News From CHEST Physician®

As a leader in education for pulmonary, critical care, and sleep medicine, staying ahead of trends in its professional fields and across educational delivery, in general, is critical to remaining relevant and to best serve the membership. The leadership of the American College of Chest Physicians (CHEST) developed a multifaceted program this year entitled, “CHEST Inspiration,” a series of programmatic initiatives aimed at stimulating and encouraging innovation within the association and recognizing individuals with great ideas that streamline current processes or disrupt ways of traditional thinking about everyday problems.

The CHEST Board of Regents recently completed one of the first components of the CHEST Inspiration program – the 2019 CHEST Environmental Scan. This article describes the development of the 2019 CHEST Environmental Scan and its fit with the other components of CHEST Inspiration program.

Environmental scanning is a formal process for tracking trends and occurrences in an organization’s internal and external environment that bear on its success--currently and in the future. The environmental scanning process examines both quantitative and qualitative factors and identifies a set of key environmental indicators believed to have the most important impact on the organization’s work.

The 2019 CHEST Environmental Scan is a synthesis of work that took place in January 2019 at the CHEST Environmental Summit, a special joint session of the Board of Regents (BOR) and the CHEST Foundation Board of Trustees (BOT). In that session attendees attempted to free themselves from the usual concentrated focus on the College and Foundation missions, goals, and strategies, recognizing that a possible (even likely) unintended consequence of a narrow focus is losing sight of the outside world and the forces there that—like it or not—influence and could even disrupt the programs and strategies of CHEST and the CHEST Foundation.

To facilitate the process, CHEST engaged a market research and consulting agency with expertise in environmental scans and a client base of nonprofit organizations and associations. The consultant conducted secondary research organized around six drivers of change selected by CHEST leadership:

• Health Care

• Economy and Workforce

• Technology

• Education, Content Delivery, and Career Advancement

• Social, Political, Regulatory, and the Environment

• Philanthropy

The leadership had the opportunity to review the consultant’s research findings prior to the Environmental Summit. Then, in the in-person BOT/BOR summit meeting, the consultant’s research findings were discussed and debated and were addressed with the following questions:

• How will this trend impact members? How will it change their work environment and what they need to know?

• How will this trend impact CHEST? What are the challenges and opportunities?

• What responses or actions should CHEST take?

• Does this insight require changes to our strategic plan?

The consultant synthesized the debates and discussions and prepared a draft document that shaped this year’s document.

The 2019 CHEST Environmental Scan, which will be undated periodically, will be used to:

• Inform members about external developments and put each in perspective

• Help leadership and staff determine future directions and program opportunities

• Keep the 5-year strategic plan fresh and relevant

The environmental scan will be published in six monthly installments in CHEST Physician, with each installment addressing one of the drivers of change. Most of the content is confirming rather than revolutionary in nature. Each installment will be accompanied comments from one of four leading physician experts who will put the content into perspective.

The two other components of the CHEST Inspiration program are to engage a group of experts from outside the field of medicine and health care who are innovative and successful in their own professions. This focus group of professionals from outside of our association will be held in conjunction with the June Board of Regents meeting. An additional component to stimulate innovative thinking and celebrate great ideas will be a new competitive event at the annual meeting. Dubbed “CHEST FISH Bowl (Furthering Innovation and Science for Health),” this event will launch this month, with contestants submitting video applications that feature their great idea, and winners in selected categories to be selected at CHEST 2019 in New Orleans. CHEST Physician will be your source for information about all the CHEST Inspiration programs through a new series of articles called “CHEST Inspiration: Pacing the Future.”

As a leader in education for pulmonary, critical care, and sleep medicine, staying ahead of trends in its professional fields and across educational delivery, in general, is critical to remaining relevant and to best serve the membership. The leadership of the American College of Chest Physicians (CHEST) developed a multifaceted program this year entitled, “CHEST Inspiration,” a series of programmatic initiatives aimed at stimulating and encouraging innovation within the association and recognizing individuals with great ideas that streamline current processes or disrupt ways of traditional thinking about everyday problems.

