Program Guide

SGIM20 On-Demand Program Guide

Initial content launches in late June. Additional sessions updated weekly. Click the title to see the description

Clinical Updates

Update in Research Methods for the General Internist CUP1

Generalists must stay abreast of novel research methods to understand, generate, and utilize research findings. This update is designed to keep generalists informed of cutting-edge methods. We will review six of the most innovative papers recently published that use novel methods to address questions of interest to generalists. We will summarize each paper and the strengths and limitations of the methods used.

Mara A. Schonberg1, Melissa Y. Wei3, Amresh D. Hanchate2

1. Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States. 2. Public Health Sciences and General Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States. 3. Medicine, University of Michigan, Ann Arbor, MI, United States.

Track: Research Methods

Update in Medical Education CUP2

The Update in Medical Education aims to present an engaging review of selected high quality medical education literature from 2019 that is relevant to the SGIM audience. Emphasis is on new insights that our membership can use in their day to day educational practice. Presenters employ a rigorous process to identify the most impactful medical education articles to discuss in this venue.

Rachel Stark1, Rachel Bonnema2, Katherine Lupton6, Milad Memari3, Attila Nemeth4, Eva Rimler5

1. Medicine, Cambridge Health Alliance, Cambridge, MA, United States. 2. Medicine, UT Southwestern, Dallas, TX, United States. 3. Medicine, Johns Hopkins, Baltimore, MD, United States. 4. Medicine, Case Western Reserve University, Cleveland, OH, United States. 5. Medicine, Emory University, Atlanta, GA, United States. 6. UCSF, San Francisco, CA, United States.

Track: Medical Education Scholarship

Update in Women's Health CUP4

This session will highlight the most significant published advances in Women’s Health from March 2019 through March, 2020. Selected articles will be critically reviewed, and faculty will use case-based vignettes to highlight how each article impacts clinical practice.

Judith M. Walsh1, Brigid M. Dolan2, Sarah B. Merriam3, Christine Prifti4

1. Division of General Internal Medicine, UCSF, San Francisco, CA, United States. 2. Internal Medicine, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States. 3. Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh , PA, United States. 4. Medicine, Boston Medical Center, Boston, MA, United States.

Track: Women's Health

Update in Perioperative Medicine CUP5

We will focus on key areas within perioperative medicine. Publications will be identified by performing a comprehensive literature review and authors selecting the most important papers through a voting process. Each paper will be presented within the context of a patient care scenario, and authors will provide practical advice on how to apply the paper's findings to patient care.

Michele Fang1, Ryan Munyon2, Marilyn Katz3, Emily S. Wang4

1. Internal Medicine, University of Pennsylvania, Wynnewood, PA, United States. 2. General Internal Medicine, Penn State, Hershey, PA, United States. 3. Internal Medicine, University of Connecticut School of Medicine, Hartford, CT, United States. 4. Medicine, University of Texas Health at San Antonio, San Antonio, TX, United States.

Track: Hospital-Based Medicine

Update in Quality Improvement and Quality of Care/Patient Safety CUP6

This Update will review important contributions to the scientific literature occurring in 2018 and 2019 in topics related to quality improvement and patient safety (QI/PS). Articles are selected from journals of broad interest to SGIM members and from journals devoted to QI/PS. Emphasis is given to reports exploring the role of QI/PS related to social determinants of health and equity.

Jennifer M. Schmidt1, Rachna Rawal4, Diane L. Levine2, Reena Gupta3

1. Internal Medicine, Saint Louis University, Saint Louis, MO, United States. 2. Internal Medicine, Wayne State University, Detroit, MI, United States. 3. Division of General Internal Medicine, UCSF, San Francisco, CA, United States. 4. Internal Medicine, University of Pittsburg, Pittsburg, PA, United States.

Track: Quality of Care/Patient Safety

Update in Geriatrics CUP7

The faculty will systematically comb journals and online databases, select original research, and review geriatrics articles published during the calendar year 2019. We will select 6-10 articles that best inform internists, and streamline the presentation according to learning objectives. We will present the articles using a case-based interactive format, keeping in mind their importance to general internists.

Patricia F. Harris1

1. Medicine-Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.

Track: Aging/Geriatrics/End of Life

2020 Clinical Updates from the U.S. Preventive Services Task Force CUP8

The U.S. Preventive Services Task Force (USPSTF) recently released several key preventive services recommendation statements on screening for abdominal aortic aneurysm, hepatitis C virus infection, illicit drug use, and risk assessment, counseling, and testing for BRCA-related cancer. The session will summarize the evidence, recommendations, implications for clinical care, and dissemination resources.

Howard Tracer1, Carol Mangione2, Michael J. Barry3

1. Center for Evidence and Practice Improvement, US Preventive Services Task Force Division, Agency for Healthcare Research and Quality, Rockville, MD, United States. 2. Medicine, David Geffen School of Medicine at UCLA, Los Angeles , CA, United States. 3. Medicine, Massachusetts General Hosp[ital, Boston, MA, United States.

Track: Clinical Medicine

Clinical Update in Nutrition CUP9

This update will focus on interactive case-based discussions of the most groundbreaking nutrition articles published in the year 2019-2020. We will explore the evidence for popular dietary approaches (e.g., plant-based diets, low-carbohydrate/keto diets) and cutting-edge topics such as probiotics and the role of gut microbiome. Lastly, we will discuss commonalities among dietary approaches and summarize findings to provide practical strategies to guide patients’ nutrition decisions.

