Society News

There is no denying that over the last few months, the world has become a very different and uncertain place. We all are slowly adjusting to our new “normal” and whether it has been through longer and more grueling hours, volunteering in areas of greater need, or switching your practice to function through an online platform, I commend you for the extra time, focus, and energy you have undoubtedly put into your everyday patient care routines throughout the pandemic.

There have been a lot of questions coming in about what the plan is for CHEST Annual Meeting 2020 in October. Will we be able to gather in large groups at that time? Will there be alternative education options if some are unable to travel to Chicago, Illinois, due to travel restrictions or an increased workload? What is our plan?

As the Program Chair of this year’s meeting, and as a practicing pulmonary and critical care physician, I will be honest with you. There is still a lot of unknown. We cannot confidently say what the world will look like come October. We do not know what travel restrictions will still be in place, or if any new ones will have been implemented. We do not know what the volume of COVID-19 cases will be at that point in time. But, we do know that the community of clinical professionals that has grown at previous CHEST Annual Meetings, and at other live CHEST education courses, is eager for an opportunity to once again connect with their peers, make new connections, and learn in new ways at the premier event in clinical pulmonary, critical care, and sleep medicine. Not forgetting, that now, more than ever, colleagues outside of our specialties are looking for the education that CHEST has to offer in management of coagulation and ARDS, and more.

I do not have all of the answers, but I do know that the staff at CHEST Global Headquarters are working tirelessly to build a meeting that is at present, still planned to take place in Chicago, but that also will be translated onto an online platform that will allow for anyone and everyone to participate, either in person or online. The CHEST team is working closely with our Scientific Program Committee to produce an innovative meeting with live interactive education, networking events, CHEST Games, and so much more.

Here at CHEST, the hope is to create a “light at the end of the tunnel,” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field. CHEST leadership and staff are continually monitoring the pandemic, weighing the shifting trajectory of the infection and infection control measures implemented nationally and locally, while ensuring that we have flexible offerings available to meet your short- and long-term educational needs.

There will be more updates available in the coming months, so I encourage you to visit chestmeeting.chestnet.org to stay up to date. I am looking forward to seeing the great community of clinical professionals at CHEST Annual Meeting 2020, this October 17-21, whether it is in-person, or online.

Best,

Victor Test, MD, FCCP

There is no denying that over the last few months, the world has become a very different and uncertain place. We all are slowly adjusting to our new “normal” and whether it has been through longer and more grueling hours, volunteering in areas of greater need, or switching your practice to function through an online platform, I commend you for the extra time, focus, and energy you have undoubtedly put into your everyday patient care routines throughout the pandemic.

There have been a lot of questions coming in about what the plan is for CHEST Annual Meeting 2020 in October. Will we be able to gather in large groups at that time? Will there be alternative education options if some are unable to travel to Chicago, Illinois, due to travel restrictions or an increased workload? What is our plan?

As the Program Chair of this year’s meeting, and as a practicing pulmonary and critical care physician, I will be honest with you. There is still a lot of unknown. We cannot confidently say what the world will look like come October. We do not know what travel restrictions will still be in place, or if any new ones will have been implemented. We do not know what the volume of COVID-19 cases will be at that point in time. But, we do know that the community of clinical professionals that has grown at previous CHEST Annual Meetings, and at other live CHEST education courses, is eager for an opportunity to once again connect with their peers, make new connections, and learn in new ways at the premier event in clinical pulmonary, critical care, and sleep medicine. Not forgetting, that now, more than ever, colleagues outside of our specialties are looking for the education that CHEST has to offer in management of coagulation and ARDS, and more.

I do not have all of the answers, but I do know that the staff at CHEST Global Headquarters are working tirelessly to build a meeting that is at present, still planned to take place in Chicago, but that also will be translated onto an online platform that will allow for anyone and everyone to participate, either in person or online. The CHEST team is working closely with our Scientific Program Committee to produce an innovative meeting with live interactive education, networking events, CHEST Games, and so much more.

Here at CHEST, the hope is to create a “light at the end of the tunnel,” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field. CHEST leadership and staff are continually monitoring the pandemic, weighing the shifting trajectory of the infection and infection control measures implemented nationally and locally, while ensuring that we have flexible offerings available to meet your short- and long-term educational needs.

There will be more updates available in the coming months, so I encourage you to visit chestmeeting.chestnet.org to stay up to date. I am looking forward to seeing the great community of clinical professionals at CHEST Annual Meeting 2020, this October 17-21, whether it is in-person, or online.

Best,

Victor Test, MD, FCCP

There is no denying that over the last few months, the world has become a very different and uncertain place. We all are slowly adjusting to our new “normal” and whether it has been through longer and more grueling hours, volunteering in areas of greater need, or switching your practice to function through an online platform, I commend you for the extra time, focus, and energy you have undoubtedly put into your everyday patient care routines throughout the pandemic.

There have been a lot of questions coming in about what the plan is for CHEST Annual Meeting 2020 in October. Will we be able to gather in large groups at that time? Will there be alternative education options if some are unable to travel to Chicago, Illinois, due to travel restrictions or an increased workload? What is our plan?

As the Program Chair of this year’s meeting, and as a practicing pulmonary and critical care physician, I will be honest with you. There is still a lot of unknown. We cannot confidently say what the world will look like come October. We do not know what travel restrictions will still be in place, or if any new ones will have been implemented. We do not know what the volume of COVID-19 cases will be at that point in time. But, we do know that the community of clinical professionals that has grown at previous CHEST Annual Meetings, and at other live CHEST education courses, is eager for an opportunity to once again connect with their peers, make new connections, and learn in new ways at the premier event in clinical pulmonary, critical care, and sleep medicine. Not forgetting, that now, more than ever, colleagues outside of our specialties are looking for the education that CHEST has to offer in management of coagulation and ARDS, and more.

I do not have all of the answers, but I do know that the staff at CHEST Global Headquarters are working tirelessly to build a meeting that is at present, still planned to take place in Chicago, but that also will be translated onto an online platform that will allow for anyone and everyone to participate, either in person or online. The CHEST team is working closely with our Scientific Program Committee to produce an innovative meeting with live interactive education, networking events, CHEST Games, and so much more.

Here at CHEST, the hope is to create a “light at the end of the tunnel,” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field. CHEST leadership and staff are continually monitoring the pandemic, weighing the shifting trajectory of the infection and infection control measures implemented nationally and locally, while ensuring that we have flexible offerings available to meet your short- and long-term educational needs.

There will be more updates available in the coming months, so I encourage you to visit chestmeeting.chestnet.org to stay up to date. I am looking forward to seeing the great community of clinical professionals at CHEST Annual Meeting 2020, this October 17-21, whether it is in-person, or online.

Best,

Victor Test, MD, FCCP

CHEST is known for innovative learning. This stems from an appetite for experimentation, a highly engaged membership, strong volunteer leaders, and a responsive staff. We are leaders in gaming, simulation, and hands-on and applied learning, and we’re best in class in key areas – namely our annual conference – that demonstrate organizational responsiveness.

I serve as Chief Learning Officer and Senior Vice President of Education and have been with CHEST for nearly a year. I was drawn to CHEST for its strong mission and look forward to sharing ideas for how we can develop and deliver learning in a changed world.

The charge for developing an organization-wide learning strategy comes from the CHEST Board and Robert Musacchio, PhD, CHEST CEO and Executive Vice President, and it is reflected in an ambitious strategic statement that links our shared direction to broad-based growth through expansion of our clinical audience and reach, resulting in an increased ability to improve the lives of patients.

CHEST will crush lung disease by creating exceptional educational experiences relevant to clinicians, patients, caregivers, and industry, applying our trusted brand and data and employing our highly respected staff and volunteers with clinical expertise.

To meet this challenge, we gathered insights from across the membership and identified that our learning strategy should be built on the three anchors of choice:

• Choice – Emphasizes easy-to-find learning that adapts to learner need through engagement, pathways, and social interaction. This is known as personalized learning.
• Responsiveness – Combines our ability to understand and respond to learners with new and enhanced programs, products, and learning experiences.
• Connection – Provides learners with immediate, longitudinal, and engaging communities to maximize their connection to CHEST over the length of their career.

The coronavirus pandemic requires us to come together as a community and further our focus. Our values remain unchanged: to meet our learners where they are. Now, more than ever, that means we need to deliver CHEST learning with an emphasis on digital. Three areas make up CHEST digital learning: virtual programming, e-learning, and game-based learning. Some concrete examples of what you can expect:

• We are currently preparing and will be prepared to deliver virtual versions of our Annual Conference and Board Review (should either event not run in-person).
• We will release a game hub called Arcades this summer, which will allow for you to access our games online.
• We continue to enhance the offerings available in our e-learning subscription.
• We continue to release fresh educational content on the CHEST COVID-19 site.

CHEST is known for innovative learning. This stems from an appetite for experimentation, a highly engaged membership, strong volunteer leaders, and a responsive staff. We are leaders in gaming, simulation, and hands-on and applied learning, and we’re best in class in key areas – namely our annual conference – that demonstrate organizational responsiveness.

I serve as Chief Learning Officer and Senior Vice President of Education and have been with CHEST for nearly a year. I was drawn to CHEST for its strong mission and look forward to sharing ideas for how we can develop and deliver learning in a changed world.

The charge for developing an organization-wide learning strategy comes from the CHEST Board and Robert Musacchio, PhD, CHEST CEO and Executive Vice President, and it is reflected in an ambitious strategic statement that links our shared direction to broad-based growth through expansion of our clinical audience and reach, resulting in an increased ability to improve the lives of patients.

CHEST will crush lung disease by creating exceptional educational experiences relevant to clinicians, patients, caregivers, and industry, applying our trusted brand and data and employing our highly respected staff and volunteers with clinical expertise.

To meet this challenge, we gathered insights from across the membership and identified that our learning strategy should be built on the three anchors of choice:

• Choice – Emphasizes easy-to-find learning that adapts to learner need through engagement, pathways, and social interaction. This is known as personalized learning.
• Responsiveness – Combines our ability to understand and respond to learners with new and enhanced programs, products, and learning experiences.
• Connection – Provides learners with immediate, longitudinal, and engaging communities to maximize their connection to CHEST over the length of their career.