The CHEST Board of Regents recently completed one of the first components of the CHEST Inspiration program – the 2019 CHEST Environmental Scan. This article describes the development of the 2019 CHEST Environmental Scan and its fit with the other components of CHEST Inspiration program.

Environmental scanning is a formal process for tracking trends and occurrences in an organization’s internal and external environment that bear on its success--currently and in the future. The environmental scanning process examines both quantitative and qualitative factors and identifies a set of key environmental indicators believed to have the most important impact on the organization’s work.

The 2019 CHEST Environmental Scan is a synthesis of work that took place in January 2019 at the CHEST Environmental Summit, a special joint session of the Board of Regents (BOR) and the CHEST Foundation Board of Trustees (BOT). In that session attendees attempted to free themselves from the usual concentrated focus on the College and Foundation missions, goals, and strategies, recognizing that a possible (even likely) unintended consequence of a narrow focus is losing sight of the outside world and the forces there that—like it or not—influence and could even disrupt the programs and strategies of CHEST and the CHEST Foundation.

To facilitate the process, CHEST engaged a market research and consulting agency with expertise in environmental scans and a client base of nonprofit organizations and associations. The consultant conducted secondary research organized around six drivers of change selected by CHEST leadership:

• Health Care

• Economy and Workforce

• Technology

• Education, Content Delivery, and Career Advancement

• Social, Political, Regulatory, and the Environment

• Philanthropy

The leadership had the opportunity to review the consultant’s research findings prior to the Environmental Summit. Then, in the in-person BOT/BOR summit meeting, the consultant’s research findings were discussed and debated and were addressed with the following questions:

• How will this trend impact members? How will it change their work environment and what they need to know?

• How will this trend impact CHEST? What are the challenges and opportunities?

• What responses or actions should CHEST take?

• Does this insight require changes to our strategic plan?

The consultant synthesized the debates and discussions and prepared a draft document that shaped this year’s document.

The 2019 CHEST Environmental Scan, which will be undated periodically, will be used to:

• Inform members about external developments and put each in perspective

• Help leadership and staff determine future directions and program opportunities

• Keep the 5-year strategic plan fresh and relevant

The environmental scan will be published in six monthly installments in CHEST Physician, with each installment addressing one of the drivers of change. Most of the content is confirming rather than revolutionary in nature. Each installment will be accompanied comments from one of four leading physician experts who will put the content into perspective.

The two other components of the CHEST Inspiration program are to engage a group of experts from outside the field of medicine and health care who are innovative and successful in their own professions. This focus group of professionals from outside of our association will be held in conjunction with the June Board of Regents meeting. An additional component to stimulate innovative thinking and celebrate great ideas will be a new competitive event at the annual meeting. Dubbed “CHEST FISH Bowl (Furthering Innovation and Science for Health),” this event will launch this month, with contestants submitting video applications that feature their great idea, and winners in selected categories to be selected at CHEST 2019 in New Orleans. CHEST Physician will be your source for information about all the CHEST Inspiration programs through a new series of articles called “CHEST Inspiration: Pacing the Future.”

As a leader in education for pulmonary, critical care, and sleep medicine, staying ahead of trends in its professional fields and across educational delivery, in general, is critical to remaining relevant and to best serve the membership. The leadership of the American College of Chest Physicians (CHEST) developed a multifaceted program this year entitled, “CHEST Inspiration,” a series of programmatic initiatives aimed at stimulating and encouraging innovation within the association and recognizing individuals with great ideas that streamline current processes or disrupt ways of traditional thinking about everyday problems.

The CHEST Board of Regents recently completed one of the first components of the CHEST Inspiration program – the 2019 CHEST Environmental Scan. This article describes the development of the 2019 CHEST Environmental Scan and its fit with the other components of CHEST Inspiration program.

