With support from the Advanced Scholars Program for Internists in Research and Education (ASPIRE) at Indiana University School of Medicine, the scholars have presented work at local and national meetings, published manuscripts, developed and deployed education programs for faculty members, and wrote essays describing their experiences of practicing medicine.
Saira Butt, MD
Saira Butt, MD Assistant Professor of Clinical Medicine in the Division of Infectious Diseases, IU School of Medicine
Dr. Saira Butt is an Assistant Professor of Medicine in the Division of Infectious Diseases at the Indiana University School of Medicine (IUSOM) since 2016 and is the Director of the Adult Infectious Diseases fellowship-training program since 2018. She trained in infectious diseases at the University of Mississippi Medical center and served as the Associate Program Director at that institute prior to joining IU School of Medicine in 2016. In addition to her efforts within the fellowship program, her education interests include curriculum development and the growth and development of learners as teachers. She has created an Infectious Diseases transitions curriculum for fourth year medical students and she participates as longitudinal ambulatory clinical preceptor for first year medical students. She contributes to the Infectious diseases medical education #IDMedEd on twitter @sairabt. Her clinical interests are HIV, Hepatitis C, NTMs and medical education. She participates in Scotts County, Indiana’s HIV/HCV outreach clinics at their local health department and at the Scottsburg jail. She also maintains outpatient practices in both general infectious diseases and HIV care at the University Hospital, and she attends on the inpatient infectious diseases consult services at the Methodist Hospital.
ASPIRE Project: Health Care Worker Perspectives on Care for Patients with Injection Drug Use Associated Infective Endocarditis (IDU-IE)
Indiana is one of the states with the highest opioid overdose death rate of 57%. Injection drug use (IDU) increases the risk of certain infections including infective endocarditis (IE). Despite the expensive hospital stay and surgery, utilization of medication for opioid use disorder (MOUD) and linkage to addiction care is dismal. There are barriers in availability and continuation of MOUD at the provider, health system and policy levels. Little is known regarding gaps in care at the health care worker (HCW) level during in-patient care of IDU-IE. Are there certain attitudes which drive decision making towards or away from addiction medicine consults? We will fill this gap by looking at perspectives of HCWs treating IDU-IE in persons who inject drugs. We want to explore the decisions driving addiction medicine consults and prescription of MOUD.
Dr. Amy Johnson, DO, an Assistant Professor of Clinical Medicine is board certified in Internal Medicine and Hospice and Palliative Medicine. Dr. Johnson joined IU Health’s Palliative Care Service in July of 2017 after completing her Palliative Care and Hospice Fellowship at Indiana University. She received her medical degree from Ohio University Heritage College of Osteopathic Medicine in 2012 and completed her Internal medicine Training at Indiana University in 2015. Her clinical work involves caring for patients with serious illness in both the hospital setting and the ambulatory setting. She focuses on education of residents and fellows in Palliative Medicine, as well as teaching clinical medicine at the medical school level. Her research interests are palliative care for patients with end-stage liver disease and the effect of communication education on moral distress in medical residents.
ASPIRE Project: Health Care Outcomes for Patients with End-Stage Liver Disease Prescribed an Opioid during a Hospitalization
Patients with end-stage liver disease (ESLD) suffer from multiple physical symptoms including pain, which is often under treated in this population. Increased bleeding, worsened hepatic encephalopathy, and impaired renal function are common side effects of analgesics medications. In patients with ESLD, there are limited studies looking at the outcomes of opioid utilization for analgesia during hospitalizations. This study will look at the prevalence of opioid use, individual opioid selection and the safety and efficacy of specific opioid therapies in patients with ESLD admitted for an acute hospitalization.