The coronavirus pandemic requires us to come together as a community and further our focus. Our values remain unchanged: to meet our learners where they are. Now, more than ever, that means we need to deliver CHEST learning with an emphasis on digital. Three areas make up CHEST digital learning: virtual programming, e-learning, and game-based learning. Some concrete examples of what you can expect:

• We are currently preparing and will be prepared to deliver virtual versions of our Annual Conference and Board Review (should either event not run in-person).
• We will release a game hub called Arcades this summer, which will allow for you to access our games online.
• We continue to enhance the offerings available in our e-learning subscription.
• We continue to release fresh educational content on the CHEST COVID-19 site.

CHEST is known for innovative learning. This stems from an appetite for experimentation, a highly engaged membership, strong volunteer leaders, and a responsive staff. We are leaders in gaming, simulation, and hands-on and applied learning, and we’re best in class in key areas – namely our annual conference – that demonstrate organizational responsiveness.

I serve as Chief Learning Officer and Senior Vice President of Education and have been with CHEST for nearly a year. I was drawn to CHEST for its strong mission and look forward to sharing ideas for how we can develop and deliver learning in a changed world.

The charge for developing an organization-wide learning strategy comes from the CHEST Board and Robert Musacchio, PhD, CHEST CEO and Executive Vice President, and it is reflected in an ambitious strategic statement that links our shared direction to broad-based growth through expansion of our clinical audience and reach, resulting in an increased ability to improve the lives of patients.

CHEST will crush lung disease by creating exceptional educational experiences relevant to clinicians, patients, caregivers, and industry, applying our trusted brand and data and employing our highly respected staff and volunteers with clinical expertise.

To meet this challenge, we gathered insights from across the membership and identified that our learning strategy should be built on the three anchors of choice:

• Choice – Emphasizes easy-to-find learning that adapts to learner need through engagement, pathways, and social interaction. This is known as personalized learning.
• Responsiveness – Combines our ability to understand and respond to learners with new and enhanced programs, products, and learning experiences.
• Connection – Provides learners with immediate, longitudinal, and engaging communities to maximize their connection to CHEST over the length of their career.

The coronavirus pandemic requires us to come together as a community and further our focus. Our values remain unchanged: to meet our learners where they are. Now, more than ever, that means we need to deliver CHEST learning with an emphasis on digital. Three areas make up CHEST digital learning: virtual programming, e-learning, and game-based learning. Some concrete examples of what you can expect:

• We are currently preparing and will be prepared to deliver virtual versions of our Annual Conference and Board Review (should either event not run in-person).
• We will release a game hub called Arcades this summer, which will allow for you to access our games online.
• We continue to enhance the offerings available in our e-learning subscription.
• We continue to release fresh educational content on the CHEST COVID-19 site.

Registration for CHEST Annual Meeting 2020 has opened! It is important now, more than ever, to stay up to date in clinical chest education. CHEST Annual Meeting is prepared to equip attendees with the latest education and original research in the field that can be taken back home and implemented into practices.

While CHEST is excited to bring the premier event in clinical chest medicine to their Second City Home of Chicago, Illinois, this October 17-21, it is understood that now may not be the best time to be planning for a conference that is 6 months down the road. Currently, your full attention is likely on your patients, your families, your health, and your safety, and it should be! Here at CHEST, the hope is to create a “light at the end of the tunnel” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field.

This year’s annual meeting will be filled with both new and returning educational opportunities, including CHEST Games; virtual patient tours; hands-on simulation courses; problem-based learning; and the return of FISH Bowl, an innovation competition. Along with the advanced education, there will be countless opportunities to network at after-hour events, such as the CHEST Challenge final competition, the Young Professionals Reception, and the CHEST Foundation Casino Night. Our hope is that you will be able to look ahead to October and be excited about the chance to experience everything that will be offered at CHEST 2020.

Before the meeting in October, don’t forget to submit your abstracts and case reports for consideration to be presented at CHEST 2020. CHEST is excited to give you and your colleagues the opportunity to present new and original research at this year’s meeting, which is why the deadline for submissions has been extended to June 1, 2020.

CHEST acknowledges that your workload is becoming increasingly heavier each day, and we are also making the safety of attendees the top priority.

That is why CHEST will be granting full refunds to any registrant who finds that they can no longer attend CHEST 2020 as the meeting approaches. Any hotel reservation that is made through CHEST’s official housing site, onPeak, will be able to be changed or canceled up to 24 hours in advance of the reservation date. Visit chestmeeting.chestnet.org/hotel-accommodations for more information.

CHEST 2020 meeting chair, Victor Test, MD, FCCP, hopes to leave CHEST learners with a beacon of hope, saying, “Signing up to come to the meeting and participating may seem impossible to think about right now. We are working hard to provide a high-quality experience and are encouraging everyone to look forward to the future, which will be a lot brighter.”

For all of the latest information on CHEST 2020, visit chestmeeting.chestnet.org.

Registration for CHEST Annual Meeting 2020 has opened! It is important now, more than ever, to stay up to date in clinical chest education. CHEST Annual Meeting is prepared to equip attendees with the latest education and original research in the field that can be taken back home and implemented into practices.

While CHEST is excited to bring the premier event in clinical chest medicine to their Second City Home of Chicago, Illinois, this October 17-21, it is understood that now may not be the best time to be planning for a conference that is 6 months down the road. Currently, your full attention is likely on your patients, your families, your health, and your safety, and it should be! Here at CHEST, the hope is to create a “light at the end of the tunnel” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field.

This year’s annual meeting will be filled with both new and returning educational opportunities, including CHEST Games; virtual patient tours; hands-on simulation courses; problem-based learning; and the return of FISH Bowl, an innovation competition. Along with the advanced education, there will be countless opportunities to network at after-hour events, such as the CHEST Challenge final competition, the Young Professionals Reception, and the CHEST Foundation Casino Night. Our hope is that you will be able to look ahead to October and be excited about the chance to experience everything that will be offered at CHEST 2020.

Before the meeting in October, don’t forget to submit your abstracts and case reports for consideration to be presented at CHEST 2020. CHEST is excited to give you and your colleagues the opportunity to present new and original research at this year’s meeting, which is why the deadline for submissions has been extended to June 1, 2020.

CHEST acknowledges that your workload is becoming increasingly heavier each day, and we are also making the safety of attendees the top priority.

That is why CHEST will be granting full refunds to any registrant who finds that they can no longer attend CHEST 2020 as the meeting approaches. Any hotel reservation that is made through CHEST’s official housing site, onPeak, will be able to be changed or canceled up to 24 hours in advance of the reservation date. Visit chestmeeting.chestnet.org/hotel-accommodations for more information.

CHEST 2020 meeting chair, Victor Test, MD, FCCP, hopes to leave CHEST learners with a beacon of hope, saying, “Signing up to come to the meeting and participating may seem impossible to think about right now. We are working hard to provide a high-quality experience and are encouraging everyone to look forward to the future, which will be a lot brighter.”

For all of the latest information on CHEST 2020, visit chestmeeting.chestnet.org.

Registration for CHEST Annual Meeting 2020 has opened! It is important now, more than ever, to stay up to date in clinical chest education. CHEST Annual Meeting is prepared to equip attendees with the latest education and original research in the field that can be taken back home and implemented into practices.

While CHEST is excited to bring the premier event in clinical chest medicine to their Second City Home of Chicago, Illinois, this October 17-21, it is understood that now may not be the best time to be planning for a conference that is 6 months down the road. Currently, your full attention is likely on your patients, your families, your health, and your safety, and it should be! Here at CHEST, the hope is to create a “light at the end of the tunnel” to give you and your colleagues something to look forward to – an opportunity to relax, learn, explore, and reconnect with your peers in the chest medicine field.

This year’s annual meeting will be filled with both new and returning educational opportunities, including CHEST Games; virtual patient tours; hands-on simulation courses; problem-based learning; and the return of FISH Bowl, an innovation competition. Along with the advanced education, there will be countless opportunities to network at after-hour events, such as the CHEST Challenge final competition, the Young Professionals Reception, and the CHEST Foundation Casino Night. Our hope is that you will be able to look ahead to October and be excited about the chance to experience everything that will be offered at CHEST 2020.

Before the meeting in October, don’t forget to submit your abstracts and case reports for consideration to be presented at CHEST 2020. CHEST is excited to give you and your colleagues the opportunity to present new and original research at this year’s meeting, which is why the deadline for submissions has been extended to June 1, 2020.

CHEST acknowledges that your workload is becoming increasingly heavier each day, and we are also making the safety of attendees the top priority.

That is why CHEST will be granting full refunds to any registrant who finds that they can no longer attend CHEST 2020 as the meeting approaches. Any hotel reservation that is made through CHEST’s official housing site, onPeak, will be able to be changed or canceled up to 24 hours in advance of the reservation date. Visit chestmeeting.chestnet.org/hotel-accommodations for more information.

CHEST 2020 meeting chair, Victor Test, MD, FCCP, hopes to leave CHEST learners with a beacon of hope, saying, “Signing up to come to the meeting and participating may seem impossible to think about right now. We are working hard to provide a high-quality experience and are encouraging everyone to look forward to the future, which will be a lot brighter.”

For all of the latest information on CHEST 2020, visit chestmeeting.chestnet.org.

Fighting the novel coronavirus together with you. By Dr. J. Li. 
 
Comparative Safety and Effectiveness of Inhaled Corticosteroid and Long-Acting Beta2-AgonistCombinations in Patients With COPD.By Dr. T-U Chang, et al. 
 
The Evolving Landscape of e-Cigarettes: A Systematic Review of Recent Evidence. By Dr. J. Bozier, et al.

Fighting the novel coronavirus together with you. By Dr. J. Li. 
 
Comparative Safety and Effectiveness of Inhaled Corticosteroid and Long-Acting Beta2-AgonistCombinations in Patients With COPD.By Dr. T-U Chang, et al. 
 
