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An SCCM Member Responds to a Call for Volunteers

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6/4/2021

Before the COVID-19 pandemic, Tina R. Shah, MD, MPH, focused her work on two questions: How can technology help improve the United States health system and, more specifically, how can it be used to improve patient and practitioner well-being?

The arrival of COVID-19 made these questions more important—and more pressing—than ever before. As medical director of virtual health at Wellstar Health System in Georgia, Dr. Shah spearheaded her company’s COVID-19 telemedicine plan and helped Wellstar go from zero to 50,000 virtual visits in just six weeks. Dr. Shah also helped implement virtual rounds in the intensive care unit (ICU), which allowed more family members to interact with their loved ones than would have otherwise been possible. And it reduced the time nurses had to spend on the phone with loved ones, increasing the time they could be at the bedside.

“It takes so long to get into the room of a COVID-19 patient because of personal protective equipment, and nurses were struggling with family members calling all the time,” Dr. Shah said. “Technology was a huge boon to help with the moral distress we were having in the hospital, because we could have crucial conversations in a more meaningful way.”

Dr. Shah remembers being able to create a virtual room for one critically ill patient so that his wife, who lived nearby; a daughter, who worked at a different hospital; and another daughter, who lived in a different state could all connect by video to see the patient and each other.

“We’ve never been able to deliver care like that before,” Dr. Shah said. “Usually if someone is in the ICU, whoever comes in to visit can get other family members involved via speakerphone a few times, but now every single day we had all the family members come in virtually and decide what the plan of care was for their dad.”

It was not the first time Dr. Shah used technology to improve patient care. She served as a White House Fellow and Special Advisor to the Secretary of Veterans Affairs from 2016 to 2017 and as the U.S. Department of Veterans Affairs first Director of Clinician Wellbeing. In that role, she focused on electronic medical record (EMR) optimization that helped physicians reduce time spent on the EMR and increase the amount of time they could dedicate to patients. This optimization allowed physicians across the country to care for tens of thousands more veterans each week.

In October 2020, after two years at Wellstar, Dr. Shah was ready for a change. Although the pandemic had not abated, she was comfortable with Wellstar’s digital presence and how the system was handling patients with COVID-19. She was also confident that her colleagues would take on her responsibilities and continue to strive for digital growth moving forward.

What Dr. Shah wanted was to find a way to aid a community that was particularly vulnerable to COVID-19. An email from the Society of Critical Care Medicine (SCCM) started her on that path. She opened the message and clicked a link to help deliver critical care to Indigenous communities living on tribal lands through the Indian Health Service, a federally run health system under the U.S. Department of Health and Human Services.

During the first three months of the pandemic, American Indians and Alaska Natives had COVID-19 infection rates that were more than 3.5 times higher than non-Hispanic whites1 and had higher mortality rates at younger ages than non-Hispanic whites.2

The opportunity Dr. Shah signed up for did not materialize, but it sent her on a path that has her now providing critical care as well as improving technological health systems for these communities. In her current role, Dr. Shah leads an initiative with TribalEM to rapidly increase the Indian Health Service’s capacity to care for critically ill patients with COVID-19.

While Dr. Shah credits SCCM with exposing her to an opportunity to aid Native Americans during COVID-19, she also says SCCM is to thank for her ability to persuade others and be a team leader. Some of that leadership experience was cultivated while serving as an SCCM delegate to the American Medical Association, a role that has allowed her to act as a voice for thousands of constituents.

Now, more than a year since the pandemic began, Dr. Shah said the medical community has learned a number of lessons. They saw the value of having multiprofessional teams care for patients with COVID-19, and she thinks this is something critical care practitioners should continue to emphasize moving forward. Beyond that, her focus is the same as it was before the pandemic as she continues to explore new ways to use technology to help improve patient and clinician experience.

“There is a lot we can do to make our systems work for us as patients and as practitioners,” Dr. Shah said. “We learned how to do it in a crisis situation, and I want to be able to take that speed and now apply it to healthcare after the pandemic. My aim is to continue to use technology to connect the dots at the same speed as we did when we innovated during the pandemic.”

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Because nobody knows what will come next, SCCM needs your ongoing support to be ready when the next disaster, epidemic, or pandemic strikes. Please consider a donation of any size to help support SCCM’s work at home and around the world. SCCM’s global disaster response would not be possible without you!


References

  1. Hatcher SM, Agnew-Brune C, Anderson M, et al. COVID-19 Among American Indian and Alaska Native Persons — 23 States, January 31–July 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1166–1169. http://dx.doi.org/10.15585/mmwr.mm6934e1
  2. Arrazola J, Masiello MM, Joshi S, et al. COVID-19 Mortality Among American Indian and Alaska Native Persons — 14 States, January–June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1853–1856. http://dx.doi.org/10.15585/mmwr.mm6949a3


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