patient navigators follow patients who meet certain “high-risk” criteria for three months in order to assist them with acquiring health insurance and appointments with physicians at either Jackson Memorial Hospital or local free/low-cost clinics throughout South Florida. The goal of this project is to ensure that patients who attend our fairs are accessing the healthcare system throughout the year, so they can receive the necessary long-term medical care. Referrals Last year we created a digital database using ArcGIS mapping technology in order to individually tailor our referrals to specific patient needs. The map includes all South Florida clinics that provide free or low-cost healthcare. For each clinic, information regarding services offered, financial assistance, transportation, laboratory/pharmacy resources, and hours of operation are available on the map in order to help volunteers recommend a clinic for each patient that is best suited for his or her needs. Each patient is provided with one or two clinics that are uniquely suited for his or her follow-up care. We print out information about these clinics with directions from the patient’s home to the clinic at the fair to reduce inequities in access to resources among our patients. The goal of this project is to increase patient follow-up rates by reducing barriers to care.
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Emergency Preparedness
Emergency Preparedness Response Team The DOCS Emergency Preparedness project expanded this year to form the Emergency Preparedness Response Team, a group that organizes hands-on training for medical students in preparation for a variety of emergency situations. This year’s events included: 1. Miami Poison Control: Drugs of Abuse Presentation 2. Active shooter response training session 3. Tactical Emergency Casualty Care Training Through these events, students learned how to recognize and treat drug overdoses, respond to active shooters, and care for the injured in a mass casualty situation. The group hopes to expand its trainings in the coming years with the goal of giving back to the community in a more tangible way.
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DOCS Health Fairs For its fourth year, the Emergency Preparedness team continued its mission of patient education at DOCS health fairs. At this station, patients learned basic hands-only CPR, received information about firearm safety and safe gun ownership, and worked with student volunteers to develop individualized hurricane preparedness plans. A new addition to the station this year was a collaboration with the American Red Cross Sound the Alarm program, which offers free installation of smoke detectors in patients’ homes.
Hurricane Preparedness Response Team This year, the Emergency Preparedness project laid the foundation for next year’s Hurricane Preparedness Response Team. Through this new project, medical students can volunteer to work in our hospitals and other local healthcare settings in the event of a hurricane affecting our community. The Hurricane Preparedness Response Team provides an excellent opportunity for students to gain hands-on clinical experience while giving back to the community in a time of great need.
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Medical Informatics ERA OF THE ELECTRONIC MEDICAL RECORD Starting in 2016, DOCS has used Research Electronic Data Capture (REDCap), a HIPAA secure online database often used for research, as an electronic medical record (EMR) system for our community health fairs. Utilizing a custom built branching logic, DOCS created a user-friendly system that provides patients a unique record number to assist in tracking their information longitudinally across different years, assist with real-time data collecting during each health fair, and ensure a standardized screening process based on US Preventive Services Task Force guidelines and other speciality specific society screening guidelines. The compilation of health fair data through REDCap also provides the opportunity for continual quality improvement and research that was not feasible with paper-based data collection. The REDCap creation allowed for seamless integration of the DOCS patient navigation program. As data is inputted in real time at each station, patients who have been identified as high risk (based on cutoff values for blood sugar, blood pressure, and other significant findings from screening stations) are flagged through the use of the branching logic function. After patients have been counseled by physicians at the Final Doctor Evaluation station, they are assigned a patient navigator (trained students who provide post-fair follow-up to ensure that the medical concerns are addressed). Managing the EMR for health fairs through REDCap has streamlined and organized the health fair experience for both patients and volunteers, while improving data maintenance and integrity. Furthermore, given the flexible nature of REDCap, our custom-made EMR will continue to be a key component for improving our screening services process and the patient experience.
