Annual Report 2021-2022 UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE Mitchell Wolfson Sr. Department of Community Service
3 Table of Contents Thank You From DOCS Page 4 DOCS Mission Page 6 A Message From Dean Ford Page 7 DOCS History Page 8 Our Year in Numbers Page 10 Clinics Page 14 Fellow Feature: Dr. Sibi Krishnamurthy Page 20 Health Fairs Page 22 Regional Medical Campus Page 34 Community Partner Feature: Rebel Recovery Page 35 Community Health Leadership Conference Page 36 National Health Leadership Consortium Page 38 Emergency Preparedness Page 40 Patient Navigation Page 42 MedIT Page 43 Student Feature: Shaheen Emami Page 44 Alumna Feature: Dr. Lindsey Finch Page 48 DOCS Executive Board Page 53
This year marks the 21st Anniversary of the Mitchell Wolfson Sr. DOCS program creation. Though the Miller school has hosted community health fairs since the 1970s, it was in 2001 that the various medical student groups running these fairs decided to join forces and create the “Department of Community Service.” Such a collaboration of efforts has allowed the DOCS pro gram and its health fairs and clinics to flourish under one umbrella organization for more than 2 decades now.
Thank you from DOCS
The end of our tenure as Executive Directors has prompted us to reflect on how much the Wolfson DOCS program has changed our lives as students and future physicians; we feel so grateful for the unparalleled experiences that DOCS has given us in the realms of leadership, mentorship, and friendship. Each University of Miami Miller School of Medicine student who gets to experience a DOCS program—whether that is volunteering through a DOCS clinic, spending a day at a health fair, or presenting at our conference—gets to experience a taste of the unique mission of DOCS in providing quality and compassionate care to all patients and develop an ethos for health care delivery that matters. We want to express our gratitude for the incredible generosity of the Mitchell Wolfson Sr. Foun dation. Their commitment to the sustainability of the DOCS program allows us to deliver con sistent care to the patients in our community while also training the next generation of physician leaders to foster a lifelong commitment to serving the needs of underserved patients.
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It is hard to believe another year has come and gone and with it, another exciting season of DOCS! On behalf of our Wolfson DOCS family, we want to extend our heartfelt gratitude to all those who made this year possible - from our philanthropic donors whose generosity allows us to accomplish our goals to our hardworking students and physicians who donate countless hours to serving our patients, DOCS is built on a foundation of true dedication to serving the commu Thoughnity. we learned a great deal from our first full year operating during the COVID-19 pan demic, this past year was not without its unexpected challenges. Variants and surges threatened to upend fairs and clinics at a time when we were hoping to return to pre-pandemic levels of operations. However, the dedication of our donors, community partners, and volunteers allowed Wolfson DOCS to continue to address the needs of our patients and even expand the services offered to the medically underserved despite a constantly evolving and often uncertain situation.
We would also like to thank the numerous other donors whose gifts have assisted us to carry out our mission this year. In particular, we were honored to be selected by the University of Miami Health System’s (UHealth) Department of Community Health as the winners of the Communi ty Health and Benefit Grant, with which we will be able to expand our screening capabilities to include gonorrhea/Chlamydia, hemoglobin A1C, and hepatitis B screening at future health fairs.
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Lastly, we profoundly thank our DOCS faculty advisor, Dr. Amar R. Deshpande, and RMC DOCS faculty advisor, Dr. Julia Belkowitz, for their constant guidance of our program and ded ication to its success. We also thank our DOCS Manager and “Mom,” Raysa Christodoulou, whose daily support and assistance to our students cannot be overstated. The support that we and our DOCS student leaders have received through this mentorship has made this experience such a treasured time and has inspired us to continue the mission of this work into our future Ascareers.welook to the future, we feel more hopeful than ever about the durability and capabilities of this organization. The unique challenges we have faced and the novel solutions our staff, volun teers, and community partners have championed have proven the resiliency of Wolfson DOCS. We are confident the Wolfson DOCS program will be able to meet any difficulties that lie ahead and remain committed to serving our community. 2021-2022 Executive Co-Directors Billy Scola, Sirisha Gaddipati, and Rick Lin
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L eading: Fostering students’ leadership abilities among peers, colleagues and patients.
Training: Through practical experience, each participating student will demonstrate proficiency in the clinical skills to be performed.
Educating: Realizing the importance of not only educat ing ourselves, but also our patients and the communities in which they live.
