Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to FMCHtuesdaytalk@umassmed.edu. |
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Table of Contents
Message from the Chair
Upcoming Events
Focus of the Week - Community
Announcements
Faculty Presentations/Publications
Department Member Recognition
Frankly Speaking Podcast
Clinical Services Spotlight
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Message from the Chair
We have concluded a national search for the next Vice Chair for Community Health, and I am pleased to announce that Dr. Hugh Silk will assume the role on September 1st. Hugh is well known to many of you. He completed his residency at Hahnemann, was Chief Resident, completed an MPH at Harvard TH Chan School of Public Health, served as Education Director for the residency, and worked at Hahnemann with a short stint at the University of Connecticut in between. After a year in New Zealand, Hugh worked at Reliant, in correctional health and then served as the medical director for Community HealthLink in Leominster and more recently with the Homeless Outreach and Advocacy (HOAP) Program and Road to Care van at FHCW.
Hugh was promoted to full professor in 2015. Among his many roles, he serves as a Learning Community mentor and has been engaged in the new VISTA curriculum. He has been funded for the last five years on public health research in collaboration with the Harvard Medical and Dental Schools. He has worked with the Worcester Department of Health and Massachusetts state agencies. He is committed to addressing health equity and social justice through teaching, mentoring, and research.
Hugh will bring his passion for full spectrum inner city care to the position. He will draw upon his expertise in integrating oral health into primary care, his experiences providing care to vulnerable populations, including those with serious mental health issues, individuals who are housing insecure, and those with justice involvement.
I extend my gratitude to the search committee and its co-chairs, Jennifer Bradford and Linda Cragin. Please join me in welcoming Hugh to the FMCH Senior Leadership Team!
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Upcoming Events
FMCH Grand Rounds relaunches after the summer hiatus for the academic year 2023
Tuesday, August 30th, 12:00 - 1:00 pm. "Integration of Doulas into Maternity Care Settings: Overcoming Barriers and Bolstering Facilitators to Teaming with Doulas and Improving Health Equity", presented by Christina Gebel, MPH, Birth Doula (DONA), LCCE.
Meeting ID: 191 986 273 Passcode: FMCH
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Focus of the Week - Community
Treatment for opioid use disorder behind bars in Massachusetts
Over the last two years, we have witnessed continued increases in fatal and nonfatal overdoses. Individuals at highest risk are individuals released from jail or prison who have other mental health problems and who are unstably housed or homeless. In 2018, as part of government’s response to the epidemic, Chapter 208 was signed into law, mandating 5 counties and 4 prisons to provide all FDA-approved medications to treat opioid use disorder. Those coming into jail or prison on MOUD are required to continue the medication and to be linked to treatment post-release. The law also included provision for the MA Department of Public Health to evaluate the initiative. Soon after, NIDA released a request for proposed research titled: “The Justice Community Opioid Innovation Network” (JCOIN) and a three-campus UMass team along with investigators from Tufts University School of Medicine, Northeastern University and Cornell University were awarded a 5-year grant to conduct an Implementation Science project to study this natural experiment. Ekaterina Pivovarova, PhD, Assistant Professor and Warren Ferguson, MD, Professor are co-investigators on the qualitative research aim of the study. The project is led by Peter Friedmann, MD, Professor of PQHS and Vice Chancellor for Research from UMass-Baystate, and Elizabeth Evans, PhD from the UMass-Amherst School of Public Health.
The team has published findings of qualitative research analyzed from interviews and focus groups with staff in the seven participating jails (under Dr. Pivovarva’s leadership) https://doi.org/10.1016/j.drugalcdep.2022.109394 and just this week, the results from interviews with community-based treatment providers (Tom Stopka, PhD, Tufts University as lead author). https://doi.org/10.1016/j.drugpo.2022.103803 Quantitative research data on the scope and outcomes of treatment is just beginning to be analyzed, having been delayed by the Covid-19 pandemic.
Several conclusions gleaned from these studies include:
- Chapter 208 legislation helped to legitimize treatment with agonists in the jails as evidence-based practice.
- Leadership, collaboration with state agencies and community treatment providers are key elements of implementation.
- Successful treatment requires significant culture shifts on OUD as illness rather than crime, treatment as effective rather than illicit contraband, intensive staff training, procedure and policy development and teamwork among treatment providers and correctional staff.
