Department of Medicine Annual Report 2021

Page 1

Emerging Stronger Department of Medicine Chairman’s Report 2021


Table of Contents Chair’s Message

1

Monitoring COVID Patients from Afar

2

Bridging the Divide

6

Academic medical

A Call to Action

10

By the Numbers

16

Division Highlights

18

such as ours, have the

Faculty and Administration

40

responsibility to face the

Philanthropy

44

challenges of our time.

Editor Laura J. Pinzon Director, Business Operations Photography UM Biomedical Communications Jenny Abreu Design, Editorial and Project Management SparkIt Communications, Inc. Published by the Chairman’s Office of the Department of Medicine at the University of Miami Miller School of Medicine. All contents, ©2021 University of Miami. Reproduction in whole or in part without previous written permission by the editor is prohibited.

centers and departments,


Chair’s Message Welcome to the 2021 Annual Report of the Department of Medicine at the University of Miami Miller School of Medicine. In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic, and life as we knew it changed. This disease impacted all aspects of life, from the healthcare we provided our community to how we continued our pursuits of discovery and education. Throughout this time, we remained focused on our missions and our patients, faculty, and staff. Something as infinitesimally small as a viral particle has killed millions of people and turned our world around. Ultimately the virus was no match for the resiliency of the human spirit. During this past year, we experienced the realization of a modern-day miracle. Consider for a moment the brilliance of engineering: a lipid sphere containing a molecule of RNA can be injected into the arm muscle resulting in our body’s cells manufacturing a viral-specific protein that alerts the immune system to fight off the Sars-CoV-2 virus, which can put a stop to the pandemic. Years of research to understand the chemistry, biology, and medicine of RNA viruses and the immune system have allowed human ingenuity to reach what is now considered the “Diamond Age” of medicine. Academic medical centers and departments, such as ours, have the responsibility to face the challenges of our time. Among our missions is to confront sickness, addiction, aging, and at the same time, never lose sight to embrace inclusivity, diversity, and humanism. In this report, we will explore how the Department of Medicine is Emerging Stronger despite the extraordinary challenges we face. As Chairman, I am proud of how the Department of Medicine showed tenacity and compassion and led the way in finding solutions to the current problems. I hope this report gives you a better understanding of how special it is to be a faculty member of the Department of Medicine at the University of Miami Miller School of Medicine. All my best,

Roy E. Weiss, M.D., Ph.D. Professor of Medicine Chair, Department of Medicine Kathleen & Stanley Glaser Distinguished Chair in Medicine Rabbi Morris I. Esformes Endowed Chair in Medicine and Endocrinology University of Miami Miller School of Medicine

Department of Medicine Chairman’s Report 2021

1


Monitoring COVID-19 Patients from Afar How innovative telemedicine technology and teamwork helped save lives

2 UHealth|University of Miami Miller School of Medicine


D

uring one of the most isolating times in human history, technology made some unexpected connections at the

University of Miami Department of Medicine. In July 2020, the department launched the UHealth Televigilance Program, allowing physicians to remotely monitor and care for qualifying COVID-19 patients. No one could have guessed its impact on the fellowship and camaraderie shared by Department of Medicine internists. Though already a cohesive team, UHealth providers rallied around this innovative device and united further to save lives while relieving strained hospital resources in the process. “We all had a call to action to make a positive difference so quickly,” says Sabrina Taldone, M.D., M.B.A., medical director of the UHealth Televigilance Program and associate program director of the Internal Medicine Residency Program at the Miller School of Medicine. “Everyone was on the same page about how to get these patients home safely. We were able to align goals across multiple ancillary services, as well as different parts of the hospital.” Physicians, nurses, and therapists came on board during the pandemic to facilitate the safest hospital-to-home transitions of care. As of last year, COVID-19 patients who met the criteria for discharge were equipped with

a TytoCare home health apparatus that electronically recorded and transmitted timely health status information to healthcare providers. Implemented under the UHealth Televigilance Program, the remote monitoring device assisted in decreasing the length of hospital stays, curtailing readmissions, and freeing hospital beds. Historically, the data captured by the TytoCare device could only be viewed in the TytoCare platform by logging into their website. The UHealth IT team built out an Epic® integration so that all submitted data, progress notes, and communications could be kept in one place in Epic®, thereby improving patient safety by making the process seamless for the healthcare teams to care for patients Department of Medicine Chairman’s Report 2021 3


in the program. For example, patients submitted vital signs daily via their TytoCare device at home. Vital signs then appeared in the provider’s Epic® (UHealth Chart) In Basket with enhancements that drew attention to abnormal vital signs so they could be acted upon. “Dr. Cristina Pravia and I would follow patients’ vitals. If there were abnormal vital signs, we would contact the patient and initiate a telehealth visit to figure out how ill they were,” recalls Taldone. “We would help to triage them to a higher level of care if necessary or, if there was something we could help them with through that encounter, give them guidance on how to help alleviate their symptoms, what to be looking for, and when to go back to the hospital.” Telemedicine has bridged many gaps that social distancing created during the pandemic, but only up to a certain level. With the TytoCare device, physicians have been

discharged from the hospital, while 17 were discharged from the emergency room. Notably, 41 percent of the COVID -19 positive patients being monitored in the program were discharged home on oxygen delivered through a nasal cannula. Tomas Camacho, 73, was discharged from UHealth Tower with oxygen after staying several days in the hospital for COVID-19 pneumonia. His son, Thomas Camacho, appreciated how much the device helped him as a caregiver. “The TytoCare device has been amazing because we’ve been able to send all the information directly to the doctor, and she has contacted us and been very helpful in everything. It gives you a little ease,” Thomas Camacho says. At one point, Mr. Camacho’s vitals data showed that his blood pressure had dropped precipitously, and his oxygen saturation was low. “After reviewing records from his hospitalization in the electronic medical record, I initiated a telemedicine visit with the patient and his “We’re actively looking into how we can learn from son,” Taldone recalls. “Our visit revealed the this experience. We were able to monitor COVID-19 patient had re-started his home medications patients remotely with this device, so we’re trying to for hypertension. After adjusting his find what other disease states that could potentially medications, his blood pressure improved. By be a good fit for this kind of technology.” seeing the patient on screen, I also noticed — Sabrina Taldone, M.D., M.B.A. the nasal cannula was not properly placed able to accomplish much more, completing on his face. The patient and his family also comprehensive exams of patients who might needed education on how to appropriately otherwise need to remain hospitalized. titrate his home oxygen. With this support, we During the pandemic, 67 patients were were able to help the patient avoid a call to monitored. Fifty of these patients were 911 and a hospital readmission.” 4 UHealth|University of Miami Miller School of Medicine


“If there were abnormal vital signs, we would contact the patient and initiate a telehealth visit to figure out how ill they were.” — Christina Pravia, M.D. While the pandemic revealed and set limitations on healthcare systems throughout the world, it also challenged participants to defy those limitations. UHealth met that challenge through collaboration and innovation, and in doing so, emerged stronger than ever to face the demands of tomorrow. Today, UHealth is conducting pilot projects using the TytoCare device and exploring additional opportunities within the ambulatory realm, such as for patients in the cystic fibrosis clinic. TytoCare is also being At a time when hospital beds were scarce, department faculty used the innovative Tytocare home health device, which allowed eligible Covid-19 patients to be discharged and monitored considered from an acute onsafely from home. demand perspective for specialty consultations. “We’re actively looking into how we can says. “COVID-19 was a good model for learn from this experience. We were able telemedicine, and remote care may not be to monitor COVID-19 patients remotely with ideal for all diseases, but there are certainly this device, so we’re trying to find what other ones where we can improve patient care and disease states that could potentially be a convenience of care, while also improving good fit for this kind of technology,” Taldone quality outcome measures.” Department of Medicine Chairman’s Report 2021 5


Bridging the Divide Pioneering, research-based outreach programs that target and empower the underserved

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F

or more than 65 years, students and faculty at the University of Miami Miller School of Medicine have been

committed to easing the burden that poverty, drugs, disease, and discrimination place on the area’s medically underserved. The school has implemented innovative, research-based outreach programs designed to improve the health and lives of Miami’s vulnerable community. And it’s worked. But this past year, COVID-19 interrupted and threatened to kill that progress. Two Miller School physicians refused to let the virus win. Hansel Tookes, M.D., M.P.H., associate professor of clinical medicine in the Division of Infectious Diseases at the University of Miami Miller School of Medicine, has spent his career fighting for social justice and equality in marginalized communities. He’s been a staunch proponent of implementing syringe service programs (SSPs) to reduce the rate of HIV, hepatitis C, and other blood-borne diseases. In 2016, he founded the Infectious Disease Elimination Act (IDEA Exchange) an SSP that offers resources for people who inject drugs. Through this program, Tookes and his staff not only continued their routine efforts during the COVID-19 outbreak but provided free vaccinations that boosted community outreach and proved the viability of using telehealth to treat addiction. Tookes and his staff promoted the Pfizer COVID-19 vaccination, obtaining media coverage on the first day of vaccination at Jackson Memorial Hospital—the first and, for a

time, only vaccination site for the surrounding community in Miami—and mounting an aggressive media and educational outreach campaign. He realized then that a large demographic was missing from the queue, alerting him to the potential for dangerous inequities in vaccine distribution. “The cars were very fancy,” Tookes says. “I was very vocal that we needed to make sure that the people we were vaccinating reflected the people we serve in the hospital, and it wasn’t necessarily that way. Our patients in the hospital are black and Hispanic and poor, so we needed to make Department of Medicine Chairman’s Report 2021 7


sure that we were redoubling efforts to vaccinate this community.” He partnered with Jackson to start an aggressive vaccination awareness campaign that featured town halls with Jackson staff, influencers, preachers, and business owners. Other outlets included live televised events, PSAs, and social media blitzes. Tookes says that Jackson picked up the slack of vaccinating members of the black community, which accounted for roughly 50 percent of the African-American population in all of Miami-Dade County. “I really started advocating for vaccine equity in the press,” says Tookes. “This was really my community engagement over the past year.” Tookes guessed correctly that substance use would increase during the pandemic, so he kept IDEA open. Students running the free clinic there suggested using telehealth to continue prescribing medication amid social distancing protocols. “Our patients usually don’t have access to WiFi and all of the technology, so we brought the technology to them,” Tookes

says. “We worked with Jackson to develop an electronic prescribing system (for addiction medications) and then received funding from the state to pay for 100 people to be in treatment. So we were able to prove the concept during the pandemic. And now we get to do a clinical trial to show that telehealth might be considered best practice. We created something out of nothing.” Tookes’ work this past year earned him the Avenir Award from the National Institute on Drug Abuse, a $2.3 million, fouryear award that will support his research project, “Tele-Harm Reduction for Rapid Initiation of Antiretrovirals in People Who Inject Drugs: A Randomized Controlled Trial.” The Tele-Harm Reduction program enlists three physicians who are on call with rotating schedules to respond to patients, regardless of their location. The program leverages telehealth technology, as well as the trust that IDEA has built in the community. The current SSP framework also shows great promise as an adaptable and transformative model for bringing HIV care out of a traditional healthcare clinic, sustaining viral suppression among people living with HIV who inject drugs, increasing the use of medications for opioid disorders, and curing patients with hepatitis C. It’s hard to believe a pandemic could result in so much positivity. “It was so amazing that we had the technology. I felt so connected to them at a time when life was so uncertain,” Tookes says. “I’m very thankful I had the army of “Our patients usually don’t have access courageous staff on my team.” For more than 10 years, Armen to WiFi and all of the technology, so Henderson, M.D., hospitalist at UHealth Tower and assistant professor of we brought the technology to them.” medicine at the University of Miami Miller School of Medicine, has brought medical — Hansel Tookes, M.D., M.P.H. care to Miami’s inner cities. Like Tookes, 8 UHealth|University of Miami Miller School of Medicine


he cares for a community ravaged by diabetes, HIV, high blood pressure, asthma, sickle cell anemia, obesity, poverty, and systemic racism. He’s a leader in building projects that see the job through. In 2014, he became a co-organizer for Dream Defenders, a social advocacy group that focuses on helping vulnerable populations obtain access to the social determinants of health. He also founded Dade County Street Response (DCSR), which trains and educates medical professionals for disaster resilience efforts. When hurricanes or tornados loom, Henderson and his team move to provide free medical care, disaster relief education, food, water, and shelter for people most affected by poverty and oppression. COVID-19’s consequences mirrored that of a natural disaster, and because DCSR was already equipped for triage, Henderson’s team handled the outbreak in a similar fashion. They spent countless hours helping the area’s homeless and poor obtain free COVID-19 testing, face masks, information about the virus, and full hygiene services. The urgency here was to outpace the disease, which would spread quickly across a population marked by underlying health conditions. “By the middle of the pandemic, we were providing toiletries, offering showers. We had bathrooms, we had handwash stations, we were testing individuals. We probably tested over 500 individuals and served thousands of people over a span of seven months,” says Henderson, who joined hundreds of volunteers at St. John’s Baptist Church in Overtown.

