Workshop Session: Friday, March 10, 2017


Click here for session handouts.

Workshop Sessions

10:45 a.m. - 12:15 p.m. 


Mapping to action: Advancing adolescent health via data, policy, and coalition building

Maggie Gustafson, LMSW, Kristie Bardell, MPH, Kendra LeSar, MPH, Shantice Atkins, MPH, Alexandra Priebe, PhD, Taslim van Hattum, LCSW, Marsha Broussard, DrPH, FSAHM
Louisiana Public Health Institute
 
Track: Public Health/Advocacy

Description: Adolescent sexual health is a critical, yet often neglected issue in Louisiana.  LPHI’s approach to improving adolescent health is via systems, policy, and environmental constructs. Despite consistently ranking among the states with the highest sexual and reproductive health morbidity in the country, state laws restricting sex education and collection of sexual risk behavior data in schools pose major barriers to building coordinated and evidence supported systems to improve health outcomes. Systems such as schools, health care providers, and community-based organizations that interact with adolescents are fragmented while stigma prevails in the most disparate communities. To address these challenges, the Louisiana Public Health Institute (LPHI) developed Connections: Bridging Teens + Sex + Health, a project that works with adolescents and communities to connect youth to sexual health education and services.  An additional objective is to provide community members with tools to understand the adolescent sexual health landscape in order to advocate for policy and system changes. Connections is conducting this work through developing statewide and regional community level coalitions to address adolescent sexual health issues. The session will focus on how ongoing dialogue with community members have informed data methodology and the evolution of community priorities.

Educational Objectives
  1. Identify strategies to incorporate adolescents and community representatives (parents, officials, education leaders, etc.) in data ownership via primary data collection and dissemination
  2. Describe a targeted approach to mobilizing coalitions amongst disparate populations while addressing challenges such as strong influences from religious-affiliated sectors and political officials
  3. Discuss how state and local coalitions can leverage data to inform policies at different levels
Faculty Expertise: Ms. Gustafson is a social worker and public health practitioner with experience engaging youth, and coordinating and evaluating programs focused on women’s, reproductive, and sexual health. Ms. Bardell is a public health practitioner with experience managing programs, assessing community health needs, and collaborating with multi-sector partners to develop and implement health improvement initiatives. Ms. LeSar is a Certified Health Education Specialist with extensive teaching, training, and presentation experience in the field of adolescent sexual health. Ms. Atkins has strong skills in partnership development, recruitment of families, working with youth, and maintaining program fidelity. Dr. Priebe has significant public health research and teaching experience. Ms. van Hattum is a clinical adjunct professor at the Tulane University School of Social Work and has clinical and teaching experience. Dr. Broussard is focused on supporting New Orleans’ most vulnerable students in successful educational completion, starting with meeting early childhood benchmarks through high school completion.


It's a TRAP:  How U.S. Targeted Regulation of Abortion Providers (TRAP) Laws Harm Adolescent Women's Health

Katherine B. Greenberg, MD, FSAHM1, Ellie Schilling, JD2, Julie L. Finger, MD, MPH, FSAHM3, Tracey A. Wilkinson, MD, MPH4 Jeryl D. Hayes, JD, LL.M5
1University of Rochester Medical Center; 2Schonekas, Evans, McGoey & McEachin, LLC; 3Tulane University Hospital & Clinic; 4Indiana University School of Medicine; 5Physicans for Reproductive Health   
 
Track: Public Health/Advocacy

Description: In June 2016, the Supreme Court struck down two Texas TRAP laws, putting the state in line with evidence based medical practice, as the TRAP laws’ requirements were deemed “medically unnecessary and dangerous” by major medical associations (Amicus Brief, H.B.2, 1/5/2016).  Under the guise of protecting women’s health and safety, TRAP and related laws in fact increase the risk, cost, and inaccessibility of abortion care (Guttmacher, 3/2016).  While this landmark decision is a huge victory for young women’s access to safe, legal medical care, considerable work remains.  States enacted 288 abortion restrictions between 2011 and 2015, and women still face unnecessary and harmful limitations in accessing abortion care (AGI, accessed 6/20/2016).  This is highly relevant to youth serving health professionals, since women less than 25 years old obtained 46% of abortions in 2014. And while these laws are specific to the U.S., the recent Lancet Commission on Global Health recognizes that “legal systems have profound effects on adolescent health and wellbeing,” and there are likewise restrictions that affect physicians and patients worldwide.    This workshop will describe the scope and impact of U.S. laws regulating abortion provision, with a focus on their relevance for adolescents and young adults.  We will then create regional “break out” groups in order to facilitate sharing of advocacy and patient care resources.  We hope to enable our SAHM network to discuss the impact of these laws, foster connections among each other, and improve relationships with adolescent patients by helping them navigate restrictive barriers to abortion care.

