Breathe Easy

Despite well-established evidence of pulmonary rehabilitation (PR)effectiveness, inadequate US reimbursement has resulted in challenges that negatively impact PR financial stability, equity and access. The road to equitable payment and access to PR is a long and complex journey. All major pulmonary societies are working together to improve equity of PR reimbursement. ATS recently published a PR clinical practice guideline to update the evidence base of PR and further substantiate and define PR’s highly effective impact. As the evidence base of effectiveness improves, we all play a role in understanding and working toward improving patient program access, awareness, and adequate payment.

Dr. Patrick Lyons sits down with Dr. Lekshmi Santhosh, the originator and chair of the ATS ICU-PAUSE program, to discuss this innovative new program.  The ATS ICU-PAUSE program is a communication framework that aims to educate health care providers, including trainees, intensivists, hospitalists, and advanced practice providers around patient safety, diagnostic uncertainty and implicit bias during transitions of care.  Dr. Lyons, an ICU-PAUSE co-investigator and collaborator, discusses the origins of this program with the ATS, some of the pitfalls of the ICU-to-ward transition, and how the ICU-PAUSE checklist has been used to improve communication across many institutions across the country! Show NotesThe ATS ICU-PAUSE toolkit and CME module are available on ATS Ed +.  This includes a CME-accredited video module featuring national patient safety experts, a downloadable implementation toolkit (including informational packet, .icutoward EHR dotphrase, print-ready post card, and print-ready flyer) as well as resources to get involved and become a participating site and implement the ICU-PAUSE at your own site.  To access these materials, please visit ATS Ed+ and create an account. ATS ICU-PAUSE

American Thoracic Society-Sleep and Respiratory Neurobiology is pleased to present the new podcast, Sleep Pioneers. Join us as we get to know trailblazers in the field better through conversations about their insights working in the field of sleep.

This episode offers a CRUCIAL overview of the Medicare hospice benefit, utilization logistics for advanced lung disease patients, communication strategies, patient-focused methodology in discussions and additional resources to enhance providers’ skill sets in caring for this important and vulnerable patient population.

In this podcast, Dr. Ally Larkin, Dr. Carol Mansfield, and Dr. Robyn Cohen discuss their experience implementing Single Maintenance and Reliever Therapy (known as "SMART" or "MART"). SMART is included in the 2020 updates to the National Asthma Education and Prevention Program Asthma Management Guidelines and the 2021 updates to the Global Initiative for Asthma Strategy. In this discussion, they cover how they implemented SMART into their clinical practice, challenges they've faced making the change, how SMART has improved asthma management and control for their patients, and advice for providers seeking to implement SMART into their own practices. References:New NAEPP/NHLBI Guidelines (2020): Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordinated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC); Cloutier MM, Baptist AP, Blake KV, Brooks EG, Bryant-Stephens T, DiMango E, Dixon AE, Elward KS, Hartert T, Krishnan JA, Lemanske RF Jr, Ouellette DR, Pace WD, Schatz M, Skolnik NS, Stout JW, Teach SJ, Umscheid CA, Walsh CG. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020 Dec;146(6):1217-1270. doi: 10.1016/j.jaci.2020.10.003. Erratum in: J Allergy Clin Immunol. 2021 Apr;147(4):1528-1530. PMID: 33280709; PMCID: PMC7924476.  New GINA Guidelines (2021): Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, Cruz AA, Duijts L, Drazen JM, FitzGerald JM, Fleming LJ, Inoue H, Ko FW, Krishnan JA, Levy ML, Lin J, Mortimer K, Pitrez PM, Sheikh A, Yorgancioglu AA, Boulet LP. Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes. Am J Respir Crit Care Med. 2022 Jan 1;205(1):17-35. doi: 10.1164/rccm.202109-2205PP. PMID: 34658302; PMCID: PMC8865583.  Articles on Implementation: Reddel HK, Bateman ED, Schatz M, Krishnan JA, Cloutier MM. A Practical Guide to Implementing SMART in Asthma Management. J Allergy Clin Immunol Pract. 2022 Jan;10(1S):S31-S38. doi: 10.1016/j.jaip.2021.10.011. Epub 2021 Oct 16. PMID: 34666208.  Cloutier MM, Teach SJ, Lemanske RF Jr, Blake KV. The 2020 Focused Updates to the NIH Asthma Management Guidelines: Key Points for Pediatricians. Pediatrics. 2021 Jun;147(6):e2021050286. doi: 10.1542/peds.2021-050286. Epub 2021 May 3. PMID: 33941586; PMCID: PMC8168603.  Article on the Implementation Gap: Krings JG, Sekhar TC, Chen V, Blake KV, Sumino K, James AS, Clover AK, Lenze EJ, Brownson RC, Castro M. Beginning to Address an Implementation Gap in Asthma: Clinicians' Views of Prescribing Reliever Budesonide-Formoterol Inhalers and SMART in the United States. J Allergy Clin Immunol Pract. 2023 Sep;11(9):2767-2777. doi: 10.1016/j.jaip.2023.05.023. Epub 2023 May 26. PMID: 37245736.  

Dr. Kathryn del Valle has a conversation with Dr. Hilary DuBrock about Pulmonary Hypertension fellowship, including what it entails, who is eligible to apply, and why it can be beneficial for those pursuing a career in PH.

The AI in Sleep Medicine Podcast series (2 episodes) will help users apply the principles of machine learning to clinical care and conceptualize future applications of pediatric and adult sleep medicine. Episode 1 focuses on the definitions and applications of AI in sleep medicine. References: Sendak MP, Gao M, Brajer N, Balu S. Presenting machine learning model information to clinical end users with model facts labels. NPJ digital medicine. 2020 Mar 23;3(1):41.Rajpurkar P, Chen E, Banerjee O, Topol EJ. AI in health and medicine. Nature medicine. 2022 Jan;28(1):31-8.s 

Katie O'Grady shares her journey with Cystic Fibrosis and how running saved her life. Hear Katie's highs and lows of running, and tips on how to support your patients to exercise.

Dr. Naftali Kaminski chats with Dr. Lynn Schnapp as she discusses how she became interested in triathlons, her passion for faculty development and mentorship, her journeys as President of the ATS during the Covid pandemic and what’s next in her career.

Dr. Naftali Kaminski chats with Dr. Terri Laguna as she discusses her love of hair bands, her thoughts on diversity in medicine and the landscape of CF as well as her decision to become a division chief.