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Our Mission
Wolfson DOCS, enlisting the participation of students and physicians of The University of Miami Miller School of Medicine, is dedicated to providing quality healthcare to the underserved populations in South Florida through:
7 A Message from the Dean ofbring“TheDOCSprogramrepresentsoneoftheMillerSchool’smostfundamentalandessentialmissions:servicetoourcommunity.Ourstudentsandfacultymedicalcaretoneighborhoodswhoseresidentsoftenhavenootherwaygettingthiscare.Thepatients’gratitudeandtheirhopeforgoodhealthinthefutureareaninspirationtoallofus.Itisaprivilegetobethedeanofamedicalschoolwhosestudentsaresocommittedtoprovidinghelptoeverymemberofourcommunitywhoneedsit.”HenriR.Ford,MD,MHADeanandChiefAcademicOfficerUniversityofMiamiMillerSchoolofMedicine
Our History
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Since the inception of the first health fair in Big Pine Key in 1971, the stu dents of the University of Miami Miller School of Medicine have made access to care for the medically underserved a top priority. In academic year 2000-2001, 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 2021-22 academic year, DOCS brought screening and educational services through its health fairs and clinics to over 1300 patients thanks to the volunteer efforts of hundreds of medical students and 181 physicians. Currently, DOCS holds 8 annual health fairs in underserved 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 and hearing loss, glaucoma, osteoporosis, fall risk, oral health, dementia, depression, HIV, and Hepatitis C, as well as colon, breast, cervical, and skin cancers. In addi tion, DOCS works closely with community partners to increase awareness about local resources through mini-health fairs and exhibitions. DOCS also operates 4 free student-run clinics that provide treatment in both primary care and specialized services through the Center for Haitian Studies Clinic, the IDEA Needle Exchange Clinic, San Juan Bosco Clinic, and our newest partnership with the Miami Rescue Mission Clinic. Using a referral system from our health fairs to free and reduced-cost clinics, we are able to provide continui ty 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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10 Our Year in UM521FacultyHours Resident551PhysicianHours 4,972MedicalStudentVolunteerHours 682 Patients Seen at Health Fairs 764 Patients Seen at Clinics
11 Numbers
12 2021-2022 Health
13 Fair Screenings
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Clinics
15 764 Total Number of Patients Seen at DOCS Clinics 4 Free Weekly Clinics
The creation of the Center for Haitian Studies (CHS) DOCS Night Clinic was inspired by a desire to expand healthcare access in the Little Haiti neighborhood of Miami. Since the clinic’s inception in 2019, all efforts have built upon our foundational partnership with the Center for Haitian Studies, an institutional beacon for the health and social needs of Little Haiti residents as well as for the greater Haitian diaspora community in South Florida.
The partnership between CHS and DOCS has led to increased access of care for those in the Little Haiti com munity and the larger Haitian diaspora. We currently serve as the sole primary care providers for a panel of over 100 patients and continually work with partners to increase community awareness of our services. We are very grateful for our patients who allow us to serve them and would like to thank the physicians who donate their time to oversee weekly clinic operations as well as CHS staff namely Dr. Pierre, Dr. Metellus, Gina, and Sonide for their support in making this clinic a reality.
Center for Haitian Studies Clinic157 patients seen
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The Center of Haitian Studies is also the site of the annual DOCS Little Haiti Health Fair which takes place each fall, so this event serves as a springboard for clinic health outreach campaigns and recruitment of patients into longitudinal care services offered weekly at the DOCS CHS Clinic.
The CHS DOCS Night Clinic is held every Monday night and offers comprehensive primary care services to uninsured individuals at no cost, thereby providing a stable, longitudinal, health hub and supportive resource in the Little Haiti community. Recognizing an unmet need for accessible culturally-component Women’s Health services amongst our patients, the CHS DOCS team began holding formal “Women’s Nights” every 6 weeks. Staffed by gynecologists, these nights aim to address the dynamic gynecological, reproductive, sexual heath needs of patients including both screening and treatment procedures. Through routine clinic operations, we are not only able to provide patients with high-quality primary care treatment as well as offer free diagnostic services such as ECGs or laboratory evaluations, but we also provide valuable health education and personally navigate patients through the process of obtaining free specialty care at Jackson Memorial Hospital should they need follow up for more complex health issues. Our DOC CHS staff, currently 8 first year medical students, work hand-in-hand with patients to ensure their health goals are met.