- Community-based providers stress the importance of care coordination, the challenge of early, unexpected release to prompt treatment access following release and the use of bridging prescriptions and treatment to ensure no lapse in treatment.
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Announcements
FMCH GME Leadership Team
The quarterly FMCH GME Leadership meeting will be September 7, 2022 at Peppercorn’s Grille and Tavern. Please RSVP through your Outlook invite or contact Erica White at Erica.white@umassmemorial.org
Hepatitis C and General Hepatology
Project ECHO (Extension for Community Healthcare Outcomes)
You are invited to join an exciting virtual collaborative learning opportunity!
What? Hepatitis C ECHO, a virtual case-based tele-mentoring educational model
Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.)
Why? Tele-mentoring model that links specialists to primary care providers (PCPs) via video conferencing from any computer; Case based, iterative learning facilitated by specialists and related experts; through guided practice, PCPs become proficient in specialty care
When? A new cohort begins Friday, September 9th, 2022, 12:30 - 1:30pm ~ with 10 sessions held bi-monthly.
Curriculum content includes:
- HCV screening
- Acute HCV
- Chronic HCV: Workup
- Treatment of non-cirrhotic patients
- Treatment of cirrhotic patients
- Monitoring during treatment
- Monitoring post treatment
- "Topic by request"
- Other hepatitides in the context of HCV/Hepatitis A&B
- Treatment of special populations
The annual Family Medicine Education Consortium meeting is September 16-18 in Arlington, VA. The residencies will be represented at the recruitment fair, and many faculty, residents, and students will be presenting their great work. Find more information here: 2022 Annual Meeting (fmec.net). Medical student scholarships are available. Consider encouraging enthusiastic students.
There will be an evening celebration on Thursday September 15th for Larry Bauer, the founding CEO of the FMEC. If you are interested in joining, please contact Stacy Potts, she will be sponsoring a table for department members.
Putterman Lecture: SAVE THE DATE
Please join us on Tuesday, September 20th, 12:00 - 1:00pm, for our Family Medicine and Community Health Grand Rounds 23rd annual Putterman Lecture, being presented by Aletha Maybank, MD, MPH. Her lecture topic will be on “Building Alliances and Sharing Power for Health Equity and Racial Justice”. For those of you who wish to join us in person, a location is to be determined. As for those who would like to join via Zoom, please copy this link into your calendar: https://us02web.zoom.us/j/191986273?pwd=NEtlZmNkdWlSUGwyeTJQU3dCeUs1QT09.
We look forward to you joining us for this event.
Calling All Fellows and Chief Residents
The FMCH Fellows and Chief Residents are invited to a dinner gathering and get to know each other on September 29th, 2022, 6:30 - 8:30pm. Location TBD.
Teaching of Tomorrow (TOT) is a nationally recognized and highly acclaimed faculty development program that focuses on building and refining foundational skills for effective clinical teaching in inpatient and ambulatory settings. Preceptors from any specialty and discipline will enhance their clinical teaching skills through discourse and practice. Workshop dates are November 18-19, 2022 and March 10-11, 2023 and will be held at the Hotel Northampton. Participants must attend all four days. See brochure for details and how to register.
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Faculty Presentations/Publications
Stacy Potts, MD had an article published in the Journal of Graduate Medical Education; Stacy Potts, Grant S. Hoekzema, Colleen K. Cagno, Eileen Anthony; Shaping GME Through Scenario-Based Strategic Planning: The Future of Family Medicine Residency Training. J Grad Med Educ 1 August 2022; 14 (4): 499–504. doi: https://doi.org/10.4300/JGME-D-22-00505.1.
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Department Member Recognition
Stacy Potts and Kristina Gracey were awarded a UMass Innovation Grant for "STEP" (Striving Towards Everyday Physical Activity), a program focused on increasing physical activity and promoting a healthy work environment at the Barre Family Health Center through a step tracking program and improving the walking path.
Kristina Gracey and Jen Marino were awarded a grant from the Health Equity Partnership of North Central Mass (CHNA9) for "SNAP into Health," which involves teaching community-based cooking classes using locally grown vegetables and promoting SNAP benefit sign-ups in Barre area.
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Frankly Speaking Podcast
A weekly Podcast series covering newsworthy topics in primary care medicine.