The Evolving Landscape of e-Cigarettes: A Systematic Review of Recent Evidence. By Dr. J. Bozier, et al.

Fighting the novel coronavirus together with you. By Dr. J. Li. 
 
Comparative Safety and Effectiveness of Inhaled Corticosteroid and Long-Acting Beta2-AgonistCombinations in Patients With COPD.By Dr. T-U Chang, et al. 
 
The Evolving Landscape of e-Cigarettes: A Systematic Review of Recent Evidence. By Dr. J. Bozier, et al.

Interventional and Chest Diagnostic Procedures

3D printing and pulmonology

Recent advances in 3D printing has enabled physicians to apply this technology in medical education, procedural planning, tissue modeling, and implantable device manufacturing. This is especially true in the field of pulmonology. Advancements in 3D printing have made personalized airway stents a reality, both by 3D printing-assisted injection molding or direct 3D printing.

Airway stents have significantly evolved over the last half century. With use of silicone, bare metallic, and hybrid stents, pulmonologists have an ever-expanding option to address airway stenosis due to both benign and malignancy etiologies. Personalized airway stents hold the potential for advance customization, minimizing pressure points, and improving airflow dynamics to increase mucus clearance. In January 2020, the US Food and Drug Administration (FDA) cleared patient-specific airway stents developed by Dr. Thomas Gildea of Cleveland Clinic. The patient-specific silicone stents are created using CT scans and 3D visualization software to generate a 3D-printed mold that was subsequently used to inject with medical-grade silicone. Two years earlier, a Duke University startup known as restor3D created the first direct 3D printed airway stent using a compressible biocompatible material with properties similar to that of silicone. Both of these stents have been used in patients with promising response.

As we look into the future, the field of pulmonology will experience significant changes with more adoption of 3D printing (ie, additive manufacturing). We may soon be able to create personalized airway prosthesis of any type (stents, spigots, valves, tracheostomies, t-tubes) for the benefit of our patients.

Pediatric Chest Medicine

COVID-19: Pediatric story of a new pandemic

In December 2019, an outbreak of pneumonia identified to be caused by 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China, possibly originating from the local wet market selling many species of live animals. A novel member of enveloped RNA coronavirus was identified in samples of BAL fluid from a patient in Wuhan.

It has since rapidly spread globally to countries across six continents. As of early April, 1,286,409 cases have been reported worldwide with 337,933 cases (9,600 deaths) in the US (https://coronavirus.jhu.edu/map.html) with more cases and deaths every day. Most of these initial reports of COVID-19 (COronaVIrusDisease) in children are from China. Fever (60%) and cough (65%) were the most common symptoms. Procalcitonin elevation (80% and co-infection (80%) were prominent clinical findings. Consolidation with surrounding halo sign (50%) and ground-glass opacities (60%) on CT scan were typical radiologic findings. Almost all children recovered without needing intensive care support.

Increased IgM COVID-19 antibody levels observed in three neonates raise questions of potential in-utero transmission (Kimberlin et al. JAMA 2020 Mar 26. doi: 10.1001/jama.2020.4868). One study provided evidence for persistent fecal shedding and possibility of fecal-oral transmission (Xu et al. Nat Med 2020 Mar 13. doi: 10.1038/s41591-020-0817-4).

Initial reports show that children appear to be at similar risk of infection as adults, though less likely to have severe symptoms. Young children, particularly infants, are more vulnerable to infection (Dong et al. Pediatrics. 2020 Apr. doi: 10.1542/peds.2020-0702); (Bi et al. medRxiv 2020 Mar 27. doi: 10.1101/2020.03.03.20028423v3). Thus far, few deaths have been reported in the pediatric age group. Trials are being conducted on a war footing to find a cure and a vaccine.

Harish Rao, MD, MBBS

Steering Committee Member
 

Pulmonary Physiology, Function, and Rehabilitation

Controversies and the clinical value of lung volume measurements

Lung volumes are often measured by body plethysmography or gas dilution. Their clinic importance in decision making is unclear. Though measured differently, predicted sets obtained by plethysmography from Caucasian populations are often used for gas dilution measurements (Ruppel GL. Respir Care. 2012 Jan;57[1]:26). Recently the GLI felt lung volume data were insufficient to develop universal reference equations (Cooper B, et al. Breathe (Sheff). 2017 Sep;13[3]:e56-e64). ERS/ATS guidelines recommend adjusting Caucasian predicted values depending on race, without advising how to adjust the confidence limits. Their algorithms show if the VC is normal, lung volumes are unnecessary, though it is not unusual to see a normal VC with reduced TLC. Does this suggest the VC is more important than the TLC, even if lacking predicted volume equations for non-Caucasians? Because combined obstructive and restrictive abnormalities occur simultaneously, recommendations state severity of impairment be determined by the FEV1 percent of predicted rather than TLC (Pellegrino R, et al. Eur Respir J. 2005;26:948). The value of quantifying other volumes such as FRC and ERV in conditions such as obesity and musculoskeletal defects is also not clear. In obstruction, volumes can indicate air trapping or hyperinflation measuring RV and RV/TLC. Though cutoffs of <80% and >120% of predicted are often used, guidelines discourage this practice, recommending using predicted equations based on age, race, height, and sex, with statistical limits of normal (Ruppel GL. Respir Care. 2012 Jan;57(1):26).

Said A. Chaaban, MD

Steering Committee Member

Zachary Q. Morris, MD

NetWork Member
 

Pulmonary Vascular Disease

Pulmonary hypertension associated with atrial septal defect in adults: closing time?

Up to 10% of adults with atrial septal defects (ASDs) can develop pulmonary arterial hypertension (PAH) according to European Guidelines on pulmonary hypertension (PH) (Galie, et al. Eur Heart J. 2016;37[1]:67). If ASD closure is considered, they propose a pulmonary vascular resistance index (PVRi) <4 Wood units (WU) m² as a safe cutoff. Higher PVRi carries a higher operative risk, warranting evaluation in specialized PH centers.

American guidelines (Stout, et al. Circulation. 2019 Apr 2;139[14]:e698) recommend closure in symptomatic patients with a net shunt (Qp/Qs) of >1.5:1. Closure appears safe if pulmonary artery (PA) systolic pressure is <1/2 systemic blood pressure, and PVR / systemic vascular resistance is <0.3. They recommend specialized evaluation for higher pressures and to avoid closure once a net right to left shunt is present (Qp/Qs <1.0).

However, in severe cases, experienced centers have reported some success with a “treat-and-close” approach if post-therapy PVR reaches <6.5 WU (Bradley, et al. Int J Cardiol. 2019;291:127).

Finally, consider the following when evaluating ASD-associated PAH: 1. A thermodilution cardiac output method should not be used to calculate PVR/PVRi because of confounding recirculation from the intracardiac shunt (Kwan, et al. Clin Cardiol. 2019;42[3]:334). Qp is used instead and is calculated using Fick equation, requiring accurate oxygen saturation measurements. 2. Mixed venous saturation (MvO2) is needed to determine Qs, and PA saturation cannot be used as MvO2 surrogate. MvO2 must be calculated using superior and inferior vena cava saturations. 3. Some patients with idiopathic PAH may have a small coexisting ASD that is not responsible for the abnormal hemodynamics. Closing the ASD in those cases would be contraindicated. 4. Patients may have more than one type of coexistent congenital heart defect.

Francisco J. Soto, MD, MS, FCCP

Steering Committee Member

Interventional and Chest Diagnostic Procedures

3D printing and pulmonology

Recent advances in 3D printing has enabled physicians to apply this technology in medical education, procedural planning, tissue modeling, and implantable device manufacturing. This is especially true in the field of pulmonology. Advancements in 3D printing have made personalized airway stents a reality, both by 3D printing-assisted injection molding or direct 3D printing.

Airway stents have significantly evolved over the last half century. With use of silicone, bare metallic, and hybrid stents, pulmonologists have an ever-expanding option to address airway stenosis due to both benign and malignancy etiologies. Personalized airway stents hold the potential for advance customization, minimizing pressure points, and improving airflow dynamics to increase mucus clearance. In January 2020, the US Food and Drug Administration (FDA) cleared patient-specific airway stents developed by Dr. Thomas Gildea of Cleveland Clinic. The patient-specific silicone stents are created using CT scans and 3D visualization software to generate a 3D-printed mold that was subsequently used to inject with medical-grade silicone. Two years earlier, a Duke University startup known as restor3D created the first direct 3D printed airway stent using a compressible biocompatible material with properties similar to that of silicone. Both of these stents have been used in patients with promising response.

As we look into the future, the field of pulmonology will experience significant changes with more adoption of 3D printing (ie, additive manufacturing). We may soon be able to create personalized airway prosthesis of any type (stents, spigots, valves, tracheostomies, t-tubes) for the benefit of our patients.

Pediatric Chest Medicine

COVID-19: Pediatric story of a new pandemic

In December 2019, an outbreak of pneumonia identified to be caused by 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China, possibly originating from the local wet market selling many species of live animals. A novel member of enveloped RNA coronavirus was identified in samples of BAL fluid from a patient in Wuhan.

It has since rapidly spread globally to countries across six continents. As of early April, 1,286,409 cases have been reported worldwide with 337,933 cases (9,600 deaths) in the US (https://coronavirus.jhu.edu/map.html) with more cases and deaths every day. Most of these initial reports of COVID-19 (COronaVIrusDisease) in children are from China. Fever (60%) and cough (65%) were the most common symptoms. Procalcitonin elevation (80% and co-infection (80%) were prominent clinical findings. Consolidation with surrounding halo sign (50%) and ground-glass opacities (60%) on CT scan were typical radiologic findings. Almost all children recovered without needing intensive care support.

Increased IgM COVID-19 antibody levels observed in three neonates raise questions of potential in-utero transmission (Kimberlin et al. JAMA 2020 Mar 26. doi: 10.1001/jama.2020.4868). One study provided evidence for persistent fecal shedding and possibility of fecal-oral transmission (Xu et al. Nat Med 2020 Mar 13. doi: 10.1038/s41591-020-0817-4).