Noor Khan1, Dina H. Griauzde3, Jude Fleming4

1. Medicine, UPMC Mercy, Pittsburgh, PA, United States. 2. Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States. 3. Internal Medicine, University of Michigan, Ann Arbor, MI, United States. 4. Department of Medicine, Columbia University Medical Center, New York, NY, United States.

Track: Clinical Medicine

Updates in Digital Scholarship CUP10

By blending asynchronous learning environments with opportunities for real-time discourse, Digital scholarship is changing the way we learn and teach medicine. This Clinical Updates session will demonstrate the breadth and depth of digital scholarship by highlighting the most impactful works published over the last calendar year.

Martin C. Fried1, Shreya P. Trivedi2, Paul Williams3, Matthew Watto4, Robert M. Centor5, Reza Manesh6

1. Internal Medicine, Ohio State Wexner Medical Center, Columbus, OH, United States. 2. Internal Medicine, NYU , New York, NY, United States. 3. General Internal Medicine, Temple University Hospital, Philadelphia, PA, United States. 4. Internal Medicine, University of Pennsylvania, Fort Washington, PA, United States. 5. Internal Medicine, UAB, Huntsville, AL, United States. 6. Department of Internal Medicine, Johns Hopkins, Baltimore, MD, United States.

Track: Medical Education Scholarship

A Clincial Update on Electronic Cigarettes: Weighing Potential Benefits and Harms CUP11

In this clinical update on electronic cigarettes, we will review a number of articles which we have grouped into four categories of questions.

  1. What do we know about the current epidemic of pulmonary illness related to vaping and e-cigarette use?
  2. What do we know about health effects of e-cigarette use from recent studies?
  3. Can e-cigarettes help smokers of combustible cigarettes quit?
  4. What are potential risks associated with e-cigarette use in nonsmoking youth and young adults?

Susan Y. Urban1, Sara Kalkhoran2, Nancy A. Rigotti3, Michael T. Bender4

1. Medicine - Division of General Internal Medicine, NYU School of Medicine, New York, NY, United States. 2. Medicine, MGH, Boston, MA, United States. 3. General Medicine Division, Massachusetts General Hospital, Boston, MA, United States. 4. Medicine, NYU Langone, Mineola, NY, United States.

Track: Mental Health/Substance Use

Update on Hepatitis C Management CUP13

The US is tasked with eliminating hepatitis C by 2030, and we are not on target to achieve this goal. Utilizing a case based format, we will present a summary of recently published evidence regarding changing epidemiology of HCV, the evolving screening guidelines and their rationale, and management of patients with the sequelae of chronic hepatitis C, cirrhosis and HCC. This update will prepare internists to play a leading role in reaching the elimination target of HCV.

Shelly-Ann Fluker1, Lesley S. Miller2

1. General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA, United States. 2. Medicine, Emory University, Atlanta, GA, United States.

Track: Clinical Medicine

Health Policy Update CUP14

This session will review the restructuring of the Health Policy Committee and SGIM's policy and advocacy work with a review of key developments in health policy in the US over the last year with a look forward to the coming year. Participants will learn how their interests and concerns related to health policy are addressed by SGIM and how they can help shape SGIM's policy agenda.

Mark Earnest1, Jennifer E. Bracey2, Meredith A. Niess3, Michael A. Fischer4

1. Medicine, University of Colorado, Aurora, CO, United States. 2. General Medicine & Geriatrics, Medical University of South Carolina, Charleston, SC, United States. 3. Internal Medicine, Fair Haven Community Health Care, New Haven, CT, United States. 4. Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham & Women's Hospital, Boston, MA, United States.

Track: Health Policy/ Advocacy/ Social Justice

Plenary Sessions

Plenary 1: Civil Rights and Health Disparities

Keynote Speech - Eliseo Perez-Stable

After presentation of an illustrative case, operational definitions for minority health and health disparities incorporating the role of discrimination as a source of chronic stress are reviewed. The role of race and ethnicity and socioeconomic status in influencing health outcomes are presented as critical individual social determinants of health. Other individual determinants of health are described in a broad context. Structural determinants of health are defined and highlighted as not individually determined but driven by policy, societal structure and history. Reference to the NIMHD Research Framework, the project on harmonization of measures used in minority health and health disparities, and how these approaches are especially important in the current reality driven by the Covid-19 pandemic. Finally, a series of recommendations leveraging health information technology, the role of community-engaged research, the impact of precision medicine, and overarching research recommendations are presented.

ELISEO J. PÉREZ-STABLE, MD, is Director of the National Institutes of Health’s National Institute on Minority Health and Health Disparities (NIMHD), which seeks to advance the science of minority health and health disparities research through research, training, research capacity development, public education, and information dissemination. Dr. Pérez-Stable practiced general internal medicine for 37 years at the University of California, San Francisco (UCSF) before moving to NIH in September 2015. He was professor of medicine at UCSF and chief of the Division of General Internal Medicine for 17 years. His research interests include improving the health of racial and ethnic minorities and underserved populations, advancing patient-centered care, improving cross-cultural communication skills among clinicians, and promoting diversity in the biomedical research workforce. For more than 30 years, Dr. Pérez-Stable led research on Latino smoking cessation and tobacco control policy in the United States and Latin America, addressing clinical and prevention issues in cancer screening, and mentoring more than 70 minority investigators. He has published more than 250 peer- reviewed articles and was elected to the National Academy of Medicine in 2001.