Educational Objectives
  1. Describe the scope, impact, and relevance of TRAP and related laws for youth-serving health professionals
  2. Discuss how misinformation about TRAP and related laws circulating in communities, legislative mandates, and the media negatively affect our patient’s perspectives
  3. Cultivate connections among regional providers across all specialties and share resources to support adolescent patients navigating access to abortion care
Faculty Expertise: All faculty are either staff, members, or affiliates of Physicians for Reproductive Health (PRH), a doctor-led advocacy organization that works to improve access to comprehensive reproductive health care.  Drs. Greenberg, Finger and Wilkinson are graduates of the Leadership Training Academy, and faculty of the Adolescent Reproductive and Sexual Health Education Program (ARSHEP), where they received additional training in advocacy skills and physician education.     Dr. Greenberg addresses sexual health access as co-director of the Greater Rochester LARC Initiative; Dr. Finger is actively engaged in reproductive rights advocacy work in the greater New Orleans area; and Dr. Wilkinson's research on emergency contraception access has brought national attention to barriers.  Ms. Hayes is the Assistant Director of Public Policy at PRH and has an extensive history of legal work in sexual and reproductive justice, and Ms. Schilling is an attorney in New Orleans with extensive experience representing reproductive healthcare providers.


HIV Pre-Exposure Prophylaxis (PrEP): Are You Ready?

May Lau, MD, MPH, FSAHM1, Brett Cooper, MD, MPH2, Adam Leonard, MS3
 1University of Texas Southwestern, 2Texas Children's Hospital/Baylor College of Medicine, 3Community Health Programs for Youth San Francisco Department of Public Health    
 
Track: Clinical Foundations

Description: Men and women 15-29 years old represent the fastest growing group of new HIV infections in the United States. When used appropriately, HIV Pre-Exposure Prophylaxis (PrEP) can be an effective tool in preventing HIV infection. Although PrEP has been available for nearly 4 years now, many providers still have not heard of PrEP and many more are still hesitant to recommend this potentially life-saving prevention measure to their adolescent and young adult patients. This topic is relevant to providers who provide sexual and reproductive care to adolescent and young adult patients. In regard to the theme of this year's SAHM meeting, Cultivating Connections, providing adolescent and young adults PrEP, and managing these patients can help enhance the provider-patient relationship due to the frequency of visits when on PrEP. This workshop will provide a foundation for clinicians to become more comfortable discussing, prescribing, and managing PrEP for their patients.

Educational Objectives
  1. Discuss the components, safety, and efficacy of Pre-Exposure Prophylaxis (PrEP) to reduce the risk of HIV infection
  2. Review the indications for PrEP use to prevent HIV infection in men who have sex with men and heterosexually active males and females, with a focus on adolescents and young adults
  3. Prescribe and manage adolescent and young adult patients who are on HIV PrEP
Faculty Expertise: May Lau is an adolescent medicine provider who has experience providing sexual and reproductive care for high-risk adolescent females and males, including those with gender dysphoria. She prescribes PrEP in her clinic. M. Brett Cooper, a 2nd year clinical fellow, provides care for homeless young adults with high-risk sexual behavior. His research interests include LGBT healthcare and promoting the use of PrEP among high-risk populations. He will be co-authoring, along with Adam Leonard, a SAHM position paper on PrEP use among youth.   Adam Leonard, a Nurse Practitioner, provides HIV management and primary care to HIV-infected youth. He has a weekly youth PrEP clinic. He has given community presentations and trainings to increase youth access to PrEP and co-authored the San Francisco Department of Public Health PrEP Protocol Adolescent and Young Adult section. He will also be co-authoring a SAHM PrEP position paper, along with Dr. Cooper and other SAHM members.