“Being able to advocate on behalf of this community is important, but so is knowing that it follows a long tradition of helping with people who are struggling to survive.”

— Armen Henderson , M.D.

One of the most rewarding aspects of his work is knowing that the community he serves can rely on him no matter what. For Henderson, there is no determinant of care other than being a person in need. This makes it all the more galling that a police officer handcuffed and detained him last year while loading a van outside his home with tents for the homeless. The police officer inexplicably thought he was dumping garbage and released him only when Henderson’s wife presented identification. The incident highlighted the social disease that threatens people of color as well as any deadly virus can. “Being able to advocate on behalf of this community is important, but so is knowing that it follows a long tradition of solidarity with people who are struggling to survive,” he says. Department of Medicine Chairman’s Report 2021 9


A Call to Action Ensuring high standards and minority representation in fast-paced vaccine trials

10 UHealth|University of Miami Miller School of Medicine


I

n 2020, physician-scientists at the University of Miami Miller School of Medicine worked hard and fast to address the threat COVID-19 imposed on

humanity. UM partnered with the National Institutes of Health (NIH) COVID-19 Prevention Trials Network to test investigational vaccines against the deadly virus. Clinical trials began in July with the Moderna vaccine, followed by the single-dose Janssen Pharmaceuticals product (Janssen is a subsidiary of Johnson & Johnson). Researchers in UM’s Department of Medicine partnered with the Department of Pathology, Interdisciplinary Stem Cell Institute (ISCI), and Sylvester Comprehensive Cancer Center (SCCC) and moved with relentless speed to demonstrate vaccine efficacy and safety. Despite the intensity of the race, the team maintained high scientific standards following strict protocols to ensure results were sound.

Above: Susan DobleckiLewis, M.D., M.P.H., speaking about the Phase 3 trial for a COVID-19 vaccine. The Miller School of Medicine’s participation in the clinical trial, part of the National Institutes of Health COVID-19 Prevention Trials Network, was one of 89 sites across the U.S.

“Absolutely no corners were cut in terms of the actual research. There were external monitors all the time, and we had our own set of monitors,” says Olveen Carrasquillo, M.D., M.P.H., professor of medicine and public health sciences and chief of the Division of General Internal Medicine. “We made sure that all the data collected was done per protocol, and we got it done quickly. I was really proud of the team.”

The Miller School’s long legacy of infectious disease treatment, prevention research, and clinical trials made it an ideal testing site. As a leader in HIV/AIDS research and a member of the NIH’s HIV Vaccine Trials Network, UM’s infrastructure was already in place to conduct COVID-19 clinical trials. Susanne Doblecki-Lewis, M.D., M.P.H., clinical director for the Miller School’s Division of Infectious Diseases and principal Department of Medicine Chairman’s Report 2021 11


“Even though we have a very experienced team, this was still much bigger than anything we’ve put together before. It was a tough time but there was a need to move with lightning speed.” — Susanne Doblecki-Lewis, M.D., M.P.H.

Data were analyzed to determine the efficacy of convalescent plasma on the severity and length of the COVID-19.

investigator on the Moderna trial, says the bigger challenge, in fact, was keeping up with the pace and scope of the work during the most intense period of the pandemic. The staff had never experienced anything like it. “Even though we have a very experienced team, this was still much bigger than anything we’ve put together before. It was a tough time but there was a need to move with lightning speed,” says DobleckiLewis. “The staff did an amazing job.” According to Doblecki-Lewis, staff from all existing research areas were called in to work on this. It also helped that most of the nonCOVID-19 research had been paused due to the pandemic. “We reassigned everyone we had available and then pulled in people from other areas and hired individuals to work on the vaccine project. It was a heavy lift. Everyone worked extended hours and the staff was here every day,” she says. Of utmost importance was ensuring vaccine equity among minority groups.

12 UHealth|University of Miami Miller School of Medicine

Early CDC studies determined that black, Hispanic, and indigenous populations would more likely suffer the effects of COVID-19. It was critical, therefore, to recruit a large representation of Miami’s multicultural population to confirm the vaccines’ mass efficacy. “We know what approaches to use to recruit these minority populations and we know how to reach them. That’s what we do. That’s our skill set,” says Carrasquillo. “Here we had a disease that was disproportionately affecting minority communities, and it looked like these individuals were not going to be well represented in the vaccine trials. Many of the landmark studies on diseases like diabetes, heart disease, and even cancer did not have adequate minority representation. I remember saying to myself, ‘This is not going to be like that.’” For the first randomized, double-blind study, 300 participants braved the unknown. Half of the group received the Moderna vaccine upon enrollment and the other half received a placebo. Once the vaccine was proven effective and authorized by the FDA, individuals in the placebo group also received the vaccine. “It was a huge team effort to get the trial off the ground,” says Doblecki-Lewis. “We were so very committed to recruiting participants that represented the diversity of Miami, and I’m pleased to say we did that well.”


Much of what the team learned from conducting the Moderna study paved the way for assessing Janssen’s vaccine product. UM’s team saw an even larger participant group, this time recruiting 1,000 participants within four to five months. They brought in 400 people in less than two months, or 20 to 25 patients per day. Sixty percent of those participants were black and Hispanic. “This was an astronomical feat,” says Dushyantha Jayaweera, M.D., associate director of the Miami Clinical and Translational Science Institute (CTSI), professor of medicine and principal investigator for Janssen’s UM site. “The difficulty in these studies was that time was of the essence. It showed how well different parts of the University came together to achieve this.” Jayaweera admits that, while successful, orchestrating the Janssen trial was a “logistical nightmare.” Sylvester Comprehensive Cancer Center’s pharmacy prepared the vaccine, maintaining a certain temperature and transporting the serum within 45 minutes. The patient’s arrival time and the time of injection required precise coordination. Any glitch with patient scheduling, data entry, lab shipments, or computer functioning further complicated the time- and resultssensitive situation.

COVID-19 Research Funding 363,849

Samples

1,368,618

Plasma

2,075,682

Outreach

8,630,068

Drug

19,183.428

Vaccine 0

5M

10M

15M

20M

In Millions

“Sometimes people ask me, ‘Was it worth it?’ It was worth it because there is a certain duty that comes in a pandemic. You must step up to the plate. We worked like crazy to do that, and then it finally came through,” recalls Jayaweera. One of the most impactful lessons came in August 2020, when the FDA issued an emergency use authorization to test the effectiveness of treating hospitalized COVID-19 patients with convalescent plasma, the antibody-rich blood product from survivors of the disease. Convalescent plasma had been used anecdotally since the 1890s, but UM was one of the first medical schools in the country approved to conduct a clinical trial to confirm its efficacy at reducing the severity or length of the disease. For Jayaweera, asking patients to participate in this research was much more challenging than what he faced with the vaccine trials.

“Here we had a disease that was disproportionately affecting minority communities, and it looked like these individuals were not going to be well represented in the vaccine trials.” — Olveen Carrasquillo, M.D., M.P.H. Department of Medicine Chairman’s Report 2021 13


“The difficulty in these studies was that time was of the essence. It showed how well different parts of the University came together to achieve this.”

The vaccine research studies conducted at the Miller School of Medicine were organized with “lightning speed” and mobilized faculty and staff from across the University.

— Dushyantha Jayaweera, M.D.

“That convalescent plasma study had to be done, and it was not easy,” Jayaweera says. “The most difficult thing with COVID-19 was that we had to see patients who were very sick and tell them, ‘I want to put you on a study.’ And people would respond, ‘I’m dying here… and you want to put me on a study!?’” Another challenging aspect was convincing patients to enroll in the study while also telling them there was a 50-50 chance of receiving a placebo. “Then I would have to tell them, ‘There is no treatment available. If we don’t do the studies, we won’t be able to find the cure.’” Data on this work will be available in late summer 2021. The trials confirmed that the Moderna vaccine, which uses a messenger RNA, is able to successfully mount a protective immune response. The presence of this

COVID-19 mRNA prompts the body to produce antibodies against the novel coronavirus, Jayaweera explains. The Janssen/Johnson & Johnson vaccine uses inactive particles of a cold virus (adenovirus) that contain COVID-19 spike protein DNA. “When Janssen vaccine is injected into a person, the adenovirus particles enter the nucleus of the cells. An adenovirus acts as a delivery vehicle to carry the coronavirus genetic material (DNA). Within the nucleus, the DNA of the COVID-19 spike protein will prompt the cell to produce mRNA, which will signal the cell to make spike proteins. These will be identified by the immune system and make antibodies that will protect us from COVID-19”. Both approaches provoked an immune response. But there was also extremely rare unanticipated developments and changes that would force the researchers to adjust. A complication from the Janssen/Johnson & Johnson vaccine posed such a challenge to UM’s team.

COVID-19 Research Grants by Division General Medicine 9%

Infectious Disease 65%

Pulmonary 26%

Division

Grant Type

Number of Grants

General Medicine Outreach

Total Cost

3 $1,960,915

Infectious Disease Drug 9 1,918,953 Outreach 2 114,767 Plasma 2 1,368,618 Samples 4 363,849 Vaccine 5 18,760,678 Pulmonary

Drug 7 6,711,115

Grand Total

14 UHealth|University of Miami Miller School of Medicine

34

$31,621,745


What occurred was that several female patients out of several million who received the Janssen/Johnson & Johnson vaccine developed blood clots—and one woman died—after receiving the vaccine. “We had to change the protocol, and now anyone who has anything that remotely sounds like a blood clot has to be evaluated. Part of that is that the platelets go low, so now we’re checking the platelet levels in patients,” says Carrasquillo. Most recently, the same vaccine has been linked to a small risk of developing GuillainBarré Syndrome, a condition where the body’s immune system attacks nerve cells. The staff will follow participants over the next two years to monitor these kinds of developments and to study the drug’s efficacy. The follow-up period will allow researchers to learn how many vaccinated patients still contracted COVID-19. Patients have been asked to record their health data in a diary and return every few months for antibody tests. Despite these careful observations the science agrees that these vaccines are safe and the most effective way to alter the course of the pandemic. The pandemic wrote a dark history that the world was forced to read. Researchers at the Miller School of Medicine revised that story, promising a better ending

for everyone, in every community, throughout the world. Although the pandemic is not yet over, we know that vaccination needs to be the cornerstone of ebbing the tide. As we further understand the variant viruses that are affecting the population we know that the vaccines will save lives. We will need to consider the use of booster vaccines as more information is just around the corner. “It was an incredible privilege to be part of such an important process,” says DobleckiLewis, “and to know it had a good chance of making a difference.”