Environmental scanning is a formal process for tracking trends and occurrences in an organization’s internal and external environment that bear on its success--currently and in the future. The environmental scanning process examines both quantitative and qualitative factors and identifies a set of key environmental indicators believed to have the most important impact on the organization’s work.

The 2019 CHEST Environmental Scan is a synthesis of work that took place in January 2019 at the CHEST Environmental Summit, a special joint session of the Board of Regents (BOR) and the CHEST Foundation Board of Trustees (BOT). In that session attendees attempted to free themselves from the usual concentrated focus on the College and Foundation missions, goals, and strategies, recognizing that a possible (even likely) unintended consequence of a narrow focus is losing sight of the outside world and the forces there that—like it or not—influence and could even disrupt the programs and strategies of CHEST and the CHEST Foundation.

To facilitate the process, CHEST engaged a market research and consulting agency with expertise in environmental scans and a client base of nonprofit organizations and associations. The consultant conducted secondary research organized around six drivers of change selected by CHEST leadership:

• Health Care

• Economy and Workforce

• Technology

• Education, Content Delivery, and Career Advancement

• Social, Political, Regulatory, and the Environment

• Philanthropy

The leadership had the opportunity to review the consultant’s research findings prior to the Environmental Summit. Then, in the in-person BOT/BOR summit meeting, the consultant’s research findings were discussed and debated and were addressed with the following questions:

• How will this trend impact members? How will it change their work environment and what they need to know?

• How will this trend impact CHEST? What are the challenges and opportunities?

• What responses or actions should CHEST take?

• Does this insight require changes to our strategic plan?

The consultant synthesized the debates and discussions and prepared a draft document that shaped this year’s document.

The 2019 CHEST Environmental Scan, which will be undated periodically, will be used to:

• Inform members about external developments and put each in perspective

• Help leadership and staff determine future directions and program opportunities

• Keep the 5-year strategic plan fresh and relevant

The environmental scan will be published in six monthly installments in CHEST Physician, with each installment addressing one of the drivers of change. Most of the content is confirming rather than revolutionary in nature. Each installment will be accompanied comments from one of four leading physician experts who will put the content into perspective.

The two other components of the CHEST Inspiration program are to engage a group of experts from outside the field of medicine and health care who are innovative and successful in their own professions. This focus group of professionals from outside of our association will be held in conjunction with the June Board of Regents meeting. An additional component to stimulate innovative thinking and celebrate great ideas will be a new competitive event at the annual meeting. Dubbed “CHEST FISH Bowl (Furthering Innovation and Science for Health),” this event will launch this month, with contestants submitting video applications that feature their great idea, and winners in selected categories to be selected at CHEST 2019 in New Orleans. CHEST Physician will be your source for information about all the CHEST Inspiration programs through a new series of articles called “CHEST Inspiration: Pacing the Future.”

CMS announced in a [press release in mid-March that as it revamped the competitive bidding program for durable medical equipment, it would move to include no invasive ventilation (NIV) in the revamped program, slated to take effect January 1, 2021.

While the implementation date is still more than 18 months in the future, the regulatory timetable for a formal announcement, as well as time for CMS to introduce its revamped bidding process, actually creates a relatively short window for aggressive action to thwart the CMS proposal.

In late November 2018, when CMS was seeking public comment on the idea of such a move, CHEST, NAMDRC and numerous other societies submitted strongly worded comments opposed to the recommendation, citing a wide array of clinical risks associated with such a proposal. The comments also highlighted CMS’ total failure to revamp its own coverage policies, frequently cited by the pulmonary medicine community and the Office of the Inspector General as the primary root cause for significant problems.

Background: Under current law, Medicare is required to pay for certain ventilators under a “frequent and substantial servicing” payment methodology, with payment continuing as long as medical necessity is documented. Nearly 2 decades ago, CMS (then HCFA) sought to circumvent those statutory requirements by declaring that some ventilators are really not ventilators (as FDA classifications indicate) but are actually “respiratory assist devices.” The long-term impact of that unilateral policy decision has been ongoing chaos, as well as flawed coverage policies. For example, it is much more challenging for a physician to order a cheaper bi-level device than to order a ventilator for treatment of “respiratory failure.” As there are no limitations or qualifying criteria tied to “respiratory failure,” the community has responded with the path of least resistance while pleading with CMS to restructure their coverage policies to reflect the standards of care for home mechanical ventilation.