Living in the Creeks

Clinical Vignette

Tammy Chuang1, Krisha Desai1, Bhavin Adhyaru2

1. Internal Medicine, Emory University, Atlanta, GA 2. General Medicine, Emory Unviersity, Atlanta, GA

Track: Social Determinants of Health/Health Disparities

Linguistic Bias in Language Used by Physicians in Medical Records of African American and White Patients

Scientific Abstract

Mary Catherine Beach1, Somnath Saha2, Jenny Park1, Brant Chee1

1. Medicine, Johns Hopkins University, Baltimore, MD 2. Section of General Internal Medicine, Portland VA Medical Center, Portland, OR

Track: Social Determinants of Health/Health Disparities

Incarceration as a mediator of black-white disparities in premature mortality: An analysis of the National Longitudinal Survey of Youth 1979 cohort

Scientific Abstract

Benjamin Bovell-Ammon1, Ziming Xuan3, Michael Paasche-Orlow2, Marc Larochelle2

1. Internal Medicine, Boston Medical Center, Boston, MA 2. General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA 3. Community Health Sciences, Boston University School of Public Health, Boston, MA

Track: Social Determinants of Health/Health Disparities

Plenary 2: Women's Health and Reproductive Rights

Keynote Speech - Leana Wen

LEANA WEN, MD, MSc, is an emergency physician, public health leader, and a passionate advocate for patient-centered healthcare reform. The author of the critically acclaimed book, When Doctors Don’t Listen, her TED Talk on transparency in medicine has been viewed nearly 2 million times. In 2019, Dr. Wen was named one of TIME 100’s Most Influential People. Dr. Wen is currently a Visiting Professor of Health Policy and Management at the George Washington University School of Public Health, where she is also the Distinguished Fellow at the Fitzhugh Mullan Institute of Health Workforce Equity. She has served as President/CEO of the Planned Parenthood Federation of America. As the first physician to lead Planned Parenthood in nearly 50 years, Dr. Wen worked to expand comprehensive healthcare for vulnerable women and families. Previously, she was the Health Commissioner for the City of Baltimore, where she led the nation’s oldest continuously operating health department in the U.S. to fight the opioid epidemic, treat violence and racism as public health issues, and improve maternal and child health.

Recognition of Health-Harming Legal Needs and the Value of the Medical-Legal Partnership

Clinical Vignette

Christina M. Kaul1, Omolara T. Uwemedimo2, Johanna Martinez3

1. Internal Medicine, Zucker School of Medicine at Hofstra/Northwell, Woodbury, NY 2. Pediatrics, Zucker School of Medicine at Hofstra/ Northwell, New Hyde Park, NY 3. Medicine, Northwell Health, Lake Success, NY

Track: Social Determinants of Health/Health Disparities

Delays in clinic visits for contraception due to not wanting a pelvic examination among young women with a history of physical, sexual, or verbal abuse

Scientific Abstract

Hunter K. Holt1, George F. Sawaya2, Alison El Ayadi2, Jillian T. Henderson3, Corinne Rocca2, Carolyn Westhoff4, Cynthia Harper2

1. Family and Community Medicine, University of California, San Francisco, San Francisco, CA 2. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 3. Center for Health Research, Kaiser Permanente, Northwest, Portland, OR 4. Epidemiology and Population and Family Health, Columbia University , New York, NY

Track: Women's Health

A Qualitative Study of Violent Political Rhetoric and Health Implications for Spanish and Chinese Speaking Immigrants

Scientific Abstract

Itzel J. Lopez-Hinojosa2, James Zhang2, Katherine M. Lopez4, Aresha Martinez-Cardoso5, Arshiya A. Baig3, Elizabeth L. Tung1

1. Section of General Internal Medicine, University of Chicago, Chicago, IL 2. Pritzker School of Medicine, University of Chicago, Chicago, IL 3. General Internal Medicine, University of Chicago, Chicago, IL 4. Washington University in St. Louis, St Louis, MO 5. Department of Public Health Sciences, University of Chicago, Chicago, IL

Track: Social Determinants of Health/Health Disparities

Do Providers Document Social Determinants? Our EMRs say…!

Scientific Abstract

Jeffrey Wilhite1, Sondra R. Zabar1, Kathleen Hanley1, Lisa Altshuler1, Harriet Fisher1, Adina Kalet1, Khemraj Hardowar1, Amanda Mari1, Barbara Porter1, Andrew Wallach1, Colleen Gillespie1

1. Division of General Internal Medicine, New York University School of Medicine, New York, NY

Track: Quality of Care/Patient Safety

Plenary 3: Integrating Social Care Into the Delivery of Health Care

Keynote Speech - Kirsten Bibbins-Domingo

This presentation will give an overview of the National Academies reports that provided a framework and detailed recommendations for integrating social care into the delivery of healthcare. The presentation will ground the report in the landscape of today’s pandemic.