Top: Roy Weiss, M.D., Ph.D., with University vaccination partner Walgreens’ employees/ representatives. Bottom: UMPresident Frenk with students at the vaccine clinic at the Shalala Student Center on the Coral Gables campus.

“It’s important to note that reports of breakthrough cases of COVID-19 in vaccinated people is not a sign that the vaccines don’t work. They do work. They are meant to prevent severe illness and keep infected individuals out of the hospital, and they are doing their job.” — Roy E. Weiss, M.D., Ph.D. Department of Medicine Chairman’s Report 2021 15


By the Numbers Clinical Activity and Care

FY19

Net Patient Revenues

FY20

FY21

% Change

$66,769,504 $64,291,500 $80,897,007

Work RVUs

26%

1,096,274 1,074,770 1,115,744 4%

Outpatient Visits

233,293 244,450 269,932 10%

Inpatient Visits

162,279 169,863 195,878 15%

Procedures

108,772

111,752

127,604

14%

0

32,740

133,847

309%

Telehealth Visits New patient visits

40,586

Admissions

Department Demographics

Research

Faculty Gender

Research Spending

Female 35%

Private Grants 30.5%

Federal Grants 68%

State Grants 1.5%

37,501,258

In Millions

Faculty Ethnicity

Research Funding Sources

36,641,258

FY2018 20

8,304 -10%

35,568,902

FY2019

Male 65%

9,195

33,116,256

FY2021 FY2020

25

30

35

40

Divisions, Grants, and Contracts FY2021 Total – $33,116,256

Hispanic or Latino 38% Other 3% Black or African American 6% Asian 12%

45,106 54,259 20%

8,598

3,267,546 / 4%

Cardiovascular

4,287,203 / 5%

Digestive

9,422,806 / 12%

Endo-Diabetes

2,850,149 / 4%

General Medicine

White 41%

7,743,461 / 10%

Hematology

2,593,302 / 3%

Hepatology

43,866,298 / 54%

Infectious Diseases

4,570,742 / 6%

Katz Center

1,958,516 / 2%

Medical Oncology 0

In Millions

16 UHealth|University of Miami Miller School of Medicine

10M

20M

30M

40M

50M


Program Directors Learner Demographics Resident Gender

Stefanie Brown, M.D., M.B.A. Internal Medicine

Resident Ethnicity

Female 56%

Resident Education

Jonathan Tolentino, M.D. Medicine-Pediatrics

Hispanic or Latino 34%

Other 7% Black or African American 11% Asian 25%

Male 44%

Medical School Outside the U.S. 22%

Residencies

White 23%

Medical School in U.S. Outside of Florida 48%

Staying at UM/JMH 18%

Out of State 74%

Staying in Miami 5%

Female 47%

Male 53%

Black or African American 11% Asian 25%

Raul Mitrani, M.D. Cardiovascular – Electrophysiology

Atil Kargi, M.D. Endocrinology Andres Carrion Monsalve, M.D. Gastroenterology Iriana Hammel, M.D. Geriatrics Janaki Sharma, M.D. Hematology/Oncology Eric Martin, M.D. Hepatology Khin Zaw, M.D. Hospice and Palliative Care Paola Natalia Lichtenberger, M.D. Infectious Diseases

Fellows Ethnicity Other 7%

E. Joseph Bauerlein, M.D. Cardiovascular- Advanced Heart Failure/Transplant

Eduardo de Marchena, M.D. Cardiovascular-Interventional Structural HD Fellow

Matches = 92% Job Placements = 8%

Fellows Gender

Carlos Alfonso, M.D. Cardiovascular

Michael Dyal, M.D. Cardiovascular – Interventional

Resident Outcomes Medical School in Florida 30%

Fellowships

Hispanic or Latino 34%

Michele Morris, M.D. Infectious Disease Transplant Jonathan Tolentino, M.D. Medicine-Pediatrics Oliver Lenz, M.D. Nephrology

White 23%

David De La Zerda, M.D. Pulmonary/Critical Care Carlos Lozada, M.D. Rheumatology

Chief Medical Residents Top Row (left to right): Jelani Grant, M.D., Jackson Memorial Hospital (JMH); Nidah Khakoo, M.D., Jackson Memorial Hospital (JMH); Stephanie Ioannou, M.D., University of Miami Hospital (UHT); Javier Ocampo Mascaro, M.D., Primary Care; Louis Vincent, M.D., Miami VA Medical Center (VA); Bottom Row (left to right): Robert Flowers, M.D., Miami VA Medical Center (VA); Michael Kaplan, M.D., Quality and Patient Safety; Monisha Bhatia, M.D., Quality and Patient Safety; Travis Forney, M.D., Quality and Patient Safety

Department of Medicine Chairman’s Report 2021 17


Division Highlights Cardiovascular Medicine Cllinical At the onset of the COVID-19 pandemic, our clinical program transitioned to provide Telehealth care and urgent procedures for those in need. This facilitated an expanded program for international consultation, as well. We quickly built protocols for the safe and efficient provision of care for those in need and addressed many of the misconceptions regarding treatments, such as ACE inhibitors for hypertension, with community programs. Our cardiologists participated in setting national

standards for these activities, such as the treatment of patients with ST elevation myocardial infarction. The Division assembled a Dream Team that designed and oversaw the MIAMI Protocol for evaluation of student and professional athletes who had had COVID-19 to determine if it was safe to return to practice/competition given the risk of post-COVID myocarditis. The team included sports medicine, sports cardiology, cardiac electrophysiologists, and experts in cardiac imaging and myocarditis. The vast majority of athletes evaluated were able to be cleared and returned to their sport

with no adverse consequences. A vascular medicine program has been started via a collaboration between our division and vascular surgery. In collaboration with radiology, our preventive cardiology team identified an important quality improvement initiative – underreporting of coronary calcium on non-coronary chest CT scans. Addressing this will improve treatment for prevention of coronary events.

Research Division faculty has continued to maintain a robust clinical and translational research program. Key UM initiated clinical trials that are in

Cardiology fellows with Cardiology Program Director Carlos Alfonso, M.D.; Interventional Cardiology Program Director Michael Dyal, M.D.; and Division Chief Jeffrey Goldberger, M.D., M.B.A. 18 UHealth|University of Miami Miller School of Medicine


process are: 1) the NIH sponsored LEAF trial has been enrolling patients undergoing ablation for atrial fibrillation to assess whether liraglutide pre-treatment can help stabilize the atrial substrate underlying the development of atrial fibrillation; 2) the NIH sponsored ACESO trial testing the effects of stem cells on endothelial function in diabetic patients undergoing percutaneous coronary intervention; and 3) the Department of Defense sponsored stem cell trial in patients with nonischemic cardiomyopathy evaluating the role of underlying genetic causes of cardiomyopathy. In addition, there was a new NIH R01 award evaluating the proteomic, genomic, and metabolomic associations between epicardial adipose tissue and atrial fibrillation. We were key participants in the multicenter randomized controlled REPLACECOVID trial evaluating whether to continue or discontinue reninangiotensin system inhibitors in patients admitted to the hospital with COVID-19, published in the Lancet.

Education A virtual clinical observership was established enabling learners from throughout the world to participate in CCU rounds and conferences.

Heart month was highlighted by four state-of-the art lectures for cardiology grand rounds. The annual Miami Valves conference was transitioned to a virtual format with attendees from 45 countries. Scholarly work by our educators includes several publications and a $100,000 grant from the Mitchell Wolfson Sr. Foundation. We have also opened up a new subspecialty fellowship in Sports Cardiology. Our faculty initiated a case-based program for all interventional cardiology programs in Florida to promote interaction and exchange across Florida.

Other Highlights Administration transitioned to provide strong support for all divisional activities including supporting frequent faculty meetings to provide updates on the rapidly evolving events in the medical center and community. This was critical to maintain a sense of connectedness and focus on our

tripartite mission. The annual Heart Month campaign was successfully launched with a revamped and updated version of the HeartAware program – expanding from a focus only on coronary artery disease prevention to diabetes, sudden cardiac death, and COVID-19. This required extensive cooperation and collaboration with multiple groups in the health center. A focused effort to streamline clinical operations that are managed/comanaged by multiple departments within the medical center was initiated and has dramatically improved communication and collaboration. Our faculty have been involved in the writing of high-profile documents, including the Cardiac Intensive Care of older adults, the revascularization guidelines, and the Braunwald’s Heart Disease chapter on Sudden Cardiac Death. Innovative efforts include the development of an emergency AV sequential pacing system and ongoing work developing a novel mapping approach for atrial fibrillation. Our CCU faculty were phenomenal in adapting to the expanded role of supervising medical intensive care patients during the periods of overload due to COVID-19 hospitalizations.

Department of Medicine Chairman’s Report 2021 19


Division Highlights Clinical Pharmacology Clinical Trials and Research The greatest challenge of 20202021 was restarting our clinical phase I operation following several months of suspended study enrollment due to the COVID-19 pandemic. With the patience, support, and encouragement of Department of Medicine leadership, we renewed our research participant database, retrained staff, obtained necessary approvals, and renewed our relationships with both clients and sponsors. Despite the closure, we have successfully completed enrollment for 12 phase Ib trials and have acquired new contracts/awards worth approximately $3,264,000. The restart of phase I studies required the division to devise and implement a comprehensive COVID-19 mitigation strategy to protect staff and research participants. Our 18-page plan is considered by several large pharmaceuticals and contract research organizations to set the highest standard for COVID-19

Left to right: (Top) Miriam Gonzalez Sosa, M.D.; Nadine Francois, M.A. and Rolando Rodco M.D.; (Center) Evelyn V. Caizapanta, M.D.; (Bottom) Eileen Alonso, A.R.N.P. and Richard A Preston, M.D., M.S.P.H., M.B.A.

prevention in phase I units. During this time period, we collected four-year longitudinal data for a cohort investigation of 1,597 patients presenting with hypertensive urgency over a three-year enrollment period. This is the largest and most comprehensive investigation to date in patients with hypertensive urgency.

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The division has also been awarded the phase Ib trial: A Phase 1, Non-Randomized, OpenLabel, 2-Part Study to Assess the Pharmacokinetics, Safety and Tolerability of Effect XX Boosted with Ritonavir in Adult Participants with Renal Impairment and in Healthy Participants with Normal Renal Function. The research team will test the pharmacokinetics/ safety of a novel inhibitor of the SARS-CoV-2 3CL protease under development as a specific oral treatment for COVID-19. This pivotal investigation will provide crucial data that is required for the design of the upcoming phase III trial.


Digestive Health and Liver Diseases Clinical During the early months of the pandemic when most clinical activities were shutting down, the Division of Digestive Health and Liver Diseases expanded patient access through several initiatives. Providers and staff began screening patients early for COVID-19, allowing for a safer patient experience. Procedures were expanded to include Saturdays as an appointment option for patients and additional faculty and APRN sessions were

made available for telehealth visits, including on evenings and weekends. This allowed the division to rebound rapidly. Telehealth visits were key to our mission to provide high-quality, continuing care to our patients over this past year. Our clinics remained open for essential in-person encounters throughout the pandemic, and telehealth has become a staple for our practice through a hybrid model for some providers and full-time

telehealth for others. Pre-procedure COVID testing allowed our endoscopists to stay ahead of the curve and safely provide high volumes of both therapeutic and elective procedures in a safe environment. Our therapeutic endoscopists offer innovative methods, including Per Oral Endoscopic Myotomy (POEM) and endoscopic submucosal dissection (ESD). Expanded industry clinical trials provides the South Florida

Digestive Health fellows with division leadership. Department of Medicine Chairman’s Report 2021 21


Division Highlights community with increased access to therapies for inflammatory bowel diseases, cancer predisposing syndromes, and liver diseases.

