News From CHEST Physician®

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Education Category Finalist Dr. Cota.

Name: Donna Cota, DO

Institutional Affiliation: Baystate Medical Center, PGY5 Critical Care

Position: 2nd Year Fellow in PGY5 Critical Care



Title: Time to Vent: A Blended Learning Experience

Brief Summary of Submission: Time to Vent is a blended learning experience focused on ventilator management that incorporates modalities for all learning types. It includes a handout, audio/visual presentation, and practice case scenarios.



1. What inspired your innovation? I remembered that as a resident, I had a very difficult time understanding ventilators and worked hard to try to understand them on my own. When I started fellowship, I thought I understood ventilator management and then realized I was still wrong. I have focused my training on education, and I wanted to create a concise resource geared toward the fundamentals of ventilators for the benefit of educational levels.

2. Who do you think can benefit most from it, and why? Right now, I have focused the project on teaching residents of varying specialties, such as internal medicine and emergency medicine. They are still in training and rotate through ICUs, needing to understand ventilators for effective patient care and questions are present on their board examinations.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? The biggest challenge is making the website able to be found on Google. This is a work in progress. However, right now, the link is sent via email to interested parties.

4. Why was it meaningful for you to emerge as a finalist in FISH Bowl 2019? It built confidence that my lifelong project is important and has merit to it. And, it ended up becoming a way for people to learn about the project and ask me for the link.

5. What future do you envision for your innovation beyond FISH Bowl 2019? I am still going to continue to improve the project with current endeavors to include a piece on waveforms and dyssynchrony of the ventilator. My ultimate goal is to create a free virtual ventilator simulator with practice cases.

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Education Category Finalist Dr. Cota.

Name: Donna Cota, DO

Institutional Affiliation: Baystate Medical Center, PGY5 Critical Care

Position: 2nd Year Fellow in PGY5 Critical Care



Title: Time to Vent: A Blended Learning Experience

Brief Summary of Submission: Time to Vent is a blended learning experience focused on ventilator management that incorporates modalities for all learning types. It includes a handout, audio/visual presentation, and practice case scenarios.



1. What inspired your innovation? I remembered that as a resident, I had a very difficult time understanding ventilators and worked hard to try to understand them on my own. When I started fellowship, I thought I understood ventilator management and then realized I was still wrong. I have focused my training on education, and I wanted to create a concise resource geared toward the fundamentals of ventilators for the benefit of educational levels.

2. Who do you think can benefit most from it, and why? Right now, I have focused the project on teaching residents of varying specialties, such as internal medicine and emergency medicine. They are still in training and rotate through ICUs, needing to understand ventilators for effective patient care and questions are present on their board examinations.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? The biggest challenge is making the website able to be found on Google. This is a work in progress. However, right now, the link is sent via email to interested parties.

4. Why was it meaningful for you to emerge as a finalist in FISH Bowl 2019? It built confidence that my lifelong project is important and has merit to it. And, it ended up becoming a way for people to learn about the project and ask me for the link.

5. What future do you envision for your innovation beyond FISH Bowl 2019? I am still going to continue to improve the project with current endeavors to include a piece on waveforms and dyssynchrony of the ventilator. My ultimate goal is to create a free virtual ventilator simulator with practice cases.

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Education Category Finalist Dr. Cota.

Name: Donna Cota, DO

Institutional Affiliation: Baystate Medical Center, PGY5 Critical Care

Position: 2nd Year Fellow in PGY5 Critical Care



Title: Time to Vent: A Blended Learning Experience

Brief Summary of Submission: Time to Vent is a blended learning experience focused on ventilator management that incorporates modalities for all learning types. It includes a handout, audio/visual presentation, and practice case scenarios.



1. What inspired your innovation? I remembered that as a resident, I had a very difficult time understanding ventilators and worked hard to try to understand them on my own. When I started fellowship, I thought I understood ventilator management and then realized I was still wrong. I have focused my training on education, and I wanted to create a concise resource geared toward the fundamentals of ventilators for the benefit of educational levels.