Since 2014, the community has repeatedly tried to convince CMS of the importance, and cost savings, associated with such a revamp, to no avail. Given 5 years of well documented efforts, it is likely that the only genuine solution will be a legislative one that forces CMS to behave in certain ways.

The challenges: There are complicating variables that the clinical community will need to address:

1. If the term “ventilator” is included in any legislative effort, CMS could expand its infamous concept “just because FDA calls a device a ventilator doesn’t make it one.” Using particular CPT or HCPCS codes would open the door for CMS to simply change coding to circumvent legislative intent.

2. If a legislative effort receives serious support, it ought to include specific guidance to CMS to force it to change its coverage policies for home mechanical ventilation to reflect standards of care and state-of-the-art devices.

For example, because devices are designed today to serve a wide range of respiratory issues, one device may be used to provide critical life support for an ALS patient, while that same device could also be used to provide nocturnal or intermittent support for other neuromuscular or COPD patients. Because the durable medical equipment benefit is focused on devices, CMS’ move to change to focus from a device to a patient is questionable.

3. Forcing CMS to move in a particular direction regarding coverage and device usage must be flexible enough to allow for technological and medical innovations; after all, no one wants to recommend legislative policies that would have to be revisited to address potential/likely advances in this field.

Broad strategies: While the durable medical equipment community is also challenging this proposal, they agreed that the medical and patient communities should take the lead. And, in principle, we agree. But implementation of that effort is a bit of a challenge as it requires a significant grassroots effort from concerned physicians, as well as patient groups to contact their legislators in Congress. After all, the worst case scenario is for a Senator to say, “How come I haven’t heard from any constituents about this problem if it is as bad as you say it is?” That is a fair and common refrain, and we must be prepared to engage the broad physician and patient communities to ensure success in this effort.

Once there is formal introduction of a proposal to move this matter forward, there will be outreach to physicians and respiratory therapists across the country to urge support of the legislation. Keep watching for such requests for action!

CMS announced in a [press release in mid-March that as it revamped the competitive bidding program for durable medical equipment, it would move to include no invasive ventilation (NIV) in the revamped program, slated to take effect January 1, 2021.

While the implementation date is still more than 18 months in the future, the regulatory timetable for a formal announcement, as well as time for CMS to introduce its revamped bidding process, actually creates a relatively short window for aggressive action to thwart the CMS proposal.

In late November 2018, when CMS was seeking public comment on the idea of such a move, CHEST, NAMDRC and numerous other societies submitted strongly worded comments opposed to the recommendation, citing a wide array of clinical risks associated with such a proposal. The comments also highlighted CMS’ total failure to revamp its own coverage policies, frequently cited by the pulmonary medicine community and the Office of the Inspector General as the primary root cause for significant problems.

Background: Under current law, Medicare is required to pay for certain ventilators under a “frequent and substantial servicing” payment methodology, with payment continuing as long as medical necessity is documented. Nearly 2 decades ago, CMS (then HCFA) sought to circumvent those statutory requirements by declaring that some ventilators are really not ventilators (as FDA classifications indicate) but are actually “respiratory assist devices.” The long-term impact of that unilateral policy decision has been ongoing chaos, as well as flawed coverage policies. For example, it is much more challenging for a physician to order a cheaper bi-level device than to order a ventilator for treatment of “respiratory failure.” As there are no limitations or qualifying criteria tied to “respiratory failure,” the community has responded with the path of least resistance while pleading with CMS to restructure their coverage policies to reflect the standards of care for home mechanical ventilation.

Since 2014, the community has repeatedly tried to convince CMS of the importance, and cost savings, associated with such a revamp, to no avail. Given 5 years of well documented efforts, it is likely that the only genuine solution will be a legislative one that forces CMS to behave in certain ways.

