Highlights of Mongan Institute Faculty COVID-19 Research: Population and Healthcare Delivery Science and the Global Pandemic

Message from the Director:

Population and Health Care Delivery Science in the COVID-19 Era

Stephen Bartels, MD, MS

Director, Mongan Institute

If there was ever a time for population and health care delivery team science it is now. Entire populations and health care systems have been overwhelmed by the daily challenges of coping with the devastating impact of COVID-19. While clinicians have been hard at work treating COVID-19, and laboratory researchers have been rushing to develop vaccines and treatments, population and healthcare delivery scientists have been working to predict and track its impact and rapidly implement new approaches to delivering care. The Mongan Institute at Massachusetts General Hospital is fortunate to have leading experts in their fields who are dedicated to addressing the most urgent and complicated challenges in health care. The team science research response to COVID-19 has required an accelerated pace, degree of innovation, and rapid application of results that is truly unprecedented in our lifetime.  

Selected examples by Mongan Institute faculty range from Dr. Rochelle Walensky’s helping to lead our response at MGH and across Massachusetts and expertise that is regularly cited in the national media….to Dr. Andy Chan helping to launch a free mobile COVID Symptom Tracker app as part of an international COronavirus Pandemic Epidemiology (COPE) Consortium. Efforts aimed at addressing COVID-19 related health disparities include research by Dr. Maggie Alegria and work by Dr. Joe Betancourt and Aswita Tan-McGrory with the MGH Equity and Community Health COVID Response Team. Attending to the impact of COVID-19 on vulnerable patients in the local Partners HealthCare system, Dr. Ingrid Bassett is leading a team studying COVID-19 in special populations such as pediatric patients, pregnant women, and people with HIV, while Dr. Christine Ritchie is co-leading a workgroup on Home Health for frail elderly and seriously ill adults. Dr. Elyse Park is leading a team testing the effectiveness of a program to reduce the impact of COVID-19 related stress in our frontline clinicians. Dr. Kim Blumenthal is studying allergic reactions to COVID-19 treatments, and Dr. Zach Wallace is participating in global research on the impact of the coronavirus on rheumatic diseases. These are only a snapshot of some of the many efforts by Mongan Institute faculty who are dedicated to reversing the tide and tragedy of this global pandemic. COVID-19 has brought into bold relief the inadequacies and inequities of our current system of care and the disproportionate impact of health-related disasters on vulnerable populations. Once we make it through this crisis, we should not waste the opportunity to apply the lessons learned to be better prepared for the next population health disaster, while also transforming care in normal times to ensure better access and health equity for all.

In the News: Helping to Lead the COVID-19 Response

Rochelle Walensky, MD, MS

Rochelle Walensky, MD, MS, is part of the COVID-19 Advisory Board brought together by Massachusetts' Baker-Polito administration. The COVID-19 Advisory Board is a group of medical experts that will support the Response Command Center as the Commonwealth of Massachusetts continues to respond to COVID-19. Click here to read more about the MA COVID-19 Advisory Board. 

 

Dr. Walensky is Chief of Infectious Diseases at Massachusetts General Hospital, Professor of Medicine at Harvard Medical School, and a practicing Infectious Disease physician at Massachusetts General Hospital.

 

In the media:

 

Watch Dr. Walensky answer questions about COVID-19:

Watch "Putting the Coronavirus Genie Back in the Bottle," an interview with Dr. Walensky (JAMA Network):

COVID Symptom Tracker App and the COronavirus Pandemic Epidemiology (COPE) Consortium

Andy Chan, MD, MPH

Andrew T. Chan, MD, MPH, is leading a research project to identify risk factors for COVID-19 infection and to produce data on their clinical outcomes over the near- and long-term. With emergency funding from the UK National Health Service and the Wellcome Trust, he helped launch a mobile “COVID Symptom Tracker” app that was co-developed by King's College and Zoe Global Ltd. It was deployed in the UK on March 24, 2020, garnering over 1 million downloads in just 48 hours. The US version of the app was deployed shortly afterwards. Click here to learn more about the COVID Symptom Tracker and the COPE Consortium. 

