Society News

Pulmonary physicians and particularly interventional bronchoscopists have been receiving denials when CPT^® codes 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe and 31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) are billed during the same procedure.

While the difference between a transbronchial forceps biopsy and transbronchial needle biopsy are obvious to bronchoscopists, there has been confusion with payers. This could have been partly on the basis of a CPT Assistant article from March 2021 describing the use of both codes that stated, “Note that performing two types of lung biopsy (forceps and needle aspiration) on the same lesion would be considered unusual and documentation of medical necessity should clearly describe why both types of biopsy were clinically necessary.” This may have been interpreted by coders and/or payers to mean that the two codes should be billed together rarely or not at all. It is also possible that computer-based coding programs (eg, Optum/Encoder Pro, etc) are responsible for these inappropriate denials. There are, however, no NCCI edits that disallow this nor was this the intent of the CPT codes when they were developed.

The previous statement from the CPT Assistant article was clarified in the following sentences, “For example, if needle aspiration were performed and immediate screening of the sample were insufficient for diagnosis, a forceps biopsy would be appropriate and reported separately. On the other hand, if a physician performed a needle aspiration out of concern that the lesion was vascular and found that it was not and proceeded with a forceps biopsy, then the needle aspiration would be integral to the forceps biopsy and not separately reported.” Importantly, with the increasing use of navigational bronchoscopy and robotic bronchoscopy, these codes will be used together more frequently, appropriately, and correctly, especially on distal lesions.

Remember, these codes are used for procedures in a single lobe. If multiple lobes are sampled then CPT codes 31632 and 31633 would be added to 31628 and 31629, respectively. If one is receiving denials for these procedures, coders and payers should be notified of these errors, and denials should be appealed.

Q&A

Question: My practice is wondering if we can use the newer codes for online digital E/M services? We know they are time-based, but we are confused about when they cannot be used. Can you please help? For example, I had an established COPD patient send a message through the electronic health record’s patient portal reporting new symptoms of headache, cough, and sputum production. They asked me to review the chest x-ray that was done two days prior when they went to urgent care. The patient is asking for an assessment and management plan. We message back and forth over the next day for a total of 13 minutes. Three days later, the patient developed more symptoms and then scheduled an office visit. How would I bill for this? 99212-99215 (Established Office E/M) or 99422 (Online digital E/M 11-20 minutes?

Answer: Online Digital E/M services (99421, 99422, 99423) are to be used for established patients, only. They are time-based codes and cumulative up to seven days. They are to be reported for asynchronous communication via HIPAA-compliance secure platforms, such as through the electronic health record portal, portal email, etc. They may not be reported if an E/M occurs within seven days before or after, though the time may be incorporated into the subsequent E/M. These codes are not to be used for communication of test results, scheduling of appointments, or other communication that does not include E/M. In your example, you would report the appropriate Office/ Outpatient Established CPT code (99212-99215).


99421 – Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes

99422 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

99423 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes


Question: Is Cardiopulmonary Resuscitation in the Intensive Care Unit considered to be part of Critical Care services? (99291- 99292)? There appears to be confusion in our billing department on this issue.

Answer: 92959 Cardiopulmonary resuscitation is not bundled into 99291-99292. Consider it as a procedure. To code for this service in addition to Critical Care, the time for the CPR must be separate from the time for Critical Care (99291-99292). A separate procedure note must also be documented. There is no minimum time for this service, and a 25 modifier must be included, as well. 92950 reimburses at 4.00 wRVUs and may be reported two times per calendar day.

Originally published in the September 2023 issue of the American Thoracic Society’s ATS Coding & Billing Quarterly. Republished with permission from the American Thoracic Society.

Pulmonary physicians and particularly interventional bronchoscopists have been receiving denials when CPT^® codes 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe and 31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) are billed during the same procedure.

While the difference between a transbronchial forceps biopsy and transbronchial needle biopsy are obvious to bronchoscopists, there has been confusion with payers. This could have been partly on the basis of a CPT Assistant article from March 2021 describing the use of both codes that stated, “Note that performing two types of lung biopsy (forceps and needle aspiration) on the same lesion would be considered unusual and documentation of medical necessity should clearly describe why both types of biopsy were clinically necessary.” This may have been interpreted by coders and/or payers to mean that the two codes should be billed together rarely or not at all. It is also possible that computer-based coding programs (eg, Optum/Encoder Pro, etc) are responsible for these inappropriate denials. There are, however, no NCCI edits that disallow this nor was this the intent of the CPT codes when they were developed.

The previous statement from the CPT Assistant article was clarified in the following sentences, “For example, if needle aspiration were performed and immediate screening of the sample were insufficient for diagnosis, a forceps biopsy would be appropriate and reported separately. On the other hand, if a physician performed a needle aspiration out of concern that the lesion was vascular and found that it was not and proceeded with a forceps biopsy, then the needle aspiration would be integral to the forceps biopsy and not separately reported.” Importantly, with the increasing use of navigational bronchoscopy and robotic bronchoscopy, these codes will be used together more frequently, appropriately, and correctly, especially on distal lesions.

Remember, these codes are used for procedures in a single lobe. If multiple lobes are sampled then CPT codes 31632 and 31633 would be added to 31628 and 31629, respectively. If one is receiving denials for these procedures, coders and payers should be notified of these errors, and denials should be appealed.

Q&A

Question: My practice is wondering if we can use the newer codes for online digital E/M services? We know they are time-based, but we are confused about when they cannot be used. Can you please help? For example, I had an established COPD patient send a message through the electronic health record’s patient portal reporting new symptoms of headache, cough, and sputum production. They asked me to review the chest x-ray that was done two days prior when they went to urgent care. The patient is asking for an assessment and management plan. We message back and forth over the next day for a total of 13 minutes. Three days later, the patient developed more symptoms and then scheduled an office visit. How would I bill for this? 99212-99215 (Established Office E/M) or 99422 (Online digital E/M 11-20 minutes?

Answer: Online Digital E/M services (99421, 99422, 99423) are to be used for established patients, only. They are time-based codes and cumulative up to seven days. They are to be reported for asynchronous communication via HIPAA-compliance secure platforms, such as through the electronic health record portal, portal email, etc. They may not be reported if an E/M occurs within seven days before or after, though the time may be incorporated into the subsequent E/M. These codes are not to be used for communication of test results, scheduling of appointments, or other communication that does not include E/M. In your example, you would report the appropriate Office/ Outpatient Established CPT code (99212-99215).


99421 – Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes

99422 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

99423 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes


Question: Is Cardiopulmonary Resuscitation in the Intensive Care Unit considered to be part of Critical Care services? (99291- 99292)? There appears to be confusion in our billing department on this issue.

Answer: 92959 Cardiopulmonary resuscitation is not bundled into 99291-99292. Consider it as a procedure. To code for this service in addition to Critical Care, the time for the CPR must be separate from the time for Critical Care (99291-99292). A separate procedure note must also be documented. There is no minimum time for this service, and a 25 modifier must be included, as well. 92950 reimburses at 4.00 wRVUs and may be reported two times per calendar day.