Research Our division kept essential clinical studies open for patients who rely on innovative therapies to manage complex diseases. Early in the

Goldberg) and an industry grant (Pfizer, Oriana Damas). Though not grantfunded, members of our division (Amin, Deshpande) participated in an alliance, comprised of medical centers across North America, identifying the Digestive Manifestations in Patients Hospitalized with Coronavirus Disease 2019. Division members also published our experience with pre-procedure COVID screening and testing in a high impact journals.

Education

Amar Deshpande, M.D. working with a GI fellow using innovative technology he is co-developing to improve patient care.

pandemic, research staff worked in staggered shifts to keep patients safe while still providing essential care. The division remained highly productive this past year with the funding of a U01 and R01 (David

The pandemic did not slow our progress in training the future of gastroenterology and hepatology at UHealth. Through online conferences, the Fellowship Program pivoted toward enhanced interdisciplinary collaboration with colleagues from surgery, radiology, and pathology. The division brought together international leaders in the field for an Academic Day of Learning through the American College of Gastroenterology’s Visiting Professor Program. Dr. Mohammad Othman from Baylor College of Medicine, a pioneer in advanced endoscopy techniques, spent a virtual day lecturing, moderating case-based interactive sessions with fellows, and meeting with fellows, faculty, and staff to share his wealth of experience. Dr.

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Justin Forde, one of two chief administrative fellows, published the UHT Endoscopy Center’s experience in screening patients for COVID ahead of GI procedures in Gastroenterology. Dr. Sunil Amin, Director of Endoscopy at JMH and Lennar, created the division’s first Advanced Endoscopy Fellowship that will begin in July 2022 with our other Chief Administrative Fellow, Dr Jordan Goldstein as the inaugural Advanced Fellow. The training program is now thriving due to our ability to expand educational opportunities during the pandemic. When learning opportunities were limited for students during the pandemic, UHealth service lines expanded and accommodated learners of all levels. First-year students received their first patient exposures in clinic through SCOPE, the students interest group for GI. Third-year medical students were consistently staffed on the inpatient consult services in both GI and hepatology, as well as in the outpatient setting rotating through varied outpatient clinics at the main hospital and at our satellites for the


core internal medicine clerkship. Fourth-year students successfully completed electives throughout the year. Virtual video conference calls allowed more attendees to join our morning educational conferences, with medical students and residents routinely in attendance. Learners (medical students, residents, and fellows) also gained their first exposures to telehealth in the GI and hepatology clinics.

Other Highlights Division faculty, fellows, and APRNs remained connected through bi-weekly and monthly virtual divisional meetings throughout the year. This allowed for participants to communicate critical information and assess the needs for patient care, fellow education, and research projects and successes. These meetings were critical in obtaining feedback from providers on how to best implement telehealth services and to identify areas for improvement. In addition, division members conducted weekly virtual meetings with the clinic and procedure area leadership to respond to the ever-changing needs of our patients. Didactic sessions combining the experience of attending physicians and the educational needs of fellows and residents transitioned to a virtual format. This novel approach allowed us to include clinical staff from UHealth Tower in these learning experiences.

Endocrinology, Diabetes & Metabolism Clinical Faced with the challenges brought on by the COVID-19 pandemic, clinical faculty of the Division of Endocrinology, Diabetes and Metabolism displayed unwavering commitment in providing uninterrupted patient care. With the implementation of telemedicine, continuity of care was maintained while minimizing virus exposure to faculty, staff, and patients. The pandemic minimally affected the number of outpatient visits with a 5% decrease in outpatient encounters. Diabetes management in the hospital setting is an important

component of the diabetes program. This year, a dedicated inpatient diabetes program at Jackson Memorial Hospital (JMH) and UHealth Tower (UHT) was developed. With an addition of an APRN to the team, the division is able to care for a higher volume of patients, which has been instrumental in helping develop postdischarge care to decrease hospital readmissions. This program also includes educational modules for nursing staff and physicians as well as hospital policies with updated order-sets consistent with latest guidelines. EMR (Electronic Health Record) solutions to alert providers to request diabetes consults when indicated were implemented. These efforts have led to a 22% increase

Ernesto Bernal-Mizrachi, M.D. with his lab members. Department of Medicine Chairman’s Report 2021 23


Division Highlights of inpatient diabetes consults, improved inpatient glucose control, and decreased length of stay and improved outcomes.

Research Supporting our faculty with their innovative research is essential to our research mission. Dr. Joao Werneck De Castro, Research Assistant Professor, has developed a novel platform to study tumor growth potential, thyroid tumor biology, and test the responses to different chemotherapeutic and immune modulator agents. In addition, he is studying in vivo effects of physical exercise on human islet structure and function. This research will use the human islet transplantation into the mouse eye model to allow studies on human islet transcriptome, structure and function which is impossible in human beings. His studies will serve as the basis of exercise prescription for human subjects aiming to improve pancreatic islet function of diabetic people and to optimize islet transplantation in type 1 diabetes patients. Dr. Werneck’s research is funded by two grants from the NIHNIDDK. The division also collaborated with the Division of Pulmonary, Critical Care and Sleep Medicine to study the effects of sleep apnea in regulation of glucose homeostasis and diabetes. This effort has

recruited a graduate student and will evolve into a translational research program to study the metabolic effects of sleep apnea. Additionally, Dr. Bernal-Mizrachi established a collaboration with Dr. Schally to investigate the effects of GHRH agonists in beta cell function. These studies will serve to develop these agents for the treatment of diabetes. Notable developments from prior years included a group QI project that resulted in the first formal thyroid ultrasound and FNA simulation-based course conducted at the JHS Center for Patient Safety using a Blue Phantom thyroid ultrasound and FNA training model under the leadership of Dr. Zeina Hannoush. The project continues during weekly FNA clinics at JHS where fellows and attendings collaborate with cytopathology to assess the effects of training on adequacy of FNA specimens. As part of this initiative, cytopathology fellows participate in the FNA clinic and provide reads for adequacy in real time.

Education A significant change in the training program was the expansion inpatient diabetes management training with a more structured program for consultations and the addition of a nurse practitioner to collaborate with fellows on patient care, which has provided a valuable opportunity for

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training in interdisciplinary teamwork. Additionally, the Lawrence M. Fishman, M.D. Endocrine Fellow Fund was developed, which will allow the division to undertake a number of activities such as providing key financial support to those in the Endocrine Fellowship Program who wish to travel and present research at meetings as well as provide the necessary seed money to support new research. The fund will also provide the needed infrastructure to allow current and recent endocrine fellows to connect with already established endocrinologists across the country (previous program graduates) for mentorship and networking. Other activities are planned to enrich fellows’ training and community connections while in the program.

Other Highlights Other notable announcements include: Dr. Rene Barro-Soria’s appointment to the Biophysics of Neural Systems Study Section at the Center for Scientific Review, National Institutes of Health; Dr. Caicedo NIH Cell Signaling and Molecular Endocrinology Study Section; Dr. Ernesto Bernal- Mizrachi is a permanent member of the Veterans Administration Study section in Endocrinology (ENDA); Dr. Mark Jara completed an Oncologic Endocrinology Fellowship at the University of Texas MD Anderson Cancer Center.


General Internal Medicine Clinical Throughout the pandemic, our providers remained focused on providing world-class primary care services to patients. We rapidly transitioned to telehealth and then back to hybrid care models to ensure patients received the necessary preventive, acute, and chronic care services. This included managing a large number of COVID cases in the outpatient setting. We also piloted the UHealth Televigilance Program, allowing providers to remotely monitor and care for COVID-19 patients who might otherwise need to continue care in inpatient settings.

Research The Division of General Internal Medicine participated in several large COVID observation and interventional studies, including recruitment of nearly 400 patients for the Johnson & Johnson COVID vaccine trial. We also are leading the NIH-funded Florida Community Engaged Alliance Against COVID Disparities (CEAL). This statewide coalition addresses the unequal burden of COVID disparities among racial and ethnic minorities and the promotion of vaccine update. We also continued our work on other important projects such as the All of

US Precision Medicine Project where have enrolled more than 10,000 participants, 75% of which are African American or Hispanic.

Education Our division faculty, which includes institutional educational leaders, led a seamless transition from in-person to virtual learning to ensure our graduate and undergraduate students continued to receive top-notch instruction in the safest (Top) Olveen Carrasquillo, M.D., M.P.H. (left) and Ana Riccio (right); (Bottom) Elizabeth Greig, M.D. (left) and Sabrina learning environments Taldone, M.D., M.B.A. (right). possible. The division also continued to enhance efforts to further diversify and voluntarism by our faculty, our student body and develop was critical to the division’ success curricular innovations as part of during a very dynamic and fluid the NextGen Curriculum, including environment this past year. The training in cultural division also formally took over humility and promotion operations of the UHealth Fischer of health equity. Island practice, providing conciergetype care to all Fischer Island Other Highlights residents and providing acute During these turbulent care for employees. With a gift times, the division from the Ocean Reef Foundation, took a multipronged we also are involved in COVID approach aimed community outreach and vaccine at supporting each education to low-income residents other and sharing and immigrants in the southern tip information (such as of Florida and Upper Keys. Our meetings, frequent work with HIV community outreach communication, and other engagement among low-income opportunities for open dialogue). African Americans in Overtown This, in combination with an and Liberty City also continued unprecedented level of altruism throughout the pandemic. Department of Medicine Chairman’s Report 2021 25


Division Highlights Geriatrics and Palliative Medicine Clinical In response to the COVID pandemic, all outpatient services of the division have been transitioned to the telehealth model. This has allowed the division to further increase the number of patients with access to palliative medicine services. The division continued to cover the critical needs of the residents of the Miami Jewish Home and Hospital, a senior healthcare facility.

Research Dr. Perez-Stable received an R03 award from the National Institute of Health to study strategies for increasing Proteotoxic Cell Death in Hepatocellular Carcinoma. Dr. Dang

participated in a study published in the Journal of the American Medical Directors Association looking into the “Factors Associated With Hospitalization by Veterans in HomeBased Primary Care.”

Education The innovative combined Geriatrics and Palliative Medicine Fellowship has graduated its first fellowship class. Meanwhile, our palliative medicine fellowship continues to grow with recent approval for a new position. The Palliative Care Interest Group was established at the UM Miller School of Medicine in 2020, which has allowed for earlier exposure

to palliative care and hospice. The group has a liaison to set up early shadowing experiences. The group also works to connect medical students with faculty mentors in the field for education and research. Several division members entered posters and submissions to the American Academy of Hospice and Palliative Medicine (AAHPM)

Other Highlights The End-of-Life Taskforce, led by Dr. Julia Sanchez, continues to work on improving awareness of advance care planning and the roll out of the advance care planning tab on Epic as well as ACP bookends.

(Left to right) Allison Leff, L.C.S.W.; Kirsten Luft, A.P.R.N.; Yvette Gomez, M.B.A.; Jenny Drice, M.D.; Julia Sanchez, M.D.; Marcio Soares, M.D.; Grisel Fed-Vega Martinez, A.P.R.N.; David Barquero, Mariana KhawandAzoulai, M.D.; Maria Rose van Zuilen, Ph.D. 26 UHealth|University of Miami Miller School of Medicine


Hematology Clinical The Division of Hematology has undergone a remarkable period of growth and change this past year. Under the new leadership of Mikkael Sekeres, M.D., M.S., our division was organized into four sections to better reflect the worldclass, sub-specialized hematology faculty now in place. We also have standardized operations and care across the network, in both inpatient and outpatient settings. This includes sections for leukemia, lymphoma, myeloma, and general hematology. We added 10 new faculty members to our team, with the largest expansion in the myeloma section, under the leadership of Ola Landgren, M.D. We have also expanded geographically. Our latest site in Fort Lauderdale has four staff physicians who are committed to high quality of service and specialization for our patients in Broward County. In total, the division now has 61 faculty, staff physicians, and advanced practice providers. The pandemic has forced us to adapt how we administer patient

Hematology-Oncology Program members, 2021-2022

care and to implement innovative approaches to treatments so we can continue to provide outstanding care for patients with blood conditions. We were one of the first divisions

to switch to telehealth in April 2020 and, as a result, telemedicine accounted for more than half of all patient visits last year. Many of our physicians volunteered at the hospital during COVID staff shortages and our APRNs handled the hotline and provided critical information to the public

Research With the goal of conducting innovative research to improve patients’ lives, faculty and medical students have been actively conducting research and clinical Department of Medicine Chairman’s Report 2021 27


Division Highlights trials, garnering 14 grants this fiscal year valued at close to $15 million. Even with the challenges of the pandemic, division researchers were able to conduct 268 accruals to intervention clinical trials. Twentyfour of our faculty published in 223 research publications of which 119 had an impact factor greater than 10, further demonstrating the depth and breadth of our research programs.