From Office to #IRL –Utilizing Technology & Social Media in Adolescent Obesity Management

Lonna P. Gordon, MD1, Caroline J. Barangan, MD1, Julie Nagpal, MD2, Temitope Ademuwagun, MD1  
1Icahn School of Medicine at Mt Sinai, Adolescent Health Center; 2Lincoln Medical and Mental Health Center
  
Track:  Clinical Foundations

Description: The prevalence of adolescent obesity continues to rise despite improvements in other age groups. Obesity has far-reaching physical, social, and mental health implications during adolescence as well as adulthood.  Obese adolescents are 49 times more likely to become obese adults in comparison to their healthy weight peers. Improving the weight status of overweight and obese adolescents is of the utmost clinical importance. Best practices in obesity management suggest office visits weekly to biweekly, and a multidisciplinary team.  Achieving these goals in clinical practice is challenging.  Patients frequently do not have the time or financial resources to attend frequent visits with a physician, nutritionist or mental health provider.  Resources to support adolescents in improving their weight status may not be readily available. Providers frequently feel that their nutrition counseling in the office does not translate into sustainable lifestyle changes that are adopted by patients.  Techniques such as motivational interviewing may not have the long term impact needed by adolescents in the real world of time constraints and abundant unhealthy food choice options. Providers need tools that will assist them in providing meaningful obesity management to diverse communities of adolescents. Technology and social media are already integrated into an adolescent’s daily life. They can be utilized as tools in promoting healthy eating habits and supporting safe weight loss. Creative use of these tools can help engage the adolescent while they are in the waiting room and exam room, and most importantly, keep them connected and motivated long after the office visit.

Educational Objectives
  1. Describe best practices in providing obesity management to adolescent youth
  2. Discuss the challenges in implementing best practices in obesity management into clinical practice
  3. Demonstrate how technology including: websites, social media platforms, and apps can be utilized to reinforce nutritional topics discussed in the office and provide close follow-up once an obese adolescent has left the office
Faculty Expertise: The faculty members for this workshop have clinical expertise in the management of adolescent obesity using multidisciplinary approaches. They each recognize the challenges of getting patients to visit non-medical providers and have created unique approaches to delivering this information in the office. Dr. Gordon specifically runs a comprehensive weight loss clinical program aimed at helping obese and morbidly obese adolescents safely lose 10% of their body weight over 12 weeks. She is also the physician coordinator for the nutrition centered patient education at The Mount Sinai Adolescent Health Center where approximately 60% of the patient population is overweight or obese.


Lessons learned including problems and solutions to starting a healthcare transition program.

Albert C. Hergenroeder, MD, FSAHM, Constance M. Wiemann, PhD, FSAHM
Baylor College of Medicine & Texas Children’s Hospital
  
Track: Education/Training

Description: The presenters will reinforce the basic principles presented in our 2015 transition workshiop and expand on additional lessons learned in building and sustaining a health care transition infrastructure. This is a relatively new area of scholarly activity that provides the opportunity to develop quality improvement projects.

Educational Objectives
  1. Describe the steps required to lay a foundation on which to build a hospital-based healthcare transition planning program
  2. Appreciate the complexity of establishing and sustaining a healthcare transition program in any setting and the time and effort required to do so
  3. Discuss methods to evaluate healthcare transition planning activities, including process and outcomes and  identify processes to evaluate transition outcomes
Faculty Expertise: Dr. Hergenroeder has provided adolescent medicine care for youth with chronic illness and disabilities since 1986. He has co-presented six abstracts at national meetings over the past four years with Dr. Wiemann. He has been a visiting professor/invited speaker to discuss health care transition at many local, state and national meetings since 2001. He is a Got Transition Center Advisory Board member since its inception; is the Founder and Program Director for the annual Chronic Illness and Disabilities Transition Conference, which will hold its 17th annual meeting in 2016; and the Principal Investigator on a HRSA-funded grant addressing health care transition. Dr. Wiemann serves as Evaluator for several externally funded projects that seek to develop/implement transition programs for youth with chronic illness and disability.  She serves on transition-related planning committees at the National, State and local levels.