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Research and Quality Improvement
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REDCap Analysis The unique platform of the REDCap EMR gives us the ability to garner insights to assess the current impact DOCS health fairs have on our patients and to improve upon the services we provide at future health fairs. The EMR contains a wide variety of information, from patient demographics to station-specific health results. We divided the potential data analysis into 3 categories: demographics/healthcare access, health statistics and trends, and health fair processes. The first category will provide us with a granular view of our patient population and how it changes over years, the health access barriers patients may face, and the reasons patients attend health fairs. The second category will enable us to assess how our screening fair may be affecting the health of our patient population in the long term. For example, by trending certain metrics over time in returning patients (such as blood pressure), we can indirectly measure the success of our screening and counseling. The final category will enable us to assess whether the health fairs are being implemented as we envisioned and identify areas we need to improve to have a more effective health fair. For example, by quantifying how many patients registered for the fair versus how many patients received counseling with a physician at the final doctor evaluation station, we can modify our processes to be able to reach more patients. This year, we focused on the first category and analyzed demographic and healthcare access data for all health fairs for the last 2 consecutive years.
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Research and Quality Improvement
Comprehensive Health Fair Report The REDCap Analysis Project gave rise to the implementation of Comprehensive Health Fair Reports. After each health fair, we generate a report that summarizes the salient aspects of the health fair. Reports include patient attendee number, demographic information, public relations information, number of patients that were able to attend the final doctor evaluation station, which healthcare diagnoses were seen the most, and station manager debrief responses. All values are presented with a comparison from the previous 2 years. The purpose of having a consolidated report is to better prepare the team organizing the health fair during the next year in terms of addressing specific issues station managers raised, improving public relations strategies, identifying which services were needed the most to better allocate volunteers, etc.
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REDCap Editing One of the main collaborative efforts this year was to streamline the REDCap EMR system. The current system consists of multiple forms, demographic questions, and screening questions to triage patients to appropriate stations and to obtain key patient information. The Research and Quality Improvement, Medical Informatics, Station Manager, and DOCS Executive Board teams decided that by reorganizing our triage format in REDCap, we could more efficiently screen patients, enable a smoother flow through the health fair, and better educate students on screening guidelines. Our goal is to test-run the updated REDCap EMR system before the 2019-2020 year starts.
DOCS Medical Education Training Video Series Two years ago, the DOCS Medical Education Training Video Series was created in order to standardize and improve student training for health fairs and clinics. We developed comprehensive modules to supplement the in-person training sessions. The modules consist of an introductory video that educates students on the purpose of the screening station and current USPSTF guidelines, a practical video that delineates how to perform the station-specific task, and a REDCap video that demonstrates how to input station-specific data into the EMR. Finally, the module includes a 5-question competency assessment. Internal surveys of students and station managers revealed increased satisfaction with training with respect to improvement in efficiency and comprehension of the material. The purpose of this training series is to enhance volunteer preparedness by having a standardized presentation of material that is consistent for each health fair, to improve volunteers’ awareness of screening guidelines and purpose of screening health fairs, to improve flow on the day of the health fair and reduce the amount of time station managers spend retraining volunteers, to ensure accessibility of training to volunteers who cannot attend the in-person training session, and to allow more time for students to engage in application-based learning and increase awareness of the cultural and societal context of each community that DOCS serves. This year, the newest modules in the series were the Intimate Partner Violence training module, the Haitian Creole Language training module, and the Psychiatry training module for San Juan Bosco Clinic. Our goal for the upcoming year is to complete training modules for all stations before the 2019-2020 health fairs begin.