Initial reports show that children appear to be at similar risk of infection as adults, though less likely to have severe symptoms. Young children, particularly infants, are more vulnerable to infection (Dong et al. Pediatrics. 2020 Apr. doi: 10.1542/peds.2020-0702); (Bi et al. medRxiv 2020 Mar 27. doi: 10.1101/2020.03.03.20028423v3). Thus far, few deaths have been reported in the pediatric age group. Trials are being conducted on a war footing to find a cure and a vaccine.

Harish Rao, MD, MBBS

Steering Committee Member
 

Pulmonary Physiology, Function, and Rehabilitation

Controversies and the clinical value of lung volume measurements

Lung volumes are often measured by body plethysmography or gas dilution. Their clinic importance in decision making is unclear. Though measured differently, predicted sets obtained by plethysmography from Caucasian populations are often used for gas dilution measurements (Ruppel GL. Respir Care. 2012 Jan;57[1]:26). Recently the GLI felt lung volume data were insufficient to develop universal reference equations (Cooper B, et al. Breathe (Sheff). 2017 Sep;13[3]:e56-e64). ERS/ATS guidelines recommend adjusting Caucasian predicted values depending on race, without advising how to adjust the confidence limits. Their algorithms show if the VC is normal, lung volumes are unnecessary, though it is not unusual to see a normal VC with reduced TLC. Does this suggest the VC is more important than the TLC, even if lacking predicted volume equations for non-Caucasians? Because combined obstructive and restrictive abnormalities occur simultaneously, recommendations state severity of impairment be determined by the FEV1 percent of predicted rather than TLC (Pellegrino R, et al. Eur Respir J. 2005;26:948). The value of quantifying other volumes such as FRC and ERV in conditions such as obesity and musculoskeletal defects is also not clear. In obstruction, volumes can indicate air trapping or hyperinflation measuring RV and RV/TLC. Though cutoffs of <80% and >120% of predicted are often used, guidelines discourage this practice, recommending using predicted equations based on age, race, height, and sex, with statistical limits of normal (Ruppel GL. Respir Care. 2012 Jan;57(1):26).

Said A. Chaaban, MD

Steering Committee Member

Zachary Q. Morris, MD

NetWork Member
 

Pulmonary Vascular Disease

Pulmonary hypertension associated with atrial septal defect in adults: closing time?

Up to 10% of adults with atrial septal defects (ASDs) can develop pulmonary arterial hypertension (PAH) according to European Guidelines on pulmonary hypertension (PH) (Galie, et al. Eur Heart J. 2016;37[1]:67). If ASD closure is considered, they propose a pulmonary vascular resistance index (PVRi) <4 Wood units (WU) m² as a safe cutoff. Higher PVRi carries a higher operative risk, warranting evaluation in specialized PH centers.

American guidelines (Stout, et al. Circulation. 2019 Apr 2;139[14]:e698) recommend closure in symptomatic patients with a net shunt (Qp/Qs) of >1.5:1. Closure appears safe if pulmonary artery (PA) systolic pressure is <1/2 systemic blood pressure, and PVR / systemic vascular resistance is <0.3. They recommend specialized evaluation for higher pressures and to avoid closure once a net right to left shunt is present (Qp/Qs <1.0).

However, in severe cases, experienced centers have reported some success with a “treat-and-close” approach if post-therapy PVR reaches <6.5 WU (Bradley, et al. Int J Cardiol. 2019;291:127).

Finally, consider the following when evaluating ASD-associated PAH: 1. A thermodilution cardiac output method should not be used to calculate PVR/PVRi because of confounding recirculation from the intracardiac shunt (Kwan, et al. Clin Cardiol. 2019;42[3]:334). Qp is used instead and is calculated using Fick equation, requiring accurate oxygen saturation measurements. 2. Mixed venous saturation (MvO2) is needed to determine Qs, and PA saturation cannot be used as MvO2 surrogate. MvO2 must be calculated using superior and inferior vena cava saturations. 3. Some patients with idiopathic PAH may have a small coexisting ASD that is not responsible for the abnormal hemodynamics. Closing the ASD in those cases would be contraindicated. 4. Patients may have more than one type of coexistent congenital heart defect.

Francisco J. Soto, MD, MS, FCCP

Steering Committee Member

Interventional and Chest Diagnostic Procedures

3D printing and pulmonology

Recent advances in 3D printing has enabled physicians to apply this technology in medical education, procedural planning, tissue modeling, and implantable device manufacturing. This is especially true in the field of pulmonology. Advancements in 3D printing have made personalized airway stents a reality, both by 3D printing-assisted injection molding or direct 3D printing.

Airway stents have significantly evolved over the last half century. With use of silicone, bare metallic, and hybrid stents, pulmonologists have an ever-expanding option to address airway stenosis due to both benign and malignancy etiologies. Personalized airway stents hold the potential for advance customization, minimizing pressure points, and improving airflow dynamics to increase mucus clearance. In January 2020, the US Food and Drug Administration (FDA) cleared patient-specific airway stents developed by Dr. Thomas Gildea of Cleveland Clinic. The patient-specific silicone stents are created using CT scans and 3D visualization software to generate a 3D-printed mold that was subsequently used to inject with medical-grade silicone. Two years earlier, a Duke University startup known as restor3D created the first direct 3D printed airway stent using a compressible biocompatible material with properties similar to that of silicone. Both of these stents have been used in patients with promising response.

As we look into the future, the field of pulmonology will experience significant changes with more adoption of 3D printing (ie, additive manufacturing). We may soon be able to create personalized airway prosthesis of any type (stents, spigots, valves, tracheostomies, t-tubes) for the benefit of our patients.

Pediatric Chest Medicine

COVID-19: Pediatric story of a new pandemic

In December 2019, an outbreak of pneumonia identified to be caused by 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China, possibly originating from the local wet market selling many species of live animals. A novel member of enveloped RNA coronavirus was identified in samples of BAL fluid from a patient in Wuhan.

It has since rapidly spread globally to countries across six continents. As of early April, 1,286,409 cases have been reported worldwide with 337,933 cases (9,600 deaths) in the US (https://coronavirus.jhu.edu/map.html) with more cases and deaths every day. Most of these initial reports of COVID-19 (COronaVIrusDisease) in children are from China. Fever (60%) and cough (65%) were the most common symptoms. Procalcitonin elevation (80% and co-infection (80%) were prominent clinical findings. Consolidation with surrounding halo sign (50%) and ground-glass opacities (60%) on CT scan were typical radiologic findings. Almost all children recovered without needing intensive care support.

Increased IgM COVID-19 antibody levels observed in three neonates raise questions of potential in-utero transmission (Kimberlin et al. JAMA 2020 Mar 26. doi: 10.1001/jama.2020.4868). One study provided evidence for persistent fecal shedding and possibility of fecal-oral transmission (Xu et al. Nat Med 2020 Mar 13. doi: 10.1038/s41591-020-0817-4).

Initial reports show that children appear to be at similar risk of infection as adults, though less likely to have severe symptoms. Young children, particularly infants, are more vulnerable to infection (Dong et al. Pediatrics. 2020 Apr. doi: 10.1542/peds.2020-0702); (Bi et al. medRxiv 2020 Mar 27. doi: 10.1101/2020.03.03.20028423v3). Thus far, few deaths have been reported in the pediatric age group. Trials are being conducted on a war footing to find a cure and a vaccine.

Harish Rao, MD, MBBS

Steering Committee Member
 

Pulmonary Physiology, Function, and Rehabilitation

Controversies and the clinical value of lung volume measurements

Lung volumes are often measured by body plethysmography or gas dilution. Their clinic importance in decision making is unclear. Though measured differently, predicted sets obtained by plethysmography from Caucasian populations are often used for gas dilution measurements (Ruppel GL. Respir Care. 2012 Jan;57[1]:26). Recently the GLI felt lung volume data were insufficient to develop universal reference equations (Cooper B, et al. Breathe (Sheff). 2017 Sep;13[3]:e56-e64). ERS/ATS guidelines recommend adjusting Caucasian predicted values depending on race, without advising how to adjust the confidence limits. Their algorithms show if the VC is normal, lung volumes are unnecessary, though it is not unusual to see a normal VC with reduced TLC. Does this suggest the VC is more important than the TLC, even if lacking predicted volume equations for non-Caucasians? Because combined obstructive and restrictive abnormalities occur simultaneously, recommendations state severity of impairment be determined by the FEV1 percent of predicted rather than TLC (Pellegrino R, et al. Eur Respir J. 2005;26:948). The value of quantifying other volumes such as FRC and ERV in conditions such as obesity and musculoskeletal defects is also not clear. In obstruction, volumes can indicate air trapping or hyperinflation measuring RV and RV/TLC. Though cutoffs of <80% and >120% of predicted are often used, guidelines discourage this practice, recommending using predicted equations based on age, race, height, and sex, with statistical limits of normal (Ruppel GL. Respir Care. 2012 Jan;57(1):26).

Said A. Chaaban, MD

Steering Committee Member

Zachary Q. Morris, MD

NetWork Member
 

Pulmonary Vascular Disease

Pulmonary hypertension associated with atrial septal defect in adults: closing time?

Up to 10% of adults with atrial septal defects (ASDs) can develop pulmonary arterial hypertension (PAH) according to European Guidelines on pulmonary hypertension (PH) (Galie, et al. Eur Heart J. 2016;37[1]:67). If ASD closure is considered, they propose a pulmonary vascular resistance index (PVRi) <4 Wood units (WU) m² as a safe cutoff. Higher PVRi carries a higher operative risk, warranting evaluation in specialized PH centers.

American guidelines (Stout, et al. Circulation. 2019 Apr 2;139[14]:e698) recommend closure in symptomatic patients with a net shunt (Qp/Qs) of >1.5:1. Closure appears safe if pulmonary artery (PA) systolic pressure is <1/2 systemic blood pressure, and PVR / systemic vascular resistance is <0.3. They recommend specialized evaluation for higher pressures and to avoid closure once a net right to left shunt is present (Qp/Qs <1.0).