Get SMAHRT: One research team’s mission to recruit and engage diverse youth as trainees, advisors and colleagues

Megan A. Moreno, MD, MSEd, MP1, Nikita Midamba, MS1, Bradley Kerr, MEd1, Danny Pham2
1Seattle Children's Research Institute; 2University of Washington 
  
Track:  Education/Training

Description: This mission of the Social Media and Adolescent Health Research Team (SMAHRT) includes education of adolescents and a focus on diversity of team members and trainees. In this workshop, our panel of team members will discuss tested strategies to recruit, engage and retain youth in the processes of our research, education and advocacy.  The three areas of presentation and discussion will include: 1) Mr. Brad Kerr will discuss application of background in Educational Administration to developing and implementing approaches for undergraduate research interns to conduct independent research, and his role on the team as an education coordinator. 2) Ms. Nikita Midamba will discuss her background in Forensic Science and as a science teacher and how these experiences contributed to her role on SMAHRT as an outreach coordinator in recruiting youth as well as engaging with community organizations that serve diverse youth.  3) Megan Moreno will discuss her team’s development and implementation of a summer program for adolescents, including the input and help she received from other SAHM members.  Our youth panelist will discuss his experiences with SMAHRT as a summer program attendee who then became a Youth Advisory Board member. As a social media research team, the role of social media as a tool to connect to youth will also be discussed.

Educational Objectives
  1. Understand new approaches to recruit diverse youth to programs and studies
  2. Consider various approaches to retain diverse youth as trainees, advisors and colleagues
  3. Learn strategies to include youth as partners in projects
Faculty Expertise: Dr. Moreno’s educational roles have included pursuing a Master’s in Education degree during her pediatric residency and serving as Chief Resident at the University of Wisconsin Madison. As an assistant professor, Dr. Moreno served as an Associate Program Director at the University of Wisconsin, as well as Director of Pediatric Resident Research. Dr. Moreno was the pediatric director of the National Research Service Award (NRSA) fellowship. Mr. Bradley Kerr  completed a Master’s degree in Administrative Leadership, specializing in Higher Education Administration. He has been part of Dr. Moreno’s team for 4 years. In that time period he has developed and implemented training tools for incoming team members.Ms. Nikita Midamba's training includes a master's degree in forensic science and experience as a high school science teacher. Our youth panelist brings experience in several of the programs we will discuss.



1:45 p.m. - 3:15 p.m. 


Who is In That Number?

Iman Shervington, Chloe Walters-Wallace
Institute of Women & Ethnic Studies
        
Track: Public Health/Advocacy

Description: This workshop will provide participants with an overview of an ongoing public will campaign, In That Number, and discuss the campaign’s use of partnership connections to amplify and contextualize the campaign’s message and advocate for change. In That Number is based on data collected by the Institute of Women & Ethnic Studies from over 1200 youth aged 11-15 in New Orleans. This data showed that youth endorsed symptoms of PTSD and depression 2-3 times higher than the national rate. In That Number was subsequently launched in January 2016 to address the provision of youth-friendly emotional wellness services, specifically Trauma-Informed Care services, and reframe the perception of traumatized youth as “sad,” not “bad.” Public attitudes and perceptions are important for shaping the policy environment and resource allocation. By “priming” the public for action, the campaign aims to change those perceptions, and through connections with advocacy partners, effect policy change. With a wide range of active partners, the campaign has been able to reach a variety of audiences and amplify its message. These partnerships have added depth and new dimensions to the campaign, and contributed to local advocacy movements. Notably, the campaign participated in the Louisiana Youth Justice Coalition, which worked to pass significant juvenile justice reform measures in the 2016 Louisiana Legislature. This workshop will help participants explore the support networks important to adolescent health and provide tools to access these networks and leverage the ensuing partnerships for policy change, whether or not one is engaged in a campaign.

Educational Objectives
  1. Identify people, institutions, and systems that impact the health of youth they work/interact with regularly.
  2. Analyze how their personal backgrounds impact their work and how it can impact their provision of services to youth.
  3. Develop messaging and tactics to engage new and existing partners, and leverage these partnerships to conduct advocacy.

Faculty Expertise: Iman has utilized her media and communications skills at IWES for over seven years, creating over 50 short films and PSAs, which have screened at film festivals across the nation (four have won awards), a web-series, a feature-length documentary, an award-winning podcast, two social marketing campaigns and one public will campaign. She has also presented at eight conferences to showcase her work. Recently, she spearheaded the In That Number campaign, which boasts over 15 partners and has had extensive media coverage since it’s launch in January 2016. Stacey is a public health professional with over 15 years’ experience in program management, evaluation, community-based interventions, and strategic planning. Her work has been both domestic and international, including Malawi, Guyana, and Kenya, and providing remote support to teams in West Africa and Asia. Stacey’s work has focused on building capacity for community-level organizations to address reproductive health rights for women and girls.