Patient Satisfaction Survey The Research and Quality Improvement team created a validated survey tool to be implemented at the DOCS clinics in the next academic year. The primary goal of the project is to gather insight into two issues that are fundamental to DOCS’ mission of providing basic medical services and education to underserved populations in an efficient and effective manner: 1) What are the barriers to care patients face? 2) Are UM students and physicians providing optimal, patient-centered care? The survey will first be implemented at the San Juan Bosco clinic. 53
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Resident Feature: Mousa Botros, MD What is your current position and role in your professional life? Chief Resident at the Department of Psychiatry – University of Miami How has volunteering at DOCS as a resident impacted your current practice of medicine? I volunteered as a resident and it was extremely helpful to see the impact of such wonderful team work on patients as well as gauging the interest of medical students in the different presentations of mental illness. What do you think DOCS has to offer to patients, medical students, residents, and physicians? DOCS is a very unique environment that offers rich collaborative work tailored to help patients while empowering the analytical and communication skills of medical students, residents and physicians. What was your fondest memory of DOCS? Patients who are relieved to have their emotional stress validated, explore potential therapeutic outlets and possible referrals. Watching as medical students pursue psychiatry as a specialty inspired by their experience in DOCS. What are you most grateful about with regards to DOCS? I am grateful and honored to be able to be of help to such underprivileged patients. Are you currently active in DOCS? What is your role now? I’d like to think I’m active as a volunteer resident. Why is it important for medical students to be involved in DOCS? It is a life changing experience where medical students experience a close interaction with patients and get to explore the surrounding stressors to their illnesses obtaining the right healthcare they need. How does DOCS contribute to medical education? Helping students conduct patient interviews, explore treatment options, values of medications and therapy. How do you think DOCS contributes to medical care in the community? It is a tremendous help to the patients who have no access to healthcare, understanding their symptoms, illnesses, exploring the treatment options if needed, validating their concerns and guiding them in the community Do you have any other comments you would like to share? Thank you for such wonderful work, time and effort! You have helped a lot of people! Mousa Botros MD Chief Resident Department of Psychiatry and Behavioral Sciences Miami VHA/Jackson Memorial Hospital/University of Miami Hospital University of Miami – Miller School of Medicine 54
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DOCS Executive Board (Left to Right): Sandy Ren, Madhu Parmar, Leah Hellerstei
behind the scenes
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Contact Information
DOCS Faculty DOCS Faculty Advisor
Amar R. Deshpande, MD
adeshpande@med.miami.edu
DOCS RMC Faculty Advisor
Julia L Belkowitz, MD
jbelkowitz2@med.miami.edu
DOCS Manager
Raysa Christodoulou
rchristodoulou@med.miami.edu
DOCS Executive Board Executive Director
Lindsey Finch
l.finch@med.miami.edu
Executive Director
Vedant Acharya
v.acharya1@med.miami.edu
Co-Director
Priyanka Reddy
prireddy9@med.miami.edu
Co-Director
Sarah Sukkar
s.sukkar@med.miami.edu
Co-Director
Kyle Sutherland
kjs132@med.miami.edu
Interprofessional Education Director
Neelima Gaddipati
gaddipatin12@med.miami.edu
Logistics and Training Director
Nicolette Vassallo
nvassallo@med.miami.edu
Longitudinal Access Director
Samantha Greissman
srg144@med.miami.edu
Medical Informatics Director
Amir Patel
asp136@med.miami.edu
Public Relations Director
Sandy Ren
sandy.ren@med.miami.edu
Research and Quality Improvement Director
Madhu Parmar
m.parmar@med.miami.edu
DOCS Regional Medical Campus Executive Board Director
Leah Hellerstein
lhh36@med.miami.edu
Director of Clinics
Kelly Brennan
kmb183@med.miami.edu
LOW Health Expo Project Manager
Nicole Lin
lin.nicole@med.miami.edu
LOW Health Expo Senior Advisor
Vikram Paranjpe
vparanjpe@miami.edu
Healthcare Access Director
Michael Hu
michael.hu@med.miami.edu
Guatemalan Mayan Center Director
Anise Crane
axc1476@med.miami.edu
Stonybrook Director
Taylor James
tmj44@med.miami.edu
Research and Quality Improvement Director
Kelsey Franklin
knf22@med.miami.edu
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