Originally published in the September 2023 issue of the American Thoracic Society’s ATS Coding & Billing Quarterly. Republished with permission from the American Thoracic Society.

Pulmonary physicians and particularly interventional bronchoscopists have been receiving denials when CPT^® codes 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe and 31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) are billed during the same procedure.

While the difference between a transbronchial forceps biopsy and transbronchial needle biopsy are obvious to bronchoscopists, there has been confusion with payers. This could have been partly on the basis of a CPT Assistant article from March 2021 describing the use of both codes that stated, “Note that performing two types of lung biopsy (forceps and needle aspiration) on the same lesion would be considered unusual and documentation of medical necessity should clearly describe why both types of biopsy were clinically necessary.” This may have been interpreted by coders and/or payers to mean that the two codes should be billed together rarely or not at all. It is also possible that computer-based coding programs (eg, Optum/Encoder Pro, etc) are responsible for these inappropriate denials. There are, however, no NCCI edits that disallow this nor was this the intent of the CPT codes when they were developed.

The previous statement from the CPT Assistant article was clarified in the following sentences, “For example, if needle aspiration were performed and immediate screening of the sample were insufficient for diagnosis, a forceps biopsy would be appropriate and reported separately. On the other hand, if a physician performed a needle aspiration out of concern that the lesion was vascular and found that it was not and proceeded with a forceps biopsy, then the needle aspiration would be integral to the forceps biopsy and not separately reported.” Importantly, with the increasing use of navigational bronchoscopy and robotic bronchoscopy, these codes will be used together more frequently, appropriately, and correctly, especially on distal lesions.

Remember, these codes are used for procedures in a single lobe. If multiple lobes are sampled then CPT codes 31632 and 31633 would be added to 31628 and 31629, respectively. If one is receiving denials for these procedures, coders and payers should be notified of these errors, and denials should be appealed.

Q&A

Question: My practice is wondering if we can use the newer codes for online digital E/M services? We know they are time-based, but we are confused about when they cannot be used. Can you please help? For example, I had an established COPD patient send a message through the electronic health record’s patient portal reporting new symptoms of headache, cough, and sputum production. They asked me to review the chest x-ray that was done two days prior when they went to urgent care. The patient is asking for an assessment and management plan. We message back and forth over the next day for a total of 13 minutes. Three days later, the patient developed more symptoms and then scheduled an office visit. How would I bill for this? 99212-99215 (Established Office E/M) or 99422 (Online digital E/M 11-20 minutes?

Answer: Online Digital E/M services (99421, 99422, 99423) are to be used for established patients, only. They are time-based codes and cumulative up to seven days. They are to be reported for asynchronous communication via HIPAA-compliance secure platforms, such as through the electronic health record portal, portal email, etc. They may not be reported if an E/M occurs within seven days before or after, though the time may be incorporated into the subsequent E/M. These codes are not to be used for communication of test results, scheduling of appointments, or other communication that does not include E/M. In your example, you would report the appropriate Office/ Outpatient Established CPT code (99212-99215).


99421 – Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes

99422 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

99423 - Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes


Question: Is Cardiopulmonary Resuscitation in the Intensive Care Unit considered to be part of Critical Care services? (99291- 99292)? There appears to be confusion in our billing department on this issue.

Answer: 92959 Cardiopulmonary resuscitation is not bundled into 99291-99292. Consider it as a procedure. To code for this service in addition to Critical Care, the time for the CPR must be separate from the time for Critical Care (99291-99292). A separate procedure note must also be documented. There is no minimum time for this service, and a 25 modifier must be included, as well. 92950 reimburses at 4.00 wRVUs and may be reported two times per calendar day.

Originally published in the September 2023 issue of the American Thoracic Society’s ATS Coding & Billing Quarterly. Republished with permission from the American Thoracic Society.

Looking ahead to 2024, one notable accomplishment of the past 12 months that will guide our organization for years to come was to establish CHEST organizational values. The result of a collaborative process that was led by the Value-Setting Work Group and informed by CHEST leaders, members, and staff, the CHEST values are Community, Inclusivity, Innovation, Advocacy, and Integrity.

The process to arrive at these values was intentionally designed to ensure input from all corners of the organization. Over the course of 5 months, CHEST members had the opportunity to participate in focus groups or submit written feedback about the proposed values. The feedback shaped subsequent iterations of the values that the work group produced, finally arriving at these five.

“These values are meant to be reflective of the CHEST organization and all of its leaders, members, and staff,” said Co-Chair of the Value-Setting Work Group and CHEST Board of Regents Member Nneka Sederstrom, PhD, FCCP. “As a society, we’ve come to a point where we can’t pretend that real life issues don’t matter to our patients and to our members. It’s become a pivotal point in our world for our systems to be clear on who they are. All too often, the question of, ‘Is this our lane?’ comes up. These values are a succinct way to show not only what falls into our ‘lane,’ but that we celebrate where we stand. It was a big undertaking, but seeing the collaboration and passion was exceptional.”

The work group was co-chaired by Dr. Sederstrom and Elizabeth Stigler, PhD, and was supported by David Zielinski, MD, FCCP; Bravein Amalakuhan, MD; Alisha Young, MD; Steven Simpson, MD, FCCP; Nehan Sher, MD; and CHEST staff members, Teresa Rodriguez, Manager, CHEST Annual Meeting; Terri Horton-O’Connell, MSW, Director, Grant and Proposal Development; and Vanessa Rancine, Recruiting Specialist.

Beyond solidifying the five succinct values, the work group strategically defined each value to clarify its intent.
 

• Community: We invest in the support, growth, and development of everyone involved with CHEST, both individually and collectively, and are tireless champions for one another.
• Inclusivity: We cherish the diverse perspectives and experiences of our community members and amplify their unique voices.
• Innovation: We strive for excellence in all that we do with an adaptable and ever-evolving perspective. We pursue bold, future-oriented possibilities for constant improvement and continual growth.
• Advocacy: We courageously and intentionally create and foster positive changes for our patients and their families, our members and staff, and the next generation of CHEST clinicians.
• Integrity: We take pride in acting responsibly with respect, honesty, and accountability that engenders trust.

“With the new values in place, hopefully, our members will feel a shift in how we, as an organization, show up when anything occurs,” Dr. Sederstrom said. “The values will be reflected through community engagement and support and will be deeply integrated into the CHEST Annual Meeting. When someone asks CHEST, ‘Who are you?’ -we can now answer it with certitude.”

Looking ahead to 2024, one notable accomplishment of the past 12 months that will guide our organization for years to come was to establish CHEST organizational values. The result of a collaborative process that was led by the Value-Setting Work Group and informed by CHEST leaders, members, and staff, the CHEST values are Community, Inclusivity, Innovation, Advocacy, and Integrity.

The process to arrive at these values was intentionally designed to ensure input from all corners of the organization. Over the course of 5 months, CHEST members had the opportunity to participate in focus groups or submit written feedback about the proposed values. The feedback shaped subsequent iterations of the values that the work group produced, finally arriving at these five.