2. Who do you think can benefit most from it, and why? Right now, I have focused the project on teaching residents of varying specialties, such as internal medicine and emergency medicine. They are still in training and rotate through ICUs, needing to understand ventilators for effective patient care and questions are present on their board examinations.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? The biggest challenge is making the website able to be found on Google. This is a work in progress. However, right now, the link is sent via email to interested parties.

4. Why was it meaningful for you to emerge as a finalist in FISH Bowl 2019? It built confidence that my lifelong project is important and has merit to it. And, it ended up becoming a way for people to learn about the project and ask me for the link.

5. What future do you envision for your innovation beyond FISH Bowl 2019? I am still going to continue to improve the project with current endeavors to include a piece on waveforms and dyssynchrony of the ventilator. My ultimate goal is to create a free virtual ventilator simulator with practice cases.

CHEST Annual Meeting 2020 will be here before you know it and we’re here to guide you through our Second City home, Chicago, Illinois. We’re so excited to be hosting CHEST 2020 in our backyard this year and want to help you experience everything that the city has to offer when you aren’t taking in the latest education in clinical chest medicine.

Whether you’re looking to embrace the culture, discover new shops, seeking entertainment, or just looking for a photo opportunity, we’ve got you covered. There’s something for everyone! Here are a few suggestions to keep you busy after your courses and sessions end.

Millennium Park Campus

Located in the heart of the city, Millennium Park is home to the Art Institute of Chicago, Cloud Gate (“The Bean”), Maggie Daley Park, Crown Fountain, Park Grill restaurant, and more. This is the perfect place to take a fall stroll this October. 

Cloud Gate (the bean)

Undoubtedly, one of Chicago’s most popular attractions, this reflective sculpture opposite of Millennium Park is a must for the perfect selfie. Don’t forget to bring your selfie stick to optimize your angles!

Field Museum

One of the largest history museums in the world, this space is filled with an extensive collection of artifacts and scientific-specimens, along with educational programs. Whether you’re interested in browsing through photo archives, taking a public tour, or strolling through the library of over 275,000 books, it would be easy to spend a few hours here during your breaks. (Kids will love it too!)

Wrigley Field Tours

The World Series is set to start during the meeting, fingers crossed the Cubs will be making a return to Wrigley Field. Regardless, you can still attend an off-season tour allowing you to visit the Visitors’ clubhouse, Cubs’ dugout, field, American Airlines 1914 Club, Maker’s Mark Barrel Room, and The W Club at the home of the Chicago Cubs.

Starbucks Reserve Roastery

While you’re strolling on Michigan Avenue, be sure to stop by the world’s largest Starbucks. Enjoy a latte while you take a tour of the roastery or even experience a master tasting.

Take a river boat tour

Embrace the outdoors by taking a scenic cruise on the Chicago River during a boat tour. Choose from tours that highlight architecture, classic Chicago spots, a dinner cruise, and more.

Skydeck Chicago

Take a step out on the Ledge during your stay in Chicago. Test your limits on the 103rd floor of the Willis Tower by stepping onto a glass platform 1,353 feet in the air. Skydeck Chicago also features museum-quality exhibits and theater presentation, Reaching For The Sky.

Navy Pier

Stretching more than 3,000 feet along the shoreline of Lake Michigan, Navy Pier offers access to parks, gardens, shops, dining experiences, live entertainment, and more. If you’re looking for an engaging experience for kids, Navy Pier is also home to the Chicago Children’s Museum.

Frank Lloyd Wright Tours

Wrap up your time in Chicago with the Wright Along the Lake tour, a half-day guided bus tour featuring some of Wright’s most iconic sites in Chicago. Tours are also available for select sites including the Frederick C. Robie House and the Rookery Light Court.