DOCS Mitchell Wolfson Sr. Department of Community seen
The DOCS San Juan Bosco (SJB) Clinic is a student-run, free clinic that operates every Tuesday night and rotates through seven different medical specialties: cardiology, psychiatry, neurology, pulmonology, rheu matology/musculoskeletal, gastroenterol ogy, and urology. Our patient population consists of individuals who do not have insurance and are at or below 200% of the federal poverty level. We offer laboratory and diagnostic testing at no cost to patients, help obtaining a Jackson discount card for those patients who need advanced special ty care or procedures, a patient assistance program that gives patients low-cost access to expensive medications, and referrals to various outside resources including physical therapy, psychotherapy, colonoscopy/endoscopy, and sleep studies. Our student-run night clinic has continued to grow and improve in the past year through various new initiatives. In order to decrease patient wait times and maximize quality of care, we follow a sched uled appointment system with patients scheduled in phased time slots throughout the evening. We continue to implement maximum limits on patients seen per evening and aim to do this responsibly by referring all patients with an active Jackson card to Jackson Memorial Hospital instead of to our weekly night clinic so that we could focus our resources on those patients who have no other access to specialty care. Finally, we have collaborated with the UM DOCS Emergency Preparedness team to offer a Two-Step CPR training session to patients while they wait to see the doctors at the clinic. This initiative will give patients in our community the opportunity to learn how to do compressions-only/ hands-only CPR in hopes to increase the chances of survival by CPR in non-hospital settings. In the 29 clinic nights held this academic year, DOCS SJB Clinic had a total of 135 patient visits with 57 physician volunteers and 319 student volunteers. We are very grateful for our patients who allow us to serve them and would also like to thank Luz Gallardo, the clinic’s medical assistants, our doctors, and our student volunteers who give their time and energy to make this clinic such a success.
San Juan Bosco Clinic
Service JUANSAN BOSCO CLINIC 135 patients
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The DOCS IDEA Clinic stemmed from a partnership with the IDEA Needle Exchange Program, the first legal syringe exchange program in TheFlorida.goalsof the DOCS IDEA clinic include addressing patient healthcare needs in a timely and comprehensive manner, working with patients to increase their trust in the healthcare system, and providing important educational opportunities for medical students regarding harm reduction. In addition to offering general primary care services and free point-of-care HIV and Hepatitis C testing, stu dent volunteers at our clinic work with dermatology, internal medi cine, infectious disease, and emergency medicine physicians to treat skin infections and abscesses that often occur secondary to chronic use of injectable drugs, as well as provide medications for opioid use disorder (MOUD) to assist patients in their recovery. Our physi cian volunteers educate both students and patients not onlyin the principles of harm reduction and methods to encourage historically marginalized patient populations to access healthcare, but also in the execution of necessary procedures such as abscess care and prevention. In addition, we offer telehealth appointments to increase healthcare accessibili ty to our patients. Through these efforts, we have been able to reach a variety of patients with primary care and wound care needs across South Florida. In June 2019 Governor Ron DeSantis signed the 2019 IDEA Act to expand the Miami-Dade pilot needle exchange program statewide. In collaboration with the DOCS National Health Leadership Consortium, the DOCS IDEA Clinic staff is now providing ongoing support to students at other Florida medical schools look ing to expand our clinic model. Through a recent grant, we have been able to provide patients with access to buprenorphine free-of-charge to aid in their recovery from severe opioid use disorder. We would like to thank Dr. Hansel Tookes, Dr. David Forrest, Dr. Serota, Dr. Chueng, Dr. Ciraldo and the entire IDEA Exchange Staff for their support and guidance. 322 patients seen on-site patients seen via telehealth
IDEA Clinic
10 0
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50 patients seen
The Miami Rescue Mission (MRM) Clinic is DOCS newest night clinic. We have a strong rela tionship with the Miami Rescue Mission Clinic which serves as a primary care clinic during the day to an all-men’s homeless shelter in Overtown and the surrounding community. Through this new clinic, we aim to improve access to specialty care for the residents at the shelter by removing the transportation and logistical barriers to seeking specialty treatment at Jackson. The MRM Clinic hosts rotating specialty nights once a month on Wednesdays. As this has been our first year as a fully operating clinic, we hope to increase the frequency of our clinic nights next year. The partnership between the Miami Rescue Mission Day Clinic and DOCS has helped residents at the homeless shelter receive timely and quality specialty care. We look forward to expanding our clinic in the years to come. We are very grateful for the day clinic staff at MRM who have helped us to get this clinic running smoothly and for their continued support.
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Miami Rescue Mission Clinic
is a Third Year Cardiology Fellow at UMH. He volunteers regularly at the SJB Clinic cardiology nights and DOCS Health Fairs. He has made a significant impact on the lives of many patients in the South Florida Community. This story exemplifies how Dr. Krishnamurthy helped provide life-saving treatment and access to longitudinal care to a patient in need.