Ellen Kaehr, MD
Ellen Kaehr, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Dr. Ellen Kaehr, MD CMD is an Assistant Professor of Clinical Medicine in Geriatrics at Indiana University School of Medicine. She is currently serving as Associate Medical Director of the OPTIMISTIC project in collaboration with Dr. Kristi Lieb and Dr. Kamal Wagle. In the OPTIMISTIC Project she provides clinical support and education to APPs and RNs embedded in nursing homes. She has been a Certified Medical Director in Post-Acute and –Long-Term Care since 2017 and enjoys quality improvement. When she is not at the facility, she provides outpatient dementia care via the Sandra Eskenazi Center for Brain Care Innovation. She has a passion for advance care planning in dementia care across all settings from outpatient to long-term care memory care. She is currently serving as site-PI to pilot wearable technology in the LTC setting, this study is to investigate technologies ability to identify agitation in patients with dementia. As a clinician education she mentors fellows (both geriatric internal medicine and geriatrics psychiatry), internal medicine residents, and medical students. She completed her geriatrics training at Saint Louis University School of Medicine and joined the faculty at Indiana University School of Medicine in 2016.
ASPIRE Project: The Impact of COVID-19 on Long-term Care Advance Care Planning The life expectancy of a long-term care resident is generally less than three years from admission, highlighting the need for advance care planning. Although advance care planning is addressed on facility admission, more research is needed to implement consistent and high-quality advance care planning in this setting. This project investigates the impact of COVID-19 on advance care planning processes in the long-term care setting. The goal is to further understanding of the barriers and facilitators for long-term care healthcare workers who completed advance care planning with nursing home residents during a COVID-19 outbreak. This mixed method study uses qualitative interviews and validated stress scales to further describe the healthcare worker experience. The voice of the long-term care healthcare worker will help inform education and quality improvement.
Dr. Khemka is an Assistant Professor of Clinical Medicine at the Indiana University School of Medicine. He serves as a cardiologist with specific clinical and research interests in cardiooncology, cardiac imaging and structural heart disease. He completed medical school at Indiana University School of Medicine, followed by internal medicine residency at Boston University. He returned to Indiana University for his general cardiovascular fellowship at the Krannert Institute of Cardiology. He is interested in cardiovascular outcomes in cancer patients. When he is not working, he enjoys spending time with his wife and two kids and reading.
ASPIRE Project: Prevalence of Cardiovascular Disease Among Survivors of Thymic Neoplasms
Patients with cancer and heart disease share multiple risk factors. Cardiovascular disease is increased in survivors of many cancers but there is a paucity of data regarding survivors of thymic cancers. This study hypothesizes that patients with thymic cancers have elevated CV risk given their age at diagnosis of the neoplasm, location of the tumor, and the cancer therapies which can lead to cardiovascular disease. We are performing a retrospective cohort study using Indiana's Health Information Exchange (IHIE) and electronic health records to describe the magnitude of cardiovascular disease risk in survivors of thymic cancers compared with matched non-cancer controls within central Indiana.
Vinod Kumar, MD, MS
Vinod Kumar, MD, MS Dr. Vinod Kumar, MD, MS is an Assistant Professor of Clinical Medicine at IU School of Medicine. He is currently serving as a hospitalist at IU Health Methodist Hospital. He received his medical degree from Dow University of Health Sciences, Karachi, Pakistan and then completed his Internal Medicine Residency at University of Illinois at Urbana Champaign, IL. His primary interests include management of acute illness in inpatient setting with focus on GI pathology. He loves teaching Nurse Practitioners, medical residents and students. He enjoys reading and spending time with his family. He is very passionate about research and recently earned his Masters in Clinical Research at Indiana University. He considers himself as a lifelong learner and wants to contribute to medical fraternity and well-being of the patients.
ASPIRE Project: The Effect of COVID-19 Pandemic on Colorectal Cancer Screening Elective procedures were largely deferred to prioritize emergent and urgent needs at the onset of the COVID-19 pandemic. This observational cohort study will quantify the effect of the pandemic on colorectal cancer (CRC) screening as measured by overall colonoscopy volume, the proportion of colonoscopy indications, use of non-invasive screening tests (FIT, FIT/sDNA) and CRC stage at diagnosis. We are retrieving total numbers of outpatient colonoscopies and non-invasive screening tests (FIT, FIT/s DNA) performed at Indiana University Health during 2020 and will compare the data to 2019 and the first six months of 2021.