However, in severe cases, experienced centers have reported some success with a “treat-and-close” approach if post-therapy PVR reaches <6.5 WU (Bradley, et al. Int J Cardiol. 2019;291:127).

Finally, consider the following when evaluating ASD-associated PAH: 1. A thermodilution cardiac output method should not be used to calculate PVR/PVRi because of confounding recirculation from the intracardiac shunt (Kwan, et al. Clin Cardiol. 2019;42[3]:334). Qp is used instead and is calculated using Fick equation, requiring accurate oxygen saturation measurements. 2. Mixed venous saturation (MvO2) is needed to determine Qs, and PA saturation cannot be used as MvO2 surrogate. MvO2 must be calculated using superior and inferior vena cava saturations. 3. Some patients with idiopathic PAH may have a small coexisting ASD that is not responsible for the abnormal hemodynamics. Closing the ASD in those cases would be contraindicated. 4. Patients may have more than one type of coexistent congenital heart defect.

Francisco J. Soto, MD, MS, FCCP

Steering Committee Member

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 the People’s Choice Award winning team that includes Dr. Russ Acevedo, Wendy Fascia, and Jennifer Pedley.

Names: Russ Acevedo, MD, FCCP; Wendy Fascia MA, RRT; Jennifer Pedley, RRT

Institutional Affiliation: Crouse Health

Title: Crouse Lung PaRTners

Brief Summary of Submission: The goal of our program is to improve the quality of life for patients with COPD by establishing a primary life-long relationship with a respiratory therapist who ensures that they and their caretakers have a thorough understanding of the disease process, as well as the ability to carry out prescribed therapy, obtain resources, and reach out for help once they leave the hospital.

Once enrolled in the Lung Partners Program, patients receive an in-depth initial assessment and daily assessments by a team of specially trained, primary respiratory therapists who will screen them for health literacy, physical functionality, anxiety, depression, sleep disorders, nutrition, and medication management.

Clinical protocols are in place to allow for optimal treatment plans in an efficient timeframe and to assist in timely referral of patients to specialists for further assessment and follow-up.


1. What inspired your innovation? By maximizing the Respiratory Care department efficiency, this allowed for the ability of a primary respiratory care inpatient disease management program. This allows us to use our respiratory therapists to the full extent of their licensure.

2. Who do you think can benefit most from it, and why? We feel this will most benefit the patients, the respiratory therapists, and our physician partners. In the end, the major benefit is to decrease health-care fractionation.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? To be successful, there needs to be very strong direction from the medical director. We do a poor job in training our fellows to be strong medical directors. Increasing attention to training our fellows in the science of respiratory care will help to overcome this challenge.

Getting the word out is also a challenge that can be overcome by increased exposure of our program like we are receiving from the Fish Bowl Competition and presentations at national meetings.

4. What impact has winning Fish Bowl 2019 had on your vision for the innovation? The positive feedback and networking from our winning has confirmed the value of our program. We have received many requests for our Lung Partner Handbook.

5. How do you think your success at Fish Bowl 2019 will continue to impact your career overall in the months and years to come? We would like to grow our involvement in state and national leadership. In all that we have learned in the development and implementation of Lung Partners, we can help support other local and national COPD initiatives.






 

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 the People’s Choice Award winning team that includes Dr. Russ Acevedo, Wendy Fascia, and Jennifer Pedley.

Names: Russ Acevedo, MD, FCCP; Wendy Fascia MA, RRT; Jennifer Pedley, RRT

Institutional Affiliation: Crouse Health

Title: Crouse Lung PaRTners

Brief Summary of Submission: The goal of our program is to improve the quality of life for patients with COPD by establishing a primary life-long relationship with a respiratory therapist who ensures that they and their caretakers have a thorough understanding of the disease process, as well as the ability to carry out prescribed therapy, obtain resources, and reach out for help once they leave the hospital.

Once enrolled in the Lung Partners Program, patients receive an in-depth initial assessment and daily assessments by a team of specially trained, primary respiratory therapists who will screen them for health literacy, physical functionality, anxiety, depression, sleep disorders, nutrition, and medication management.

Clinical protocols are in place to allow for optimal treatment plans in an efficient timeframe and to assist in timely referral of patients to specialists for further assessment and follow-up.


1. What inspired your innovation? By maximizing the Respiratory Care department efficiency, this allowed for the ability of a primary respiratory care inpatient disease management program. This allows us to use our respiratory therapists to the full extent of their licensure.

2. Who do you think can benefit most from it, and why? We feel this will most benefit the patients, the respiratory therapists, and our physician partners. In the end, the major benefit is to decrease health-care fractionation.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? To be successful, there needs to be very strong direction from the medical director. We do a poor job in training our fellows to be strong medical directors. Increasing attention to training our fellows in the science of respiratory care will help to overcome this challenge.

Getting the word out is also a challenge that can be overcome by increased exposure of our program like we are receiving from the Fish Bowl Competition and presentations at national meetings.

4. What impact has winning Fish Bowl 2019 had on your vision for the innovation? The positive feedback and networking from our winning has confirmed the value of our program. We have received many requests for our Lung Partner Handbook.

5. How do you think your success at Fish Bowl 2019 will continue to impact your career overall in the months and years to come? We would like to grow our involvement in state and national leadership. In all that we have learned in the development and implementation of Lung Partners, we can help support other local and national COPD initiatives.






 

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 the People’s Choice Award winning team that includes Dr. Russ Acevedo, Wendy Fascia, and Jennifer Pedley.

Names: Russ Acevedo, MD, FCCP; Wendy Fascia MA, RRT; Jennifer Pedley, RRT

Institutional Affiliation: Crouse Health

Title: Crouse Lung PaRTners

Brief Summary of Submission: The goal of our program is to improve the quality of life for patients with COPD by establishing a primary life-long relationship with a respiratory therapist who ensures that they and their caretakers have a thorough understanding of the disease process, as well as the ability to carry out prescribed therapy, obtain resources, and reach out for help once they leave the hospital.

Once enrolled in the Lung Partners Program, patients receive an in-depth initial assessment and daily assessments by a team of specially trained, primary respiratory therapists who will screen them for health literacy, physical functionality, anxiety, depression, sleep disorders, nutrition, and medication management.

Clinical protocols are in place to allow for optimal treatment plans in an efficient timeframe and to assist in timely referral of patients to specialists for further assessment and follow-up.


1. What inspired your innovation? By maximizing the Respiratory Care department efficiency, this allowed for the ability of a primary respiratory care inpatient disease management program. This allows us to use our respiratory therapists to the full extent of their licensure.

2. Who do you think can benefit most from it, and why? We feel this will most benefit the patients, the respiratory therapists, and our physician partners. In the end, the major benefit is to decrease health-care fractionation.

3. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? To be successful, there needs to be very strong direction from the medical director. We do a poor job in training our fellows to be strong medical directors. Increasing attention to training our fellows in the science of respiratory care will help to overcome this challenge.

Getting the word out is also a challenge that can be overcome by increased exposure of our program like we are receiving from the Fish Bowl Competition and presentations at national meetings.

4. What impact has winning Fish Bowl 2019 had on your vision for the innovation? The positive feedback and networking from our winning has confirmed the value of our program. We have received many requests for our Lung Partner Handbook.

5. How do you think your success at Fish Bowl 2019 will continue to impact your career overall in the months and years to come? We would like to grow our involvement in state and national leadership. In all that we have learned in the development and implementation of Lung Partners, we can help support other local and national COPD initiatives.






 

Amid the COVID-19 pandemic, we are filled with gratitude because of the support you have provided the CHEST Foundation. Along with our sincere thanks, we wanted to share how your philanthropic dollars are being put to use fulfilling the urgent needs of our community during this crisis. Specifically, the CHEST Foundation is:

1. Continuing to provide reliable educational materials and resources that support our clinicians, their patients, and caregivers;

2. Actively working with manufacturers and vendors from around the globe to secure life-saving equipment for US hospitals; and

3. Partnering with other leading health-care organizations to increase our impact in vulnerable and at-risk communities.

These are just some of the ways the CHEST Foundation and CHEST are rallying to support the fight against COVID-19. To see more of what we are doing, and to keep an eye out for future resources, please visit us here: CHEST COVID-19 Website. We will continue to identify new ways in which we can support the efforts of our health-care providers and serve as a leading resource for patients, caregivers, and those we consider “at-risk, noninfected” populations.

Additionally, the CHEST Foundation’s redesigned website will be launching May 1! Be sure to visit us at chestfoundation.org to view and share our clinician-authored patient education guides with anyone who needs them.

Thank you for providing your generous support, which has allowed us to develop these much-needed resources. We would not be able to do it without you.

Amid the COVID-19 pandemic, we are filled with gratitude because of the support you have provided the CHEST Foundation. Along with our sincere thanks, we wanted to share how your philanthropic dollars are being put to use fulfilling the urgent needs of our community during this crisis. Specifically, the CHEST Foundation is:

1. Continuing to provide reliable educational materials and resources that support our clinicians, their patients, and caregivers;

2. Actively working with manufacturers and vendors from around the globe to secure life-saving equipment for US hospitals; and

3. Partnering with other leading health-care organizations to increase our impact in vulnerable and at-risk communities.

These are just some of the ways the CHEST Foundation and CHEST are rallying to support the fight against COVID-19. To see more of what we are doing, and to keep an eye out for future resources, please visit us here: CHEST COVID-19 Website. We will continue to identify new ways in which we can support the efforts of our health-care providers and serve as a leading resource for patients, caregivers, and those we consider “at-risk, noninfected” populations.

Additionally, the CHEST Foundation’s redesigned website will be launching May 1! Be sure to visit us at chestfoundation.org to view and share our clinician-authored patient education guides with anyone who needs them.

Thank you for providing your generous support, which has allowed us to develop these much-needed resources. We would not be able to do it without you.