The Magnificent Mile

One of the most iconic shopping centers in the world, The Magnificent Mile stretches across downtown Michigan Avenue and features historic landmarks, more than 460 retailers, and more than 275 restaurants.

Don’t forget to bring your jacket for outdoor activities! They don’t call Chicago the Windy City for nothing.

We look forward to exploring clinical chest medicine and the city of Chicago with you at CHEST Annual Meeting 2020 in October. See you there!

CHEST Annual Meeting 2020 will be here before you know it and we’re here to guide you through our Second City home, Chicago, Illinois. We’re so excited to be hosting CHEST 2020 in our backyard this year and want to help you experience everything that the city has to offer when you aren’t taking in the latest education in clinical chest medicine.

Whether you’re looking to embrace the culture, discover new shops, seeking entertainment, or just looking for a photo opportunity, we’ve got you covered. There’s something for everyone! Here are a few suggestions to keep you busy after your courses and sessions end.

Millennium Park Campus

Located in the heart of the city, Millennium Park is home to the Art Institute of Chicago, Cloud Gate (“The Bean”), Maggie Daley Park, Crown Fountain, Park Grill restaurant, and more. This is the perfect place to take a fall stroll this October. 

Cloud Gate (the bean)

Undoubtedly, one of Chicago’s most popular attractions, this reflective sculpture opposite of Millennium Park is a must for the perfect selfie. Don’t forget to bring your selfie stick to optimize your angles!

Field Museum

One of the largest history museums in the world, this space is filled with an extensive collection of artifacts and scientific-specimens, along with educational programs. Whether you’re interested in browsing through photo archives, taking a public tour, or strolling through the library of over 275,000 books, it would be easy to spend a few hours here during your breaks. (Kids will love it too!)

Wrigley Field Tours

The World Series is set to start during the meeting, fingers crossed the Cubs will be making a return to Wrigley Field. Regardless, you can still attend an off-season tour allowing you to visit the Visitors’ clubhouse, Cubs’ dugout, field, American Airlines 1914 Club, Maker’s Mark Barrel Room, and The W Club at the home of the Chicago Cubs.

Starbucks Reserve Roastery

While you’re strolling on Michigan Avenue, be sure to stop by the world’s largest Starbucks. Enjoy a latte while you take a tour of the roastery or even experience a master tasting.

Take a river boat tour

Embrace the outdoors by taking a scenic cruise on the Chicago River during a boat tour. Choose from tours that highlight architecture, classic Chicago spots, a dinner cruise, and more.

Skydeck Chicago

Take a step out on the Ledge during your stay in Chicago. Test your limits on the 103rd floor of the Willis Tower by stepping onto a glass platform 1,353 feet in the air. Skydeck Chicago also features museum-quality exhibits and theater presentation, Reaching For The Sky.

Navy Pier

Stretching more than 3,000 feet along the shoreline of Lake Michigan, Navy Pier offers access to parks, gardens, shops, dining experiences, live entertainment, and more. If you’re looking for an engaging experience for kids, Navy Pier is also home to the Chicago Children’s Museum.

Frank Lloyd Wright Tours

Wrap up your time in Chicago with the Wright Along the Lake tour, a half-day guided bus tour featuring some of Wright’s most iconic sites in Chicago. Tours are also available for select sites including the Frederick C. Robie House and the Rookery Light Court.

The Magnificent Mile

One of the most iconic shopping centers in the world, The Magnificent Mile stretches across downtown Michigan Avenue and features historic landmarks, more than 460 retailers, and more than 275 restaurants.

Don’t forget to bring your jacket for outdoor activities! They don’t call Chicago the Windy City for nothing.

We look forward to exploring clinical chest medicine and the city of Chicago with you at CHEST Annual Meeting 2020 in October. See you there!

CHEST Annual Meeting 2020 will be here before you know it and we’re here to guide you through our Second City home, Chicago, Illinois. We’re so excited to be hosting CHEST 2020 in our backyard this year and want to help you experience everything that the city has to offer when you aren’t taking in the latest education in clinical chest medicine.