Dr. Chan is a Professor of Medicine at Harvard Medical School, Chief of the Clinical and Translational Epidemiology Unit at Mass General, and Director of Cancer Epidemiology at the MGH Cancer Center.

In the media:

COVID-19 Mental Health Disparities: Call for Research Participants

Margarita Alegria, PhD

As part of the COVID-19 response, the Disparities Research Unit staff at the Mongan Institute have adapted our STRONG MINDS program for adults 18 years or older who are fluent in English, Spanish, Mandarin, or Cantonese, with symptoms of depression, anxiety, or trauma to participate in this research study. We aim to help adults better handle stress, and lead happier and healthier lives by promoting mental health in these times of extreme uncertainty. We would like to see how COVID-19 is impacting your life and how STRONG MINDS can help you cope with the related stress.

 

Eligible participants who speak any of the study languages may receive at no cost 10 individual psychoeducation sessions and referral to services by a care manager. The sessions will introduce you to skills that may help you manage unhelpful thoughts, strategies to practice self-care and mindfulness, and ways to maintain a more positive outlook on life. If interested, please contact Dr. Larimar Fuentes in English or Spanish at 617-643-0514 or 617-755-0763, or Liao Zhang in English, Mandarin, or Cantonese at 617-417-4783.

Dr. Maggie Alegria is Chief of the Disparities Research Unit and a​ Professor in the Departments of Medicine and Psychiatry at Harvard Medical School.

In the media: 

MGH Equity and Community Health COVID Response Team

Joseph Betancourt, MD, MPH

Aswita Tan-McGrory, MBA, MSPH

Joseph R. Betancourt, MD, MPH, Vice President and Chief Equity and Inclusion Officer at Mass General, is leading the MGH Equity and Community Health COVID Response Team with Joan Quinlan, MPA, Vice President of Community Health. Aswita Tan-McGrory, MBA, MSPH, Administrative Director of the Mongan Institute and Director of the Disparities Solutions Center, is also part of the MGH Equity and Community COVID Response Team.

 

The MGH Equity and Community Health COVID Response Team is working to assure that all we do to address COVID at MGH has equity and community health as our foundation. The team has workstreams focused on assuring that all communications to patients and employees are in multiple languages, that all clinical interactions have the capacity to meet the needs of diverse and multilingual populations, and that the critical social needs of our communities are addressed. 

Click here to learn more about equity in the COVID-19 response. This website page has recommendations for addressing equity in the COVID-19 response, and a repository that has:

  • Multilingual resources to serve the needs of patients, providers, and employees who speak languages other than English

  • Resources to support clinicians working with people with disabilities

  • Community health resources

In the media:

Observational Data Collection for COVID-19 Suspects/Cases

Ingrid V. Bassett, MD, MPH

Virginia (Jeanne) Triant, MD, MPH

Ingrid Bassett, MD, MPH, James Meigs, MD, MPH, and Virginia (Jeanne) Triant, MD, MPH, are leading an effort to launch observational data collection for COVID-19 suspects/cases across all Partners HealthCare hospitals. This builds on expertise from multiple specialities and will utilize a combination of manual chart review and Epic data extraction. There will be a focus on special populations (e.g., pregnant women, pediatrics, people living with HIV). The team is also working with hospitals throughout Boston to harmonize data for a Boston-wide observational cohort study. 

Dr. Bassett is Co-Director of the Medical Practice Evaluation Center within the Mongan Institute at Massachusetts General Hospital, an Associate Professor of Medicine at Harvard Medical School, and an infectious disease physician at Mass General.

 

Dr. Meigs is a Professor of Medicine at Harvard Medical School, a physician in the Division of General Internal Medicine at Mass General, and Co-Director of the MGH Clinical Research Program’s Clinical Effectiveness Research Group.

 

Dr. Triant is an associate physician in the Division of General Internal Medicine at Mass General and an Assistant Professor of Medicine at Harvard Medical School.