The challenges: There are complicating variables that the clinical community will need to address:

1. If the term “ventilator” is included in any legislative effort, CMS could expand its infamous concept “just because FDA calls a device a ventilator doesn’t make it one.” Using particular CPT or HCPCS codes would open the door for CMS to simply change coding to circumvent legislative intent.

2. If a legislative effort receives serious support, it ought to include specific guidance to CMS to force it to change its coverage policies for home mechanical ventilation to reflect standards of care and state-of-the-art devices.

For example, because devices are designed today to serve a wide range of respiratory issues, one device may be used to provide critical life support for an ALS patient, while that same device could also be used to provide nocturnal or intermittent support for other neuromuscular or COPD patients. Because the durable medical equipment benefit is focused on devices, CMS’ move to change to focus from a device to a patient is questionable.

3. Forcing CMS to move in a particular direction regarding coverage and device usage must be flexible enough to allow for technological and medical innovations; after all, no one wants to recommend legislative policies that would have to be revisited to address potential/likely advances in this field.

Broad strategies: While the durable medical equipment community is also challenging this proposal, they agreed that the medical and patient communities should take the lead. And, in principle, we agree. But implementation of that effort is a bit of a challenge as it requires a significant grassroots effort from concerned physicians, as well as patient groups to contact their legislators in Congress. After all, the worst case scenario is for a Senator to say, “How come I haven’t heard from any constituents about this problem if it is as bad as you say it is?” That is a fair and common refrain, and we must be prepared to engage the broad physician and patient communities to ensure success in this effort.

Once there is formal introduction of a proposal to move this matter forward, there will be outreach to physicians and respiratory therapists across the country to urge support of the legislation. Keep watching for such requests for action!

CMS announced in a [press release in mid-March that as it revamped the competitive bidding program for durable medical equipment, it would move to include no invasive ventilation (NIV) in the revamped program, slated to take effect January 1, 2021.

While the implementation date is still more than 18 months in the future, the regulatory timetable for a formal announcement, as well as time for CMS to introduce its revamped bidding process, actually creates a relatively short window for aggressive action to thwart the CMS proposal.

In late November 2018, when CMS was seeking public comment on the idea of such a move, CHEST, NAMDRC and numerous other societies submitted strongly worded comments opposed to the recommendation, citing a wide array of clinical risks associated with such a proposal. The comments also highlighted CMS’ total failure to revamp its own coverage policies, frequently cited by the pulmonary medicine community and the Office of the Inspector General as the primary root cause for significant problems.

Background: Under current law, Medicare is required to pay for certain ventilators under a “frequent and substantial servicing” payment methodology, with payment continuing as long as medical necessity is documented. Nearly 2 decades ago, CMS (then HCFA) sought to circumvent those statutory requirements by declaring that some ventilators are really not ventilators (as FDA classifications indicate) but are actually “respiratory assist devices.” The long-term impact of that unilateral policy decision has been ongoing chaos, as well as flawed coverage policies. For example, it is much more challenging for a physician to order a cheaper bi-level device than to order a ventilator for treatment of “respiratory failure.” As there are no limitations or qualifying criteria tied to “respiratory failure,” the community has responded with the path of least resistance while pleading with CMS to restructure their coverage policies to reflect the standards of care for home mechanical ventilation.

Since 2014, the community has repeatedly tried to convince CMS of the importance, and cost savings, associated with such a revamp, to no avail. Given 5 years of well documented efforts, it is likely that the only genuine solution will be a legislative one that forces CMS to behave in certain ways.

The challenges: There are complicating variables that the clinical community will need to address:

1. If the term “ventilator” is included in any legislative effort, CMS could expand its infamous concept “just because FDA calls a device a ventilator doesn’t make it one.” Using particular CPT or HCPCS codes would open the door for CMS to simply change coding to circumvent legislative intent.