Teaching As a teaching institution, many of our faculty are course directors in the NextGen curriculum and are heavily involved with the recruitment and education of medical students, residents, and fellows. This year, we’ve had over 500 applicants to our Hematology-Oncology Fellowship Program, resulting in the matching of six fellows. It’s exciting to note that most of the fellows we matched in hematology are females, and the majority of our fellows are racially and culturally diverse, which reflects the department’s emphasis on diversity and inclusion.

Other Highlights Our division conducts weekly hematology-oncology conferences and tumor boards, and despite the pandemic, our faculty has participated in or has led international education meetings attracting thousands of participants. In addition to these educational meetings, the division holds monthly meetings for faculty, APRNs, and staff.

Hematology-Oncology fellows enjoying the Romero Britto Installation at Holtz Childrens Hospital

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Hospital Medicine Clinical Hospitalists function as primary care physicians when a patient is first admitted at UHealth Tower, Sylvester Comprehensive Cancer Center, Bascom Palmer Eye Institute, and Jackson Memorial Hospital. The division continues to expand and finetune its infrastructure with a focus on quality patient care. We modified our Nurse Care Model to improve patient to provider ratio. Most teams are now comprised of a physician along with a collaborating APRN. During COVID, we restructured our teams in order to keep COVID patients separated from the rest. In theory, we built a hospital within a hospital and by doing so, we significantly helped reduce the spread of COVID. Our faculty have

gone above and beyond to fill crucial scheduling gaps in order to care for our most vulnerable patients.

Education In the past year, the Division of Hospital Medicine has expanded to include 64 faculty and staff dedicated to teaching, research activities, and academic missions, all focused on quality inpatient care. Our average hospital census is 250 patients per day. We have two teaching teams composed of senior faculty mentoring internal medicine residents sponsored through our affiliated JMH Health System.

Other Highlights Dr. Maria Delgado recently placed UHealth in the spotlight for being recognized as a designated Comprehensive Hypertension Center

by the American Heart Association. Dr. Efren Manjarrez is a respected speaker and on the Board of Editors for the Society of Hospital Medicine (May 2021-2024). Dr. Manjarrez also was awarded the 2020 Society of Hospital Medicine Award of Excellence for Outstanding Service. Other noteworthy faculty with a focus on teaching is Dr. Matthew Imm, who holds a clerkship director role during a time of great change/ adaptation due to COVID. (He currently oversees and mentor’s third- and fourth-year residents). Dr. Armen Henderson’s participation in diversity efforts awarded him a U-link grant earlier last year. Vital to the division’s success was the formal appointment of Medical Directors Dr. Olga Tarasova, Dr. Vijay Mehta, Dr. Pamela Trotter (nocturnist director) and APRN Laura Traini-Mongelli.

Department of Medicine Chairman’s Report 2021 29


Division Highlights Infectious Diseases Clinical Although challenging at the beginning, telemedicine was a very useful resource during the peak of the COVID pandemic by enabling us to follow patients closely through a virtual platform. The division has been a nationwide leader regarding the management of the pandemic and testing COVID variants. Jackson Health System, our affiliated system, led South Florida in vaccinations and the dissemination of multilingual,

multicultural education to the community. The quality of outpatient care improved during the last fiscal year. The advent of telemedicine has increased access to division services as well as reducing the number of appointment no-shows. Through both medical student efforts and grant funding from the Florida Department of Children and Families, we have drastically increased our capacity to provide addiction treatment services through our division at the IDEA Syringe Services Program.

Research The role of division faculty during COVID has been invaluable. Dr. Doblecki-Lewis worked on CoVPN Moderna COVID vaccine and Compass trials, Dr. Jayaweera was involved with the Janssen vaccine trial, Dr. Stevenson secured an AIDS Healthcare Foundation grant to conduct COVID surveillance. Dr. Tookes received the NIH DP2 Director’s New Innovator Award to implement a tele-harm reduction intervention at the IDEA SSP. Additionally, both Dr. Doblecki-

The Rapid Access Wellness team: (Left to right) Marco Torrealba, Stefani Butts, Inza Patton, Liz Rivera, Jakisha Blackmon, Katherine King, Susanne Doblecki-Lewis, M.D., Katie Klose, Blonsky Batalien, Brahian Erazo, Gilianne Narcisse, Cristobal Becerril, Brian Baez, and Junlin Long. 30 UHealth|University of Miami Miller School of Medicine


(Left to right) Marilyn Fernandez, Lunnaire Acosta, Adhar Mohamed, Maria Alcaide, M.D., Patricia Raccamarich, Emily Montgomerie, E’lexus Ryan, and Jesus Senabre in front of Converge Miami.

Lewis and Dr. Tookes were awarded funding from the NIH CFAR Ending the HIV Epidemic (EHE) Supplements.

Education Although this was an atypical year, the division continued to make education of our learners a high priority. The constraints placed on in-person teaching made the division more resourceful. Dr. Powell and Dr. Serota both completed one year as

longitudinal clinical educators for the NextGenMD curriculum.

Other Highlights Dr. Bhavarth Shukla, Medical Director for Infection Control and Employee Health, played a crucial role during the pandemic. He was involved in numerous aspects of pandemic response including creation of COVID-19 wards, institutional guidelines for care of patients and

employees, prediction modeling, a comprehensive testing and tracing program, and most recently vaccination efforts. The division took strategic steps to encourage the development of the division and the best outcomes for its clinical, research, and educational missions. Meetings (COVID update meetings, virtual international conferences, clinical update meetings) were very helpful, not only at the administration level, but to ensure division staff were consistently engaged and focused on the demands of a difficult year.

Department of Medicine Chairman’s Report 2021 31


Division Highlights Medical Oncology Clinical The Division of Medical Oncology expanded its sarcoma services to Broward patients during FY20. Dr. Emily Jonczak joined the division in August 2020 and has been providing sarcoma services in our Plantation and Miami satellite oncology clinics. The division provided telemedicine services, which enabled us to reach patients who live in remote areas and follow up with patients who were unable to or feared coming into the facility due to COVID-19. The division also restarted our Oncology Care Clinic, to serve as a walk-in, urgent care option for patients and physicians. The goal of this service is to decrease the

Gilberto Lopes, M.D., M.B.A., F.A.M.S., with fellows Thomas Platé, M.D., Nina Nguyen, M.D., and Asaad Trabols, M.D., at Jackson Memorial Hospital’s Ambulatory Care Center East Oncology Clinic.

number of ER visits and UHealth Tower admissions over time.

Research Dr. Gilberto Lopes continued to lead the COVID-19 and Cancer Consortium (CCC19), which has led to more than six high-impact journal entries, including publications as senior author in Nature Cancer, Annals of Oncology, The Oncologist, JCO Global Oncology, and coauthored publications in the Lancet

Gina D’Amato, M.D. getting her vaccine. 32 UHealth|University of Miami Miller School of Medicine

and JAMA Oncology. Dr. Erin Kobetz had leadership roles in several COVID-19-related projects, including publications on SARS-Cov2 testing programs published in academic journals such as Academic Pathology, Science of the Total Environment, and the Journal of Occupational and Environmental Medicine. Dr. Jaime Merchán published his work on the development of several different compounds in cancer with publications in Nature


Gina D’Amato, M.D. with nephew Joseph (Joey) D’Amato Kass at the American Jonathan Trent, M.D., P.h.D., Stephen Nimer, M.D., Alejandra Perez, M.D., Carmen Calfa, M.D., and Gina D’Amato, M.D.

Society of Clinical Oncology Annual

Medicine, The New England Journal of Medicine, and Investigational New Drugs. Dr. Gilberto Lopes published the results of two papers in Lancet Oncology and Lancet Diabetes and Endocrinology on the RET inhibitor pralsetinib, leading to its approval in lung and thyroid cancers that harbor RET gene fusions. Drs. D’Amato and Trent also published several articles in Lancet Oncology, JAMA Oncology, and Annals of Oncology on new drugs for the treatment of various sarcomas. Dr. Carmen Calfa published results of immunotherapy in breast cancer form the TAPUR study in the Journal of Clinical Oncology.

Other awarded grants include: Zinzi Bailey. NIMHD U01 Supplement (PI): The Development of Sexual Orientation and Gender Identity Measures (in a CHW-led multimodality intervention). Drs. Carmen Calfa and Gilberto Lopes as co-PIs 15. NIH UG3/UH3. Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Cohort Study. Total grant value: US$ 999,612.

tumor boards, and journal clubs, which were recorded so trainees could access the videos at any time. Virtual meetings also provided the opportunity to bring in national and international experts to discuss their specific topics of interest with our fellows. These experts also served as an inspiration for fellows when considering their research careers.

Education

The division continued to coordinate monthly meetings with faculty and staff, weekly grand round teaching conferences, and ad hoc meetings to discuss specific topics. We also reached out to national and international organizations to increase the national recognition of our faculty. Dr. Carmen Calfa was selected as Chair for the ASCO Tapur study steering committee and Dr. Jaime Merchán was invited to lead an educational session at the annual genitourinary (GU) cancers conference by ASCO.

All activities transitioned to a virtual format due to the pandemic, including lectures, discussions,

Meeting.

Other Highlights

Department of Medicine Chairman’s Report 2021 33


Division Highlights Katz Family Division of Nephrology and Hypertension Clinical Telehealth visits were critically important over the last year to provide high-quality and safe continuity of care especially for patients at high risk for severe COVID infection. These virtual visits also helped to increase the division’s outpatient volume by 25%. Our APRNs added an educational telehealth clinic for those patients starting on dialysis.

Additionally, the division developed a Hypertension Nephrology Clinic Cardiovascular Center at UHealth Tower. Dr. Efren Chavez and Dr. Yelena Drexler – both certified hypertensions specialists – joined the UHealth Hypertension Center to lead an expansion of services in collaboration with Hospitalist, Dr. Maria Delgado. The center also earned an AHA Comprehensive Hypertension Center designation by the American Heart Association, one of only 18 centers in the U.S. and the first in Florida. Despite the challenges wrought

by COVID, the division continued to witness clinical growth on both inpatient and outpatient service sides over the past year.