KIRSTEN BIBBINS-DOMINGO, PhD,MD, MAS, is the Lee Goldman, MD Endowed Chair in Medicine, Professor and Chair of the Department of Epidemiology and Biostatistics, and Professor of Medicine at the University of California, San Francisco. She is the inaugural Vice Dean for PopulationHealth and Health Equity in the UCSF School of Medicine. She co-founded the UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, a research center focused on discovery, implementation, policy, advocacy, and community engagement for communities at risk for poor health and inadequate healthcare. She is one of the principal investigators for the UCSF Clinical and Translational Sciences Institute. Dr. Bibbins-Domingo is a general internist and cardiovascular epidemiologist who uses observational epidemiology, pragmatic trials, and simulation modeling to examine the impact of clinical and public health approaches to cardiovascular disease prevention in the U.S., in U.S. population subgroups, and in other countries globally. She is an expert in prevention and previously served on the U.S. Preventive Services Task Force as a member (2010–2017) and as vice chair and chair (2014–2017). She is an inducted member of the American Society for Clinical Investigation, the Association of American Physicians, and the National Academy of Medicine.

Special Symposia

Lessons from the National Academies of Sciences, Engineering, and Medicine (NASEM) Committee Report: “Integrating Social Care into the Delivery of Health Care to Improve the Nation’s Health” SS1

This is a moderated panelist discussion with individuals from the NASEM Committee that wrote the report on integrating social needs care into delivery of health care to improve the nation’s health. The discussion will emphasize how to apply this report in clinical settings, medical education, research and advocacy.

Etsemaye P. Agonafer1, Thuy Bui2

1. Department of Medicine, UCLA, Los Angeles, CA, United States. 2. Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

Track: Health Systems Redesign

SGIM Position Statement: Recognizing and Addressing the Social Determinants of Health Population Health SS2

As the concept of social determinants of health (SDOH) has gained significant attention for physicians, health care systems, policy-makers and payers, we as General Internal Medicine clinicians felt compelled to issue a position statement acknowledging the spectrum of social determinants of health, from upstream policy and structural issues to downstream individual clinical encounters and medical education curricula. The entire range of SDOH impacts the work we do, our ability to care for our patients across inpatient and outpatient settings, and the way we teach future internists and collaborate with our colleagues in public health, social work, government, research and beyond. This position statement was developed by a dedicated SGIM workgroup, including representatives from each standing committee. As general internists, this position statement shines a spotlight on where we fit into the larger systems and communities we serve, and where our spheres of influence can be leveraged to improve SDOH. In this statement we recognize that medical care as necessary but insufficient to create health and wellness in our patients, the communities we serve, and society as a whole.

Karen DeSalvo1, Elena Byhoff2

1. President, SGIM, New Orleans, LA, United States. 2. Medicine, Tufts Medical Center, Boston, MA, United States.

Track: Population Health

Who's job is it anyway? - the role of physicians and health care systems in addressing the American health care paradox SS3

Social and economic factors often play a larger role in patient’s outcome than severity of illness and quality of the treatments received. The current health care environment has prompted some health care organizations to come up with innovative social programming. Our Panel of experts will discuss how best to apportion the responsibility for addressing SDoH among clinicians, health systems, and society at large. An unsettled question with distinct political, ethical and practical implications.

Bjorg Thorsteinsdottir1, Matthew DeCamp3, Deidra C. Crews4, Margot Kushel5, Stefan Kertesz6

1. Internal Medicine, Mayo Clinic, Rochester, MN, United States. 2. Program in Bioethics, Mayo Clinic, Rochester, MN, United States. 3. Berman Institute of Bioethics and Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, United States. 4. Medicine, Johns Hopkins University, Baltimore, MD, United States. 5. Medicine, UCSF, San Francisco, CA, United States. 6. Medicine, Birmingham VA Medical Center & U. Alabama Birmingham, Homewood, AL, United States.

Track: Health Care Paradox; Health Policy/Advocacy/Social Justice

Just Care: Principles and evidence supporting reproductive justice as a social determinant of health SS4

In the setting of recent abortion bans in Alabama and other states, and the exclusion of Planned Parenthood from Title X funding, a panel of national leaders will frame reproductive health as a fundamental part of social justice. We will review principles of reproductive justice and recent supporting evidence, then identify specific actions that clinicians and educators can take to dismantle bias, discrimination, and inequity, while transforming the medical and social determinants of health.

Brita Roy1, E. Bimla Schwarz2

1. Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, United States. 2. Division of General Medicine, University of California, Davis , Sacramento, CA, United States.

Track: Health Policy/Advocacy/Social Justice

Equality of Opportunity? A Debate of Ideas on Equitable Value-Based Payment Policy SS5

Value-based payment policies are intended to improve health outcomes. However, current policies, which do not explicitly account for social determinants, may widen health disparities. Yet by accounting for social determinants in payment policy would we be forced to accept lower standards of care for safety-net hospital patients? In this debate of ideas, the SGIM Research Committee has invited national experts to address these fundamental questions at the intersection of quality and equity.

