During my DIHI year I worked primarily on two projects: 1. a video visit project to increase access to primary care among GME trainees, and 2. an evaluation of a pilot to improve sepsis bundle compliance at Duke University Hospital. For the video visit project, my initial goal was to evaluate video visit functionality—does the platform work, are trainees satisfied with the service, do the video visits result in prescriptions, referrals, labs, or close follow up? However, only a small amount of video visits were requested by GME trainees so the analysis became an interesting investigation into why video visits were not being scheduled and what would be a more useful resource for GME trainees. For the sepsis analysis, I was able to develop data science skills to do an analysis of how and where sepsis develops across Duke’s three hospitals, evaluate sepsis bundle compliance across all three hospitals, and evaluate mortality and ICU requirement at DUH before and after the pilot.

This year was eye opening in a lot of ways, but particularly I learned a lot about how large health systems prioritize and evaluate health care improvement projects. Being able to take part in the DIHI RFA application review process and hear from healthcare leaders about the changes they would like to see revealed a new yet crucial aspect to healthcare innovation. This year, I was also able to participate in the Learning Health Systems Training Program, a program where primarily residents and fellows are able to attend seminars held by Duke leadership to help develop and evaluate their own independent projects. Participating in this program in addition to working with DIHI, demonstrated the breadth of projects occurring at Duke and how important it is for physicians to have the capacity to work on improvement the quality of patient care.

I am planning on applying to be a pediatric resident this fall. In the long term, I would like to work as a general pediatrician within an academic medical center. I hope to be able to split by time between clinic and program development work. I am most interested in the ways clinics can be better equipped to address patient psycho-social needs and would like to spend a significant part of my career building the infrastructure and connections to do so within my future clinic. The crux of this dream is working in a clinic that values innovation. This means that clinic leaders are interested in solving problems in novel ways, that they are open to piloting projects, and that they are willing to encourage innovation among their staff by providing compensation and dedicated time to create and evaluate improvement projects. I am very excited about the amount of innovation I observed during my year at DIHI, and I hope I continue to be inspired by the work of my colleagues wherever I work in the future.