Unfortunately, the pain was also becoming more intense and more frequent, even occurring at rest. At this point, she was experiencing what we call crescendo angina, which was progressing to unstable angina, a type of acute coronary syndrome where a blood vessel in the heart likely has a significant but not complete blockage. She had gone to another hospital the week prior but only had lab tests done (negative troponins to assess for an active heart attack). There was no echocardiogram, stress test, or cardiac catheterization performed, which are very important in a workup for a patient with these symptoms and risk factors. I’ve been to the SJB clinic many times through medical school, residen cy, and fellowship, but this was the first time I was really concerned that something needs to be done
“I first met our patient in the cardiology subspecialty night. The medical students I worked with had taken a great, thorough history and told me that she had been dealing with chest pain limiting her ability to do work over the past few weeks with symptoms that sounded like angina: substernal, worse with exertion, and relieved with rest. Our patient had all the classic risk factors for coronary artery dis ease: poorly controlled diabetes with an A1c of about 13%, severe hyperlipidemia with an LDL of 212, hypertension, obesity with a BMI of 31, and approaching her late 40s in age.
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Dr.urgently.SibiKrishnamurthy
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Fortunately, I saw her at the next Cardiology night. Her symptoms had gotten even worse since the last visit, and we once again spent a thorough amount of time explaining the importance of seeking im mediate medical attention at the hospital. She finally agreed to go the following night. I contacted my colleagues in the cath lab and ER at Jackson to expedite her admission so that we would minimize her length of stay and costs at the hospital. After being admitted to the hospital, she underwent the cardiac cath in the morning and was found to have a severe 80% blockage in the proximal portion of the biggest vessel of her heart, the Left Anterior Descending (LAD) artery. Heart attacks in this vessel have colloquially been referred to as the “widow maker” due to high rates of mortality. She had a stent placed at that site with significant improvement in the size and flow of the blood vessel. She was monitored overnight, started on the appropriate med ical therapy for her stent as well as for her hyperlipidemia and diabetes, and went home the following day without any complications. Since then, she has followed up at both the post-stent clinic at Jackson and at SJB where she reports no further chest pain. She has been able to go back to work without any limitations. Going forward, our main goal at the clinic will be to prevent any new plaques from form ing by optimizing her risk factors: cholesterol, diabetes, blood pressure, and weight.”
Dr. Sibi Krishnamurthy
The patient population that we see at SJB clinic has very limited access to medical care and testing provided at most major hospitals. A majority of these patients can’t even qualify for a Jackson Card, which has been a great resource for underserved populations in our county. As such, our best option was to stress to the patient that she needed to go the Jackson ER and that we would expedite a cardiac catheterization for her to assess her blood vessels and fix the potential blockage. We discussed the pos sible financial difficulties this may cause, especially with her work, but also relayed that the high risk of mortality and morbidity if she has an unstable plaque. I coordinated with the on-call cardiology fellow that night as well as the daytime consult fellow to be on the lookout for her arrival in the ER so that she would not slip through the cracks of the busy hospital. Unfortunately, she was hesitant to go, and despite phone calls from the daytime SJB staff as well, she never came to the ER.
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HealthFairs
the
Northside Seventh Day Adventist Church | August 21st, 2021
23 Opa Locka Mini Fair
We kicked off this year with our first “mini fair” in Opa Locka. a spike in cases, we enforced strict COVID precautions which set the precedent for rest of the year.
Amidst
COVID-19
LITTLE HAITI HEALTH FAIR
Little Haiti
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The Little Haiti Health fair is hosted annually at the Center for Haitian Studies, a non-profit organization that works with local members of the large Haitian community living in Miami. The ability to partner with and serve the Haitian community makes this fair unique and pro vides an exciting experience for DOCS students and physicians. The Little Haiti Health Fair was one of the first and longest standing partnerships of DOCS within the greater Miami com munity. The Little Haiti Health Fair was able to return to near full capacity this year, adapting to in-person social distancing and COVID precautions with masking and sanitation. This fair was the first of the year and a great success. The Little Haiti Health Fair provided a foundation for DOCS returning to full-scale health fairs for the 2021-2022 academic year.
Center for Haitian Studies | October 9th, 2021 DOCS
Mitchell Wolfson Sr. Department of Community Service
Liberty City is a community that truly represents the culture and history of Miami. Though just a few miles away from our medical campus, the healthcare challenges that this community faces continue to be evident. Through the Liberty City Health Fair, we aim to address these medical concerns by providing on-site care and resources to community clinics. This year we were able to partner with a new location, Dorsey Technical College, a school that educates health pro fessional students in the Miami area, with great success. Liberty City is known to be in a food desert where access to healthy fruits and vegetables is difficult for families. This is why we pro vide each family with a fresh bag of fruits and vegetables. We also were able to provide clothing, books, and toys to children whose parents attended the fair. Further, as the COVID-19 pandem ic continues to be present, we provided health fair attendees the option to receive the COVID-19 vaccine at our fair. Sr.