2. If a legislative effort receives serious support, it ought to include specific guidance to CMS to force it to change its coverage policies for home mechanical ventilation to reflect standards of care and state-of-the-art devices.

For example, because devices are designed today to serve a wide range of respiratory issues, one device may be used to provide critical life support for an ALS patient, while that same device could also be used to provide nocturnal or intermittent support for other neuromuscular or COPD patients. Because the durable medical equipment benefit is focused on devices, CMS’ move to change to focus from a device to a patient is questionable.

3. Forcing CMS to move in a particular direction regarding coverage and device usage must be flexible enough to allow for technological and medical innovations; after all, no one wants to recommend legislative policies that would have to be revisited to address potential/likely advances in this field.

Broad strategies: While the durable medical equipment community is also challenging this proposal, they agreed that the medical and patient communities should take the lead. And, in principle, we agree. But implementation of that effort is a bit of a challenge as it requires a significant grassroots effort from concerned physicians, as well as patient groups to contact their legislators in Congress. After all, the worst case scenario is for a Senator to say, “How come I haven’t heard from any constituents about this problem if it is as bad as you say it is?” That is a fair and common refrain, and we must be prepared to engage the broad physician and patient communities to ensure success in this effort.

Once there is formal introduction of a proposal to move this matter forward, there will be outreach to physicians and respiratory therapists across the country to urge support of the legislation. Keep watching for such requests for action!

CHEST leadership meets quarterly in person, but the fall and spring meetings include all of the combined committees of CHEST. As the fall meeting takes place during the CHEST Annual Scientific Meeting, the spring meeting takes on a particular importance in providing the impetus of the upcoming year. The meeting spanned from March 27 to March 30. Traditionally, the first day consists of committee meetings, such as the Council of Networks, Training and Transition, Education, Membership, Guideline Oversight, and Professional Standards. On the morning of the second day, the following committees met: Finance, Diversity, and the Governance Committee. The afternoon of the second day was a combined boards meeting with all members of the Board of Trustees and the Board of Regents, where we received updates from each of the committees. In addition, all of the board members underwent professional media training as professional development.

On the 29th, the Foundation Board of Trustees had their meeting, which was attended by several of the members of the Board of Regents (highlights listed below). In the afternoon, we had the biannual meeting of the CHEST Industry Advisory Council, where CHEST leadership meets with our industry partners, working together to anticipate the needs of our members and our patients. The Board of Regents convened on March 30 for our formal board meeting.



Highlights of the Spring Combined Meeting:

CHEST Leadership Committees:

Education Committee: Under the leadership of the Chair, Dr. Alex Niven, the Education Committee has grown in scope and focus with the increasing strength of their subcommittees, including Live Learning, Simulation, Peer Review, Outcomes, Innovations, and Educator Development. The Education Committee is now working to develop a revolving education curriculum to ensure that our members have a solid base at the annual meeting, as well as in online learning. The committee is working to increase coordination with the APCCMPD, as well.

Membership Committee: The Membership Committee reported on several accomplishments during the year, including an increase in nonphysician membership and rolling out several new programs, including automatic membership renewal option and adjusted membership fees for international members and retired members.

Finance Committee: The financial report for the last quarter of the CHEST fiscal year was robust with solid outlook for the year.

Training and Transitions: The T & T Committee has had marked success with a dramatic increase in fellow education programs and learners at the CHEST annual meeting. This year will bring new fellow courses in Pulmonary Nodules and Lung Transplantation. In addition, the committee is also reviewing abstract submissions for trainees at a record pace, with case report submissions exceeding last year’s record number of 1,015 submissions.

Guideline Oversight: There are currently 12 guidelines in development, in addition to the 6 guidelines that were completed last fiscal year. This committee updated us regarding the ongoing development of “living guidelines.”

Scientific Program Committee: Dr. Bill Kelly, chairman of CHEST 2019 in New Orleans, reported on the meeting, including the record number of submissions in all curriculum areas. He updated us regarding the ongoing maintenance of certification credits for the meeting, as well as important new initiatives, such as child care and innovative electronic options for the meeting, designed to make the experience “easy” on attendees in New Orleans - The Big Easy.