Diane Donegan, MB BCh, is an Assistant Professor of Clinical Medicine at Indiana University School of Medicine. Prior to moving to Indiana, she completed her Internal Medicine Residency followed by a Fellowship in Endocrinology, Diabetes and Metabolism at the Mayo Clinic, Rochester. During this time she obtained her Masters in Clinical and Translational Science. She joined the Endocrinology faculty in 2017 and holds a joint position with Neurosurgery. She has a special interest in neuroendocrinology, in particular pituitary related pathologies.
ASPIRE Project: Anxiety in Patients with Pituitary Tumors Given the unique potential complications of pituitary surgery, Dr. Donegan’ s ASPIRE project has focused on the optimization peri-operative care of pituitary patients through the development of evidence-based standardization of practice and assess the impact such changes will have on patient care and team satisfaction. In recognition of the vital role patients play in their care, the project will also focus on enhancing and standardizing patient education through the development of novel educational tools.
Carrie Leathers, MD
Carrie Leathers, MD Assistant Professor of Clinical Medicine, Indiana University School of Medicine
Carrie Leathers, MD is an Assistant Professor of Clinical Medicine and Pediatrics at Indiana University School of Medicine and practices in both the inpatient and outpatient settings. She is an active educator in the clinical setting, supervising residents from the Internal Medicine, Pediatric, and combined Med-Peds training programs, as well as IUSM medical students both in the hospital and in clinic. Her primary outpatient site is Pecar Health Center, where a large Spanish-speaking population is served. Prior to her career in medicine she worked in youth development in the non-profit sector with United Hispanic Americans and Boys and Girls Clubs of Fort Wayne, as well as Primeros Pasos clinic in Guatemala. She is currently part of team developing an advanced training program for pediatricians practicing in urban settings, “Our Kids Our Community.”
ASPIRE Project: Symptoms in Latino Young Adults Who Have Moved to the United States: Depression, anxiety, and somatization Dr. Leathers’ ASPIRE project seeks to better understand the mental health of Spanish speaking young adults who reside in the United States without a federally recognized lawful status. This vulnerable population has limited access to healthcare and recent immigration policy changes and continued violence in Central America pose additional threats to emotional and physical health.
Kristi Lieb, MD
Kristi Lieb, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Kristi Lieb is a Geriatrician and Certified Medical Director specializing in post-acute and long-term care medicine. Kristi trained in internal medicine at Indiana University where she then went on to complete her Geriatric fellowship. Kristi has been involved with IMDA—Indiana Society for Post-Acute and Long-Term Care Medicine since 2011. She served as the education chair for the organization for several years and helped to establish and organize quarterly educational meetings. She also served as president of IMDA from 2014-2016. Kristi participated in the Indiana SMART campaign which was a state-wide quality improvement project for Indiana nursing homes funded by the Indiana State Department of Health aimed at reducing polypharmacy in Indiana nursing homes. Kristi also served as the Associate Medical Director then as the Medical Director of the OPTIMISTIC Program. Kristi is a Geriatrician at
the Richard L Roudebush VA Medical Center. Outside of work, Kristi enjoys
spending time with her husband, their 2 children, and extended family
ASPIRE Project: Nursing Home Residents with Urinary Tract Infections: A Comparison of Treatment in Place Versus Hospitalization Antibiotics are frequently overprescribed in nursing home with the most common indication being urinary tract infection. This has led to a rise in antibiotic resistance in long term care facilitieswhich affects not only the nursing home facility but also the hospital system which receives residents from the facility and the surrounding medical community. Kristi’s ASPIRE project used the rich OPTIMISTIC database to evaluate antibiotic prescribing patterns in nursing homes for urinary tract infections with the long term goal of improving antibiotic prescribing in the nursing home setting.