Dorsey Technical College | November 6th, 2021 DOCS Mitchell Wolfson
Department of Community Service LIBERTY CITY HEALTH FAIR
25 Liberty City
The West Kendall Health Fair provides healthcare screening services to a community that pri marily consists of Hispanic immigrants. This was our fourth year partnering with Capilla Del Rey, a church that is located in the heart of West Kendall. This year we returned to a full-capac ity health fair after the limited COVID-19 fair. We hosted a successful health fair and we were able to further strengthen our relationship with the church and the local community.
Capilla Del Rey
Church | December 11th, 2021
26 West Kendall
27 Marathon Middle High School + Key West High School | February 5th, 2022
Florida Keys
of Community Service FLORIDA KEYS HEALTH FAIRS
DOCS Mitchell
This year marked the 51st Annual Florida Keys Health Fair hosted by the University of Miami Department of Community Service in the Florida Keys. This year, we served over 200 patients across Marathon Key and Key West, Florida, at the height of the Delta wave during the COVID-19 pandemic. We safely and successfully provided essential diagnos tic and screening services to one of our most loyal patient populations, and we ensured their safety through the implementation of social distancing and enforcing the use of N95 masks. We remain grateful to our community partners for their continued support and dedication, and we look forward to hosting all three Florida Keys Health Fairs next year. Wolfson Sr. Department
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30 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 local community organizations and farms to engage those populations who may otherwise lack access to routine health screenings. South Dade Branches United Methodist Church | March 5th, 2022 DOCS Mitchell Wolfson Sr. Department of Community Service SOUTH DADE HEALTH FAIR
31 Allapattah
Village of Allapatah YMCA Family Center | April 16th, 2022
Allapattah is one of the most historic neighborhoods in Miami and is just miles away from our medical campus. We’re incredibly proud to have hosted our inaugural Allapattah Health Fair this year where we served a significant number of patients in a community where the health disparities are great. In just our first year, we provided patients with the knowledge and access to resources so that our healthcare system can better provide for them. We look forward to growing the fair next year and further assisting the Allapattah community for years to come!
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Scholarly Work
This year, RMC DOCS students worked to host multiple events in partnership with the GMC, including CPR and First Aid training sessions (in partnership with the DOCS Emergency Preparedness team), and a Skin Cancer screening event. As part of preparing for the screening event, students worked extensively to develop strategies and partnerships with other community organizations to connect patients to both primary care services and specialty services (if any skin cancer or other issues were identified). We hope that building these connections will allow for en during partnerships, which will help to strengthen access to healthcare for this underserved com munity.
The Guatemalan-Maya Center (GMC) is a non-profit community organization located in Palm Beach County that serves the Guatemala-Maya immigrant population in South Florida. In past years, DOCS has held events such as health literacy workshops focusing on community edu cation topics such as diabetes, physical activity, nutrition, and healthcare utilization, along with a simultaneous pediatric program, complementing the adult curriculum to engage the children and encourage families to come together.
Regional Medical Campus
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Healthcare Access
The RMC DOCS team presented two posters at the DOCS Community Health Leadership Conference on April 2022. The FLASH Clinic team presented a poster entitled “Establishing a free mobile wound care clinic for patients with injection drug use in Palm Beach County.” The GMC team presented a poster entitled “Implementing skin cancer screening at a LEP community center.”
Guatemalan-Maya Center
The RMC DOCS Healthcare Access Project aims to educate and empower students regard ing the health insurance and healthcare resources options in Palm Beach and Broward Counties, as well as provide students with public health volunteer opportunities in partnership with the Health Council of Southeast Florida (HCSEF). A major initiative of the Healthcare Access team is to con nect students to resources for their patients, including free and reduced clinics and other healthcare resources. The HCA team maintains a digital catalog of resources that can be accessed by a QR code distributed in sticker format to all RMC students, and presents on key community resources to all incoming RMC students during their public health and orientation sessions.
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FLASH Exchange Clinic
The FLASH Clinic is a new project for RMC DOCS, building off of previous advocacy efforts by past RMC students. FLASH is a syringe service program operated by Rebel Recovery, an organiza tion that serves people who inject drugs and/or are experiencing homelessness in Palm Beach County. RMC DOCS students operate a bimonthly mobile clinic in partnership with FLASH, the Department of Health, and local physicians, providing wound care and other medical services to FLASH participants. The clinic, which first started in Fall 2021, now operates at two locations in Delray Beach and Lake Worth.