Research The division remained highly productive, receiving funding from several grants. Dr. Alessia Fornoni received an NIH new training grant. The goal of this initiative is to engage first-year medical students across the state in a summer program designed to foster interest in nephrology by exposing students to basic, clinical, and translational science research

Alessia Fornoni, M.D., P.h.D. with the Peggy and Harold Katz Family Drug Discovery Center lab members. 34 UHealth|University of Miami Miller School of Medicine


opportunities. Dr. Tali Elfassy received an NIN/NIA related supplement to better understand the drivers of incident hypertension disparities among U.S. Hispanics. Dr. Yelena Drexler received the Miami CTSI Mentored Translational Research Scholars Program Award (KL2) for a research study titled Apolipoprotein M and S1P as Novel Biomarkers of Glomerular Lipotoxicity in Nephrotic Syndrome. Dr. Alla Mitrofanova received the Carl W. Gottschalk Research Scholar Grant, a very prestigious ASN grant— the first time a UM faculty member has been awarded such a grant as well as a Chernowitz grant. Jin Ju Kim received an NIH K01 Research Scientist Development Award (pending official NOA). The division also received a large industry grant from Kyowa Kirin for Mechanistic and PK study of Apolipoprotein M-Fc (APOM-Fc). The PIs are Drs. Fornoni, Merscher, and Al-Ali. An internal grant for High Risk/ High Reward pilot (Hassan Al-Ali) was also received. The division was also involved in 12+ industry or NIHsponsored clinical trials (Contreras-

Alessia Fornoni, M.D., P.h.D., Gabriel Contreras, M.D., M.P.H. and the Katz lab members with retired Miami Heat basketball player Alonzo Mourning.

Fornoni-Drexler-Munoz Mendoza, Chavez, Mattiazzi, Sosa) and more than 12 COVID -related publications (JAMA, Annals of IM, Critical Care Med, JASN and more). Division faculty published 56 peer-reviewed publications in 2021 and 58 between June and December 2020, 12 of which are COVIDrelated.

Education The fellowship training program continues to attract a highly diverse and competitive group of fellows. In collaboration with the Division of Hospital Medicine and the Gordon Center for Research in Medical Education, the program has strengthened its focus on simulation training to enhance patient safety, starting off the academic year with simulation training for central line placements. Dr. Maria Antonietta Mosetti was instrumental in providing a hands-on renal ultrasound course

and supports the kidney biopsy simulation training. Dr. Ross Scalese (Division of General Internal Medicine) has provided unwavering support to ensure the successful annual Objective Structured Clinical Examination (OSCE). The COVID-19 pandemic has resulted in a significantly higher patient load, but thanks to the combined effort of all faculty members who took on additional patients this has not had a negative impact on the training program. Instead, fellows learned how to adapt to changing demands, such as increased dialysis needs and the inability to conduct in-person clinic visits. The expansion of telemedicine has allowed the fellows to become familiar with this modality and learn its advantages and limitations.

Other Highlights Division faculty, fellows, and APRNs, remained connected through monthly virtual division meetings throughout the year. This allowed us to communicate critical information and assess our needs for patient care, fellow education, and communicate on research projects and successes.

Department of Medicine Chairman’s Report 2021 35


Division Highlights Pulmonary, Critical Care, and Sleep Medicine Clinical Several services were launched and/ or expanded this year to better serve our patients. The Pulmonary Clinic opened at UMH West to promote improved provider collaboration and access for patients. The JMH Progressive Care Unit (PCU) and vent (ventilator) management was expanded. Intuitive Ion Robotic Bronchoscopy technology was implemented at UHT. Future phase 2 expansion of the UHT CCU was approved but CCU has not opened due to the surge in COVID-19. Future expansion of the interventional pulmonology procedure service line has been approved and will facilitate the expansion of our procedure team by adding more support staff to better meet the needs of our growing patient population. Plans are also underway to expand the PFT/Bronchoscopy service. Telemedicine has had a positive impact on clinical operations and patient care, especially for immunocompromised patients and those who live far from the medical campus. Telemedicine visits have become a safe, viable option

for care. Telemedicine also allowed providers the flexibility to swap clinic days with minimal notice or prior clinical manager approvals.

Research The Division is in collaboration with other divisions (Endocrinology, Diabetes & Metabolism) as well as other departments (Public Health) to conduct research and is also focusing on some PI initiated studies. Our faculty were highly productive this past year and this is evidenced by the multiple R01s (Wanner, Gershengorn) received as well as a grant from the CDC (Mallow) and an I-SPY grant (Kett). We currently have 9 COVIDrelated active trials and we completed 7.

Education To ensure the best learning environment for medical students, residents, fellows, and other learners, the Division implemented changes in its academic interactions with fellows. The Division has streamlined all

36 UHealth|University of Miami Miller School of Medicine

academic activities and standardized the time, place, and purpose of many educational series. The Fellows Bootcamp was modified by incorporating input from division faculty and fellows, which has allowed for additional guided training and resources for fellows. A quarterly discussion with the chief and fellows was also launched with the goal of listening to fellows’ input and comments to help guide future academic medicine efforts. Our new structured academic/ scholarly activities have sparked renewed interest in research. We now have more engaged junior faculty with interest in academics/ scholarly events. This effort has also reinvigorated interest from some fellows who are requesting more involvement in research focused training. We hope this will lead to more academic/scholarly active physicians in the future.

Other Highlights Many strategic steps were implemented this year to encourage the development of the division and the best outcomes for our clinical, research and educational missions. The division has focused on additional cross training on


Division of Pulmonary, Critical Care and Sleep Medicine faculty.

the clinical and research support side, which has proven helpful with flexibility and cross coverage capabilities. Weekly PCCSM leadership meetings to plan and coordinate weekly events and strategize/ operationalize tasks have been

organized, including bi-weekly team huddles to discuss relevant topics for clinical and research support groups and monthly faculty divisional meetings to provide up-to-date information on current developments and updates that impact operations. Teamwork has been essential in

our day-to-day operations. Faculty, APPs, Clinical and Research Staff provided substantial support to the COVID mission. Faculty/APPs came together to support one another, provide support with coverage, communicate challenges and needs. PCCSM Leadership came together to listen to faculty and staff to better gauge the needs of the division and modify as needed. During these challenging times, the division has focused on finding solutions to problems to make it through the last few difficult months. This has led to creative coverage models and matrices to use available resources and to provide quality cardiovascular care.

Department of Medicine Chairman’s Report 2021 37


Division Highlights Rheumatology and Immunology

spondyloarthropathies.

Clinical

Numbers of applicants to our renowned Rheumatology Fellowship Program continued to increase on a yearly basis, surpassing 200 this year. Dr. Lozada, Division Chief and Program Director, was honored with the 2020 Distinguished Program Director Award from the American College of Rheumatology. His career trajectory as program director was recognized as was his leadership role in originating the use of the ERAS system and the Maria Carpintero, M.D. and fellows in clinic. medical subspecialties match in rheumatology. Dr. Lozada the Executive Committee of the is currently developing a program International League of Associations within the Panamerican League for Rheumatology (ILAR) in 2020. of Associations for Rheumatology Senior Rheumatology fellow Dr. (PANLAR) that will lead to an Amanda Worme was honored increased number with an invitation to present her of training positions research at the American College in rheumatology of Rheumatology’s Rheumatology throughout the Research Workshop in May. Americas. Her presentation was entitled “Adherence to Bone Health Other Highlights Guidelines in Patients on Long Term Dr. Carlos Lozada, Steroids for Rheumatic Disorders Division Chief, is at the Miami Veterans Affairs serving as President Medical Center.” Nurse Navigator of the PanAmerican Denise Perez joined the Division of League of Associations Rheumatology. She will play a critical for Rheumatology (PANLAR) 2020role in facilitating care in chronically 2022 and served as Chair of acute patients.

The Division of Rheumatology quickly adapted to the challenges of the pandemic. A strong telemedicine component was developed, which complemented our in-person clinical services, and served as a vehicle for providing care not only to those concerned about in-person visits but also to expand the reach of the division’s consultative services throughout Florida, particularly Central Florida and the Keys.

Research Dr. Eric Greidinger obtained a new research grant from Eli Lilly and Company. This one-year grant will study the efficacy of Baricitinib in animal models to treat mixed connective tissue disease ($87,190 direct costs per year). Dr. Ozlem Pala continues active participation in the national CORRONA registry of inflammatory arthritis, recently renamed CorEvitas. Dr. Maria Carpintero and Dr. Greidinger are actively participating in over 13 clinical trials in the management of systemic lupus erythematosus and other autoimmune diseases. Division Chief Dr. Carlos Lozada is part of a leadership group developing the new Panamerican guidelines for the management of

Education

38 UHealth|University of Miami Miller School of Medicine


Transplantation and Cellular Therapy

intensive inpatient care required in cellular therapy.

Clinical

Research

The Division of Transplantation and Cellular Therapy continued to expand its national footprint as a leader in clinical care in hematopoietic stem cell transplantation (both autologous and allogeneic) and at the cutting edge of T cell immunotherapies. Division faculty adapted to the COVID19 pandemic by creating a hybrid system to evaluate new patient consultations and follow-up visits by using telemedicine whenever possible, while continuing the

the NIH to the Komanduri laboratory and multiple investigator-initiated clinical trial awards from industry partners to division faculty.

Researchers within the division are conducting research across multiple areas, spanning the spectrum from basic to translational research and novel investigator-initiated and multicenter trials, including those funded by the NIH sponsored BMT Clinical Trials Network. Some particularly exciting areas include: the expansion of the use of mismatched unrelated donor transplantation, a key option for the diverse population we serve in South Florida, who often lack matched registry donors; expansion of an already strong program in adoptive cellular immunotherapy, including “off the shelf” CAR-T therapies derived from donors and CAR-T therapies targeting multiple antigens to reduce relapse; a continued expansion in translational research to improve complications of donor stem cell transplantation, including graft-versus-host disease and viral infections; leadership in clinical research in infectious complications of transplantation and cellular therapy, including studies of COVID-19 infection in our (Top) Michelle Emokpae, A.P.R.N.; Juan Ramirez, patients. A.P.R.N.; Lazaro Lekakis, M.D. and Laura Baquero, Multiple grants were A.P.R.N. (Bottom) Yvette Morlote, A.P.R.N.; Sila received this past year, Shalhoub, Pharm.D.; Selgrys Cisneros, A.P.R.N. and including one from the Katrina Piedra, Pharm.D. at the Dolphins Cancer Applebaum Foundation as well Challenge. as collaborative grants from

Education Faculty members were actively involved in medical school and postgraduate medical education, both in the classroom and clinical settings. In addition, faculty and staff hosted a major national educational conference targeted at advanced practice professionals and hematology/oncology and cellular therapy fellows.

Other Highlights Faculty meetings were held on a weekly basis to discuss clinical and research issues and then monthly to focus on special concerns. Dr. Denise Pereira continued in her role as President of the Medical Staff. The division adapted quickly to the challenges posed by the COVID-19 pandemic, which were magnified for our highly immunocompromised patient population. This was done by adapting all clinical care approaches to deal with the high susceptibility of our patient population and publishing multiple papers related to COVID-19 incidence, diagnosis, and outcomes in cellular therapy recipients. Despite the challenges of the past year, we have an extraordinary and cohesive group of physicians, staff, and administrators who continue to support the broad range of clinical and emotional needs of our unique and deserving patient population.

Department of Medicine Chairman’s Report 2021 39


Department of Medicine Divisions Cardiovascular Jeffrey Goldberger, M.D., M.B.A. Division Chief

Professors of Medicine Simon C. Chakko, M.D. Mauricio G. Cohen, M.D. Eduardo J. De Marchena, M.D. Chunming Dong, M.D. Jeffrey Goldberger, M.D., M.B.A. Joshua M. Hare, M.D. Robert J. Myerburg, M.D. Carl E. Orringer, M.D. Rafael F. Sequeira, M.D. Professors of Clinical Medicine Maureen H. Lowery, M.D. Raul Mitrani, M.D. Leonardo Tamariz, M.D. Research Professor of Medicine Lina Shehadeh, Ph.D. Associate Professor of Medicine Martin S. Bilsker, M.D. Associate Professors of Clinical Medicine Carlos E. Alfonso, M.D. Eugene J. Bauerlein, M.D. Claudia A. Martinez-Bermudez, M.D. Alan H. Schob, M.D. Luanda Grazette, M.D. Assistant Professors of Clinical Medicine Sharon N. Andrade-Bucknor, M.D. Antonio Barquet-Leon, M.D. Michael Dyal, M.D. Joseph Esterson, M.D. George Marzouka, M.D. Roberto A. Miki, M.D. Mrudula Munagala, M.D. (M.T.I.) Litsa K. Lambrakos, M.D. Anita Phancao, M.D. (M.T.I.) Nina Thakkar Rivera, D.O. Robert B. Stang, M.D. Alex Velasquez, M.D. Research Assistant Professor of Medicine Jian Wei, M.D. Staff Physicians Murry Drescher, M.D. Hoda Butrous, M.D. (M.T.I.) Mehrdad Ghahramani, M.D. Zachariah Zachariah, M.D.