Transdisciplinary Connections: Managing discomfort for those not used to dealing with adolescent issues: Teaching Practice to Policy for non-Adolescent Health Specialists

April Suanne Elliott, MD, FSAHM1, Deborah Christie, PhD, FSAHM2
1University of Calgary; 2University College London Hospitals NHS Foundation Trust
 
Track: Education/Training

Description: Adolescent healthcare practitioners actively advocate for the protection and wellbeing of youth and young adults. We are uniquely placed to help others understand new evidence about growth and development of the brain and the body and have a key role in informing colleagues and other professionals that work with adolescents and young adults.   Many of us are asked to help them ‘handle’ young people either through formal presentations (or informal hall way consults) on understanding why adolescents are behaving in a way that is a challenge to successful professional practice. Just as adolescents are the shaky bridge between paediatrics and adult care adolescent health specialists are ideally located to help connect research and practice in tertiary care centres with those at the front line in primary care and in the community.  This workshop will present an integrated model that is informed by frameworks that take a solution focused, resiliency based approach including MI, DBTi, mindfulness and handy tips to use when that next "tough" (challenging) case comes along. It will appeal to both individuals that are new to SAHM and seasoned professionals. 

Educational Objectives
  1. To identify specific approaches that can be used within an integrated model for teaching or coaching non-adolescent medicine specialist working with challenging youth health cases
  2. To evaluate approaches and develop skills that create awareness and tolerance of emotional distress by non-adolescent health colleagues
  3. To review unique scenarios and presentation approaches with like-minded experts for feedback and coaching
Faculty Expertise: Dr. Elliott has extensive coaching and leadership training and has developed experiential workshops that build skills in healthcare professionals. These skills facilitate succesful encounters with challenging adolescent situations and help the healthcare professional find joy and satisfaction in their work through self-regulatory techniques such as mindfulness.  Dr. Elliott has presented to many groups in both a teach the teacher format and to non-adolescent health professionals to enhance their skills in these areas. Dr. Christie is an Inspriational motivational speaker and internationally respected academic and clinician with an outstanding record of peer-reviewed publications., teaching and leadership in innovative award winning clinical programmes in adolescent health.


The Wild Ride of ARFID: Embracing Diagnostic Challenges, Exploring New Treatments

Rollyn M. Ornstein, MD, FSAHM1, Debra K. KatzmanMD, FSAHM2, Jennifer J. Thomas, PhD3
1Penn State Children's Hospital; 2Hospital for Sick Children and University of Toronto, Research Institute; 3Harvard Medical School; Massachusetts General Hospital Eating Disorders Program
    
Track: Clinical Advances

Description: Avoidant/Restrictive Food Intake Disorder (ARFID), a DSM-5 reformulation of DSM-IV Feeding Disorder of Infancy and Early Childhood, has created a great deal of clinical and academic interest among clinicians caring for patients with this eating disorder since its recognition in 2013. Much has been learnt over the past three years about the presentation, clinical characteristics, and course of this disorder, and research into its neurobiology is ongoing. This workshop, led by Adolescent Medicine providers from the US and Canada, as well as an eminent psychologist in the eating disorder field, will take an evidence-based approach to presenting a wide range of interesting and challenging clinical cases of ARFID, including patients who restrict their intake due to sensory sensitivity, fear of aversive consequences of eating, and/or lack of interest in food. The cases will illustrate critical concepts that will enhance the participant’s clinical skills and aim to nurture lively discussion and debate, incorporating an interdisciplinary perspective. As is true for all eating disorders, cultivating connections among providers is essential in the management of ARFID. Each case will represent a challenge of broad interest to the audience and will include a discussion that highlights the application of the diagnostic criteria, clinical presentation and expression, clinical course, and the current treatments.  We will also focus on how to distinguish ARFID from other disorders, and the impact of differential diagnosis on treatment planning.

Educational Objectives
  1. Identify the challenges in applying the DSM-5 diagnostic criteria for ARFID to children and adolescents and recognize the presentation and clinical expression of ARFID, and differentiate it from related eating disorders, such as anorexia nervosa.
  2. Describe how children and adolescents with a diagnosis of ARFID are different from those youth with other physical and mental disorders.
  3. Examine the various treatments being used to treat adolescents with ARFID, including cognitive-behavioral and exposure-based interventions.
Faculty Expertise: Rollyn Ornstein is the co-director of an eating disorder partial hospitalization program at Penn State Children’s Hospital. Her research focuses on children and adolescents with eating disorders, with a concentration on ARFID.  Along with Debra Katzman, her work helped secure the inclusion of ARFID in the DSM-5. Debra Katzman’s research focuses on the unique physiologic and developmental issues in pediatric eating disorders.  She is the co-founder of the Eating Disorders Program at the Hospital for Sick Children in Toronto. She is a Past- President of SAHM and the Academy for Eating Disorders. Jennifer Thomas is Co-Director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital.  Her clinical work as well as her research focuses on atypical eating disorders, particularly ARFID, with a current NIMH-funded study investigating the neurobiology of ARFID. She has also co- developed a new cognitive-behavioral treatment for ARFID which she is currently testing.