Amid the COVID-19 pandemic, we are filled with gratitude because of the support you have provided the CHEST Foundation. Along with our sincere thanks, we wanted to share how your philanthropic dollars are being put to use fulfilling the urgent needs of our community during this crisis. Specifically, the CHEST Foundation is:

1. Continuing to provide reliable educational materials and resources that support our clinicians, their patients, and caregivers;

2. Actively working with manufacturers and vendors from around the globe to secure life-saving equipment for US hospitals; and

3. Partnering with other leading health-care organizations to increase our impact in vulnerable and at-risk communities.

These are just some of the ways the CHEST Foundation and CHEST are rallying to support the fight against COVID-19. To see more of what we are doing, and to keep an eye out for future resources, please visit us here: CHEST COVID-19 Website. We will continue to identify new ways in which we can support the efforts of our health-care providers and serve as a leading resource for patients, caregivers, and those we consider “at-risk, noninfected” populations.

Additionally, the CHEST Foundation’s redesigned website will be launching May 1! Be sure to visit us at chestfoundation.org to view and share our clinician-authored patient education guides with anyone who needs them.

Thank you for providing your generous support, which has allowed us to develop these much-needed resources. We would not be able to do it without you.

As I write, I must admit this message is different than the one I’d envisioned sharing with you weeks ago. I anticipated updating you on meetings and collaborations with sister societies, new educational offerings, and how the Bologna World Congress and Annual Meeting plans were progressing, but activities at CHEST – and our sense of priority – have evolved along with those of our global community.

Pulmonary and critical care providers are now at the forefront of health care. Our patients, and now the greater public, are relying on our efforts and those of our teams. Amid this crisis, there is a renewed appreciation for the work all of you do; and with it, an opportunity for CHEST to lead and help ensure that the profession and our systems emerge stronger.

Back in February, we held the program committee meeting for the Annual Meeting with over 1000 submissions. It is astounding how the program came together over just a few days thanks to the preemptive work done by Chair, Dr. Victor Test, and, Co-Chair, Dr. Christopher Carroll, and all of the curricular groups, program committee members, and staff putting in so much work prior to the face-to-face meeting. Also during February, CHEST leadership held the Forum of International Respiratory Societies’ (FIRS) strategic planning meeting. The main outcome is a plan to engage a lobbyist to represent the worldwide respiratory societies in the WHO in Geneva on universal topics such as air pollution and now, unfortunately, COVID-19. CHEST was represented at the Society of Critical Care Medicine (SCCM) Congress where we heard late-breaking information as the pandemic was beginning to unfold. We met with the Critical Care Societies Collaborative (CCSC), which is composed of representatives from CHEST, SCCM, the American Thoracic Society (ATS), and the American Association of Critical-Care Nurses (AACN). We had an opportunity to meet with the European Society of Intensive Care Medicine (ESICM) and initiate discussions toward future collaboration.

In early March, as COVID-19 began to interfere with in-person meetings, we participated virtually in the NAMDRC meeting, and finalized our commitment to formally joining forces under the umbrella of CHEST to better serve our members in the area of advocacy. To this end, a new standing CHEST committee was founded, consisting of members from the former NAMRDC Board and members from the CHEST Board of Regents and Board of Trustees and chaired by Dr. Neil Freedman and Dr. Jim Lamberti. We look forward to hosting advocacy sessions during our October meeting, and going forward, our Spring Leadership Meeting will be combined with the former NAMDRC meeting to allow our leaders to participate in advocacy efforts. We will continue to publish the Washington Watchline, bringing important news on efforts to enhance access to care and our ability to deliver it effectively. Our spring leadership meetings, board meetings, and committee meetings in early April were held virtually in light of the pandemic.

Since March, CHEST has been heavily immersed in COVID-19 preparation with new plans for alternate methods of educational delivery, new business models, and curtailment of travel on both our home fronts and on the CHEST front. Zoom and like platforms are now my best friend! Our daily vocabulary now includes an abundance of caution, surge, sheltering in place, quarantine, social distancing, flattening the curve, tele-medicine, and don and doff, and we close e-mails, texts, and phone calls with Stay Safe! I established a COVID task force led by Dr. Steve Simpson (CHEST President-Elect) and with representation from the Critical Care, Chest Infections, and Disaster Response and Global Health NetWorks. They have been meeting weekly with the goals of disseminating and distilling COVID-related materials for the busy practitioner with links to the specific article or statement along with the BLUF (Bottom Line Up Front). I’m sure you were able to see and hear some of the reports by Dr. Mangala Narasimhan and others on the front lines in New York, on the CHEST website, 60 Minutes, and CNN. CHEST held a two-part webinar with our Chinese colleagues who shared their COVID experiences with us. These relationships were in part built from the PCCM Fellowship Training program we conducted with Chinese physicians, led by Dr. Darcy Marciniuk and Dr. Chen Wang under the guidance of Dr. Renli Qiao, and with the help of the late Dr. Mark Rosen, Dr. Jack Buckley, and myself. CHEST has posted a webinar on point of care ultrasound testing in the setting of COVID since many units are now using more POCUS instead of standard imaging for the critically ill. We have also posted some of our board review lectures on demand for those who want to brush up on their critical care skills and knowledge.

CHEST, unfortunately, had to reschedule the Bologna meeting due to the tragic situation in Italy and plans to reconvene the meeting June 24-26 of 2021. As of now, CHEST 2020 in Chicago is a go, but, of course, we will monitor that situation carefully. We have extended the deadline for abstracts and case reports to June 1, 2020, given the ongoing crisis. The team is busy planning for standalone and complementary online offerings to ensure seamless delivery of critical education in formats that cater easily to our newly formed habits.

CHEST staff have been working from home due to the Illinois shelter in place order but continue to work tremendously hard. They are implementing new areas to the website in an effort to improve the user experience by making information easier to find and more timely. In the publishing space, Dr. Peter Mazzone and the journal team have been receiving hundreds of COVID-related publications, which they have been reviewing and expediting for publication where appropriate. There will also be additional podcasts coming from our journal. The guidelines group has been working on shorter expert panel statements in the setting of rapidly changing evidence. And, to keep us all well, there are opportunities to share our personal feelings and experiences with treating those with COVID in video format on the website and across CHEST social media channels. The CHEST and the CHEST Foundation have initiated a new microgrants program and have reached out to over 150 ILD and COPD support groups across the country to offer them the opportunity to apply for a max $2,500 grant. So far, 7seven groups have requested support. These grants go directly to patients and caregivers and provide needed relief through provision of:

1. Groceries

2. Gift cards

3. Medical supplies (including PPE for patients)

4. Technology needed to communicate with their community and HCPs

5. Household supplies, cleaning supplies

In an attempt to assist our colleagues in New York City, a call went out for volunteers at the end of March and has resulted in over 200 volunteers and more than 400 inquiries from our members. Bravo!!! We want to thank our sister societies for joining our efforts during this time to help all of our respective members and, ultimately, those patients stricken with this terrible illness. As I don and doff my COVID gear, I hope you are all safe and well in this time of unprecedented change in our lives. I look forward to my next report in a few months, hopefully on a happier note.

Stay safe!

Stephanie

As I write, I must admit this message is different than the one I’d envisioned sharing with you weeks ago. I anticipated updating you on meetings and collaborations with sister societies, new educational offerings, and how the Bologna World Congress and Annual Meeting plans were progressing, but activities at CHEST – and our sense of priority – have evolved along with those of our global community.

Pulmonary and critical care providers are now at the forefront of health care. Our patients, and now the greater public, are relying on our efforts and those of our teams. Amid this crisis, there is a renewed appreciation for the work all of you do; and with it, an opportunity for CHEST to lead and help ensure that the profession and our systems emerge stronger.

Back in February, we held the program committee meeting for the Annual Meeting with over 1000 submissions. It is astounding how the program came together over just a few days thanks to the preemptive work done by Chair, Dr. Victor Test, and, Co-Chair, Dr. Christopher Carroll, and all of the curricular groups, program committee members, and staff putting in so much work prior to the face-to-face meeting. Also during February, CHEST leadership held the Forum of International Respiratory Societies’ (FIRS) strategic planning meeting. The main outcome is a plan to engage a lobbyist to represent the worldwide respiratory societies in the WHO in Geneva on universal topics such as air pollution and now, unfortunately, COVID-19. CHEST was represented at the Society of Critical Care Medicine (SCCM) Congress where we heard late-breaking information as the pandemic was beginning to unfold. We met with the Critical Care Societies Collaborative (CCSC), which is composed of representatives from CHEST, SCCM, the American Thoracic Society (ATS), and the American Association of Critical-Care Nurses (AACN). We had an opportunity to meet with the European Society of Intensive Care Medicine (ESICM) and initiate discussions toward future collaboration.

In early March, as COVID-19 began to interfere with in-person meetings, we participated virtually in the NAMDRC meeting, and finalized our commitment to formally joining forces under the umbrella of CHEST to better serve our members in the area of advocacy. To this end, a new standing CHEST committee was founded, consisting of members from the former NAMRDC Board and members from the CHEST Board of Regents and Board of Trustees and chaired by Dr. Neil Freedman and Dr. Jim Lamberti. We look forward to hosting advocacy sessions during our October meeting, and going forward, our Spring Leadership Meeting will be combined with the former NAMDRC meeting to allow our leaders to participate in advocacy efforts. We will continue to publish the Washington Watchline, bringing important news on efforts to enhance access to care and our ability to deliver it effectively. Our spring leadership meetings, board meetings, and committee meetings in early April were held virtually in light of the pandemic.