Whether you’re looking to embrace the culture, discover new shops, seeking entertainment, or just looking for a photo opportunity, we’ve got you covered. There’s something for everyone! Here are a few suggestions to keep you busy after your courses and sessions end.

Millennium Park Campus

Located in the heart of the city, Millennium Park is home to the Art Institute of Chicago, Cloud Gate (“The Bean”), Maggie Daley Park, Crown Fountain, Park Grill restaurant, and more. This is the perfect place to take a fall stroll this October. 

Cloud Gate (the bean)

Undoubtedly, one of Chicago’s most popular attractions, this reflective sculpture opposite of Millennium Park is a must for the perfect selfie. Don’t forget to bring your selfie stick to optimize your angles!

Field Museum

One of the largest history museums in the world, this space is filled with an extensive collection of artifacts and scientific-specimens, along with educational programs. Whether you’re interested in browsing through photo archives, taking a public tour, or strolling through the library of over 275,000 books, it would be easy to spend a few hours here during your breaks. (Kids will love it too!)

Wrigley Field Tours

The World Series is set to start during the meeting, fingers crossed the Cubs will be making a return to Wrigley Field. Regardless, you can still attend an off-season tour allowing you to visit the Visitors’ clubhouse, Cubs’ dugout, field, American Airlines 1914 Club, Maker’s Mark Barrel Room, and The W Club at the home of the Chicago Cubs.

Starbucks Reserve Roastery

While you’re strolling on Michigan Avenue, be sure to stop by the world’s largest Starbucks. Enjoy a latte while you take a tour of the roastery or even experience a master tasting.

Take a river boat tour

Embrace the outdoors by taking a scenic cruise on the Chicago River during a boat tour. Choose from tours that highlight architecture, classic Chicago spots, a dinner cruise, and more.

Skydeck Chicago

Take a step out on the Ledge during your stay in Chicago. Test your limits on the 103rd floor of the Willis Tower by stepping onto a glass platform 1,353 feet in the air. Skydeck Chicago also features museum-quality exhibits and theater presentation, Reaching For The Sky.

Navy Pier

Stretching more than 3,000 feet along the shoreline of Lake Michigan, Navy Pier offers access to parks, gardens, shops, dining experiences, live entertainment, and more. If you’re looking for an engaging experience for kids, Navy Pier is also home to the Chicago Children’s Museum.

Frank Lloyd Wright Tours

Wrap up your time in Chicago with the Wright Along the Lake tour, a half-day guided bus tour featuring some of Wright’s most iconic sites in Chicago. Tours are also available for select sites including the Frederick C. Robie House and the Rookery Light Court.

The Magnificent Mile

One of the most iconic shopping centers in the world, The Magnificent Mile stretches across downtown Michigan Avenue and features historic landmarks, more than 460 retailers, and more than 275 restaurants.

Don’t forget to bring your jacket for outdoor activities! They don’t call Chicago the Windy City for nothing.

We look forward to exploring clinical chest medicine and the city of Chicago with you at CHEST Annual Meeting 2020 in October. See you there!

On Thursday, March 12, The American College of Chest Physicians (CHEST) and the National Association for Medical Direction of Respiratory Care (NAMDRC) announced publicly our official intent to come together as one association, integrating all NAMDRC activities and operations into CHEST.

This integration launch followed months of discussion between CHEST and NAMDRC leadership. Our respective Boards agreed that united efforts will amplify our individual involvement in patient advocacy and policy.

CHEST and NAMDRC have an intertwined purpose of delivering the highest standard of care for our patients. For this reason, our likeminded advocacy agendas can be even better fulfilled when we can leverage strengths from both associations.

CHEST and NAMDRC have shared an overlapping membership and collaborative history of empowering patients through the advancement of public policy and clinical education for decades. In additional to our individual efforts, our associations historically leveraged a combined advocacy presence in Washington D.C. to advance legislation against major tobacco corporations.