“These values are meant to be reflective of the CHEST organization and all of its leaders, members, and staff,” said Co-Chair of the Value-Setting Work Group and CHEST Board of Regents Member Nneka Sederstrom, PhD, FCCP. “As a society, we’ve come to a point where we can’t pretend that real life issues don’t matter to our patients and to our members. It’s become a pivotal point in our world for our systems to be clear on who they are. All too often, the question of, ‘Is this our lane?’ comes up. These values are a succinct way to show not only what falls into our ‘lane,’ but that we celebrate where we stand. It was a big undertaking, but seeing the collaboration and passion was exceptional.”

The work group was co-chaired by Dr. Sederstrom and Elizabeth Stigler, PhD, and was supported by David Zielinski, MD, FCCP; Bravein Amalakuhan, MD; Alisha Young, MD; Steven Simpson, MD, FCCP; Nehan Sher, MD; and CHEST staff members, Teresa Rodriguez, Manager, CHEST Annual Meeting; Terri Horton-O’Connell, MSW, Director, Grant and Proposal Development; and Vanessa Rancine, Recruiting Specialist.

Beyond solidifying the five succinct values, the work group strategically defined each value to clarify its intent.
 

• Community: We invest in the support, growth, and development of everyone involved with CHEST, both individually and collectively, and are tireless champions for one another.
• Inclusivity: We cherish the diverse perspectives and experiences of our community members and amplify their unique voices.
• Innovation: We strive for excellence in all that we do with an adaptable and ever-evolving perspective. We pursue bold, future-oriented possibilities for constant improvement and continual growth.
• Advocacy: We courageously and intentionally create and foster positive changes for our patients and their families, our members and staff, and the next generation of CHEST clinicians.
• Integrity: We take pride in acting responsibly with respect, honesty, and accountability that engenders trust.

“With the new values in place, hopefully, our members will feel a shift in how we, as an organization, show up when anything occurs,” Dr. Sederstrom said. “The values will be reflected through community engagement and support and will be deeply integrated into the CHEST Annual Meeting. When someone asks CHEST, ‘Who are you?’ -we can now answer it with certitude.”

Looking ahead to 2024, one notable accomplishment of the past 12 months that will guide our organization for years to come was to establish CHEST organizational values. The result of a collaborative process that was led by the Value-Setting Work Group and informed by CHEST leaders, members, and staff, the CHEST values are Community, Inclusivity, Innovation, Advocacy, and Integrity.

The process to arrive at these values was intentionally designed to ensure input from all corners of the organization. Over the course of 5 months, CHEST members had the opportunity to participate in focus groups or submit written feedback about the proposed values. The feedback shaped subsequent iterations of the values that the work group produced, finally arriving at these five.

“These values are meant to be reflective of the CHEST organization and all of its leaders, members, and staff,” said Co-Chair of the Value-Setting Work Group and CHEST Board of Regents Member Nneka Sederstrom, PhD, FCCP. “As a society, we’ve come to a point where we can’t pretend that real life issues don’t matter to our patients and to our members. It’s become a pivotal point in our world for our systems to be clear on who they are. All too often, the question of, ‘Is this our lane?’ comes up. These values are a succinct way to show not only what falls into our ‘lane,’ but that we celebrate where we stand. It was a big undertaking, but seeing the collaboration and passion was exceptional.”

The work group was co-chaired by Dr. Sederstrom and Elizabeth Stigler, PhD, and was supported by David Zielinski, MD, FCCP; Bravein Amalakuhan, MD; Alisha Young, MD; Steven Simpson, MD, FCCP; Nehan Sher, MD; and CHEST staff members, Teresa Rodriguez, Manager, CHEST Annual Meeting; Terri Horton-O’Connell, MSW, Director, Grant and Proposal Development; and Vanessa Rancine, Recruiting Specialist.

Beyond solidifying the five succinct values, the work group strategically defined each value to clarify its intent.
 

• Community: We invest in the support, growth, and development of everyone involved with CHEST, both individually and collectively, and are tireless champions for one another.
• Inclusivity: We cherish the diverse perspectives and experiences of our community members and amplify their unique voices.
• Innovation: We strive for excellence in all that we do with an adaptable and ever-evolving perspective. We pursue bold, future-oriented possibilities for constant improvement and continual growth.
• Advocacy: We courageously and intentionally create and foster positive changes for our patients and their families, our members and staff, and the next generation of CHEST clinicians.
• Integrity: We take pride in acting responsibly with respect, honesty, and accountability that engenders trust.

“With the new values in place, hopefully, our members will feel a shift in how we, as an organization, show up when anything occurs,” Dr. Sederstrom said. “The values will be reflected through community engagement and support and will be deeply integrated into the CHEST Annual Meeting. When someone asks CHEST, ‘Who are you?’ -we can now answer it with certitude.”

As a woman in a dynamic and ever-changing profession, balancing life as a powerhouse physician or scientist is no easy feat. AGA recognizes the challenges you face and is committed to addressing them directly at the AGA Women in GI Regional Workshops.

Expanded to six workshops in 2024, AGA is pleased to offer regionally curated workshops with distinguished speakers at all experience levels to fuel your professional and personal growth. Participate in candid discussions regarding the distinct challenges you face as a woman navigating the 21st century healthcare environment. Derive inspiration from your community and cultivate meaningful connections that will carry you beyond the workshop.

Join us in-person or virtually, whatever fits into your busy schedule. We are also pleased to offer travel grants of up to $300 (per workshop) to help offset the costs of attending this program for one selected individual per region. The travel grant is to support travel and registration fees for early-career women. Additional details for the Maria Leo-Lieber Travel Award may be found in your confirmation email.

Ready to thrive? Register today to attend one of our first workshops or stay tuned for an additional workshop coming near you.

This program is supported by Janssen. 



Midwest Regional Workshop
Saturday, Feb. 24, 2024 
8 a.m.-3 p.m. CT 
University of Chicago, Gleacher Center, Chicago, IL 
Deadline to apply for a travel grant: Feb. 9, 2024 Deadline to register: Feb. 16, 2024 
Click here to register.

Western Regional Workshop
Saturday, April 27, 2024 
8 a.m.-3 p.m. PT 
UCLA Luskin Conference Center, Los Angeles, CA 
Meet fellow attendees at our pre-workshop networking event on Friday, Apr. 26 from 8 p.m. to 10:30 p.m. 
Deadline to apply for a travel grant: April 12, 2024 Deadline to register: April 19, 2024 
Click here to register.

As a woman in a dynamic and ever-changing profession, balancing life as a powerhouse physician or scientist is no easy feat. AGA recognizes the challenges you face and is committed to addressing them directly at the AGA Women in GI Regional Workshops.

Expanded to six workshops in 2024, AGA is pleased to offer regionally curated workshops with distinguished speakers at all experience levels to fuel your professional and personal growth. Participate in candid discussions regarding the distinct challenges you face as a woman navigating the 21st century healthcare environment. Derive inspiration from your community and cultivate meaningful connections that will carry you beyond the workshop.

Join us in-person or virtually, whatever fits into your busy schedule. We are also pleased to offer travel grants of up to $300 (per workshop) to help offset the costs of attending this program for one selected individual per region. The travel grant is to support travel and registration fees for early-career women. Additional details for the Maria Leo-Lieber Travel Award may be found in your confirmation email.