COVID and Home-Based Care for Elderly and Seriously Ill Adults

Christine Ritchie, MD, MSPH

Christine Ritchie, MD, MSPH, is co-leading the Home-based Care Workgroup with Judy Flynn of Partners Home Health as part of Partners’ Covid Continuum of Care response. This Partners-wide effort includes: 1) Adapting infection control guidelines for all home visits (including people who are  immunocompromised, frail elderly, and other seriously ill adults); 2) Creating an inventory for all programs that involve visits at home to optimize coordination and workflows; 3) Developing frameworks for triaging all home visits; 4) Developing capacity strategies to accommodate outflow from hospitals; 5) Engaging an environmental scan of national guidelines and best practices; and 6) Optimizing Communication (clinician, patient), dissemination. 

 

Dr. Ritchie is the Kenneth L. Minaker Chair in Geriatrics and Director of Research for the Division of Palliative Care and Geriatric Medicine at Massachusetts General Hospital. She is a board-certified geriatrician and palliative care physician and conducts research focused on optimizing quality of life for those with chronic serious illness and multimorbidity. She co-leads the NINR-funded Palliative Care Research Cooperative and the national Home-based Primary Care and Palliative Care Consortium, which seeks to improve our understanding and care of the homebound population. Dr. Ritchie is the Director of the Center for Aging and Serious Illness Research at the MGH Mongan Institute.

Frontline Clinician Resilience Program

Elyse Park, PhD, MPH

Karen Donelan, ScD, EdM

Elyse Park, PhD, MPH, is leading the Frontline Clinician Resilience Program, which helps Partners HealthCare employees develop resiliency skills to adapt to the additional burden COVID-19 has placed on the medical system and its constituents. This program offers one-hour sessions that are held twice weekly for 4 weeks via Zoom to help those providing direct care to patients with much-need stress management, self-care, and resiliency tools during the COVID-19 pandemic. Partners HealthCare physicians and nurses can register for the groups at the Benson-Henry Institute website by clicking here.

Karen Donelan, ScD, EdM, and Christine Vogeli, PhD, are partnering with Dr. Park on behalf of Partners Population Health to conduct a pre/post assessment.

Dr. Park is an Associate Professor of Psychiatry at Harvard Medical School, Associate Director of Survivorship Research and Psychosocial Services for the Mass General Cancer Center Survivorship Program, Director of Behavioral Sciences at the MGH Tobacco Treatment & Research Center, and Director of Behavioral Research at the MGH Benson-Henry Institute for Mind Body Medicine.

Dr. Donelan is a senior scientist at the Health Policy Research Center within the Mongan Institute at Mass General, Director of the Survey Research and Implementation Unit in the MGH Division of Clinical Research, and an Associate Professor of Medicine at Harvard Medical School. 

Dr. Vogeli is an Assistant Professor of Medicine at Harvard Medical School and Director of Evaluation and Research at Partners Population Health.

Christine Vogeli, PhD

Adverse and Allergic Drug Reactions related to COVID-19 Treatments

Kimberly Blumenthal, MD, MSc, is collaborating with informaticians at Brigham and Women's Hospital to study adverse and allergic drug reactions related to COVID-19 treatments across Partners HealthCare hospitals.

 

Dr. Blumenthal is Co-Director of the Division of Rheumatology, Allergy, and Immunology Clinical Epidemiology Program within the Mongan Institute at Massachusetts General Hospital. 

Kim Blumenthal, MD, MSc

COVID-19 Global Rheumatology Alliance

Zach Wallace, MD, MSc

Zachary Wallace, MD, MSc, is on the Steering Committee of the COVID-19 Global Rheumatology Alliance, which launched an IRB-approved physician-reported registry to collect cases of rheumatic disease patients infected with COVID-19. There is also a complementary patient-reported experience registry.

Dr. Wallace is a rheumatologist and researcher in the Division of Rheumatology, Allergy, and Immunology Clinical Epidemiology Program and an Assistant Professor of Medicine at Harvard Medical School. 