John N. Mafi1, Sachin J. Shah2, Giselle M. Corbie-Smith3, Susannah Bernheim4, Rachel M. Werner5, Renuka Tipirneni6

1. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States. 2. Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States. 3. Social Medicine, University of North Carolina, Chapel Hill, NC, United States. 4. Yale School of Medicine, New Haven, CT, United States. 5. Medicine, University of Pennsylvania and Philadelphia VA, Philadelphia, PA, United States. 6. Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI, United States.

Track: Research Methods

Healthcare 2020 - Are the underserved and working class at risk? SS6

This nation’s choice of health care coverage options remains unsure. With continuous criticism of the ACA and attempts to dismantle it, new ideas have emerged. How will the new plans presented by our current Presidential candidates fare for the working class and underserved?

Marshall Fleurant1, Mark Earnest2, Oliver Fein3, Ryan A. Crowley4, Sara R. Collins5, David Himmelstein6

1. General Internal Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA, United States. 2. Medicine, University of Colorado, Aurora, CO, United States. 3. Departments of Medicine and Public Health , Weill Cornell Medical College, New York, NY, United States. 4. American College of Physicians, Philadelphia, PA, United States. 5. The Commonwealth Fund, New York, NY, United States. 6. Public Health, City University of New York at Hunter College, New York, NY, United States.

Track: Health Policy/Advocacy/Social Justice

Teaching Social Determinants at all Levels of Training: Scoping Review of Current Practices with Spotlights on Curricular Innovations SS7

Medical educators are acutely aware of wide disparities in health within the U.S. population and the need to train future clinicians to identify and address social determinants of health in order to promote equity. Nonetheless, implementing effective curricula can be challenging. We will present approaches to teaching about social determinants of health based on findings from two parallel scoping reviews and spotlights on innovative curricular approaches across the country.

Mita S. Goel1, Ashti Doobay-Persaud2, Maura George3, Nancy M. Denizard-Thompson4, Deepak Palakshappa5

1. Internal Medicine, Northwestern University, Chicago, IL, United States. 2. Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States. 3. Medicine, Emory University, Atlanta, GA, United States. 4. Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States. 5. Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States.

Track: Spotlights on Curricular Innovations; Medical Education Scholarship

Integrating Lay Community Health Workers into Clinical Teams to Address Social Determinants of Health SS8

Increasingly, health systems are working to integrate lay community health workers (CHW)—including care coordinators, patient navigators, and health coaches—into clinical teams to address social determinants of health and achieve just care and more equitable health outcomes. Physician-leaders and CHW will share experience integrating lay CHW into clinical teams and will foster discussion of pragmatic approaches for developing and sustaining lay CHW initiatives in diverse settings nationwide.

Andrea Cherrington1, John Jones2, Lynetta West3, Stacie Schmidt4, Jocelyn A. Carter5, Cardella L. Leak6

1. Medicine, University of Alabama Birmingham, Birmingham, AL, United States. 2. Methodist Medical Group, Methodist Le Bonheur Healthcare, Memphis, TN, United States. 3. Connection Health, Birmingham, AL, United States. 4. General Medicine, Emory University, Atlanta, GA, United States. 5. Department of Medicine, Massachusetts General Hospital, Boston, MA, United States. 6. Health Science Center, University of Tennessee, Memphis, TN, United States.

Track: Clinical Care Redesign

Common Data Elements for Social Determinants of Health: The NIMHD Perspective SS9

The goals of the proposed Special Symposium are to: identify major standard measures related to CDE- in social determinants of health for inclusion in the NIH Toolkit, and organize these measures into a Core collection of key measures that are broadly relevant to all minority health, health disparities, and heath equities researchers and practitioners.

Eliseo J. Perez-Stable1, Nicole Redmond2

1. NIMHD, National Institutes of Health, Bethesda, MD, United States. 2. Division of Cardiovascular Sciences, National Heart Lung and Blood Institute, Bethesda, MD, United States.

Track: Health Disparities/Vulnerable Populations

Getting to Universal Healthcare: Single Payer vs. Public Option SS10

The healthcare system, a core domain of SDOH, continues to fail millions of uninsured and underinsured residents, leading to substantial financial suffering. Major physician organizations support the concept of universal healthcare without taking a stand on specific policy. In this Symposium, speakers will explore the details of active healthcare proposals, comparing and contrasting “Single Payer” and “Public Option” plans in order for participants to make informed advocacy choices.

Christopher Wong1, Oliver Fein5, Stephanie Woolhandler2, Mark Earnest3, C S. Landefeld4

1. General Internal Medicine, University of Washington, Seattle, WA, United States. 2. Public Health, Cambridge Hospital, New York, NY, United States. 3. Medicine, University of Colorado, Aurora, CO, United States. 4. Medicine, UAB, Birmingham, AL, United States. 5. Departments of Medicine and Public Health , Weill Cornell Medical College, New York, NY, United States.

Track: Health Policy/Advocacy/Social Justice

It Takes a Village: Assessing and Addressing Food Insecurity Among Patients Within Academic Safety Net Primary Care Centers SS11

This symposium describes two institutional initiatives aiming to assess food insecurity within health systems, and form community collaborations that provide access to free, healthy foods to food-insecure patients. This session will review the collaborative process, needs assessment initiatives, and community partnerships that have made these initiatives possible, along with lessons learned.