Ready to thrive? Register today to attend one of our first workshops or stay tuned for an additional workshop coming near you.

This program is supported by Janssen. 



Midwest Regional Workshop
Saturday, Feb. 24, 2024 
8 a.m.-3 p.m. CT 
University of Chicago, Gleacher Center, Chicago, IL 
Deadline to apply for a travel grant: Feb. 9, 2024 Deadline to register: Feb. 16, 2024 
Click here to register.

Western Regional Workshop
Saturday, April 27, 2024 
8 a.m.-3 p.m. PT 
UCLA Luskin Conference Center, Los Angeles, CA 
Meet fellow attendees at our pre-workshop networking event on Friday, Apr. 26 from 8 p.m. to 10:30 p.m. 
Deadline to apply for a travel grant: April 12, 2024 Deadline to register: April 19, 2024 
Click here to register.

As a woman in a dynamic and ever-changing profession, balancing life as a powerhouse physician or scientist is no easy feat. AGA recognizes the challenges you face and is committed to addressing them directly at the AGA Women in GI Regional Workshops.

Expanded to six workshops in 2024, AGA is pleased to offer regionally curated workshops with distinguished speakers at all experience levels to fuel your professional and personal growth. Participate in candid discussions regarding the distinct challenges you face as a woman navigating the 21st century healthcare environment. Derive inspiration from your community and cultivate meaningful connections that will carry you beyond the workshop.

Join us in-person or virtually, whatever fits into your busy schedule. We are also pleased to offer travel grants of up to $300 (per workshop) to help offset the costs of attending this program for one selected individual per region. The travel grant is to support travel and registration fees for early-career women. Additional details for the Maria Leo-Lieber Travel Award may be found in your confirmation email.

Ready to thrive? Register today to attend one of our first workshops or stay tuned for an additional workshop coming near you.

This program is supported by Janssen. 



Midwest Regional Workshop
Saturday, Feb. 24, 2024 
8 a.m.-3 p.m. CT 
University of Chicago, Gleacher Center, Chicago, IL 
Deadline to apply for a travel grant: Feb. 9, 2024 Deadline to register: Feb. 16, 2024 
Click here to register.

Western Regional Workshop
Saturday, April 27, 2024 
8 a.m.-3 p.m. PT 
UCLA Luskin Conference Center, Los Angeles, CA 
Meet fellow attendees at our pre-workshop networking event on Friday, Apr. 26 from 8 p.m. to 10:30 p.m. 
Deadline to apply for a travel grant: April 12, 2024 Deadline to register: April 19, 2024 
Click here to register.

Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments, therapies and discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

“I give back because I have a firsthand knowledge of what it will mean to a young investigator’s career,” said Shrikant Anant, PhD, AGAF, University of Kansas, AGA Legacy Society member. “I was propelled in my career when I received the 2002 AGA Research Scholar Award from the AGA Research Foundation. The funds helped me develop my independent research that led to many NIH grants and, associated with it, career advancement. I still vividly remember the day I received the notice of award and how my whole life changed. Today, I am proud to be a donor myself because I know it is making a difference on yet another young investigator.”

The AGA Legacy Society boasts 161 members. AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations.

AGA members who make gifts at the AGA Legacy Society level anytime before Digestive Disease Week^® (DDW) 2024 will receive an invitation to the AGA Research Foundation Benefactor’s Event in Washington, D.C. Individuals interested in learning more about the AGA Legacy Society membership may contact foundation@gastro.org or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.

Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments, therapies and discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

“I give back because I have a firsthand knowledge of what it will mean to a young investigator’s career,” said Shrikant Anant, PhD, AGAF, University of Kansas, AGA Legacy Society member. “I was propelled in my career when I received the 2002 AGA Research Scholar Award from the AGA Research Foundation. The funds helped me develop my independent research that led to many NIH grants and, associated with it, career advancement. I still vividly remember the day I received the notice of award and how my whole life changed. Today, I am proud to be a donor myself because I know it is making a difference on yet another young investigator.”

The AGA Legacy Society boasts 161 members. AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations.

AGA members who make gifts at the AGA Legacy Society level anytime before Digestive Disease Week^® (DDW) 2024 will receive an invitation to the AGA Research Foundation Benefactor’s Event in Washington, D.C. Individuals interested in learning more about the AGA Legacy Society membership may contact foundation@gastro.org or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.

Research creates successful practices. Patients benefit from GI research daily in practices. Scientists are working hard to develop new treatments, therapies and discover cures to advance the field and better patient care. But they can’t do this without research funding.

AGA Legacy Society members have answered this call for support. They recognize the value that research has had in their profession, both in academic medicine and in private practice, and are showing their appreciation by giving back.

“I give back because I have a firsthand knowledge of what it will mean to a young investigator’s career,” said Shrikant Anant, PhD, AGAF, University of Kansas, AGA Legacy Society member. “I was propelled in my career when I received the 2002 AGA Research Scholar Award from the AGA Research Foundation. The funds helped me develop my independent research that led to many NIH grants and, associated with it, career advancement. I still vividly remember the day I received the notice of award and how my whole life changed. Today, I am proud to be a donor myself because I know it is making a difference on yet another young investigator.”

The AGA Legacy Society boasts 161 members. AGA Legacy Society members see the promise the future holds and are committed to furthering research in gastroenterology and hepatology through their generous donations.

AGA members who make gifts at the AGA Legacy Society level anytime before Digestive Disease Week^® (DDW) 2024 will receive an invitation to the AGA Research Foundation Benefactor’s Event in Washington, D.C. Individuals interested in learning more about the AGA Legacy Society membership may contact foundation@gastro.org or visit https://foundation.gastro.org/our-donors/aga-legacy-society/ for more information about the AGA Legacy Society.

Registration is now open for the 2024 Gut Microbiota for Health World Summit!

Join global experts in-person or online as they gather for the 2024 Gut Microbiota for Health World Summit (GMFH) on March 23-24, 2024, in Washington, DC.

This meeting brings together an international and multidisciplinary community of GI clinicians, dietitians, and researchers to discuss personalized approaches to modifying the gut microbiome to improve health and treat disease. 

This year’s program will explore:

• Better health through the gut microbiome.
• Big data and the gut microbiome.
• Human-derived to synthetic communities.
• Bringing new microbiome-based products to market.

Early-career faculty and trainees are encouraged to submit abstracts for presentation during the reception. Five $1,000 abstract prizes are available for top-scoring submissions.

Register here.

Registration is now open for the 2024 Gut Microbiota for Health World Summit!

Join global experts in-person or online as they gather for the 2024 Gut Microbiota for Health World Summit (GMFH) on March 23-24, 2024, in Washington, DC.

This meeting brings together an international and multidisciplinary community of GI clinicians, dietitians, and researchers to discuss personalized approaches to modifying the gut microbiome to improve health and treat disease. 

This year’s program will explore:

• Better health through the gut microbiome.
• Big data and the gut microbiome.
• Human-derived to synthetic communities.
• Bringing new microbiome-based products to market.

Early-career faculty and trainees are encouraged to submit abstracts for presentation during the reception. Five $1,000 abstract prizes are available for top-scoring submissions.

