DOM CONNECT:

In this month’s Chair’s Spotlight, we highlight the work of Elena Byhoff, MD, MSc, an associate professor of medicine in the Division of General Internal Medicine with research activities in the Division of Health Systems Science. 

Dr. Byhoff is a primary care physician and researcher whose focus is on reducing health disparities and improving health outcomes for her patients through screening for social needs in the clinical setting and establishing partnerships between health care and community organizations. By engaging relevant stakeholders, her goals are to partner with historically marginalized communities to implement evidence-based interventions that may help alleviate negative Health Related Social Needs (HRSN), which can have an impact on an individual’s physical and mental health across the lifespan.  

Read the full spotlight by clicking the button below.

The Center for Digital Health Solutions (CDHS) is a new initiative at UMass Memorial Health that builds and implements intelligent digital health solutions which enable measurable change and make health care delivery more efficient and accessible. Under the leadership of Michael Hyder, MD, MPH, executive director of the CDHS and associate professor of medicine, and supported by Joyce Simon, CITC senior strategic project manager, the initiative encourages and supports providers to find innovative approaches to patient care that improve outcomes through various core programs including the Advanced Therapeutics Program (ATRx). 

The Advanced Therapeutics Program enables patients living with chronic diseases greater access to life-changing, next-generation therapies through groundbreaking approaches that bridge a current, critical gap in care. The Advanced Therapeutics team identifies patients that might benefit from targeted interventions through advanced analytic tools which create complex queries of data to ask specific questions of the Electronic Health Record (EHR). Those questions are related to criteria needed to initiate beneficial therapies that are critical to improving patient health and wellness.  

Currently, the Advanced Therapeutics Program is being implemented with a focus on patients with cardiometabolic and osteoporosis diseases. This highly collaborative effort integrates specialty medicine into primary care and heavily relies on discussion and consultation with both primary care providers and specialists. The program is meant to optimize patient care and support primary care in some of their most complex cases. After patients are identified through advanced analytics, Sandy Aiello, ACNP, the lead cardiometabolic APP, reviews the EHR and consults virtually and directly with the physician specialist team including, Madona Azar, MD (Endo-DM), Matthew Niemi, MD (Renal), Kostya Abramov, MD (Renal), and Khanh-Van Tran, MD, PhD (Cardiology). The team runs cardiometabolic rounds where they discuss approximately five cases each week for patients that may be good candidates for groundbreaking drugs and therapies that would typically be prescribed by specialists after an in-person visit. These weekly virtual meetings help facilitate efficient case reviews, recommendations, and prompt implementation when appropriate. Ms. Aiello then works with primary care providers and patients through all steps of the process from a discussion about the drug that may be of benefit, to prescribing, subsequent labs, and follow-up on possible side effects. In addition to working collaboratively with providers, she works closely with the UMass Memorial Specialty Pharmacy on everything from prior authorizations to insurance co-pays, often working with them to significantly lower co-pays to lessen the financial strain on patients. Along with the cardiometabolic initiative, the Advanced Therapeutics Program is also currently being implemented with osteoporosis patients under the clinical supervision of Jonathan Cheah, MD (Rheumatology). 

Sunita Puri’s Essay, “As a Doctor, I Know Being Ready to Die Is an Illusion”, Published in the New York Times  

Sunita Puri, MD, associate professor of medicine, program director of the Hospice and Palliative Care Medicine Fellowship, and provider in the Division of Palliative Care Medicine, had her Opinion Guest Essay, “As a Doctor, I Know Being Ready to Die Is an Illusion,” published in the New York Times on March 29, 2023. 

Here, Dr. Puri explores a physician’s expectations and response to the intricacies and complexity of patients coming to terms (or not) with dying.  

“…death is never neat. A good death should be defined by how well and honestly we care for the dying, not by their performance on our behalf.” Dr. Sunita Puri

Roberto Caricchio Featured in Voices of UMass Chan Podcast

Lupus is an autoimmune disease that occurs when the body's immune system attacks its own tissues and organs. In a recent episode of Voices of UMass Chan, Roberto Caricchio, MD, the Myles J. McDonough Chair of Rheumatology, professor of medicine, and chief of the Division of Rheumatology, describes a new lupus program launching at UMass Chan in collaboration with UMass Memorial. 