Cultivating Connections in Clinical Settings to Address and Prevent Gun Violence (SAHM Violence Prevention Special Interest Group)

Alison J. Culyba, MD, MPH1, Nicholas J. WestersPsy.D2, Elizabeth Miller, MD, PhD, FSAHM3, Eric Sigel, MD4
1The Children's Hospital of Philadelphia; 2Children’s Medical Center Dallas, UT Southwestern Medical Center; 3Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine; 4University of Colorado, Children’s Hospital of Colorado
      
Track:  Clinical Foundations

Description: As evidenced by recent high-profile mass shootings, as well as the lived experiences of many youth in underserved communities, firearm violence is common and leads to significant morbidity and mortality including homicide, suicide, and unintentional injury. Youth, and minority youth in particular, bear the disproportionate burden of the gun violence epidemic in the U.S. This SIG will provide a brief overview of the prevalence and correlates of firearm access and firearm violence exposure using data from peer-reviewed research publications, the 2015 Youth Risk Behavior Surveillance, and the CDC National Center for Injury Prevention and Control. We will review evidence-based and expert consensus guidelines to screen for and address firearm access in clinical settings, including strategies to effectively engage with gun-rights advocates in clinical contexts. We will critically appraise trauma-informed interventions to ameliorate the consequences of firearm violence, including hospital-based violence prevention programs. We will discuss innovative approaches to build partnerships and support advocacy efforts to reduce gun access among youth. This workshop will serve as the Violence Prevention Special Interest Group meeting, and will include time to address SIG business at the end of the session.

Educational Objectives
  1. Recognize the risks firearm access pose to youth presenting for routine care, as well as increased risks associated with depression, suicidal ideation, and assault injury
  2. Synthesize evidence-based and consensus guidelines to screen for firearm access in clinical settings and to counsel youth and families about decreasing adolescents’ access to firearms
  3. Critically appraise existing collaborative approaches to reduce youth access to firearms and to mitigate the effects of firearm exposure
Faculty Expertise: Faculty facilitating this workshop are all members of the SAHM Violence Prevention Special Interest Group and Violence Prevention Committee. Alison Culyba, MD MPH is a researcher and clinician with expertise in strengths-based approaches to youth violence prevention. She serves as the adolescent medicine consultant to the CHOP Violence Intervention Program. Nicholas J. Westers, Psy.D. is a clinical psychologist with expertise in violence toward the self, including suicide and nonsuicidal self-injury. He frequently teaches and presents on nonsuicidal self-injury.  Elizabeth Miller, MD PhD’s community-partnered, stakeholder-engaged research focuses on interpersonal violence prevention among adolescents. She has authored numerous clinical and policy guidelines related to prevention of gender-based violence and its health effects. Eric Sigel MD’s research focuses on violence prevention and intervention through the primary care setting; currently he has an NIJ funded project focusing on training health care providers how to counsel families on firearm risk.


Transforming Adolescent Care at a Safety Net Hospital: Lessons Learned in Providing Timely Confidential Care in the Era of the Electronic Health Record

Maria Veronica Svetaz, MD, MPH, FSAHM, Jennifer Mary O'Brien, MPH
Hennepin County Medical Center
        
Track: Clinical Advances

Description: Confidentiality is essential in order for adolescents to access comprehensive health care, particularly reproductive and mental health services. The advent of Electronic Health Records (EHR) has posed extra challenges in this regard for most health care organizations and providers caring for them. For years, most adolescents have been referred out of Primary Care to Family Planning Clinics for their confidential care.   Teen patients seen in the ambulatory setting of a safety net hospital experience significant social determinants of health and do not have the luxury to leave their primary care clinics to seek sexual or mental health services elsewhere. Excellent and timely confidential sexual and mental health care must happen within the primary care setting, where teens are already seeking care, in order to improve needed access to these services.   To address this issue for its patients, The Hennepin County Medical Center (HCMC)’s “Henne-Teen” initiative formed a multi-disciplinary task force that proposed modifications to HCMC’s EHR that made possible to document, order labs, order treatments, process billing and print out visit summaries, while at the same time protecting teen confidentiality.  Their experiences were presented at the Fall Epic conference in 2010, and again at Epic Fall Conference 2015.   While some have claimed victory over this issue, not all hospitals are familiar with the ways that teen confidentiality can best be maintained, and there continues to be a patchwork of modifications across systems, and no uniform resolution.