Coming together as a joint advocacy-focused organization, the initiation of CHEST’s Health Policy and Advocacy Committee, which will be comprised of an equal selection of CHEST and NAMDRC leadership, will drive CHEST’s advocacy agenda. The committee will work directly with policymakers, and target legislative and regulatory issues impacting pulmonary, critical care, and sleep medicine.

A committee of this kind, dedicated strictly to advocacy efforts, will be absolutely invaluable to our united organization. This group will be a true asset for membership to turn, to voice concerns within our practice, and to direct action on policies that matter to our patients.

Members of both organizations were notified of the integration by email on Wednesday, March 11. Along with email notification, NAMDRC members also received a voting ballot, as the dissolution of a nonprofit organization for Virginia-based organizations requires a vote of approval by membership within a 25-day waiting period.

NAMDRC’s long regarded monthly publication, Washington Watchline, will continue through CHEST, as will the NAMDRC Annual Meeting, slated for next March 18-20, 2021 in Sonoma, California, in conjunction with the CHEST Spring Leadership Meeting.

Concentrating our efforts under one organization allows us offer the best possible opportunities to our membership, patients, and far-reaching network. This is an exciting time for everyone involved, and we are looking forward to seeing all we can accomplish together.

On Thursday, March 12, The American College of Chest Physicians (CHEST) and the National Association for Medical Direction of Respiratory Care (NAMDRC) announced publicly our official intent to come together as one association, integrating all NAMDRC activities and operations into CHEST.

This integration launch followed months of discussion between CHEST and NAMDRC leadership. Our respective Boards agreed that united efforts will amplify our individual involvement in patient advocacy and policy.

CHEST and NAMDRC have an intertwined purpose of delivering the highest standard of care for our patients. For this reason, our likeminded advocacy agendas can be even better fulfilled when we can leverage strengths from both associations.

CHEST and NAMDRC have shared an overlapping membership and collaborative history of empowering patients through the advancement of public policy and clinical education for decades. In additional to our individual efforts, our associations historically leveraged a combined advocacy presence in Washington D.C. to advance legislation against major tobacco corporations.

Coming together as a joint advocacy-focused organization, the initiation of CHEST’s Health Policy and Advocacy Committee, which will be comprised of an equal selection of CHEST and NAMDRC leadership, will drive CHEST’s advocacy agenda. The committee will work directly with policymakers, and target legislative and regulatory issues impacting pulmonary, critical care, and sleep medicine.

A committee of this kind, dedicated strictly to advocacy efforts, will be absolutely invaluable to our united organization. This group will be a true asset for membership to turn, to voice concerns within our practice, and to direct action on policies that matter to our patients.

Members of both organizations were notified of the integration by email on Wednesday, March 11. Along with email notification, NAMDRC members also received a voting ballot, as the dissolution of a nonprofit organization for Virginia-based organizations requires a vote of approval by membership within a 25-day waiting period.

NAMDRC’s long regarded monthly publication, Washington Watchline, will continue through CHEST, as will the NAMDRC Annual Meeting, slated for next March 18-20, 2021 in Sonoma, California, in conjunction with the CHEST Spring Leadership Meeting.

Concentrating our efforts under one organization allows us offer the best possible opportunities to our membership, patients, and far-reaching network. This is an exciting time for everyone involved, and we are looking forward to seeing all we can accomplish together.

On Thursday, March 12, The American College of Chest Physicians (CHEST) and the National Association for Medical Direction of Respiratory Care (NAMDRC) announced publicly our official intent to come together as one association, integrating all NAMDRC activities and operations into CHEST.

This integration launch followed months of discussion between CHEST and NAMDRC leadership. Our respective Boards agreed that united efforts will amplify our individual involvement in patient advocacy and policy.

CHEST and NAMDRC have an intertwined purpose of delivering the highest standard of care for our patients. For this reason, our likeminded advocacy agendas can be even better fulfilled when we can leverage strengths from both associations.