Neetu Mahendraker, MD, CHCQM, FHM was born and raised in India. She finished her medical school from the prestigious Gandhi medical College, Hyderabad, India. She completed internal medicine residency from University of Illinois-Urbana Champaign in 2009. She started her hospitalist career in 2009 with Indiana University Health (IUH) Physician as an academic hospitalist. Her goal is to thrive as an academic hospitalist with nationally recognized expertise in clinical medicine, research and an educator. She has recently received the designation of a fellow in hospital medicine for her commitment to the field of hospital medicine. She was awarded Indiana University (IU)-COVID heroes’ award in 2020 for her exemplary services to IU during the COVID-19 pandemic. She is the quality improvement pillar lead at IU-AHC and has led several quality improvement projects at IUH-AHC. She strives to improve the inpatient care for seriously ill hospitalized patients by identifying and reporting rare cases with a high mortality and improving end of life patient-clinician communication by identifying them early in the hospital course. She is a peer reviewer for prestigious journals including Health informatics journal and Journal of General Internal Medicine. As an educator, she is focused on education of quality improvement methods to the medical students.
ASPIRE Project: Mortality Predictive Model for Inter-Facility Transfer Patients Predicting the risk of in-hospital mortality on admission is challenging but essential for risk stratification of patient outcomes and designing an appropriate plan-of-care, especially among transferred patients. The aim of this project was to develop a model that uses administrative and clinical data within 24 h of transfer to predict 30-day in-hospital mortality at an Academic Health Center (AHC). This was a retrospective cohort study. We used 30 putative variables in a multiple logistic regression model in the full data set (n = 10,389) to identify 20 candidate variables obtained from the electronic medical record (EMR) within 24 h of admission that were associated with 30-day in-hospital mortality (p < 0.05). This model can use electronic health record and administrative data within 24 hours of transfer to predict the risk of 30-day in-hospital mortality with reasonable accuracy among seriously ill transferred patients.
Maria Robles, MD
Maria Robles, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Maria went to University of Wisconsin-Madison for her undergraduate education, where she earned a Bachelor of Science in Mathematics and Molecular Biology. She then joined the Peace Corps and taught Mathematics and Health Education in a small rural high school in Ghana, West Africa for two years. After returning she earned a Master of Science in Biology. She then completed medical school from IU School of Medicine and moved to Rhode Island to do her residency in General Internal Medicine with Alpert School of Medicine/Brown University. After completing residency, she returned to Indianapolis in 2011 and has been working with Eskenazi since that time. She became Chief Physician Executive of West 38th Street in 2017. She has two Internal Medicine resident continuity clinics per week and also works with medical students and fellows.
She started treating patients with medications for opioid use disorder (OUD) in 2017 and learned that people responded well to MOUD in the primary care setting. She then listened to the experiences her learners were having with people with OUD and realized that the majority of their experiences were with people when they were in the hospital and in crisis. They were not getting exposed to people with OUD who were in long term recovery. She worked to create a week-long curriculum for the residents focused on exposure to patients with OUD who were receiving treatment in the outpatient setting and then completed a qualitative study to gain a deeper understanding of the impact of the curriculum on the residents.
ASPIRE Project: Teaching Learners about Medication Based Treatment for Opioid Addiction Opioid misuse has reached epidemic proportions in the United States; more than 115 people die daily from opioid overdose. The medical community as a whole has been slow to respond, leaving patients without good options. Less than 10% of patients with substance use disorder receive treatment. Although medications for opioid use disorder (MOUD) is safe, effective and the standard of care, the majority of internal medicine residents do not receive training in it. The study’s purpose was to understand internal medical residents’ perceptions of a new week-long substance use curriculum with a focus on opioid addiction and MOUD (Addiction Week).
Neshahthari Wijeyakuhan, MD, FACP, FHM
Neshahthari Wijeyakuhan, MD, FACP, FHM Assistant Professor of Clinical Medicine, IU School of Medicine
Neshahthari Wijeyakuhan MD, FACP, FHM was born in London, England and raised in Toronto Canada. She completed her Internal Medicine residency from NYU Langone Hospital Brooklyn in New York; Followed by Fellowship in Geriatrics at Abington Hospital Jefferson Health in Pennsylvania. She is both Internal Medicine and Geriatric board certified. Neshah worked as a hospitalist at IU Methodist Hospital, prior to transitioning to her Geriatric position. During her practice, she combines her geriatric and internal medicine skills and knowledge to provide the best interdisciplinary care for her elderly patients and teach those skills to the students and residents.