Educational Objectives
  1. Identify the leading barriers to providing confidential care in the era of the Electronic Health Record, and acquire specific strategies for any electronic health record to advance best practices in adolescent health.
  2. Review several examples of adaptations to the electronic health record to comply with adolescent confidentiality requirements and consider one model for training the Primary Care workforce in the standard of care for adolescents.
  3. Discuss key lessons learned and steps needed to be successful in this journey.
Faculty Expertise: Maria Veronica Svetaz, MD, MPH is a Faculty Family Practice and Adolescent Health Boarded physician at HCMC Department of Family and Community Medicine, and an Assistant Professor at the School of Medicine, University of Minnesota. Dr Svetaz developed a system wide program called “Henne-Teen”, an initiative designed to tackle modifications to their new Electronic Health Records, EPIC, to make them compatible with Minor Confidentiality. Her work has been presented in the Fall EPIC Conference in 2010 and 2015. Jennifer M. O’Brien, MPH has worked in adolescent health and healthy youth development for over 19 years. She has both worked directly with youth and their families, as well as indirectly through policy and systems change.  She manages “Henne-Teen”, shepherding along the implementation EHR confidentiality changes, pharmaceutical access for teens, and clinical work flow adjustments. She has a Master’s Degree in Public Health from the University of Minnesota.


The diagnosis and treatment of common ankle, knee and hip injuries in adolescents.

Albert C. Hergenroeder, MD, FSAHM1, Keith J. Loud, MD2
1Baylor College of Medicine & Texas Children's Hospital; 2Children's Hospital at Dartmouth-Hitchcock    
 
Track: Clinical Foundations

Description: Diagnosing and treatment common musculokeletal problems is a deficiency among most adolescent medicine providers and adolescent medicine training programs, yet musculoskeltal complaints are common among adolescents seen by these providers.

Educational Objectives
  1. The diagnosis and treatment of an acute ankle sprain
  2. The diagnosis and treatment of chronic knee pain
  3. The diagnosis and treatment of hip injuries
 Faculty Expertise: Dr. Hergenroeder – Chief, Adolescent Medicine and Sports Medicine Section, Baylor College of Medicine and Texas Children's Hospital. He has been a team physician for high school and college teams since 1984.  He received the American Academy of Pediatrics Council on Sports Medicine and Fitness 2012 Thomas E. Shaffer Award. Dr. Loud - Dr. Loud is certified in adolescent medicine, sports medicine, and general pediatrics by the American Board of Pediatrics (ABP). A member of the Children’s Hospital at Dartmouth-Hitchcock Sports Medicine Team; Member, Executive Committee, Council on Sports Medicine and Fitness, American Academy of Pediatrics.


Publishing and Promoting Your Scientific Research: Tips from the Journal of Adolescent Health

Tor D. Berg, BA, Charles E. Irwin, Jr, MD, FSAHM
Journal of Adolescent Health

Track: Education/Training

Description: Want to increase your chances of getting your paper accepted? Not sure whether open access is important for your work? And we have to tweet our articles now? Academic publishing has changed a lot in the past 10 years, and the pace of change is increasing. Come hear insights from the editors of the Journal of Adolescent Health. You'll learn how to critically evaluate journals to find the best place for your paper. You'll hear tips on how to represent yourself to a journal before, during, and after peer review. And you'll discover the increasing importance of taking an active role in promoting your scientific work post-publication.

Educational Objectives
  1. Match one's scientific work to the most appropriate journal for publication.
  2. Negotiate rights and post-publication licensing in an open-access world.
  3. Promote and disseminate one's scientific work post-publication.
Faculty Expertise: Tor Berg and Dr. Irwin have been the Managing Editor and the Editor-in-Chief, respectively, of the Journal of Adolescent Health for 12 years. They have seen many strange and wonderful things during that time.

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