Stacie Schmidt1, Amy Girard Webb4, Nancy T. Kubiak2, Jada C. Bussey-Jones3, Tammy Reasoner5

1. General Medicine, Emory University, Atlanta, GA, United States. 2. Internal Medicine, University of Louisville, Louisville, KY, United States. 3. medicine, Emory University, Atlanta, GA, United States. 4. Rollins School of Public Health, Atlanta, GA, United States. 5. Open Hand Atlanta, Atlanta, GA, United States.

Track: Health Systems Redesign

Bridging the Gap: Cross-Sector Partnerships to Address Social Determinants of Health among Persons with Diabetes SS12

Three Bridging the Gap healthcare organizations discuss synergistic partnerships and factors that support alignment to address medical and social needs of shared populations through: co-located community health worker models at frontier Idaho food distribution sites; medical-legal partnership to support immigrant patients at a Washington D.C. FQHC; and an integrated delivery system in Oregon that embeds social services agency staff in clinics to link patients to community resources.

Monica E. Peek1, Cody Wilkinson2, Suyanna Barker4, Rachel Smith3, Marshall Chin1

1. Medicine, University of Chicago, Chicago, IL, United States. 2. St. Mary's and Clearwater Valley Hospitals and Clinics, Orofino, ID, United States. 3. Providence Health and Services, Portland, OR, United States. 4. La Clínica del Pueblo, Washington, D.C., DC, United States.

Track: Health Disparities/Vulnerable Populations

Scientific Abstracts

Hamolsky

A Resident-Led Interdisciplinary Quality Improvement Initiative to Increase Osteoporosis Screening in an Urban Clinic

Catherine Teskin2, Hiba Sayed1, Patrick Ho1, Nikita Donti2, Melissa Morgan-Gouveia3

1. Internal Medicine, Christiana Care, Wilmington, DE 2. Internal Medicine, Christiana Care Health Systems, Wilmington, DE 3. Medicine, Christiana Care Health System, Wilmington, DE

Track: Preventive Medicine

Establishing Competencies for Leadership Development for Internal Medicine Residents

Sarah B. Merriam1,2, Jennifer Corbelli3

1. Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 2. Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA 3. Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA

Track: Medical Education Scholarship

Early experiences and perspectives of pediatric and adult providers who deliver care using telemedicine

Natalie Laub2, Anish Agarwal3, Catherine Shi4, T. Arianna Sjamsu5, Krisda H. Chaiyachati1

1. General Internal Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 2. Pediatrics, Childrens Hospital of Philadelphia, Philadelphia, PA 3. Emergency Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 4. Medicine, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 5. New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY

Track: Medical Education Scholarship

Intensification of older adults’ diabetes medications at hospital discharge leads to increased hypoglycemia visits without long term benefit

Timothy S. Anderson1, Bocheng Jing2, Sei Lee2, Sarah Ngo2, Kathy Fung2, Michael A. Steinman2

1. Medicine, Beth Israel Deaconess Medical CEnter, Jamaica Plain, MA 2. Div of Geriatrics, UCSF/SFVA, San Francisco, CA

Track: Hospital-Based Medicine

Social Determinants of Health and 30-day Readmissions among Adults Hospitalized for Heart Failure in the REasons for Geographic and Racial differences in Stroke (REGARDS) study

Madeline R. Sterling1, Joanna Bryan1, Laura C. Pinheiro1, Monika M. Safford1, Emily B. Levitan2, Erica Phillips3, Todd Brown4, Oanh K. Nguyen5, Jacklyn Cho1, Parag Goyal1

1. Medicine, Weill Cornell Medicine, New York, NY 2. Epidemiology, University of Alabama at Birmingham, Birmingham, AL 3. Medicine, Weill Cornell Medical Medicine, New York, NY 4. Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 5. Internal Medicine, University of California, San Francisco, San Francisco, CA

Track: Social Determinants of Health/Health Disparities

Living at the Margin: ACA Income-Cutoffs and Stability of Coverage

Anna Goldman1, Sarah Gordon2

1. Internal Medicine, Boston Medical Center, Boston, MA 2. Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA

Track: Health Policy/ Advocacy/ Social Justice

Evaluating the impact of housing insecurity on hospitalized patients: a qualitative study

Erin Bredenberg1, Julie Knoeckel2, Gregory J. Misky1, Sarah A. Stella2, Lauren McBeth1, Ellen Sarcone2, Kathryn L. Havranek3, Mackenzie L. Garcia3, Robert Cragg4, Lauryn Dombrouski4

1. Hospital Medicine, University of Colorado, Aurora, CO 2. Department of Medicine, Denver Health, Denver, CO 3. University of Colorado School of Medicine, University of Colorado, Denver, CO 4. University of Colorado School of Nursing, Denver, CO

Track: Social Determinants of Health/Health Disparities

Examining Use of Urine Drug Testing Among Opioid-Naïve and Long-Term Opioid Medicaid Beneficiaries: A Retrospective Cross-Sectional Study

Sarah A. Friedman1, Kirtan Patel2, Yan Liu5, Sarah Hartzell3, Michelle S. Keller4

1. School of Community Health Sciences, UNR,, Reno, NV 2. Administration, Renown Health, Sparks, NV 3. Public Health, University of Nevada, Reno, Reno, NV 4. Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 5. Community Health Sciences, University of Nevada Reno, Reno, NV