Register here.

Registration is now open for the 2024 Gut Microbiota for Health World Summit!

Join global experts in-person or online as they gather for the 2024 Gut Microbiota for Health World Summit (GMFH) on March 23-24, 2024, in Washington, DC.

This meeting brings together an international and multidisciplinary community of GI clinicians, dietitians, and researchers to discuss personalized approaches to modifying the gut microbiome to improve health and treat disease. 

This year’s program will explore:

• Better health through the gut microbiome.
• Big data and the gut microbiome.
• Human-derived to synthetic communities.
• Bringing new microbiome-based products to market.

Early-career faculty and trainees are encouraged to submit abstracts for presentation during the reception. Five $1,000 abstract prizes are available for top-scoring submissions.

Register here.

AGA journals have welcomed new social media editors for Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) and Gastro Hep Advances (GHA).

These social media editors will work to bridge the gap between scholarly research and the GI community by leveraging the power of social media to amplify the impact of AGA’s journals.
 

Clinical Gastroenterology and Hepatology (CGH)

Joseph Sleiman, MD

University of Pittsburgh Medical Center

Dr. Sleiman’s research interests include inflammatory bowel disease (IBD), immunotherapy-induced colitis, Lynch Syndrome surveillance strategies and machine learning for GI research purposes.

Follow Dr. Sleiman
 

Cellular and Molecular Gastroenterology and Hepatology (CMGH)

Lindsey Kennedy, PhD

Indiana University School of Medicine

Dr. Kennedy’s research interests include the cellular crosstalk and pathological mechanisms regulating biliary and liver damage in cholestatic disorders, such as primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC).

Follow Dr. Kennedy
 

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE)

Judy Trieu, MD, MPH

Washington University Physicians

Dr. Trieu specializes in interventional endoscopy and general gastroenterology.

Follow Dr. Trieu
 

Gastro Hep Advances (GHA)

Shida Haghighat, MD, MPH

University of Miami

Dr. Haghighat’s research interests center around the prevention and screening of gastrointestinal cancers.

Follow Dr. Haghihat

AGA journals have welcomed new social media editors for Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) and Gastro Hep Advances (GHA).

These social media editors will work to bridge the gap between scholarly research and the GI community by leveraging the power of social media to amplify the impact of AGA’s journals.
 

Clinical Gastroenterology and Hepatology (CGH)

Joseph Sleiman, MD

University of Pittsburgh Medical Center

Dr. Sleiman’s research interests include inflammatory bowel disease (IBD), immunotherapy-induced colitis, Lynch Syndrome surveillance strategies and machine learning for GI research purposes.

Follow Dr. Sleiman
 

Cellular and Molecular Gastroenterology and Hepatology (CMGH)

Lindsey Kennedy, PhD

Indiana University School of Medicine

Dr. Kennedy’s research interests include the cellular crosstalk and pathological mechanisms regulating biliary and liver damage in cholestatic disorders, such as primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC).

Follow Dr. Kennedy
 

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE)

Judy Trieu, MD, MPH

Washington University Physicians

Dr. Trieu specializes in interventional endoscopy and general gastroenterology.

Follow Dr. Trieu
 

Gastro Hep Advances (GHA)

Shida Haghighat, MD, MPH

University of Miami

Dr. Haghighat’s research interests center around the prevention and screening of gastrointestinal cancers.

Follow Dr. Haghihat

AGA journals have welcomed new social media editors for Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) and Gastro Hep Advances (GHA).

These social media editors will work to bridge the gap between scholarly research and the GI community by leveraging the power of social media to amplify the impact of AGA’s journals.
 

Clinical Gastroenterology and Hepatology (CGH)

Joseph Sleiman, MD

University of Pittsburgh Medical Center

Dr. Sleiman’s research interests include inflammatory bowel disease (IBD), immunotherapy-induced colitis, Lynch Syndrome surveillance strategies and machine learning for GI research purposes.

Follow Dr. Sleiman
 

Cellular and Molecular Gastroenterology and Hepatology (CMGH)

Lindsey Kennedy, PhD

Indiana University School of Medicine

Dr. Kennedy’s research interests include the cellular crosstalk and pathological mechanisms regulating biliary and liver damage in cholestatic disorders, such as primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC).

Follow Dr. Kennedy
 

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE)

Judy Trieu, MD, MPH

Washington University Physicians

Dr. Trieu specializes in interventional endoscopy and general gastroenterology.

Follow Dr. Trieu
 

Gastro Hep Advances (GHA)

Shida Haghighat, MD, MPH

University of Miami

Dr. Haghighat’s research interests center around the prevention and screening of gastrointestinal cancers.

Follow Dr. Haghihat

Did you know you can honor a family member, friend, or colleague and support the AGA Research Awards Program, while giving you a tax benefit? Any charitable gift can be made in honor or memory of someone.

• A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax.
• A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one.
• AGA Institute program naming opportunities. Individuals interested in receiving name recognition for selected AGA Institute program can do so by contributing a new, unrestricted gift totaling a designated amount to the AGA Research Foundation.

Your next step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

Did you know you can honor a family member, friend, or colleague and support the AGA Research Awards Program, while giving you a tax benefit? Any charitable gift can be made in honor or memory of someone.

• A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax.
• A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one.
• AGA Institute program naming opportunities. Individuals interested in receiving name recognition for selected AGA Institute program can do so by contributing a new, unrestricted gift totaling a designated amount to the AGA Research Foundation.

Your next step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

Did you know you can honor a family member, friend, or colleague and support the AGA Research Awards Program, while giving you a tax benefit? Any charitable gift can be made in honor or memory of someone.

• A gift today. An outright gift will help fund the AGA Research Awards Program. Your gift will assist in furthering basic digestive disease research which can ultimately advance research into all digestive diseases. The financial benefits include an income tax deduction and possible elimination of capital gains tax.
• A gift through your will or living trust. You can include a bequest in your will or living trust stating that a specific asset, certain dollar amount, or more commonly a percentage of your estate will pass to the AGA Research Foundation in honor of your loved one.
• AGA Institute program naming opportunities. Individuals interested in receiving name recognition for selected AGA Institute program can do so by contributing a new, unrestricted gift totaling a designated amount to the AGA Research Foundation.

Your next step

An honorary gift is a wonderful way to acknowledge someone’s vision for the future. To learn more about ways to recognize your honoree, visit our website at www.foundation.gastro.org.

CHEST 2023 in Honolulu kicked off for Network Leadership during the Council of Networks meeting. Leadership from the seven Networks presented their plans for CHEST 2023, participation in proposed guidelines, CHEST projects completed over the past year, and other accomplishments.

We congratulated our Network leaders – Margaret Pisani, Council of Networks Vice-chair, who was awarded the Roger C. Bone Memorial Lecture in Critical Care; and Jean Elwing, Chair of the Pulmonary Vascular & Cardiovascular Network, for being awarded the Distinguished Scientist Honor Lecture in Cardiopulmonary Physiology. CHEST 2023 included excellent educational content by the Networks, including two Network highlights per each of the seven Networks, as well as an Experience CHEST submission from each of the 22 sections.