Since March, CHEST has been heavily immersed in COVID-19 preparation with new plans for alternate methods of educational delivery, new business models, and curtailment of travel on both our home fronts and on the CHEST front. Zoom and like platforms are now my best friend! Our daily vocabulary now includes an abundance of caution, surge, sheltering in place, quarantine, social distancing, flattening the curve, tele-medicine, and don and doff, and we close e-mails, texts, and phone calls with Stay Safe! I established a COVID task force led by Dr. Steve Simpson (CHEST President-Elect) and with representation from the Critical Care, Chest Infections, and Disaster Response and Global Health NetWorks. They have been meeting weekly with the goals of disseminating and distilling COVID-related materials for the busy practitioner with links to the specific article or statement along with the BLUF (Bottom Line Up Front). I’m sure you were able to see and hear some of the reports by Dr. Mangala Narasimhan and others on the front lines in New York, on the CHEST website, 60 Minutes, and CNN. CHEST held a two-part webinar with our Chinese colleagues who shared their COVID experiences with us. These relationships were in part built from the PCCM Fellowship Training program we conducted with Chinese physicians, led by Dr. Darcy Marciniuk and Dr. Chen Wang under the guidance of Dr. Renli Qiao, and with the help of the late Dr. Mark Rosen, Dr. Jack Buckley, and myself. CHEST has posted a webinar on point of care ultrasound testing in the setting of COVID since many units are now using more POCUS instead of standard imaging for the critically ill. We have also posted some of our board review lectures on demand for those who want to brush up on their critical care skills and knowledge.

CHEST, unfortunately, had to reschedule the Bologna meeting due to the tragic situation in Italy and plans to reconvene the meeting June 24-26 of 2021. As of now, CHEST 2020 in Chicago is a go, but, of course, we will monitor that situation carefully. We have extended the deadline for abstracts and case reports to June 1, 2020, given the ongoing crisis. The team is busy planning for standalone and complementary online offerings to ensure seamless delivery of critical education in formats that cater easily to our newly formed habits.

CHEST staff have been working from home due to the Illinois shelter in place order but continue to work tremendously hard. They are implementing new areas to the website in an effort to improve the user experience by making information easier to find and more timely. In the publishing space, Dr. Peter Mazzone and the journal team have been receiving hundreds of COVID-related publications, which they have been reviewing and expediting for publication where appropriate. There will also be additional podcasts coming from our journal. The guidelines group has been working on shorter expert panel statements in the setting of rapidly changing evidence. And, to keep us all well, there are opportunities to share our personal feelings and experiences with treating those with COVID in video format on the website and across CHEST social media channels. The CHEST and the CHEST Foundation have initiated a new microgrants program and have reached out to over 150 ILD and COPD support groups across the country to offer them the opportunity to apply for a max $2,500 grant. So far, 7seven groups have requested support. These grants go directly to patients and caregivers and provide needed relief through provision of:

1. Groceries

2. Gift cards

3. Medical supplies (including PPE for patients)

4. Technology needed to communicate with their community and HCPs

5. Household supplies, cleaning supplies

In an attempt to assist our colleagues in New York City, a call went out for volunteers at the end of March and has resulted in over 200 volunteers and more than 400 inquiries from our members. Bravo!!! We want to thank our sister societies for joining our efforts during this time to help all of our respective members and, ultimately, those patients stricken with this terrible illness. As I don and doff my COVID gear, I hope you are all safe and well in this time of unprecedented change in our lives. I look forward to my next report in a few months, hopefully on a happier note.

Stay safe!

Stephanie

As I write, I must admit this message is different than the one I’d envisioned sharing with you weeks ago. I anticipated updating you on meetings and collaborations with sister societies, new educational offerings, and how the Bologna World Congress and Annual Meeting plans were progressing, but activities at CHEST – and our sense of priority – have evolved along with those of our global community.

Pulmonary and critical care providers are now at the forefront of health care. Our patients, and now the greater public, are relying on our efforts and those of our teams. Amid this crisis, there is a renewed appreciation for the work all of you do; and with it, an opportunity for CHEST to lead and help ensure that the profession and our systems emerge stronger.

Back in February, we held the program committee meeting for the Annual Meeting with over 1000 submissions. It is astounding how the program came together over just a few days thanks to the preemptive work done by Chair, Dr. Victor Test, and, Co-Chair, Dr. Christopher Carroll, and all of the curricular groups, program committee members, and staff putting in so much work prior to the face-to-face meeting. Also during February, CHEST leadership held the Forum of International Respiratory Societies’ (FIRS) strategic planning meeting. The main outcome is a plan to engage a lobbyist to represent the worldwide respiratory societies in the WHO in Geneva on universal topics such as air pollution and now, unfortunately, COVID-19. CHEST was represented at the Society of Critical Care Medicine (SCCM) Congress where we heard late-breaking information as the pandemic was beginning to unfold. We met with the Critical Care Societies Collaborative (CCSC), which is composed of representatives from CHEST, SCCM, the American Thoracic Society (ATS), and the American Association of Critical-Care Nurses (AACN). We had an opportunity to meet with the European Society of Intensive Care Medicine (ESICM) and initiate discussions toward future collaboration.

In early March, as COVID-19 began to interfere with in-person meetings, we participated virtually in the NAMDRC meeting, and finalized our commitment to formally joining forces under the umbrella of CHEST to better serve our members in the area of advocacy. To this end, a new standing CHEST committee was founded, consisting of members from the former NAMRDC Board and members from the CHEST Board of Regents and Board of Trustees and chaired by Dr. Neil Freedman and Dr. Jim Lamberti. We look forward to hosting advocacy sessions during our October meeting, and going forward, our Spring Leadership Meeting will be combined with the former NAMDRC meeting to allow our leaders to participate in advocacy efforts. We will continue to publish the Washington Watchline, bringing important news on efforts to enhance access to care and our ability to deliver it effectively. Our spring leadership meetings, board meetings, and committee meetings in early April were held virtually in light of the pandemic.

Since March, CHEST has been heavily immersed in COVID-19 preparation with new plans for alternate methods of educational delivery, new business models, and curtailment of travel on both our home fronts and on the CHEST front. Zoom and like platforms are now my best friend! Our daily vocabulary now includes an abundance of caution, surge, sheltering in place, quarantine, social distancing, flattening the curve, tele-medicine, and don and doff, and we close e-mails, texts, and phone calls with Stay Safe! I established a COVID task force led by Dr. Steve Simpson (CHEST President-Elect) and with representation from the Critical Care, Chest Infections, and Disaster Response and Global Health NetWorks. They have been meeting weekly with the goals of disseminating and distilling COVID-related materials for the busy practitioner with links to the specific article or statement along with the BLUF (Bottom Line Up Front). I’m sure you were able to see and hear some of the reports by Dr. Mangala Narasimhan and others on the front lines in New York, on the CHEST website, 60 Minutes, and CNN. CHEST held a two-part webinar with our Chinese colleagues who shared their COVID experiences with us. These relationships were in part built from the PCCM Fellowship Training program we conducted with Chinese physicians, led by Dr. Darcy Marciniuk and Dr. Chen Wang under the guidance of Dr. Renli Qiao, and with the help of the late Dr. Mark Rosen, Dr. Jack Buckley, and myself. CHEST has posted a webinar on point of care ultrasound testing in the setting of COVID since many units are now using more POCUS instead of standard imaging for the critically ill. We have also posted some of our board review lectures on demand for those who want to brush up on their critical care skills and knowledge.

CHEST, unfortunately, had to reschedule the Bologna meeting due to the tragic situation in Italy and plans to reconvene the meeting June 24-26 of 2021. As of now, CHEST 2020 in Chicago is a go, but, of course, we will monitor that situation carefully. We have extended the deadline for abstracts and case reports to June 1, 2020, given the ongoing crisis. The team is busy planning for standalone and complementary online offerings to ensure seamless delivery of critical education in formats that cater easily to our newly formed habits.

CHEST staff have been working from home due to the Illinois shelter in place order but continue to work tremendously hard. They are implementing new areas to the website in an effort to improve the user experience by making information easier to find and more timely. In the publishing space, Dr. Peter Mazzone and the journal team have been receiving hundreds of COVID-related publications, which they have been reviewing and expediting for publication where appropriate. There will also be additional podcasts coming from our journal. The guidelines group has been working on shorter expert panel statements in the setting of rapidly changing evidence. And, to keep us all well, there are opportunities to share our personal feelings and experiences with treating those with COVID in video format on the website and across CHEST social media channels. The CHEST and the CHEST Foundation have initiated a new microgrants program and have reached out to over 150 ILD and COPD support groups across the country to offer them the opportunity to apply for a max $2,500 grant. So far, 7seven groups have requested support. These grants go directly to patients and caregivers and provide needed relief through provision of:

1. Groceries

2. Gift cards

3. Medical supplies (including PPE for patients)

4. Technology needed to communicate with their community and HCPs

5. Household supplies, cleaning supplies

In an attempt to assist our colleagues in New York City, a call went out for volunteers at the end of March and has resulted in over 200 volunteers and more than 400 inquiries from our members. Bravo!!! We want to thank our sister societies for joining our efforts during this time to help all of our respective members and, ultimately, those patients stricken with this terrible illness. As I don and doff my COVID gear, I hope you are all safe and well in this time of unprecedented change in our lives. I look forward to my next report in a few months, hopefully on a happier note.

Stay safe!

Stephanie

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

As you know, the COVID-19 pandemic has caused immense strain on global health systems. With our membership at the epicenter, many of you have experienced firsthand the shortages that result from a surging patient population – lack of personal protective equipment (PPE), access to ventilators, and increasing demand for more qualified health-care workers needed on the front lines to treat and care for patients. As the staff leader of your organization, I feel an immense responsibility to support our community through this crisis.

In recent weeks, CHEST petitioned the federal and local governments on several issues, advocating for tax relief for COVID responders, expansion of liability protections, and the development of a provider relief fund. We will continue to collaborate with other societies and push such efforts. However, we also recognize an obligation to make a more tangible, real-time difference in the circumstances of our membership and the lives of the patients you are working to save.

An opportunity arose when we received a call from Dr. Doreen Addrizzo-Harris, Immediate Past President of the CHEST Foundation and Professor of Medicine at NYU Langone Health. In late March, New York City was seeing an uptick in patients with confirmed COVID infection in critical condition that was escalating by the day. The situation was beginning to resemble the trajectory of hotspots in Wuhan, China and Italy, and it was already taking a toll on health-care teams. Dr. Adrizzo-Harris asked whether there was any way to leverage the strength of the CHEST community to provide help. Already, our headquarters team had received unsolicited offers to travel to areas in need from our members. The question was how could we more proactively identify such willing and able clinicians.