CHEST Foundation Board of Trustees: Doreen Addrizzo-Harris, MD, FCCP, President of the Foundation, updated us on the quarterly activities of the foundation and guided the board through some of the novel fundraising opportunities, including the 6th Annual Irv Feldman Poker Night, the Inaugural CHEST Foundation Derby Dinner and Auction in New York, and the Popovich Endowment Dinner and future Gala. The Foundation is sponsoring a number of activities at CHEST in New Orleans, including a Lung Health Experience, Breakfast of Champions, Women & Pulmonary Luncheon, the Young Professionals Reception, and the Foundation Reception.

CHEST Board of Regents (BoR): The Board of Regents, led by Clayton Cowl, MD, FCCP, President of CHEST, had a packed session. The session started off with a unique team building exercise. The Board approved the Master Fellow Award selection that will honor Dr. Darcy Marciniuk. The Digital Strategy Task Force, led by Dr. Chris Carroll, Nicki Augustyn, and Ron Moen, reported on their findings, which led to a lively discussion on how to move forward with an innovative and successful digital plan. A report was also given on the membership recruitment and retention initiative. Finally, the BoR approved a new agreement with PA Consulting to assist in the ongoing CHEST Analytics program.

CHEST leadership meets quarterly in person, but the fall and spring meetings include all of the combined committees of CHEST. As the fall meeting takes place during the CHEST Annual Scientific Meeting, the spring meeting takes on a particular importance in providing the impetus of the upcoming year. The meeting spanned from March 27 to March 30. Traditionally, the first day consists of committee meetings, such as the Council of Networks, Training and Transition, Education, Membership, Guideline Oversight, and Professional Standards. On the morning of the second day, the following committees met: Finance, Diversity, and the Governance Committee. The afternoon of the second day was a combined boards meeting with all members of the Board of Trustees and the Board of Regents, where we received updates from each of the committees. In addition, all of the board members underwent professional media training as professional development.

On the 29th, the Foundation Board of Trustees had their meeting, which was attended by several of the members of the Board of Regents (highlights listed below). In the afternoon, we had the biannual meeting of the CHEST Industry Advisory Council, where CHEST leadership meets with our industry partners, working together to anticipate the needs of our members and our patients. The Board of Regents convened on March 30 for our formal board meeting.



Highlights of the Spring Combined Meeting:

CHEST Leadership Committees:

Education Committee: Under the leadership of the Chair, Dr. Alex Niven, the Education Committee has grown in scope and focus with the increasing strength of their subcommittees, including Live Learning, Simulation, Peer Review, Outcomes, Innovations, and Educator Development. The Education Committee is now working to develop a revolving education curriculum to ensure that our members have a solid base at the annual meeting, as well as in online learning. The committee is working to increase coordination with the APCCMPD, as well.

Membership Committee: The Membership Committee reported on several accomplishments during the year, including an increase in nonphysician membership and rolling out several new programs, including automatic membership renewal option and adjusted membership fees for international members and retired members.

Finance Committee: The financial report for the last quarter of the CHEST fiscal year was robust with solid outlook for the year.

Training and Transitions: The T & T Committee has had marked success with a dramatic increase in fellow education programs and learners at the CHEST annual meeting. This year will bring new fellow courses in Pulmonary Nodules and Lung Transplantation. In addition, the committee is also reviewing abstract submissions for trainees at a record pace, with case report submissions exceeding last year’s record number of 1,015 submissions.

Guideline Oversight: There are currently 12 guidelines in development, in addition to the 6 guidelines that were completed last fiscal year. This committee updated us regarding the ongoing development of “living guidelines.”

Scientific Program Committee: Dr. Bill Kelly, chairman of CHEST 2019 in New Orleans, reported on the meeting, including the record number of submissions in all curriculum areas. He updated us regarding the ongoing maintenance of certification credits for the meeting, as well as important new initiatives, such as child care and innovative electronic options for the meeting, designed to make the experience “easy” on attendees in New Orleans - The Big Easy.