Track: Mental Health/Substance Use

Rejection of Patients with Opioid Use Disorder Referred for Post-Acute Medical Care Before and After an Anti-Discrimination Settlement in Massachusetts

Simeon D. Kimmel1,2, Sophie J. Rosenmoss1, Benjamin Bearnot3,4, Marc Larochelle1,2, Alexander Y. Walley1,2

1. Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA 2. Grayken Center for Addiction, Boston Medical Center, Boston, MA 3. Department of Medicine, Massachusetts General Hospital, Boston, MA 4. Mongan Institute, Massachusetts General Hospital, Boston, MA

Track: Mental Health/Substance Use

Racial and Ethnic Disparities in Anticoagulant CHoice for Atrial Fibrillation in the Veterans Health Administration: Results from the REACH-AF Study

Utibe R. Essien1,2, Nadejda Kim1, Leslie R. Hausmann1, Maria K. Mor1, Chester Good1, Walid F. Gellad1, Michael J. Fine1

1. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 2. Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA

Track: Social Determinants of Health/Health Disparities

Scientific Abstracts

Lipkin

Disparities After Discharge: How Limited English Proficiency Patients Fare After Hospitalization

Lev Malevanchik1, Margaret Wheeler3, Kristin Gagliardi3, Leah S. Karliner4, Sachin J. Shah2

1. Internal Medicine, UCSF, San Francisco, CA 2. Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 3. UCSF, San Francisco, CA 4. Medicine, UCSF, San Francisco, CA

Track: Hospital-Based Medicine

Longitudinal Cohort Study of the Association between Grit and Burnout among First Year Internal Medicine Residents

Andrew J. Klein1, Thomas Grau3, Kwonho Jeong2, Scott D. Rothenberger2,1, Kathryn Berlacher4

1. Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 2. Center for Research on Health Care Data Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 3. VA Pittsburgh Health System, Pittsburgh, PA 4. Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA

Track: Medical Education Scholarship

How we learn: A nationwide survey of the use and perceived value of novel and traditional educational resources among Internal Medicine residents.

Nakul Bhardwaj1, Eden Bernstein1, Elizabeth Pfoh2, Eric Yudelevich3

1. Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 2. Medicine, Cleveland Clinic, Cleveland, OH 3. General Internal Medicine, Cleveland Clinic Foundation, Beachwood, OH

Track: Medical Education Scholarship

Educational Lapses and Signals in Discharge Care: A Multi-Institutional Survey

Shreya P. Trivedi1, Zoe Kopp2, Alice Tang3, Dharmini Pandya 6, Leora I. Horwitz4, Mark D. Schwartz5

1. Internal Medicine, NYU , New York, NY 2. Internal Medicine, UCSF, San Francisco, CA 3. Internal Medicine, New York University, New York, NY 4. Population Health, NYU School of Medicine, New York, NY 5. Population Health, NYU School of Medicine, New York, NY 6. Internal Medicine, Temple University, Philadelphia, PA

Track: Medical Education Scholarship

Impact of Longitudinal Virtual Primary Care on Diabetes Quality of Care

Amy D. Lu1,2, Elise Gunzburger4, Thomas J. Glorioso4, William B. Smith1,2, Mary Whooley1,2, Michael Ho3

1. Medicine, San Francisco VA Health Care System, San Francisco, CA 2. Medicine, University of California San Francisco, San Francisco, CA 3. Cardiology, Eastern Colorado Health Care System, Denver, CO 4. Denver Center of Innovation for Veteran Centered and Value Driven Care, Denver VA Medical Center, Aurora, CO

Track: Quality of Care/Patient Safety

Disparities in Mortality among Dually Enrolled Medicare Beneficiaries Living in Rural vs. Urban Areas, 2004-2017

Eméfah C. Loccoh1,3, Karen E. Joynt Maddox2, Jiaman Xu3, Changyu Shen3, Jose Figueroa4, Dhruv S. Kazi3, Robert Yeh3, Rishi Wadhera3

1. Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 2. Medicine/Cardiology, Washington University School of Medicine, Saint Louis, MO 3. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA 4. Department of Health Policy/ Advocacy/ Social Justiceand Management, Harvard T.H. Chan School of Public Health, Boston, MA

Track: Social Determinants of Health/Health Disparities

Healthcare delivery interventions to improve hypertension management in community health settings: A systematic-review

Maarya Pasha1, Susie Sennhauser2, M. Hassan Murad3

1. General Internal Medicine, Mayo Clinic, Apple Valley, MN 2. Cardiovascular Disease, Mayo Clinic College of Medicine, Jacksonville, FL 3. Preventative Medicine, Mayo Clinic, Rochester, MN

Track: Organization of Care/Chronic Disease Management

Features of New Drug Indications Not Approved by the Food and Drug Administration, 2008-2017

Audrey D. Zhang3, Jason L. Schwartz2, Joseph S. Ross1

1. Internal Medicine, Yale University School of Medicine, Woodbridge, CT 2. Health Policy/ Advocacy/ Social Justice& Management, Yale School of Public Health, New Haven, CT 3. Medicine, New York University School of Medicine, New York, NY

Track: Health Policy/ Advocacy/ Social Justice

“I’m the disease”: Explanatory model of opioid addiction among patients with opioid use disorder in sustained remission.