We quickly drew upon our existing CHEST Analytics platform to target physicians outside New York City who might be well-positioned to travel. We harnessed our communication channels to get the word out. The response was immediate, with more than 100 people completing applications to join forces with their colleagues in New York. In the first 10 days of recruitment efforts, we added an additional 250 interested volunteers to the system. The positive response from members showed both the willingness of qualified medical staff to assist on the front lines but also highlighted deficiencies in other registration systems overwhelmed with requests in the face of this pandemic. Finding certified pulmonary and critical care physicians who are willing to step in where they are needed is time- and labor-intensive and detracts from health systems’ ability to focus on care. Watching the projections in other regions, we recognized other areas may soon need this same help.

With this in mind, CHEST approached ATS and our long-time partner PA Consulting to help us address the problem on a national scale. We felt we had the resources to leverage our databases and our analytic tools to create a more efficient process that would put physicians in hospitals where they could do the most good more efficiently. We knew that if we could apply our knowledge and deploy our heroic members, we could develop a solution that could save lives and relieve frontline clinicians. By leveraging the existing CHEST Analytics platform, the team created a solution that can be used by provider institutions, government agencies, and willing clinicians to quickly and effectively provide care where it is needed most. The team has engineered the solution to be scalable nationally and expandable to other critical care specialties (eg, anesthesia, emergency, nursing, respiratory therapy).

The Clinician Matching Network formally launched on April 14, 2020. It provides a two-way input that accepts sign up from individual clinicians and gathers needs and requirements from hospital systems, connecting health-care providers with the systems most in need of the specific support they are equipped to provide. We believe this has the potential to enable us to move ahead of the curve of the crisis.

I am very proud of the teams that lead this effort and have gained a greater appreciation of how CHEST, in partnership with other medical societies, can fully utilize data and analytics toward implementing public health solutions. The design and development of the Clinician Matching Network was accomplished in less than a week, leveraging a methodology that will enable the team to continuously improve and iterate through weekly releases, adding functionality quickly as the pandemic evolves.

In the weeks ahead, communications will be distributed to hospitals and hospital systems to help identify their staffing needs, encourage them to input their needs into the Clinician Matching Network, and expand the clinician-to-hospital matching effort. We aim to increase the number of collaborationg associations to grow the pool of clinicians who can be deployed to areas in need.

Please visit www.chestnet.org/clinician-matching to learn more, sign up to serve, tell us about the needs of your institution, or collaborate toward this cause.

As you know, the COVID-19 pandemic has caused immense strain on global health systems. With our membership at the epicenter, many of you have experienced firsthand the shortages that result from a surging patient population – lack of personal protective equipment (PPE), access to ventilators, and increasing demand for more qualified health-care workers needed on the front lines to treat and care for patients. As the staff leader of your organization, I feel an immense responsibility to support our community through this crisis.

In recent weeks, CHEST petitioned the federal and local governments on several issues, advocating for tax relief for COVID responders, expansion of liability protections, and the development of a provider relief fund. We will continue to collaborate with other societies and push such efforts. However, we also recognize an obligation to make a more tangible, real-time difference in the circumstances of our membership and the lives of the patients you are working to save.

An opportunity arose when we received a call from Dr. Doreen Addrizzo-Harris, Immediate Past President of the CHEST Foundation and Professor of Medicine at NYU Langone Health. In late March, New York City was seeing an uptick in patients with confirmed COVID infection in critical condition that was escalating by the day. The situation was beginning to resemble the trajectory of hotspots in Wuhan, China and Italy, and it was already taking a toll on health-care teams. Dr. Adrizzo-Harris asked whether there was any way to leverage the strength of the CHEST community to provide help. Already, our headquarters team had received unsolicited offers to travel to areas in need from our members. The question was how could we more proactively identify such willing and able clinicians.

We quickly drew upon our existing CHEST Analytics platform to target physicians outside New York City who might be well-positioned to travel. We harnessed our communication channels to get the word out. The response was immediate, with more than 100 people completing applications to join forces with their colleagues in New York. In the first 10 days of recruitment efforts, we added an additional 250 interested volunteers to the system. The positive response from members showed both the willingness of qualified medical staff to assist on the front lines but also highlighted deficiencies in other registration systems overwhelmed with requests in the face of this pandemic. Finding certified pulmonary and critical care physicians who are willing to step in where they are needed is time- and labor-intensive and detracts from health systems’ ability to focus on care. Watching the projections in other regions, we recognized other areas may soon need this same help.

With this in mind, CHEST approached ATS and our long-time partner PA Consulting to help us address the problem on a national scale. We felt we had the resources to leverage our databases and our analytic tools to create a more efficient process that would put physicians in hospitals where they could do the most good more efficiently. We knew that if we could apply our knowledge and deploy our heroic members, we could develop a solution that could save lives and relieve frontline clinicians. By leveraging the existing CHEST Analytics platform, the team created a solution that can be used by provider institutions, government agencies, and willing clinicians to quickly and effectively provide care where it is needed most. The team has engineered the solution to be scalable nationally and expandable to other critical care specialties (eg, anesthesia, emergency, nursing, respiratory therapy).

The Clinician Matching Network formally launched on April 14, 2020. It provides a two-way input that accepts sign up from individual clinicians and gathers needs and requirements from hospital systems, connecting health-care providers with the systems most in need of the specific support they are equipped to provide. We believe this has the potential to enable us to move ahead of the curve of the crisis.

I am very proud of the teams that lead this effort and have gained a greater appreciation of how CHEST, in partnership with other medical societies, can fully utilize data and analytics toward implementing public health solutions. The design and development of the Clinician Matching Network was accomplished in less than a week, leveraging a methodology that will enable the team to continuously improve and iterate through weekly releases, adding functionality quickly as the pandemic evolves.

In the weeks ahead, communications will be distributed to hospitals and hospital systems to help identify their staffing needs, encourage them to input their needs into the Clinician Matching Network, and expand the clinician-to-hospital matching effort. We aim to increase the number of collaborationg associations to grow the pool of clinicians who can be deployed to areas in need.

Please visit www.chestnet.org/clinician-matching to learn more, sign up to serve, tell us about the needs of your institution, or collaborate toward this cause.

As you know, the COVID-19 pandemic has caused immense strain on global health systems. With our membership at the epicenter, many of you have experienced firsthand the shortages that result from a surging patient population – lack of personal protective equipment (PPE), access to ventilators, and increasing demand for more qualified health-care workers needed on the front lines to treat and care for patients. As the staff leader of your organization, I feel an immense responsibility to support our community through this crisis.

In recent weeks, CHEST petitioned the federal and local governments on several issues, advocating for tax relief for COVID responders, expansion of liability protections, and the development of a provider relief fund. We will continue to collaborate with other societies and push such efforts. However, we also recognize an obligation to make a more tangible, real-time difference in the circumstances of our membership and the lives of the patients you are working to save.

An opportunity arose when we received a call from Dr. Doreen Addrizzo-Harris, Immediate Past President of the CHEST Foundation and Professor of Medicine at NYU Langone Health. In late March, New York City was seeing an uptick in patients with confirmed COVID infection in critical condition that was escalating by the day. The situation was beginning to resemble the trajectory of hotspots in Wuhan, China and Italy, and it was already taking a toll on health-care teams. Dr. Adrizzo-Harris asked whether there was any way to leverage the strength of the CHEST community to provide help. Already, our headquarters team had received unsolicited offers to travel to areas in need from our members. The question was how could we more proactively identify such willing and able clinicians.

We quickly drew upon our existing CHEST Analytics platform to target physicians outside New York City who might be well-positioned to travel. We harnessed our communication channels to get the word out. The response was immediate, with more than 100 people completing applications to join forces with their colleagues in New York. In the first 10 days of recruitment efforts, we added an additional 250 interested volunteers to the system. The positive response from members showed both the willingness of qualified medical staff to assist on the front lines but also highlighted deficiencies in other registration systems overwhelmed with requests in the face of this pandemic. Finding certified pulmonary and critical care physicians who are willing to step in where they are needed is time- and labor-intensive and detracts from health systems’ ability to focus on care. Watching the projections in other regions, we recognized other areas may soon need this same help.

With this in mind, CHEST approached ATS and our long-time partner PA Consulting to help us address the problem on a national scale. We felt we had the resources to leverage our databases and our analytic tools to create a more efficient process that would put physicians in hospitals where they could do the most good more efficiently. We knew that if we could apply our knowledge and deploy our heroic members, we could develop a solution that could save lives and relieve frontline clinicians. By leveraging the existing CHEST Analytics platform, the team created a solution that can be used by provider institutions, government agencies, and willing clinicians to quickly and effectively provide care where it is needed most. The team has engineered the solution to be scalable nationally and expandable to other critical care specialties (eg, anesthesia, emergency, nursing, respiratory therapy).

The Clinician Matching Network formally launched on April 14, 2020. It provides a two-way input that accepts sign up from individual clinicians and gathers needs and requirements from hospital systems, connecting health-care providers with the systems most in need of the specific support they are equipped to provide. We believe this has the potential to enable us to move ahead of the curve of the crisis.

I am very proud of the teams that lead this effort and have gained a greater appreciation of how CHEST, in partnership with other medical societies, can fully utilize data and analytics toward implementing public health solutions. The design and development of the Clinician Matching Network was accomplished in less than a week, leveraging a methodology that will enable the team to continuously improve and iterate through weekly releases, adding functionality quickly as the pandemic evolves.

In the weeks ahead, communications will be distributed to hospitals and hospital systems to help identify their staffing needs, encourage them to input their needs into the Clinician Matching Network, and expand the clinician-to-hospital matching effort. We aim to increase the number of collaborationg associations to grow the pool of clinicians who can be deployed to areas in need.

Please visit www.chestnet.org/clinician-matching to learn more, sign up to serve, tell us about the needs of your institution, or collaborate toward this cause.