CHEST and NAMDRC have shared an overlapping membership and collaborative history of empowering patients through the advancement of public policy and clinical education for decades. In additional to our individual efforts, our associations historically leveraged a combined advocacy presence in Washington D.C. to advance legislation against major tobacco corporations.

Coming together as a joint advocacy-focused organization, the initiation of CHEST’s Health Policy and Advocacy Committee, which will be comprised of an equal selection of CHEST and NAMDRC leadership, will drive CHEST’s advocacy agenda. The committee will work directly with policymakers, and target legislative and regulatory issues impacting pulmonary, critical care, and sleep medicine.

A committee of this kind, dedicated strictly to advocacy efforts, will be absolutely invaluable to our united organization. This group will be a true asset for membership to turn, to voice concerns within our practice, and to direct action on policies that matter to our patients.

Members of both organizations were notified of the integration by email on Wednesday, March 11. Along with email notification, NAMDRC members also received a voting ballot, as the dissolution of a nonprofit organization for Virginia-based organizations requires a vote of approval by membership within a 25-day waiting period.

NAMDRC’s long regarded monthly publication, Washington Watchline, will continue through CHEST, as will the NAMDRC Annual Meeting, slated for next March 18-20, 2021 in Sonoma, California, in conjunction with the CHEST Spring Leadership Meeting.

Concentrating our efforts under one organization allows us offer the best possible opportunities to our membership, patients, and far-reaching network. This is an exciting time for everyone involved, and we are looking forward to seeing all we can accomplish together.

Editor’s Picks

Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR). By Dr. D. B. Price, et al.

Validation of the COPD Assessment Test (CAT) as an outcome measure in bronchiectasis. By Dr. J. D. Chalmers, et al.

Comparative effects of LAMA-LABA-ICS versus LAMA-LABA for COPD: Cohort study in real world clinical practice. By Dr. S. Suissa, et al.

Airway Management in Critical Illness: An Update. By Dr. J. Scott, et al.

Extremes of age decrease survival in adults after lung transplant. By Dr. M. Valapour, et al.

Editor’s Picks

Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR). By Dr. D. B. Price, et al.

Validation of the COPD Assessment Test (CAT) as an outcome measure in bronchiectasis. By Dr. J. D. Chalmers, et al.

Comparative effects of LAMA-LABA-ICS versus LAMA-LABA for COPD: Cohort study in real world clinical practice. By Dr. S. Suissa, et al.

Airway Management in Critical Illness: An Update. By Dr. J. Scott, et al.

Extremes of age decrease survival in adults after lung transplant. By Dr. M. Valapour, et al.

Editor’s Picks

Characterization of severe asthma worldwide: data from the International Severe Asthma Registry (ISAR). By Dr. D. B. Price, et al.

Validation of the COPD Assessment Test (CAT) as an outcome measure in bronchiectasis. By Dr. J. D. Chalmers, et al.

Comparative effects of LAMA-LABA-ICS versus LAMA-LABA for COPD: Cohort study in real world clinical practice. By Dr. S. Suissa, et al.

Airway Management in Critical Illness: An Update. By Dr. J. Scott, et al.

Extremes of age decrease survival in adults after lung transplant. By Dr. M. Valapour, et al.

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.

Original Research

Safety and Effectiveness of Bronchial Thermoplasty When FEV1 Is Less Than 50%.
By Dr. D. Langton, et al.

Utilization and Outcomes of Thrombolytic Therapy for Acute Pulmonary Embolism: A Nationwide Cohort Study.
By S. E. Beyer, et al.

An Individualized Prediction Model for Long-term Lung Function Trajectory and Risk of COPD in the General Population.
By Dr. W. Chen, et al.

CHEST Review

Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement.
By Dr. P. Agarwala, et al.
 

How I Do It

An Algorithmic Approach to the Interpretation of Diffuse Lung Disease on Chest CT Imaging: A Theory of Almost Everything.
By Dr. J. F. Gruden, et al.