We also had the opportunity to meet face-to-face at the Network Open Forums, the Network Mixer, and the inaugural Fellow-in-Training Mixer in the Trainee Lounge. We saw a lot of familiar faces at these events, and 182 new individuals also signed up to become Network members.

There will be one final Council of Networks leadership meeting in December prior to our leadership transition in January.

We thank outgoing Network chairs, Dr. Marcos Restrepo of the Chest Infections & Disaster Response Network, Dr. Christopher Carroll of the Critical Care Network, Dr. Debbie Levine of the Diffuse Lung Disease & Lung Transplant Network, and Dr. Carolyn D’Ambrosio of the Sleep Medicine Network, for their leadership and hard work dedicated to the Networks that have greatly benefited from their service.



Cassie Kennedy, MD, FCCP – Chair, Council of Networks

Margaret Pisani, MD, MPH, FCCP – Vice-Chair, Council of Networks

CHEST 2023 in Honolulu kicked off for Network Leadership during the Council of Networks meeting. Leadership from the seven Networks presented their plans for CHEST 2023, participation in proposed guidelines, CHEST projects completed over the past year, and other accomplishments.

We congratulated our Network leaders – Margaret Pisani, Council of Networks Vice-chair, who was awarded the Roger C. Bone Memorial Lecture in Critical Care; and Jean Elwing, Chair of the Pulmonary Vascular & Cardiovascular Network, for being awarded the Distinguished Scientist Honor Lecture in Cardiopulmonary Physiology. CHEST 2023 included excellent educational content by the Networks, including two Network highlights per each of the seven Networks, as well as an Experience CHEST submission from each of the 22 sections.

We also had the opportunity to meet face-to-face at the Network Open Forums, the Network Mixer, and the inaugural Fellow-in-Training Mixer in the Trainee Lounge. We saw a lot of familiar faces at these events, and 182 new individuals also signed up to become Network members.

There will be one final Council of Networks leadership meeting in December prior to our leadership transition in January.

We thank outgoing Network chairs, Dr. Marcos Restrepo of the Chest Infections & Disaster Response Network, Dr. Christopher Carroll of the Critical Care Network, Dr. Debbie Levine of the Diffuse Lung Disease & Lung Transplant Network, and Dr. Carolyn D’Ambrosio of the Sleep Medicine Network, for their leadership and hard work dedicated to the Networks that have greatly benefited from their service.



Cassie Kennedy, MD, FCCP – Chair, Council of Networks

Margaret Pisani, MD, MPH, FCCP – Vice-Chair, Council of Networks

CHEST 2023 in Honolulu kicked off for Network Leadership during the Council of Networks meeting. Leadership from the seven Networks presented their plans for CHEST 2023, participation in proposed guidelines, CHEST projects completed over the past year, and other accomplishments.

We congratulated our Network leaders – Margaret Pisani, Council of Networks Vice-chair, who was awarded the Roger C. Bone Memorial Lecture in Critical Care; and Jean Elwing, Chair of the Pulmonary Vascular & Cardiovascular Network, for being awarded the Distinguished Scientist Honor Lecture in Cardiopulmonary Physiology. CHEST 2023 included excellent educational content by the Networks, including two Network highlights per each of the seven Networks, as well as an Experience CHEST submission from each of the 22 sections.

We also had the opportunity to meet face-to-face at the Network Open Forums, the Network Mixer, and the inaugural Fellow-in-Training Mixer in the Trainee Lounge. We saw a lot of familiar faces at these events, and 182 new individuals also signed up to become Network members.

There will be one final Council of Networks leadership meeting in December prior to our leadership transition in January.

We thank outgoing Network chairs, Dr. Marcos Restrepo of the Chest Infections & Disaster Response Network, Dr. Christopher Carroll of the Critical Care Network, Dr. Debbie Levine of the Diffuse Lung Disease & Lung Transplant Network, and Dr. Carolyn D’Ambrosio of the Sleep Medicine Network, for their leadership and hard work dedicated to the Networks that have greatly benefited from their service.



Cassie Kennedy, MD, FCCP – Chair, Council of Networks

Margaret Pisani, MD, MPH, FCCP – Vice-Chair, Council of Networks

Pulmonary rehabilitation (PR) is an invaluable program typically set in structured in-person environments for individuals living with chronic respiratory conditions. It offers a comprehensive approach to improving lung health and overall quality of life using a combination of tailored exercise routines, educational sessions, and emotional support. It empowers our patients to better manage their conditions, improve their fitness level, and regain a sense of control over their lives. However, the response to the COVID-19 pandemic increased the use of telemedicine as a method for providing health care (Shaver J. Prim Care. 2022;49[4]:517).

Many patients have welcomed the convenience offered by virtual care, and studies have demonstrated high levels of patient satisfaction (Polinski JM, et al. Gen Intern Med. 2016;31[3]:269). Geography also drives telehealth use. In urban areas in the United States, the median travel distance is 7.5 miles one way with a resulting travel time of 3 to 25 minutes. In rural areas, the estimated travel distance is three times as long. Distance and travel time have been recognized as major barriers to attending PR (Keating A, et al. Chron Respir Dis. 2011;8[2]:89).

Access to PR is also hindered by lack of program availability. As of 2019, there were only 831 pulmonary rehab centers in the United States serving roughly 24 million patients with COPD. Only 561 of these centers are certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, leaving only one certified center for every 43,000 patients with COPD (Chan L, et al. J Rural Health. 2006;22[2]:140). As such, virtual PR is one option for augmenting availability and accessibility.

While virtual PR programs offer numerous advantages, including accessibility and convenience, there are inherent risks and challenges. There is also concern that they are inferior to in-person PR. They offer less supervision by trained health care professionals and no immediate access to medical assistance. Combined with the absence of real-time monitoring of vitals or symptoms, there may be a higher risk of adverse events despite the incorporation of safety measures. Furthermore, the lack of accountability forces an increased reliance on self-motivation, which may hinder progress (Spruit MA, et al. Am J Respir Crit Care Med. 2013;188[8]:e13).

Although the digital divide is narrowing rapidly, reliable access to technology, combined with poor internet connections or computer literacy, will prevent adoption by some patients. Even in well-resourced areas, technical issues can disrupt continuity. Finally, virtual PR lacks the intangible benefits from in-person group sessions. Social interactions in this already isolated subset of patients are lost in virtual PR, and the cultivation of motivation and support to seek a common goal goes unrealized.

While these concerns are appreciated, PR is currently highly underutilized and essentially unavailable to most pulmonary patients. As such, further study is needed to shape the future design of quality virtual PR programs. In the March 2023 issue of the journal CHEST, Huynh and colleagues published an observational cohort study comparing virtual with traditional PR programs (Huynh VC, et al. Chest. 2023; Mar;163[3]:529). Of the 554 participants in the study, 171 were enrolled in virtual and 383 to in-person PR. Attendance and drop-out rates did not differ, CAT scores significantly improved in both programs, and there were no adverse events during virtual PR. Participants in the virtual group received a TheraBand and were required to have a sturdy chair, three large step-lengths of empty space surrounding their chair, and access to internet/Zoom. They had one-on-one Zoom meetings but relied mostly on staff-made or online videos. These results replicate past investigations that have demonstrated low adverse event rates, positive overall patient satisfaction, and noninferiority in patient-centered outcomes with PR. The total volume of data remains limited though (Cox NS, et al. Cochrane Database Syst Rev. 2021;Issue 1;Art No: CD013040).