Project: Retrospective Chart Review for Adherence to Geriatric Guidelines for
Medications Dr. Wijeyakuhan’s ASPIRE project focuses on how the current
geriatric guidelines on benzodiazepine prescribing, are practiced amongst the
hospitalists’ group and to implement guidelines, which will help improve the
geriatric patient’s outcome in the hospital, promote comfort as outpatient, and
possibly reduce readmission rates for the elderly patients.
Lyle Fettig, MD
Lyle P. Fettig, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Director, Hospice and Palliative Medicine Fellowship, IU School of Medicine
Lyle Fettig, MD is an Assistant Professor of Clinical Medicine at Indiana University School of Medicine. He directs the IUSM Palliative Medicine Fellowship and is a team physician with the Eskenazi Health Palliative Care Team. His interests include education to improve the communication skills of clinicians and care of underserved populations. Dr. Fettig leads IU Talk which provides VitalTalk based communication skills training to a variety of providers. The project started with a focus on IUSM trainees, including critical care and oncology fellows and has expanded to other groups at the graduate medical education level as well as sessions for new providers joining IU Health Physicians Group Dr. Fettig has written for the blog Pallimed and a few of his blogs have been featured on the popular site KevinMD.
ASPIRE Project: Feasibility and Acceptability of a Structured ICU Interdisciplinary Team Workshop to Improve Communication with Patients and Families
Dr. Fettig’s ASPIRE study has explored the feasibility, acceptability, utility and clinician outcomes of a communication skills training workshop for an interdisciplinary group of clinicians in the intensive care unit setting. The workshop is geared towards improving the quality of both individual and team communication with patients and families about goals of care in serious illness.
Jennifer Hur, MD
Jennifer R. Hur, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Key Clinical Educator for GIMG, Department of Medicine, IU School of Medicine
Jennifer Hur, MD is an Assistant Professor of Clinical Medicine at Indiana University School of Medicine who also serves as one of the Department of Medicine’s Key Clinical Educators, representing General Internal Medicine. She came to Indy from New England and NY in 2006, started as an academic Hospitalist at Eskenazi, and in 2008, transitioned to running and teaching in the Pre-Admission Testing Clinic at IUH-University Hospital. When she is not evaluating, optimizing, and coordinating care for patients having complex surgeries, training medical residents or other faculty in preoperative medicine, collaborating with hospital leadership in perioperative quality improvement initiatives, or supporting the multiple hospitalist groups on campus with their educational endeavors, she is juggling schedules with her husband John, a busy orthopedic surgeon, as they raise their 3 kids.
ASPIRE Project: Using Technology to Flip Hospitalist Ward Orientations into an Online Tool for Faculty Development Dr. Hur’s interest is in finding efficient and effective ways to improve inpatient faculty's clinical teaching skills and her ASPIRE project explores harnessing online technology to do this. She has developed You Tube™ videos, using best practices in instructional technology, to improve academic hospitalists’ skills in feedback and evaluation, which will be shared on all of IUSM’s clinical campuses, as well as at the Alliance for Academic Internal Medicine’s, 2018 Academic Internal Medicine Week spring meeting.
Areeba Kara, MD
Areeba Kara, MD Associate Professor of Clinical Medicine, IU School of Medicine
Areeba Kara MD, MS was born and raised in Karachi, Pakistan where she attended medical school at the Aga Khan University. She completed her internal medicine residency at IU and joined IU Health Methodist hospital as a hospitalist in 2003, where she’s been ever since. In parallel with her enjoyment of the challenges of clinical hospital medicine, Areeba has developed a diverse set of skills and interests. Her focus is on hospital-based care quality and safety in clinical hospital medicine, teamwork and education.
ASPIRE Project: Geographic Cohorting of Hospitalists and Their Patients
Dr Kara’s ASPIRE project has focused on delving deeper into the practice of Geographic Cohorting in the hospital to understand the benefits and downsides of assigning hospitalists by units.