Medical students that volunteer at FLASH clinic with DOCS at the RMC get a unique oppor tunity to work with people who use drugs in those participants’ environment. Medical student vol unteers get to interact with many participants that will not go to a hospital, unless they are absolutely forced too. This is because of poor treatment, stigma and negative experiences they have had in the past. Unfortunately, most of our participants have had these experiences, which has made them weary and untrusting of doctors in a normal medical setting.
Community Partner: Rebel Recovery
Medical students will get one on one experience dealing with people who are currently using drugs and get an inside perspective. Because of the relationship and trust that the participants have built between the employees on FLASH, they know that they are in a place where they will not be judged or have consequences for their drug use. Because of this, they are more honest and open with the medical team. The medical students also gain knowledge of safe use practices, drug interactions, what drugs are currently being distributed and used on the street, and different medical complications as they relate to the use of specific substances.
36 Community Health Leadership Conference
The seventh annual DOCS Community Health Leadership Conference (CHLC) was held on April 15th-16th, 2022. We had 135 participants from 8 medical schools through out the country in attendance at the first back in-person DOCS conference since 2019. We hosted over 65 unique posters on community health initiatives at student-run free clinics, health fairs, and healthcare service organizations across the United States. This year, we had the pleasure of hearing from Dr. Erin Kobetz, Vice Provost for Re search + Scholarship, as our Keynote Speaker, who spoke candidly about the importance of aligning passion with purpose. We also offered conference participants an opportunity to volunteer at the Allapattah Health Fair and get a behind-the-scenes perspective on the logistics of health fair planning. We are very proud of our success over the past seven years and are hoping we can continue improving the conference to become the premier national event for leaders at student-run health initiatives to share, collaborate, and improve the services they provide to their patients.
37 Awards Gala Highlights First Place in Oral Presentation: Renaissance School of Medicine at Stony Brook University “Development and Implementation of Social Needs Assessment at a Student Run Free Clinic” First Place in Poster Presentation: Northeast Ohio Medical University “Telehealth Education at a Student Run Free Clinic”
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National Health
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:
ConsortiumLeadership
Florida Clinics Collaborative (FCC): In partnership with the University of Florida, DOCS NHLC formed a Florida Clinics Collaboration that includes medical schools from across Florida. We have assisted other Florida medical schools with a variety of endeavors, including assisting Florida International University medical school in setting up REDCap to use as their electronic medical record system for health-fairs, sharing the details of the UM DOCS upperclassmen clinical elective structure with University of Central Florida, and sharing online training modules and standard operating procedures with all other Florida schools who are looking to implement Intimate Partner Violence training into their free clinics. During the COVID pandemic, we disseminated DOCS protocols with other schools on how we were updating our procedures as well as a protocol for commu nicating with local health systems. 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 aims 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 Spring 2022. This year, NHLC is collaborating with the University of Florida to establish Uber Health at our CHS clinic. University of Florida has already implemented Uber Health at their free clinics as a means to improve appointment attendance for patients who lack re liable transportation to and from their appointments, and they are guiding us through the logistical groundwork that was laid to implement this program.
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National Clinics Collaborative (NCC): NHLC has begun to expand the Florida Clinics Collaborative Model to other states and regions around the country. NHLC aims to disseminate the DOCS model by creating a “starter-kit” for how to start a clinic and/ or a health fair using the DOCS structure as a guideline. NHLC has partnered with UF to create a survey to assess clinic and health fair demographics that will be disseminated nationally to assess needs for clinic and health fair services. During the COVID pandemic, there were collaboration efforts to translate important COVID health information, gath er and provide information on obtaining stimulus checks, and establish EMRs for stu dent-run free clinics.
IDEA Clinic Expansion: After contact established at the annual DOCS Community Health Leadership Conference, medical students at University of Central Florida (UCF), University of Florida (UF), and University of South Florida (USF) all expressed interest in establishing their own needle exchange clinic, modeled after the IDEA Needle Exchange. NHLC facilitated meetings between the UCF and UF student groups and Dr. Hansel Tookes, founder of the Miami IDEA Clinic, to help them navigate the current political landscape and engage key community leaders. NHLC has also connected with students in Texas, California, Arizona, and New York who are interested in collaborating on needle exchange programs.
40 Emergency Preparedness
The Emergency Preparedness Response Team organizes hands-on training for medical students in preparation for a variety of emergency situations, coordinates student volun teers for university disaster response, and provides community outreach in emergency and disaster preparedness. This year’s activities included:
2. Medical Student Event - Stop the Bleed: Tactical Emergency Casualty Care Training
1. Leading DOCS/medical student response for the 2021 Haiti Earthquake by inventorying supplies with UM partners and providing logistics support
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3. CPR education expansion to RMC at the Guatamalan Maya Center and Miami DOCS clinic nights The Emergency Preparedness (EP) team continued its mission of patient education at DOCS health fairs through the EP Station. At this station, patients learned about hands-only CPR, received information about firearm safety and safe gun ownership, were offered free installation of smoke detectors through partnership with the American Red Cross Sound the Alarm program, and worked with student volunteers to develop individ ualized hurricane preparedness plans.