PR is an essential resource for the management of chronic lung diseases. Given existing barriers and the growing number of eligible patients, we must embrace alternative delivery strategies, all the while ensuring that a quality and useful product is deployed (Rochester CL, et al. Am J Respir Crit Care Med. 2015;192[11]:1373). Additional study is needed to standardize and validate the implementation of virtual PR. Ultimately, virtual and alternative methods of care delivery may help optimize outcomes for our patients where more traditional methods fall short.
 

The views and opinions of authors expressed herein do not necessarily reflect those of the Department of Veterans Affairs or the U.S. government. Dr. Cagle and Dr. Gartman are with the Warren Alpert Medical School of Brown University and Providence VA Medical Center, Division of Pulmonary, Critical Care, and Sleep Medicine. Providence, R.I.

Pulmonary rehabilitation (PR) is an invaluable program typically set in structured in-person environments for individuals living with chronic respiratory conditions. It offers a comprehensive approach to improving lung health and overall quality of life using a combination of tailored exercise routines, educational sessions, and emotional support. It empowers our patients to better manage their conditions, improve their fitness level, and regain a sense of control over their lives. However, the response to the COVID-19 pandemic increased the use of telemedicine as a method for providing health care (Shaver J. Prim Care. 2022;49[4]:517).

Many patients have welcomed the convenience offered by virtual care, and studies have demonstrated high levels of patient satisfaction (Polinski JM, et al. Gen Intern Med. 2016;31[3]:269). Geography also drives telehealth use. In urban areas in the United States, the median travel distance is 7.5 miles one way with a resulting travel time of 3 to 25 minutes. In rural areas, the estimated travel distance is three times as long. Distance and travel time have been recognized as major barriers to attending PR (Keating A, et al. Chron Respir Dis. 2011;8[2]:89).

Access to PR is also hindered by lack of program availability. As of 2019, there were only 831 pulmonary rehab centers in the United States serving roughly 24 million patients with COPD. Only 561 of these centers are certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, leaving only one certified center for every 43,000 patients with COPD (Chan L, et al. J Rural Health. 2006;22[2]:140). As such, virtual PR is one option for augmenting availability and accessibility.

While virtual PR programs offer numerous advantages, including accessibility and convenience, there are inherent risks and challenges. There is also concern that they are inferior to in-person PR. They offer less supervision by trained health care professionals and no immediate access to medical assistance. Combined with the absence of real-time monitoring of vitals or symptoms, there may be a higher risk of adverse events despite the incorporation of safety measures. Furthermore, the lack of accountability forces an increased reliance on self-motivation, which may hinder progress (Spruit MA, et al. Am J Respir Crit Care Med. 2013;188[8]:e13).

Although the digital divide is narrowing rapidly, reliable access to technology, combined with poor internet connections or computer literacy, will prevent adoption by some patients. Even in well-resourced areas, technical issues can disrupt continuity. Finally, virtual PR lacks the intangible benefits from in-person group sessions. Social interactions in this already isolated subset of patients are lost in virtual PR, and the cultivation of motivation and support to seek a common goal goes unrealized.

While these concerns are appreciated, PR is currently highly underutilized and essentially unavailable to most pulmonary patients. As such, further study is needed to shape the future design of quality virtual PR programs. In the March 2023 issue of the journal CHEST, Huynh and colleagues published an observational cohort study comparing virtual with traditional PR programs (Huynh VC, et al. Chest. 2023; Mar;163[3]:529). Of the 554 participants in the study, 171 were enrolled in virtual and 383 to in-person PR. Attendance and drop-out rates did not differ, CAT scores significantly improved in both programs, and there were no adverse events during virtual PR. Participants in the virtual group received a TheraBand and were required to have a sturdy chair, three large step-lengths of empty space surrounding their chair, and access to internet/Zoom. They had one-on-one Zoom meetings but relied mostly on staff-made or online videos. These results replicate past investigations that have demonstrated low adverse event rates, positive overall patient satisfaction, and noninferiority in patient-centered outcomes with PR. The total volume of data remains limited though (Cox NS, et al. Cochrane Database Syst Rev. 2021;Issue 1;Art No: CD013040).

PR is an essential resource for the management of chronic lung diseases. Given existing barriers and the growing number of eligible patients, we must embrace alternative delivery strategies, all the while ensuring that a quality and useful product is deployed (Rochester CL, et al. Am J Respir Crit Care Med. 2015;192[11]:1373). Additional study is needed to standardize and validate the implementation of virtual PR. Ultimately, virtual and alternative methods of care delivery may help optimize outcomes for our patients where more traditional methods fall short.
 

The views and opinions of authors expressed herein do not necessarily reflect those of the Department of Veterans Affairs or the U.S. government. Dr. Cagle and Dr. Gartman are with the Warren Alpert Medical School of Brown University and Providence VA Medical Center, Division of Pulmonary, Critical Care, and Sleep Medicine. Providence, R.I.

Pulmonary rehabilitation (PR) is an invaluable program typically set in structured in-person environments for individuals living with chronic respiratory conditions. It offers a comprehensive approach to improving lung health and overall quality of life using a combination of tailored exercise routines, educational sessions, and emotional support. It empowers our patients to better manage their conditions, improve their fitness level, and regain a sense of control over their lives. However, the response to the COVID-19 pandemic increased the use of telemedicine as a method for providing health care (Shaver J. Prim Care. 2022;49[4]:517).

Many patients have welcomed the convenience offered by virtual care, and studies have demonstrated high levels of patient satisfaction (Polinski JM, et al. Gen Intern Med. 2016;31[3]:269). Geography also drives telehealth use. In urban areas in the United States, the median travel distance is 7.5 miles one way with a resulting travel time of 3 to 25 minutes. In rural areas, the estimated travel distance is three times as long. Distance and travel time have been recognized as major barriers to attending PR (Keating A, et al. Chron Respir Dis. 2011;8[2]:89).

Access to PR is also hindered by lack of program availability. As of 2019, there were only 831 pulmonary rehab centers in the United States serving roughly 24 million patients with COPD. Only 561 of these centers are certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, leaving only one certified center for every 43,000 patients with COPD (Chan L, et al. J Rural Health. 2006;22[2]:140). As such, virtual PR is one option for augmenting availability and accessibility.

While virtual PR programs offer numerous advantages, including accessibility and convenience, there are inherent risks and challenges. There is also concern that they are inferior to in-person PR. They offer less supervision by trained health care professionals and no immediate access to medical assistance. Combined with the absence of real-time monitoring of vitals or symptoms, there may be a higher risk of adverse events despite the incorporation of safety measures. Furthermore, the lack of accountability forces an increased reliance on self-motivation, which may hinder progress (Spruit MA, et al. Am J Respir Crit Care Med. 2013;188[8]:e13).