Please join us for an overview: Excessive screen time has been associated with numerous adverse health outcomes. Join us for a look at a fascinating new study that explores how limiting screen time can increase physical activity in children. Listen to this brief podcast before you counsel your next patient on how screen time can affect their children's (and their) health. Guest: Alan Ehrlich, MD, FAAFP, presents: "Limit Screen Time to Increase Physical Activity". - Frankly Speaking Ep 289.
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Clinical Services Spotlight: |
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CLINICAL UPDATES
COVID-19 MA
- MA has to date 1,987,385 confirmed COVID cases, and 21,285 deaths as of 8/14/22.
- The 7-day average percent positivity is 8.07%.
- On average, 1,412 cases occurred in the last week in MA. Although cases have decreased, deaths increased by 24%.
- 1 in 3 residents in MA has been infected and 1 in 324 have died.
- Cases are slightly up in Worcester county at 2%.
- Worcester Stop-the-Spread percent positivity increased to 17%.
COVID-19 UMMMC
- COVID inpatient census is stable, with 7-day average of 39 (69% fully vaccinated).
- About 1/3 are primary COVID.
- The 7-day positivity rate is 15.6%.
- Of the 5 cases in the ICU, 100% are fully vaccinated.
Two Variants BA.4 and BA.5 and other
- BA.5 is more contagious and usually presents with sore throats and sinus-like symptoms. This includes upper respiratory symptoms like cough, fatigue, runny nose, headaches, sore throats, and myalgias.
- BA.4 presents with similar symptoms. However, it is less contagious.
- These are less likely to produce shortness of breath or loss of smell or taste.
- Each time a person is re-infected with COVID, the risk of long COVID increases.
- Long COVID is present in 6% of children diagnosed with COVID.
Monkeypox
- From the first outbreak on May 6, 2022, in the United Kingdom to more than 31,400 worldwide.
- Currently, there are 11,177 cases of Monkeypox in the US. New York, California, and Florida continue to have the most cases.
- Massachusetts has 202 cases.
FDA has authorized emergency use of intradermal injection of Monkeypox vaccine to extend supply
- To increase the number of Monkeypox vaccine doses available, the FDA issued an emergency use authorization for the JYNNEOS vaccine to allow intradermal injection of the vaccine for 18 years and older who are determined at high risk.
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The EUA allows the use of vaccines for people younger than 18 years who are determined to be at high risk of Monkeypox infection. Both groups should receive two doses four weeks apart.
- Find MA sites for vaccination at: https://www.mass.gov/info-details/monkeypox-vaccination.
Eligibility for vaccine includes
- Known contacts including those who have been identified by public health, risk exposure, and identified by risk assessment.
- Other risks include someone who has had sex with someone who has known Monkeypox in the last 14 days or has had multiple sexual partners in the past 14 days in an area with a high count of Monkeypox.
Spread Precautions
- Monkeypox is not an STI.
- It can spread through close contact or skin-to-skin contact.
- It can spread by direct contact with lesions or body fluids.
- Surfaces and objects that have been used by persons with Monkeypox.
- Contact with respiratory droplets through kissing and face-to-face contact.
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Wellness Resources
The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or www.LiveandWorkWell.com, [company code UmassMemorial]. More information is available on the Caring for the Caregiver page.
Wellness
You are invited to become a member of the Department Wellness Committee. Key goals for this year include improving the efficiency of use with the Electronic Health Record. Watch your email for future training sessions.
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Yoga Classes with Dr. Liz Erban
Classes have resumed!!
Great time to join!
This is a great time to join, new members always welcome. Start your mid week with some relaxing yoga!
Please join for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.
Join Zoom Meeting ID: 923 9393 3653 Passcode: 764113
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Zumba with Dr. Anna Zheng
ZOOM Zumba, Thursdays at 6:00am.
Meeting ID: 557 899 5952
Passcode: 123456
Please join department members Thursday, early mornings at 6:00am. Please note details and any changes via webpage: http://annazheng.zumba.com/. Much appreciation to Dr. Anna Zheng for hosting these outstanding classes. New to the class? Please email Dr. Zheng at ZumbawithAnnaZheng@gmail.com to register, complete brief health screen if it's your first class and the ZOOM link.
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