Clinical Pharmacology Richard A. Preston, M.D., M.S.P.H., M.B.A. Division Chief Professors of Medicine Barry Materson, M.D. (Emeritus) Richard A. Preston, M.D.

Hepatology Section Professors of Medicine Paul Martin, M.D. Eugene R. Schiff, M.D. Professor of Clinical Medicine Christopher B. O’Brien, M.D. Cynthia Levy, M.D. Associate Professor of Clinical Medicine Kalyan R. Bhamidimarri, M.D., M.P.H.

Associate Professor of Medicine David Afshartous, M.D.

Assistant Professors of Medicine Leopoldo B. Arosemena, M.D. Patricia D. Jones, M.D., M.S.C.R. Eric F. Martin, M.D.

Digestive Health and Liver Diseases

Endocrinology, Diabetes & Metabolism

Paul Martin, M.D. Division Chief

Ernesto BernalMizrachi, M.D. Division Chief

Gastroenterology Section

Professors of Medicine Rodolfo Alejandro, M.D. Ernesto Bernal-Mizrachi, M.D. Ronald Goldberg, M.D. Karl Muench, M.D. Alberto Pugliese, M.D. Jay Skyler, M.D. Jay Sosenko, M.D. Roy E. Weiss, M.D., Ph.D.

Professors of Medicine Maria T. Abreu, M.D. Jaime S. Barkin, M.D. Amar Deshpande, M.D. Cynthia Levy, M.D. Paul Martin, M.D. Christopher B. O’Brien, M.D. Jeffrey B. Raskin, M.D. (Emeritus) Daniel Sussman, M.D., MPH Associate Professors of Medicine Kalyan Bhamidimarri, M.D. Jose Garrido, M.D. David Goldberg, M.D. David Kerman, M.D. Andres Carrion Monsalve, M.D. Assistant Professors of Medicine Sunil Amin, M.D. Leopoldo Arosemena, M.D. Jodie Barkin, M.D. Sean Bhalla, M.D. Oriana Damas, M.D. Paul Feldman, M.D. Roberto Fogel, M.D. Patricia Jones, M.D., M.S.C.E. Shria Kumar, M.D., M.S.C.E. Emory Manten, M.D. Eric Martin, M.D. Morgan Sendzischew Shane, M.D. Il Joon Paik, M.D. Michelle Pearlman, M.D. Siobhan Proksell, M.D. Ami Panara Shukla, M.D. Enrico Souto, M.D.

40 UHealth|University of Miami Miller School of Medicine

Professors of Clinical Medicine Alejandro Ayala, M.D. Rajesh Garg, M.D. Gianluca Iacobellis, M.D., Ph.D. Research Professor of Medicine, Immunology and Microbiology Ricardo Pastori, Ph.D. Associate Professors of Clinical Medicine Atil Kargi, M.D. Violet Lagari-Libhaber, D.O. Research Associate Professors Alejandro Diego Caicedo-Vierkant, Ph.D. Armando Mendez, Ph.D. Assistant Professor of Medicine David Baidal, M.D.


Assistant Professors of Clinical Medicine Zeina Hannoush, M.D. Mark Jara, M.D. Jason Levine, D.P.M. Silvia Gra Menendez, M.D. Bresta Miranda-Palma, M.D. Marcela Perez-Bustamante, M.D. Valentina Rodriguez, M.D. Maria del Pilar Solano, M.D. Francesco Vendrame, M.D., Ph.D. Research Assistant Professors Joana Almaca, Ph.D. Rene Barro-Soria, Ph.D. Manuel Blandino, Ph.D. Tengjiao Cui, Ph.D. Joao Pedro Saar Werneck De Castro, Ph.D. Lisa Rafkin, Ph.D. Rayner Rodriguez-Diaz, Ph.D.

General Internal Medicine Olveen Carrasquillo, M.D., M.P.H. Division Chief Professors of Medicine Olveen Carrasquillo, M.D., M.P.H. Laurence Gardner, M.D. S. Barry Issenberg, M.D. Kenneth Goodman, PhD Professor of Clinical Medicine Panagiota Caralis, M.D., J.D. Daniel Lichtstein, M.D. Erin Marcus, M.D., M.P.H. Joan St. Onge, M.D. Associate Professor Mark Gelbard, M.D. Associate Professor of Clinical Medicine Stefanie Brown, M.D. Yvonne Diaz, M.D. Hilit Mechaber, M.D. Paul Mendez, M.D. Ross Scalese, M.D. Jonathan Tolentino, M.D. Frederick Williams, M.D. Assistant Professors of Clinical Medicine Howard Anapol, M.D. Stephen Avallone, M.D. Alexandra Calandriello, M.D. Manuela Calvo, M.D. Stephanie Clauss, M.D. Gregory Coleman, M.D. Janelle Cuervo, M.D. Nishi Dedania, M.D. Sherin Ghali, M.D.

Hematology

Elizabeth Greig, M.D. Lilliam Guzman, M.D. Brian Hagenlocker, M.D. Melanie Helfman, M.D. Hannah Lipshultz, M.D. Margarita Llinas, M.D. Elizabeth Parra-Garnica, M.D. Cristina Pravia, M.D. Hiram Rodriguez, M.D. Stacy Rubin, M.D. Anjali Saxena, M.D. Katelin Snow, M.D. Jacobo Wajner, M.D. Kendra Van Kirk, M.D. Sabrina Taldone, M.D.

Mikkael Sekeres, M.D., M.S. Division Chief

Associate Professor, Educator Sonjia Kenya, Ph.D. Associate Professor of Professional Practice Gauri Agarwal, M.D. Assistant Professor of Professional Practice Chi Zhang, Ph.D. Analinnette Zito, M.D. Staff Physicians Sudah Lolayekar, M.D. Grettel Garcia, M.D.

Geriatrics & Palliative Medicine Marcio Rotta Soares, M.D. Division Chief Professors of Medicine Stuti Dang, M.D., M.P.H. Silvina Levis-Dusseau, M.D. Research Professor Guy Howard, Ph.D. Associate Professor Jorge Ruiz, M.D. Research Associate Professor Carlos Perez-Stable, Ph.D. Assistant Professors Enrique Aguilar, M.D. Jenny Drice, M.D. Iriana Hammel, M.D. Mariana Khawand-Azoulai, M.D. Julia Sanchez, M.D. Luis Samos-Gutierrez, M.D. Marcio Soares, M.D. Khin Zaw, M.D.

Professors of Medicine Yeon Soong Ahn, M.D. (Emeritus) John Byrnes, M.D. Diko Kazandjian, M.D. Carl Landgren, M.D., Ph.D. Izidore Lossos, M.D. Craig Moskowitz, M.D. Stephen Nimer, M.D. Joseph Rosenblatt, M.D. Mikkael Sekeres, M.D. Gerald Soff, M.D. Research Professor Ramiro Verdun, Ph.D. Associate Professor Jack Temple, M.D. (Emeritus) Associate Professors of Clinical Medicine Alvaro Alencar, M.D. Juan Carlos Ramos, M.D. Jonathan Schatz, M.D. Justin Watts, M.D. Assistant Professors of Clinical Medicine Juan Alderuccio, M.D. Ney Alves, M.D. Terrence Bradley, M.D. Diane Byrnes, M.D. Roberto Cano, M.D. Namrata Chandhok, M.D. Jonathan Cohen, M.D. David Coffey, M.D. Benjamin Diamond, M.D. Thomas Harrington, M.D. James Hoffman, M.D. Francesco Maura, M.D. Georgios Pongas, M.D. Justin Taylor, M.D. Steven Weiss, M.D. Research Assistant Professors Marzenna Blonska, Ph.D. Xiaoyu Jiang, Ph.D. Jun Sun, Ph.D. Yu Zhang, M.D. Staff Physicians Diogenes Alayon, M.D. Sharhabil Ammus, M.D. Mayda Arias, M.D. Douglas Faig, M.D. David Lessen, M.D. Jorge Antunez de Mayolo, M.D.

Department of Medicine Chairman’s Report 2021 41


Department of Medicine Divisions Hospital Medicine

Infectious Diseases

Medical Oncology

Michael Kolber, M.D. Interim Division Chief

Mario Stevenson, Ph.D. Division Chief

Gilberto Lopes, M.D., M.B.A., F.A.M.S. Interim Division Chief

Professors of Medicine Gordon Dickinson, M.D. Margaret Fischl, M.D. Michael Kolber, M.D. Mario Stevenson, Ph.D.

Professors Bach Ardalan, M.D. Pasquale Benedetto, M.D. Lynn Feun, M.D. Erin Kobetz, Ph.D. Marc Lippman, M.D. (Emeritus) Stephen Richman, M.D. (Emeritus) Jonathan Trent, M.D., Ph.D.

Associate Professors Efren Manjarrez, M.D. Assistant Professors Juan Serralles Allongo, M.D. Candido Anaya, M.D. Roberto Andino, M.D. Alberto R. Arancibia, M.D. Scott Berger, M.D. Reese Cargioli, M.D. Aldo Pavon Canseco, M.D. Sharde Chambers, M.D. Tanya Clarke, M.D. Stephanie Chery, M.D. Iman Doostan, M.D. Chadwick Flowers, M.D. Kunal Gawri, M.D. Erica Graff, M.D. Oxana Harlamova, M.D. Armen Henderson, M.D. Devora Kahn, M.D. Matthew Imm, M.D. Joshua Laban, M.D. Maria Carolina Delgado-Lelievre, M.D. Ahmed Luqman, M.D. Vijay Mehta, M.D. Maria Antonietta Mosetti, M.D. Deepak Mummidavarapu, M.D. Lubna Osman, M.D. Rafael Enrique Hernandez Oquet, M.D. Christian Quintana, M.D. Phillip Rubin, M.D. Allan Rubinfeld, M.D. Jonathan Salter, M.D. Olga Tarasova, M.D. Pamela Trotter, M.D. Bruno Urrea, M.D. Avinash Vernekar, M.D. Jessica Zuleta, M.D. Staff Physicians Glenda Sosa, M.D. Jorge Diaz Valdes, M.D.

Professors of Clinical Medicine Lilian Abbo, M.D. Maria Alcaide, M.D. Gio Baracco, M.D. Jose Castro, M.D. Susanne Doblecki-Lewis, M.D. Michele Morris, M.D. Allan Rodriguez, M.D. Dushyantha Jayaweera, M.D. Associate Professors Catherine Boulanger, M.D. Jacques Simkins-Cohen, M.D. Isabella Rosa-Cunha, M.D. Jose Camargo Galvis, M.D. Paola Lichtenberger, M.D. Stephen Symes, M.D. Hansel Tookes, M.D. Assistant Professors Shweta Anjan, M.D. Folusakin Ayoade, M.D. Laura Beauchamps, M.D. Hector Bolivar, M.D. Jovanna Bertran-Lopez, M.D. Stephen Morris, M.D. Yoichiro Natori, M.D. Alexis Powell, M.D. Mohammed Raja, M.D. Antoine Salloum, M.D. David Serota, M.D. Bhavarth Shukla, M.D. Candice Sternberg, M.D. Stephen Symes, M.D. Jose Gonzales Zamora, M.D. Research Assistant Professor Mark Sharkey, Ph.D.