Patient Navigation
In total, we helped 163 patients from the health fairs with Patient Navigators, 44 patients with MS1s in their curriculum, and 14 patients from the Jackson Emergency Department. Next year, we hope to focus on quality improvement within our patient navigation pro gram. We plan on reaching out to patients who have been navigated within the last two years and asking them about their experience to identify points of improvement within our current navigation system. We also want to assess whether or not they were able to achieve their health care goals through our navigation program.
We train about 206 students to serve as patient navigators each year to provide longitu dinal 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 or 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. Additionally, this year, we trained navigators to help patients from the Jackson Emergency Department and trained MS1 students to begin navigation as a portion of their curriculum.
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43 MedIT
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, assists with real-time data collecting during each health fair, and ensures a standardized screening process based on US Preventive Services Task Force guidelines and other specialty specific society screening guidelines. This year, the Medical Informatics team (MedIT) worked on incorporating health fair pre-registration for patients into our existing REDCap EMR. Patients could access pre-registration through either a link or scanning a QR code which eased the demands on our health fair teams. In addition, patients could be triaged to various health fair sta tions earlier through this pre-registration process thus giving health fair teams additional time to strategize efficient health fair flow. MedIT also authored a paper that explains how DOCS uses REDCap as a novel-EMR. The hope is to disseminate this information to oth er student-run clinics throughout the nation and have our EMR serve as a low-cost model for others.
Whatgoalsdidyouhaveforyourpositionthisyear?
I chose to apply for this position because of my prior experiences and deep passion for emergency medicine! Before and even during medical school, I worked as an Emergency Department Technician for a total of about 3 years. I also worked as a Burn Technician in the Burn ICU and as a CPR Instructor for about 6 months. The love I found for emergency medicine is what inspired my journey to become a physician, and the EP station provided exactly what I wanted: education and emergencies!
This year, I really wanted to expand our hands-on training, as COVID protocols were rightfully a signif icant obstacle to that in the previous year. I added a training Epi-pen, malleable splints, ACE wraps, and even a Choking Trainer to expand our first aid education. In addition, we had an Emergency Medicine resident come to one of our fairs to provide Stop the Bleed training. With the help of our medical stu dent and graduate student volunteers, I believe our CPR education with adult and infant mannequins were the biggest attraction. Many patients wanted to learn CPR and about AEDs, and we were happy to teach these potentially lifesaving skills. In the upcoming year, we are hoping to add an emphasis on opi oid overdose management. The recent work by emergency medicine resident, Dr. Joshua Goldstein, and medical student, Kelley Benck, at the HIV/HCV station to distribute Narcan to patients has stirred the potential for us to provide hands-on training of opioid overdose recognition and Narcan administration on our CPR mannequins. I’m looking forward to what we add to the station this upcoming year.
44 Student Feature chooseWhatwasyourroleinDOCSthispastyear?Whydidyoutoapplytothisspecificposition?Thispastyear,IwastheEmergencyPreparedness(EP)StationManagerforDOCScommunityhealthfairsthroughoutMiamiandSouthFlorida.Ourstationisuniqueinthatitisnotatypicalstationthatperformshealthscreenings.Instead,ourroleispredominantlyeducation.Throughphysicalinstructionandpaperresources,westrivetopreparepatientsforunexpectedemergenciesthattheymayexperienceoneday.WediscussgunsafetyandprovidegunlockssuppliedbyourlocalVeteransAffairshospital,aswellaseducationonhurricanes,firesafety,householdtoxicology,animalsafety,COVID-19,andmanymoretopics.
This upcoming year, I will continue my involvement with DOCS Emergency preparedness as a Senior Advisor, and I am ex cited to work with the new station manager, as well as becoming more involved with the other projects that our incredible team has to offer. With the help of Tara Tardino and our resources at the Gordon Center, this year we have also expanded CPR training to our RMC sites, such as the Guatemalan-Maya Center and Lake Worth High School. I hope those connections and educational opportunities continue to expand at our RMC locations in Broward and Palm Beach County. I am returning to Miami at the end of this year, and I am hopeful that our Emergency Preparedness team can continue working to cre ate educational opportunities for our communities in the Miami-Dade area as well. In addition, it would be great if we can continue to work with our Emergency Medicine residents involved in Stop the Bleed training events. We have so many resources here at UM, and I am hopeful that our team will utilize these resources to provide education opportunities to our students and communities.