Although the digital divide is narrowing rapidly, reliable access to technology, combined with poor internet connections or computer literacy, will prevent adoption by some patients. Even in well-resourced areas, technical issues can disrupt continuity. Finally, virtual PR lacks the intangible benefits from in-person group sessions. Social interactions in this already isolated subset of patients are lost in virtual PR, and the cultivation of motivation and support to seek a common goal goes unrealized.

While these concerns are appreciated, PR is currently highly underutilized and essentially unavailable to most pulmonary patients. As such, further study is needed to shape the future design of quality virtual PR programs. In the March 2023 issue of the journal CHEST, Huynh and colleagues published an observational cohort study comparing virtual with traditional PR programs (Huynh VC, et al. Chest. 2023; Mar;163[3]:529). Of the 554 participants in the study, 171 were enrolled in virtual and 383 to in-person PR. Attendance and drop-out rates did not differ, CAT scores significantly improved in both programs, and there were no adverse events during virtual PR. Participants in the virtual group received a TheraBand and were required to have a sturdy chair, three large step-lengths of empty space surrounding their chair, and access to internet/Zoom. They had one-on-one Zoom meetings but relied mostly on staff-made or online videos. These results replicate past investigations that have demonstrated low adverse event rates, positive overall patient satisfaction, and noninferiority in patient-centered outcomes with PR. The total volume of data remains limited though (Cox NS, et al. Cochrane Database Syst Rev. 2021;Issue 1;Art No: CD013040).

PR is an essential resource for the management of chronic lung diseases. Given existing barriers and the growing number of eligible patients, we must embrace alternative delivery strategies, all the while ensuring that a quality and useful product is deployed (Rochester CL, et al. Am J Respir Crit Care Med. 2015;192[11]:1373). Additional study is needed to standardize and validate the implementation of virtual PR. Ultimately, virtual and alternative methods of care delivery may help optimize outcomes for our patients where more traditional methods fall short.
 

The views and opinions of authors expressed herein do not necessarily reflect those of the Department of Veterans Affairs or the U.S. government. Dr. Cagle and Dr. Gartman are with the Warren Alpert Medical School of Brown University and Providence VA Medical Center, Division of Pulmonary, Critical Care, and Sleep Medicine. Providence, R.I.

It wasn’t until Başak Çoruh, MD, FCCP, was a mentee herself that she realized the value of structured mentoring. And now, she has more to give.

Dr. Çoruh, Associate Professor of Pulmonary, Critical Care, and Sleep Medicine and Director of the Pulmonary and Critical Care Medicine fellowship program at the University of Washington, was named as the mentor for the Medical Educator Diversity Scholarship Fellowship.

This mentorship opportunity is part of a joint program sponsored by CHEST and the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD). It was created to support a fellow who intends to pursue a career in medical education but who may have limited resources to train in teaching, formal medical education curricula, and medical education research.

“The fellowship is an incredible opportunity to increase the diversity of our medical education community,” Dr. Çoruh said.

The fellowship also closely aligns with CHEST’s newly established philanthropic pillar of “Support of the profession.” CHEST is devoted to elevating the field of chest medicine through top-notch clinical education and empowering early career clinicians from diverse backgrounds with the latest knowledge.

“I’m particularly excited to serve as a mentor for an aspiring medical educator without access to resources for coursework, teaching activities, or scholarship at their home institution,” Dr. Çoruh said. “I am fortunate to be a part of a large and welcoming education community at the University of Washington that I’m excited to share with my mentee.”

The importance of mentorship cannot be overstated, as it can shape the rest of a clinician’s career. There is immense value in not only the funding and research aspect but in the wisdom-sharing and motivational side, as well.

“It wasn’t until my own fellowship that I experienced the value of structured mentoring, and the mentoring I have received has impacted my career in countless ways. I look forward to helping [the fellow] achieve their goals.”

The fellowship recipient will be announced in early 2024.

It wasn’t until Başak Çoruh, MD, FCCP, was a mentee herself that she realized the value of structured mentoring. And now, she has more to give.

Dr. Çoruh, Associate Professor of Pulmonary, Critical Care, and Sleep Medicine and Director of the Pulmonary and Critical Care Medicine fellowship program at the University of Washington, was named as the mentor for the Medical Educator Diversity Scholarship Fellowship.

This mentorship opportunity is part of a joint program sponsored by CHEST and the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD). It was created to support a fellow who intends to pursue a career in medical education but who may have limited resources to train in teaching, formal medical education curricula, and medical education research.

“The fellowship is an incredible opportunity to increase the diversity of our medical education community,” Dr. Çoruh said.

The fellowship also closely aligns with CHEST’s newly established philanthropic pillar of “Support of the profession.” CHEST is devoted to elevating the field of chest medicine through top-notch clinical education and empowering early career clinicians from diverse backgrounds with the latest knowledge.

“I’m particularly excited to serve as a mentor for an aspiring medical educator without access to resources for coursework, teaching activities, or scholarship at their home institution,” Dr. Çoruh said. “I am fortunate to be a part of a large and welcoming education community at the University of Washington that I’m excited to share with my mentee.”

The importance of mentorship cannot be overstated, as it can shape the rest of a clinician’s career. There is immense value in not only the funding and research aspect but in the wisdom-sharing and motivational side, as well.

“It wasn’t until my own fellowship that I experienced the value of structured mentoring, and the mentoring I have received has impacted my career in countless ways. I look forward to helping [the fellow] achieve their goals.”

The fellowship recipient will be announced in early 2024.

It wasn’t until Başak Çoruh, MD, FCCP, was a mentee herself that she realized the value of structured mentoring. And now, she has more to give.

Dr. Çoruh, Associate Professor of Pulmonary, Critical Care, and Sleep Medicine and Director of the Pulmonary and Critical Care Medicine fellowship program at the University of Washington, was named as the mentor for the Medical Educator Diversity Scholarship Fellowship.

This mentorship opportunity is part of a joint program sponsored by CHEST and the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD). It was created to support a fellow who intends to pursue a career in medical education but who may have limited resources to train in teaching, formal medical education curricula, and medical education research.

“The fellowship is an incredible opportunity to increase the diversity of our medical education community,” Dr. Çoruh said.

The fellowship also closely aligns with CHEST’s newly established philanthropic pillar of “Support of the profession.” CHEST is devoted to elevating the field of chest medicine through top-notch clinical education and empowering early career clinicians from diverse backgrounds with the latest knowledge.

“I’m particularly excited to serve as a mentor for an aspiring medical educator without access to resources for coursework, teaching activities, or scholarship at their home institution,” Dr. Çoruh said. “I am fortunate to be a part of a large and welcoming education community at the University of Washington that I’m excited to share with my mentee.”

The importance of mentorship cannot be overstated, as it can shape the rest of a clinician’s career. There is immense value in not only the funding and research aspect but in the wisdom-sharing and motivational side, as well.

“It wasn’t until my own fellowship that I experienced the value of structured mentoring, and the mentoring I have received has impacted my career in countless ways. I look forward to helping [the fellow] achieve their goals.”

The fellowship recipient will be announced in early 2024.