Emily Machogu, MD
Emily Machogu MD Assistant Professor of Clinical Medicine, IU School of Medicine
Emily Machogu, MD, and Assistant Professor of Clinical Medicine and Pediatrics at Indiana University School of Medicine. She is a med/peds hospitalist at Eskenazi. Clinically, she spends time on the teaching and non-teaching teams on the internal medicine service, as well as the teaching team on the newborn service. She also serves as the Associate Program Director for the Med/Peds Residency, where she runs the Clinical Competency Committee and works closely with residents in a mentoring role.
ASPIRE Project: Stress from Uncertainty and Diagnostic Test Ordering in an Inpatient, Team-Based Environment
Dr. Machogu’s ASPIRE work builds on previous studies demonstrating a physician’s level of stress regarding uncertainty on validated scales is related to costs of care. Her project examines the relationship between the Stress Regarding Uncertainty scales for each physician member of six teaching teams on the internal medicine service at Eskenazi Health, as well as each team’s diagnostic test ordering practices. It also explores the ways team structure affects these results.
Amy Munchhof, MD
Amy Munchhof, MD Assistant Professor of Clinical Medicine, IU School of Medicine
Assistant Professor of Clinical Pediatrics, IU School of Medicine
Associate Program Director for the IM-Peds Residency Program
Medical Director, Eskenazi Newborn unit, Eskenazi Hospital
Amy Munchhof attended IUSM completing the MD/PhD program in May 2008. She then completed a residency in Internal Medicine and Pediatrics at IUSM in June 2012 and accepted a position as an academic hospitalist at Wishard/Eskenazi hospital as a med/peds hospitalist. The majority of Amy's clinical time is as a medicine hospitalist on teaching and non-teaching teams with the remainder of her time in the pediatric urgent care and newborn service. Through her work as a hospitalist Amy has sought projects to improve transitions of care from the hospital to primary care focusing on the discharge process. Amy lives with her husband in Indianapolis and enjoys running, reading, and spending time outdoors.
ASPIRE Project: Improving Communication between inpatient and outpatient providers during transition of care from hospital to primary care
The goal Dr. Munchhof’s ASPIRE project is to explore preferences of both hospitalists and primary care providers for direct communication at patient discharge to better understand the direct communication process between providers during transition of care. Her project aims to identify shared and different challenges to direct communication, modes of communication, and characteristics of hospitalized patients where direct communication is essential to safely transition care from hospital to primary care.
Dr. Shilpee Sinha is the Service Line Lead for the Indiana University Health Palliative Care Services at the Adult Academic Health Center and part of the faculty of Indiana University School of Medicine as an assistant professor for clinical medicine. She completed her medical studies at the Armed Forces Medical College India and a Residency in Internal Medicine at Overlook Hospital, a UMDNJ affiliated program in New Jersey. After completing a Fellowship in Hospice and Palliative care at Beth Israel Medical Center Manhattan, Albert Einstein College of Medicine she joined the IU System in 2006. Dr. Sinha worked as a Hospitalist and Associate Hospice Medical director for Ruth Lilly/IU Hospice for a few years until the Palliative Care department was formally established in 2011. Dr. Sinha is currently the Service Line Leader for the adult academic health center Palliative Care services. She has been integrally involved in developing a robust inpatient program at the AAHC, IU’s Indiana Suburban Region hospitals, and the community through outpatient clinics, virtual health and home based service. She is a cofounder of the Indiana Network for Hospice and Palliative Care a statewide collaborative which was started in 2020. Her passion is caring for patients with serious illness and helping to advance palliative care both at a specialty level and at a primary level.
ASPIRE Project: Advance Care Planning in the Perioperative Clinic: A Retrospective Chart Review
Dr. Sinha’s ASPIRE project focused on prevalence of advance care planning documents in patients undergoing a surgical procedure who are evaluated in a perioperative clinic for medical optimization. Patients undergoing surgery are under anesthesia and lack capacity for at least that duration and are at risk of complications but often lack any advance care plan or surrogate decision making documents which can impact their care if complications occur. She performed a retrospective chart review on a cohort of 400 patients at 2 sites in an urban tertiary care center.