Jarratt Pytell1, Michael Sklar4, Joseph A. Carrese2, Darius Rastegar3, Geetanjali Chander3

1. Division of General Internal Medicine / Division of Addiction Medicine, Johns Hopkins Universtiy, Baltimore, MD 2. Department of Medicine, Johns Hopkins University, Baltimore, MD 3. Medicine, Johns Hopkins University, Baltimore, MD 4. Addiction Treatment Services, Johns Hopkins University, Baltimore, MD

Track: Mental Health/Substance Use

Characterizing the Variation of Alcohol Cessation Pharmacotherapy Utilization in Primary Care

Eden Bernstein1, Ning Guo1, Toyomi Goto1, Michael B. Rothberg1

1. Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH

Track: Mental Health/Substance Use

The Association of Geographic Versus Patient Reported Social Determinants of Health on Mortality in Cardiovascular Patients

Sophia Kostelanetz1, Chiara Di Gravio4, Jonathan S. Schildcrout4, Christianne Roumie2, Douglas Conway2, Sunil Kripalani3

1. Internal Medicine, Vanderbilt University Medical Center, Nashville, TN 2. General Internal Medicine and Public Health, Vanderbilt University, Nashville, TN 3. Medicine, Vanderbilt University Medical Center, Nashville, TN 4. Biostatistics, Vanderbilt University Medical Center, Nashville, TN

Track: Social Determinants of Health/Health Disparities

Patient Experience-Based Physician Compensation and Quality of Care in the United States, 2012-2016

David Burstein1, David T. Liss1, Jeffrey A. Linder1

1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL

Track: Quality of Care/Patient Safety

Neighborhood Socioeconomic Status Is Associated with Advance Care Planning: Geocoding of Electronic Health Data

Sarah Nouri1, Courtney R. Lyles2, Anna D. Rubinsky1, Kanan Patel3, Riya Desai2, Mindy deRouen1, Aiesha Volow4, Kirsten Bibbins-Domingo1, Rebecca L. Sudore5

1. Medicine, University of California, San Francisco, San Francisco, CA 2. Center for Vulnerable Populations at SFGH, University of California San Francisco, San Francisco, CA 3. Medicine-Geriatrics, UCSF, San Francisco, CA 4. Geriatrics, University of California, San Francisco, San Francisco, CA 5. Medicine/Geriatrics, University of California, San Francisco, San Francisco, CA

Track: Aging/Geriatrics/End of Life

VA Special Series Sessions

Primary Care for Homeless Individuals: Can Lessons from VA Health Care Apply More Broadly? VA1

This session seeks to deliver a lively 60-minute interactive deliberation on whether optimizing primary care design for individuals and families experiencing homelessness is (a) supported by evidence; (b) generalizable beyond the US Department of Veterans Affairs; (c) feasible; and (d) responsive to the problem of homelessness in society.

Stefan Kertesz1, Audrey Jones3, Lillian Gelberg4, Jack Tsai6

1. Medicine, Birmingham VA Medical Center & U. Alabama Birmingham, Homewood, AL, United States. 2. University of Alabama at Birmingham, Birmingham, AL, United States. 3. VA Salt Lake City Health Care System, Salt Lake City, UT, United States. 4. Department of Family Medicine, UCLA, Los Angeles, CA, United States. 5. VA of Greater Los Angeles Health Care System, Los Angeles, CA, United States. 6. National Center on Homelessness Among Veterans, Philadelphia, PA, United States. 7. Yale University School of Medicine, New Haven, CT, United States.

Track: Health Disparities/Vulnerable Populations

Screening for Social Determinants of Health in the Veterans Health Administration: Evolution, Current Practice, and Lessons Learned from Nation’s Largest Integrated Healthcare System VA2

Social Determinants of Health (SDH) including material hardship and exposure to violence are common among Veterans. The VA has invested heavily in screening for SDH and is uniquely positioned to address these issues. This interdisciplinary session reviews the evolution of VA approaches to screening for SDH and the research guiding it, with a focus on care in general medical and ED settings. Implementation lessons learned can inform future care both within and beyond VA.

Alicia Cohen1, Ann E. Montgomery3, Megan R. Gerber2, Jill Huded4

1. Primary Care, Providence VA Medical Center, Providence, RI, United States. 2. Boston VA Medical Center, Boston, MA, United States. 3. Birmingham VA Medical Center, Birmingham, AL, United States. 4. Cleveland VA Medical Center, Cleveland, OH, United States.

Track: Health Disparities/Vulnerable Populations

Supporting community reintegration after a period of incarceration: Reducing disparities through an integrated peer support intervention for Veterans VA3

This symposium highlights findings from an intensive peer support intervention developed out of the Bedford, MA VA Medical Center to support veterans returning to community settings following a period of incarceration. Presentations are designed to raise awareness of health disparities among individuals who have been incarcerated, describe an integrated peer support model that addresses these disparities, and share impacts based on implementation and outcome studies.

Keith McInnes1, Justeen Hyde1, Beth Ann Petrakis1, Mike Kane1, Vera Yakovchenko1

1. Center for Healthcare Organization and Implementation Research, Department of Veteran Affairs, ENRM Bedford, MA, Bedford, MA, MA, United States.

Track: Health Disparities/Vulnerable Populations