 

Original Research

Safety and Effectiveness of Bronchial Thermoplasty When FEV1 Is Less Than 50%.
By Dr. D. Langton, et al.

Utilization and Outcomes of Thrombolytic Therapy for Acute Pulmonary Embolism: A Nationwide Cohort Study.
By S. E. Beyer, et al.

An Individualized Prediction Model for Long-term Lung Function Trajectory and Risk of COPD in the General Population.
By Dr. W. Chen, et al.

CHEST Review

Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement.
By Dr. P. Agarwala, et al.
 

How I Do It

An Algorithmic Approach to the Interpretation of Diffuse Lung Disease on Chest CT Imaging: A Theory of Almost Everything.
By Dr. J. F. Gruden, et al.








 

Original Research

Safety and Effectiveness of Bronchial Thermoplasty When FEV1 Is Less Than 50%.
By Dr. D. Langton, et al.

Utilization and Outcomes of Thrombolytic Therapy for Acute Pulmonary Embolism: A Nationwide Cohort Study.
By S. E. Beyer, et al.

An Individualized Prediction Model for Long-term Lung Function Trajectory and Risk of COPD in the General Population.
By Dr. W. Chen, et al.

CHEST Review

Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement.
By Dr. P. Agarwala, et al.
 

How I Do It

An Algorithmic Approach to the Interpretation of Diffuse Lung Disease on Chest CT Imaging: A Theory of Almost Everything.
By Dr. J. F. Gruden, et al.








 

The first quarterly meeting of your CHEST Board of Regents for the 2019-2020 CHEST year occurred from January 30 to February 1. We were welcomed to Coronado, California, by CHEST's new President Stephanie M. Levine, MD, FCCP, who began by reviewing the success of the CHEST 2019 Annual Meeting. The meeting had both the highest attendance of medical professionals and the highest total attendance in CHEST history, as well as CHEST's largest Fellow-in-Training attendance. There was also a significant increase in the number of international colleagues who attended the meeting. Dr. Levine next reported on upcoming CHEST activities including six live-learning courses scheduled to occur before May, the CHEST Congress in collaboration with the Italian delegation in Bologna, Italy in June, ongoing planning for CHEST 2020, the next volume of SEEK Critical Care and two additional cough guidelines. 
 

The first quarterly meeting of your CHEST Board of Regents for the 2019-2020 CHEST year occurred from January 30 to February 1. We were welcomed to Coronado, California, by CHEST's new President Stephanie M. Levine, MD, FCCP, who began by reviewing the success of the CHEST 2019 Annual Meeting. The meeting had both the highest attendance of medical professionals and the highest total attendance in CHEST history, as well as CHEST's largest Fellow-in-Training attendance. There was also a significant increase in the number of international colleagues who attended the meeting. Dr. Levine next reported on upcoming CHEST activities including six live-learning courses scheduled to occur before May, the CHEST Congress in collaboration with the Italian delegation in Bologna, Italy in June, ongoing planning for CHEST 2020, the next volume of SEEK Critical Care and two additional cough guidelines. 
 

The first quarterly meeting of your CHEST Board of Regents for the 2019-2020 CHEST year occurred from January 30 to February 1. We were welcomed to Coronado, California, by CHEST's new President Stephanie M. Levine, MD, FCCP, who began by reviewing the success of the CHEST 2019 Annual Meeting. The meeting had both the highest attendance of medical professionals and the highest total attendance in CHEST history, as well as CHEST's largest Fellow-in-Training attendance. There was also a significant increase in the number of international colleagues who attended the meeting. Dr. Levine next reported on upcoming CHEST activities including six live-learning courses scheduled to occur before May, the CHEST Congress in collaboration with the Italian delegation in Bologna, Italy in June, ongoing planning for CHEST 2020, the next volume of SEEK Critical Care and two additional cough guidelines.