42 UHealth|University of Miami Miller School of Medicine

Professors of Clinical Medicine Marijo Bilusic, M.D., Ph.D. Judith Hurley, M.D. Gilberto Lopes, M.D., M.B.A. Jose Lutzky, M.D. Research Professor Niramol Savaraj, M.D. Associate Professors Tracy Crane, Ph.D., R.D.N. Jaime Merchan, M.D. Associate Professors of Clinical Medicine Gina D’Amato, M.D. Peter Hosein, M.D. Chukwuemeka Ikpeazu, M.D. Reshma Mahtani, D.O. Alejandra Perez, M.D. Catherine Welsh, M.D. Assistant Professors of Clinical Medicine Carmen Calfa, M.D. Leonel Hernandez Aya, M.D. Emily Jonczak, M.D. Lawrence Negret, M.D. Daniel O’Neil, M.D. Agustin Pimentel, M.D. Pearl Seo, M.D. Janaki Sharma, M.D. Frances Valdes-Albini, M.D. Luis Villa, M.D. Research Assistant Professors Zinzi Bailey, Sc.D., M.S.P.H. Akina Natori, M.D. Natasha Solle, Ph.D. Staff Physicians Richa Dawar, M.D. Mauricio Escobar, M.D. Nkiruka Ezenwajiaku, M.D. Gustavo Fernandez, M.D. Elisa Krill Jackson, M.D. Vinay Minocha, M.D. Joseph Pizzolato, M.D. Estelamari Rodriguez, M.D. Tariq Sabir, M.D. Rakesh Singal, M.D.


Katz Family Division of Nephrology and Hypertension

Pulmonary, Critical Care and Sleep Medicine

Alessia Fornoni, M.D., Ph.D. Division Chief

Naresh Punjabi, M.D., Ph.D. Division Chief

Professor of Medicine Alessia Fornoni, M.D., Ph.D. David Roth, M.D.

Professors Horst J. Baier, M.D. (Emeritus) Michael A. Campos, M.D. Hayley B. Gershengorn, M.D. Robert M. Jackson, M.D. Daniel H. Kett, M.D. Naresh Punjabi, M.D., Ph.D. Andrew Quartin, M.D. Matthias A. Salathe, M.D. (Emeritus) Roland M. Schein, M.D. Shirin Shafazand, M.D., M.S. Adam Wanner, M.D. Philip Whitney, Ph.D. (Emeritus)

Professors of Clinical Medicine Gabriel Contreras, M.D., M.P.H. Warren Kupin, M.D. Oliver Lenz, M.D., M.B.A. Giselle Guerra, M.D. Associate Professors of Clinical Medicine Marco Ladino Avellaneda, M.D. Adela Mattiazzi, M.D. Jair Munoz Mendoza, M.D. Mariella Ortigosa-Goggins, M.D. Research Associate Professor Sandra Merscher, Ph.D. Assistant Professors of Clinical Medicine Adriana Dejman, M.D. Juan Duque, M.D. Yelena Drexler, M.D. Zain Mithani, M.D. Efren Chavez Morales, M.D. Javier Pagan, M.D. Marie Anne Sosa, M.D. Research Assistant Professors Tali Elfassy, Ph.D. Hassan Al-Ali, Ph.D.

Population Health and Computational Medicine Assistant Professor of Clinical Medicine Maritza Suarez, M.D.

Associate Professors Alexandre Abreu, M.D. Alejandro Chediak, M.D. David De La Zerda, M.D. Elio Donna, M.D. Tanira Ferreira, M.D. Gregory Holt, M.D., Ph.D. Diane Lim, M.D. Neeraj Sinha, M.D. Assistant Professors Saramaria Afanador-Castiblanco, M.D. Roger Alvarez, D.O. Sixto Arias, M.D. Kori Ascher, D.O. Jonathan Auerbach, M.D. Yaroslav Buryk, M.D. Jorge Cabrera, D.O. Rafael Calderon Candelario, M.D. Oveimar De La Cruz, M.D. Lisa Domaradzki, M.D. Lesley Farquharson, M.D. Hannah Ferenchick, M.D. Brian Garnet, M.D. Sergey Gerasim, M.D. Adhiraj Gosine, M.D. Eric Lang, M.D. Christopher Mallow, M.D. Suresh Manickavel, M.D. Maria Tupayachi Ortiz, M.D. Erick Palma, M.D. Yoslay Perez, M.D. Andrea Shioleno, M.D. Trishul Siddharthan, M.D. Waleed Sneij, M.D. Rene Rico Tresgallo, M.D. Martin Zak, M.D.

Staff Physicians Andrew Calzadilla, M.D. Christopher Jordan, M.D. Sajid Kadir, M.D. Jeffrey Scott, D.O. Andres Sosa, M.D. Laiqua Khalid, M.D. Moe Zaw, M.D.

Rheumatology and Immunology Carlos J. Lozada, M.D. Interim Division Chief

Professor of Clinical Medicine Carlos J. Lozada, M.D. Associate Professors Eric Greidinger, M.D. Elaine C. Tozman, M.D. Assistant Professors Maria F. Carpintero, M.D. Ozlem Pala, M.D. Staff Physicians Elena Oberstein, M.D. Schartess Culpepper-Pace, M.D.

Transplantation and Cellular Therapy Krishna Komanduri, M.D. Division Chief Professor of Clinical Medicine Krishna Komanduri, M.D. Associate Professors of Clinical Medicine Lazaros J. Lekakis, M.D. Amer Beitinjaneh, M.D. Mark S. Goodman, M.D. Research Associate Professor Eric Wieder, Ph.D. Assistant Professors of Clinical Medicine Denise L. Pereira, M.D. Trent Wang D.O. Antonio M. Jimenez, M.D. Jay Y. Spiegel, M.D. Research Assistant Professor Cara Benjamin, Ph.D.

Department of Medicine Chairman’s Report 2021 43


Philanthropy Number of Gifts by Amount

Top 10 Gifts

Number of Donors

175

Functional Lung Imaging Research Fund

167

$1,100,000 $500,000

Asthma Research Fund 150 125

General Internal Medicine

104

100

43

50 25

1 1M

5

6

17

200K 100K 50K

$250,000

IDEA Exchange Harm Reduction Education and Outreach Fund

75

0

$450,000

Crohn’s and Colitis

$170,000

Heart Rhythm

$125,000

Arrhythmia Research Fund

$125,000 $100,000

COVID-19 UHealth Gift Support

18

$50,000

Percutaneous Structural Heart 25K

10K

1K

>999

$25,000

Cardiology Gift Fund

Donor Levels ($)

0

$250K

$500K

$750K

$1M

$1,250M

Department of Medicine Endowed Chairs and Professorships Maria T. Abreu, M.D. Martin H. Kalser, M.D. Chair in Gastroenterology

Joshua M. Hare, M.D. Louis Lemberg, M.D. Chair in Cardiology

Joseph Rosenblatt, M.D. William J. Harrington, M.D.Chair in Hematology/Oncology

Pasquale W. Benedetto, M.D. Courtelis Distinguished Chair in Medical Oncology

Paul Martin, M.D. Sol Cye Mandel Chair in Gastroenterology

David Roth, M.D. William Way Anderson, M.D. Chair in Nephrology David Roth, M.D Endowed Chair in Transplant Nephrology

Alessia Fornoni, M.D., Ph.D. Peggy & Harold Katz Family Chair for Kidney and Vascular Disease Research

Jeffrey Goldberger, M.D., M.B.A. Elaine & Sydney Sussman Endowed Professorship in Interventional Cardiology

Robert J. Myerburg, M.D. American Heart Association Chair in Cardiovascular Research

Il Joon Paik, M.D. Chester Cassel Chair for Research in Gastroenterology Roy E. Weiss, M.D., Ph.D. Stanley & Kathleen Glaser Chair in Medicine Naresh Punjabi, M.D., Ph.D. Mary Jane Sertel Professorship in Pulmonary Diseases

44 UHealth|University of Miami Miller School of Medicine

Adam Wanner, M.D. Joseph Weintraub Family Foundation Chair in Pulmonary Diseases

Rabbi Morris I.Esformes Endowed Chair in Medicine and Endocrinology


Leadership University of Miami Leadership

Carlos Prieto

Gilberto de Lima Lopes Junior, M.D., M.B.A., F.A.M..S (Interim)

Julio Frenk, M.D., M.P.H., Ph.D.

Executive Director, Business Development & Clinical Operations

Joseph J. Echevarria

Ivelisse Rodriguez

Dipen J. Parekh, M.D.

Laura J. Pinzon, M.B.A.

Henri R. Ford, M.D., M.H.A.

Alina Kasyanova, M.B.A.

Pulmonary, Critical Care and Sleep Medicine

Jannet Yern

Rheumatology and Immunology

President

CEO, UHealth and EVP of Health Affairs COO, UHealth

Director, Finance

Director, Business Operations

Dean and Chief Academic Officer

Director, Research Support

Department Leadership

Practice Director, Student Health Services

Roy Weiss, M.D., Ph.D. Chair

Division Chiefs

Medical Oncology

Alessia Fornoni, M.D., Ph.D.

Katz Family Division of Nephrology and Hypertension

Naresh M. Punjabi, M.D., Ph.D. Carlos Lozada, M.D. (Interim) Krishna Komanduri, M.D.

Transplantation and Cellular Therapy

Anna Carol Herman-Giddens, R.N., B.S.N.

Jeffrey Goldberger, M.D., M.B.A.

Division Administration

Maureen Lowery, M.D., F.A.C.C.

Richard Preston, M.D., M.S.P.H., M.B.A.

Cardiovascular

Ernesto Bernal-Mizrachi, M.D.

Endocrinology, Diabetes and Metabolism

Paul Martin, M.D.

Digestive Health and Liver Diseases

Olveen Carrasquillo, M.D., M.P.H.

General Internal Medicine

Marcio Soares, M.D.

Geriatrics and Palliative Medicine

Associate Vice Chair for Research Regulatory Compliance

Mikkael A. Sekeres M.D., M.S.

Hematology

David H. Kerman, M.D.

Michael Kolber, M.D., Ph.D. (Interim)

Hospital Medicine

Mario Stevenson, Ph.D.

Infectious Diseases

Senior Administrative Officer

Vice Chair of Faculty Development and Diversity

Cardiovascular

Clinical Pharmacology

Michael Kolber, M.D., Ph.D.

Endocrinology, Diabetes and Metabolism

Amar Deshpande, M.D.

Digestive Health and Liver Diseases

Maria Abreu, M.D.

General Internal Medicine

Khemraj Hirani, M.D.

Geriatrics and Palliative Medicine

Vice Chair for Clinical Affairs Vice Chair for Education Vice Chair for Research

CMO for DOM

Hematology

Hospital Medicine

Infectious Diseases

Francisco M. Rodriguez, M.S. Cristina Calderon-Parra Carol Cottrell

Joanne Alonso, M.B.A. Joanne Alonso, M.B.A. Ali R. Ismail Ivette Vento

Lily Ferrer, M.B.A., C.R.A. Ingrid V. Rodriguez, M.B.A. Medical Oncology

Carol Cottrell

Katz Family Division of Nephrology and Hypertension

Rolando Briceno, M.B.A

Pulmonary, Critical Care and Sleep Medicine

Carol Cottrell

Rheumatology and Immunology


“I’d like to leave you with a positive thought, as always. The late writer Leo Buscaglia wrote that ‘too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.’ We might need to remain physically distant right now, but we always have the ability to smile, be kind, and listen—we are in this together. I wish you good health, happiness, and success.”

1120 NW 14th Street, Suite 310 Miami, FL 33136 305-243-9120 med.miami.edu/departments/medicine

— Roy E. Weiss, M.D., Ph.D.