As COVID-19 began to strain the world’s health care systems, members of Ariadne Labs’s global community quickly pivoted to launch initiatives and produce research aimed at mitigating the pandemic. Ten of those projects were highlighted in the labs’ first virtual Community Meeting, “Health Innovation in the Time of COVID-19,” held on June 11.
More than 200 participants across the health care industry logged in to hear members of the research community discuss the ways the COVID-19 pandemic is being confronted in primary care, nursing, surgery, hospital architecture, and patient-clinician communication. Researchers spoke of insights gleaned from South Korea’s COVID-19 efforts and the changes in patient perspectives about COVID-19 in India. Other topics included the development of a new COVID-19 surgical checklist and a look ahead at “the new normal.”
For the first time, Ariadne Labs’ annual Community Meeting was open to the public. Explained Chief Medical Officer Evan Benjamin, MD, MS, FACP, “With research around COVID-19 changing so rapidly, we felt it was really important to be part of a larger, broader discussion.” Executive Director Asaf Bitton, MD, MPH, stressed, “The virus has illuminated how interconnected we all are … COVID-19 is forcing us to put our scientific method on display, accelerating it much faster than usual.”
In rapid-fire, five-minute presentations, moderated by Dr. Benjamin and Susan Haas, MD, MSc, researchers described how they discerned and then confronted a health care challenge posed by COVID-19. Justin Sanders, MD, of Ariadne’s Serious Illness Care Program, for example, cited profound social isolation, collective fear, and health care disparities among vulnerable populations and how an Ariadne team devised a simple communication toolkit to help patients feel informed, prepared, and cared for and for clinicians to feel supported in initiating difficult conversations about patients’ priorities for care.
Mary Brindle, MD, MPH, incoming director of Ariadne’s Safe Surgery/Safe Systems Program, described the huge demands placed on human resources by COVID-19. Her team interviewed seven health system leaders on their human resource redeployment. One insight: “Despite the urgent need of human resources during health crises such as COVID, we still need to pay attention to credentialing checks and good onboarding,” she said.
Mount Sinai Hospital, the epicenter of the New York City pandemic, rapidly converted and repurposed spaces for the care of critically ill COVID-19 patients, said Amie Shao, MArch, of MASS Design Group, which collaborated with Ariadne Labs to examine how principles of spatial design can help mitigation. Infection-control protocols in unit entrances proved to be as important as those in patients’ rooms. “Even things as simple as paint on the floor can be a really powerful tool to orient people in a care environment,” Shao said. The future may bring a “larger definition of safety beyond infection control.”
Richard Gitomer, MD, MBA, Director of the Primary Care Center of Excellence at Brigham & Women’s Hospital, noted that primary care was able to help flatten the curve of the infection. The pandemic “forced us to do things we hadn’t done before, at a scale we hadn’t done before,” he said. He acknowledged that he became convinced of the value of telemedicine, despite earlier misgivings.
As preamble to a presentation on South Korea’s COVID-19 response, June-Ho Kim, MD, MPH, a Fellow in General Medicine and Primary Care at Ariadne Lab, said, “If we are committed to saving lives, we need to get beyond our complacency and exceptionalism and learn from these other countries.” One key lesson from his team: The virus can be contained through public health fundamentals.
Presenters also spoke of the impact of COVID-19 on certain populations. “This group is well aware communities of color, particularly black individuals and Latinos, are bearing the brunt of the coordinated pandemic,” said Ravi Kavasery, MD, medical director of quality and population health for Ultimate Health Services, which has a health center in East Los Angeles, a “testing desert,” where patients are mostly low-income, essential workers unable to self-isolate. The center was able to find a partner to conduct massive testing, switched 50 percent of the practice to telehealth, and proactively outreached to patients most in need, including people with diabetes, frail elderly, and children with complex conditions.
“A key learning for us has been that the conversation needs to move beyond the potential of telehealth,” Dr. Kavasery said. “What we’re really talking about is moving care delivery beyond brick and mortar care and meeting the patient where they are.”
The meeting reflected what is possible through local and global collaboration. “We have a community of you,” Dr. Bitton told participants in the meeting. “Clinicians, staff, researchers, public health practitioners, and others were able to help us together design solutions that are equitable, solutions that narrow disparities, not widen them, and solutions that pragmatically approach the problems at hand…And though we’re separated virtually, I think we still clearly are showing that we’re staying connected.”
The presenters and the titles of their presentations, in order:
- Amie Shao, MArch, Redesigning Hospital Spaces on the Fly to Protect Healthcare Workers
- Maureen E. Farrell, MD, FACOG, and Joyce K. Edmonds, PhD, MPH, RN, Nursing Insight and COVID-19
- Ravi Kavasery, MD, How the Largest FQHC in America Navigated COVID to Address Health Equity
- Justin Sanders, MD, MSc, The Serious Illness Care Program’s COVID-19 Toolkit – A Rapid Response to an Evolving Pandemic
- Lauren Kennedy-Metz, PhD, Development of a COVID-19 Cognitive Aid to Support Operating Room Personnel
- Mary Brindle, MD, MPH, Managing and Navigating Safe Systems Through COVID-19
- June-Ho Kim, MD, MPH, Global Learnings in Adapting Health Systems for Pandemic Response
- Richard Gitomer, MD, MBA, Brigham Primary Care in the Time of COVID
- Shahed Alam, MD, MHS, Supporting Health at Home: Implementing a Rapid Learning-driven COVID-19 Health Facility + Community Training Program
- Jay Want, MD, What I Did On My Spring Break: Building A Way For Colorado To Re-open In 35 Days