HowhasyourinvolvementwithDOCSimpactedyourmedicalschoolcareer?MyinvolvementwithDOCShasopenedmanydoorsformeinmedicalschool.
45 Shaheen Emami
WhatskillshaveyoulearnedfromyourexperienceswithDOCSthatyouhopetocarryintoyourcareer?BeingtheStationManagerfortheDOCSEmergencyPreparednessstationconfirmedformethatcommunityoutreachandpatienteducationwillbeanimportantaspectofmyfuturecareerinmedicine.IbelievethatithassupplementedmyownexperienceasanMD/MPHstudent,andgivenmeideasonhowIwouldliketoinvolvepublichealthandeducationintomycareerasaphysician.Whetheritbeholdingeducationalclassesorteachingmyindividualpatientswhentheopportunityarises,orgettinginvolvedwithoutreachgroupstoprovidecommunityhealthservices,DOCShasnodoubthelpedmeframemyviewofmyfuturecareer.Additionally,theseexperienceshavereinforcedinmemycareerinterestofEmergencyMedicine.Ihaveworkedwithandmetsomanyemergencymedicinephysicianswhoarepassionateaboutbothcommunityoutreachandeducation.IttrulyfeelslikeIfoundmyfit,andIamgratefulformyexperienceswithDOCSthatIhavehadthusfar.
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Whatisyourcurrentareaofpractice?Iamarisingfourthyear(PGY-4)residentphysicianintheDepartmentofObstetrics at Jackson Memorial Hospital.
WhatisyourinvolvementinDOCS?Ihavevolunteeredatthehealthfairsfor the past 3 years and look forward to continuing this year.
nizationWhatwasyourinvolvementwithDOCSduringmedicalschool?Howhaveyouseentheorgaevolvesinceyourtimeasamedicalstudent?IwastheProjectManagerataweeklyfreeclinicDOCSusedtohaveatLotusHouse,andalsoservedasaCo-DirectorandeventuallywasoneoftwostudentDirectorsofDOCS.Ialsolovedservingasavolunteeratourhealthfairsandclinics,includingtheclinicatSanJuanBosco,MytimeworkingwithDOCSasamedicalstudentissomethingthatItrulycherish,andithelpedmetobetterunderstandthemyriadbarriersmanypatientsfaceinreceivingcare.MytimewithDOCScontinuestoinformandguidemypracticeasaphysicianeveryday.Ithasbeensoincrediblyrewardingtoseetheevolutionofthisfantasticorganization.Iamespeciallyexcitedaboutthegrowthoftheclinics,thenewinitiativestohelppeopleexperiencinghomelessness,andtheamazingcreativityandperseverancethatallowedDOCStocontinueandexpanditsmissionduringthepandemic.Theachievementsyouallhavemadehaveexceededmywildestdreamsandexpectations.Iamtrulythrilledtoseealloftheprogressthatyouhavemade.Iknowhowmuchtime,effortandthoughtgoesintomakingDOCSsuchasuccess,andIamsoimpressedbytheeffortsthatyouallhavemade.Ilookforwardwatchingyourcontinuedsuccess,butItrulythankyouallsomuchforyourfantasticworkonbehalfofpatients.
48 Alumna Feature
and Gynecology
do. I
and impressed
throughout our community and expanding efforts in the areas of patient education and access to primary care. As
done and
forward to the privilege of continuing to work
you all.
I am so proud
all of the work
49 Dr. Lindsey Finch
you
WhatWhatisyourfavoritepartaboutyourworkwithDOCS?Ilovebeingabletospendtimeworkingwithouramazingpatientsandvolunteers.Cervicalcancerpreventionisapassionofmine,andbeingabletotaketimediscussingthistopicwithpatientsandstudentsisanincredibleopportunitythatIcherish.doyouhopetoseeincomingyearsatthehealthfairs?Ilookforwardtocontinuingtoservepatients I mentioned earlier, of by that have will continue to look with
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53 DOCS Executive Board 2021-2022 Co-Executive Directors: Billy Scola, Rick Lin, Sirisha Gaddipati Co-Directors: Ankit Shah, CJ Na, Tori Gabor RMC Director: Maggie Ginoza Logistics Director: Emily Swafford Interprofessional Education Director: Liz Caldera Longitudinal Access Director: Emily Dawra Medical Informatics Co-Directors: Kireeti Dulla, Kristin Gmunder Public Relations Director: Natalie Hickerson Research & Quality Improvement Director: Evie Sobczak Training Director: Marquese Noel-McCormick Faculty Advisor: Amar R. Deshpande, MD DOCS Manager: Raysa Christodoulou
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