Breast Cancer Screening, Diagnosis, and Treatment During COVID-19

Led by Erica Warner, ScD, MPH, this study is being conducted in partnership with breast cancer organizations including Dr. Susan Love Foundation for Breast Cancer Research, SHARE, Survivingbreastcancer.org, Sisters Network Inc., the African American Breast Cancer Alliance, and through ResearchMatch.org. Individuals were eligible for this study if they:

  1. Receive routine breast cancer screening; OR

  2. Are undergoing diagnostic evaluation for breast cancer; OR

  3. Have ever been diagnosed with breast cancer.

 

Participants are asked to complete a 10-15-minute REDCap survey which collects information on respondent demographics, breast cancer screening and diagnosis, the extent to which care has been changed, delayed, or cancelled because of COVID-19, personal protective practices, extent of worry about financial and health implications of COVID-19, and use of telemedicine. The surveys are available in English and Spanish and will be open through the end of June and are available here:

Dr. Warner is an Assistant Professor in the Department Medicine at Harvard Medical School and an Assistant Investigator at Massachusetts General Hospital where she conducts epidemiological research on cancer in the Mongan Institute’s Clinical Translational Epidemiology Unit.

Erica Warner, ScD, MPH

COVID-19 and Health Equity, Community Engagement Research, and Advocacy

Julie Levison, MD, MPhil, MPH

Julie Levison, MD, MPhil, MPH, is Co-Director of the MGH Chelsea Community Research Program, where she and her colleagues developed a Clinical Research Advisory Board to review COVID-19 research protocols at MGH Chelsea HealthCare Center with attention to equity and cultural and linguistic appropriateness.

Dr. Levison is involved in a number of COVID-19 efforts. She is a member of the Diagnostics Working Group of the Massachusetts Consortium on Pathogen Readiness, an unprecedented, multi-institutional research collaboration that aims to stem the tide of COVID-19 and create a rapid-response system to address future health crises. Dr. Levison is serving on the COVID-19 sub-committee of the Massachusetts Ending the HIV Pandemic Steering Committee, as well as on the Advisory Board of the Infectious Diseases Society of America Research Committee. 

Dr. Levison is also a Co-Investigator on a study led by PI Daphne Holt, MD, PhD, Resilience and Prevention Intervention for Health Care Workers.

In the media:

Engaging patients in decisions about rescheduling colonoscopies delayed due to COVID-19

Karen Sepucha, PhD

Leigh Simmons, MD

Principal Investigators: Karen Sepucha and Leigh Simmons  

Co-Investigators (from MGH): Steve Atlas, Sanja Percac-Lima, James Richter

As the initial surge of patients with COVID-19 recedes, one pressing issue facing health care systems is how to manage the large and growing backlog of screening tests and elective procedures. To further complicate matters, public health officials warn that further waves of infection may occur over the next 12-18 months, and each may cause additional restrictions on capacity, increasing backlogs and delaying needed care even more. Managing demand with reduced capacity while planning for additional shutdowns represents a key new challenge for health care delivery systems during this crisis. Moreover, even if there is capacity, many patients may feel differently about the value of seeking healthcare, including cancer screening, until an effective treatment or vaccine for COVID-19 is found. 

 

In this PCORI-funded study, investigators will examine the distribution of patients’ preferences for rescheduling a screening or surveillance colonoscopy that was delayed or postponed due to COVID, and factors associated with those preferences. Then, we will study whether shared decision making tools and training will increase patients involvement in decisions, increase their intention to follow through with some type of colon cancer screening, and reduce decisional conflict. There are many challenges to resuming healthcare during this crisis, and this study will address important research questions about how to do this in a safe, equitable and patient-centered manner.

Dr. Sepucha is Director of the Health Decision Sciences Center and an associate professor in Medicine at Harvard Medical School. Dr. Simmons is Medical Director of the Health Decision Sciences Center and an internal medicine physician at Massachusetts General Hospital. 

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