Nancy McCool and Team Create Program to Enhance Skills of Hospital Social Workers

Nancy McCool, LICSW, AHPSW-C, ACHP-SW, a social worker in the Division of Palliative Care Medicine, along with her team, have implemented a new program to train hospital social workers to conduct earlier care conversations with patients using the Serious Illness Conversation Guide. 



Nancy and her team created this program with the goal of adding to the skillset of social workers in conversation, family dynamics, and resource management, with a structured format for having earlier care conversations with patients. By implementing this program, social workers will be able to bring information from these conversations to the medical team earlier in the patient’s hospital course and disease trajectory. 

Matthew Hemming and Team Work to Find New Treatments for Gastrointestinal Stromal Tumors 

Matthew Hemming, MD, PhD, assistant professor of medicine in the Division of Hematology and Oncology, and his team are studying a sarcoma known as a gastrointestinal stromal tumor (GIST), in search of a potential treatment.  

In his study, “MOZ and Menin-MLL Complexes are Complementary Regulators of Chromatin Association and Transcriptional Output in Gastrointestinal Stromal Tumor,” published in Cancer Discovery, Dr. Hemming and his team worked to knock out GIST cell lines using the gene-editing tool known as Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), with the goal of searching for genes essential to the cells’ survival. They discovered that GIST cells depend upon the gene regulatory complexes MOZ and Menin-MLL to live, and the suppression of these complexes decreases GIST cell multiplication. According to Dr. Hemming and his team, the results define unique chromatin regulatory dependencies in GIST and identify potential therapeutic strategies for clinical use.    

The Department of Medicine Grand Rounds series continued this past month, with presentations from Georg Schett, MD, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU), titled "Car T Cell Therapy in Autoimmune Disease," Vijay Shah, MD, Mayo Clinic, titled "Alcohol Associated Liver Disease: The Present and the Future," Ilhom Akobirshoev, MSW, MA, PhD, Brandeis University, Diana Cejas, MD, MPH, University of North Carolina at Chapel Hill, and Yoel Carrasquillo-Vega, MD, UMass Chan Medical School, titled "Health Care Disparities for People of Color with Disabilities," and from Anand Viadya, MD, Harvard Medical School, titled "Re-Defining Primary Aldosteronism: Re-Thinking our Approach to Hypertension."

Medical Grand Rounds also featured two special lectures: The Inaugural Robert W. Finberg, MD, Memorial Lecture, featuring Jean-Laurent Casanova, MD, PhD, The Rockefeller University and The Rockefeller University Hospital, titled "The Human Genetic and Immunological Determinants of Life-Threatening COVID-19," and the annual Howe Lecture, featuring Cansu Canca, PhD, Northeastern University, and Neil Marya, MD, UMass Chan Medical School, titled "The Dog Has Finally Caught the Car, Now What? Ethical Challenges of AI-Based Diagnoses of Malignancy." The Howe Lecture was moderated by Apurv Soni, MD, PhD, and panel members included Eric Alper, MD, Sunita Puri, MD, Navine Nasser-Ghodsi, MD, and Scot Bateman, MD, all of UMass.

View this year's line-up of speakers here. Please join us in person for these presentations if you are able. Light refreshments will be available. 

Interested in watching our Grand Rounds presentations? Click on the links below.

March 2 - CAR T Cells in Rheumatic Disease

March 9 - Alcohol Associated Liver Disease: The Present and the Future

March 16 - Adverse Health and Healthcare Outcomes: Disparities at the Intersection of Race/Ethnicity and Disability

March 23 - Finberg Lecture - No Recording Permitted

March 30 - Re-Defining Primary Aldosteronism: Re-Thinking our Approach to Hypertension - No Recording Permitted

April 6 - Howe Lecture

Congratulations to the following staff member on her recent promotion:

Promotions

Shanna Spencer, in the ASG, has been promoted to Academic Administrator III.