CHEST Foundation Board of Trustees: Doreen Addrizzo-Harris, MD, FCCP, President of the Foundation, updated us on the quarterly activities of the foundation and guided the board through some of the novel fundraising opportunities, including the 6th Annual Irv Feldman Poker Night, the Inaugural CHEST Foundation Derby Dinner and Auction in New York, and the Popovich Endowment Dinner and future Gala. The Foundation is sponsoring a number of activities at CHEST in New Orleans, including a Lung Health Experience, Breakfast of Champions, Women & Pulmonary Luncheon, the Young Professionals Reception, and the Foundation Reception.

CHEST Board of Regents (BoR): The Board of Regents, led by Clayton Cowl, MD, FCCP, President of CHEST, had a packed session. The session started off with a unique team building exercise. The Board approved the Master Fellow Award selection that will honor Dr. Darcy Marciniuk. The Digital Strategy Task Force, led by Dr. Chris Carroll, Nicki Augustyn, and Ron Moen, reported on their findings, which led to a lively discussion on how to move forward with an innovative and successful digital plan. A report was also given on the membership recruitment and retention initiative. Finally, the BoR approved a new agreement with PA Consulting to assist in the ongoing CHEST Analytics program.

CHEST leadership meets quarterly in person, but the fall and spring meetings include all of the combined committees of CHEST. As the fall meeting takes place during the CHEST Annual Scientific Meeting, the spring meeting takes on a particular importance in providing the impetus of the upcoming year. The meeting spanned from March 27 to March 30. Traditionally, the first day consists of committee meetings, such as the Council of Networks, Training and Transition, Education, Membership, Guideline Oversight, and Professional Standards. On the morning of the second day, the following committees met: Finance, Diversity, and the Governance Committee. The afternoon of the second day was a combined boards meeting with all members of the Board of Trustees and the Board of Regents, where we received updates from each of the committees. In addition, all of the board members underwent professional media training as professional development.

On the 29th, the Foundation Board of Trustees had their meeting, which was attended by several of the members of the Board of Regents (highlights listed below). In the afternoon, we had the biannual meeting of the CHEST Industry Advisory Council, where CHEST leadership meets with our industry partners, working together to anticipate the needs of our members and our patients. The Board of Regents convened on March 30 for our formal board meeting.



Highlights of the Spring Combined Meeting:

CHEST Leadership Committees:

Education Committee: Under the leadership of the Chair, Dr. Alex Niven, the Education Committee has grown in scope and focus with the increasing strength of their subcommittees, including Live Learning, Simulation, Peer Review, Outcomes, Innovations, and Educator Development. The Education Committee is now working to develop a revolving education curriculum to ensure that our members have a solid base at the annual meeting, as well as in online learning. The committee is working to increase coordination with the APCCMPD, as well.

Membership Committee: The Membership Committee reported on several accomplishments during the year, including an increase in nonphysician membership and rolling out several new programs, including automatic membership renewal option and adjusted membership fees for international members and retired members.

Finance Committee: The financial report for the last quarter of the CHEST fiscal year was robust with solid outlook for the year.

Training and Transitions: The T & T Committee has had marked success with a dramatic increase in fellow education programs and learners at the CHEST annual meeting. This year will bring new fellow courses in Pulmonary Nodules and Lung Transplantation. In addition, the committee is also reviewing abstract submissions for trainees at a record pace, with case report submissions exceeding last year’s record number of 1,015 submissions.

Guideline Oversight: There are currently 12 guidelines in development, in addition to the 6 guidelines that were completed last fiscal year. This committee updated us regarding the ongoing development of “living guidelines.”

Scientific Program Committee: Dr. Bill Kelly, chairman of CHEST 2019 in New Orleans, reported on the meeting, including the record number of submissions in all curriculum areas. He updated us regarding the ongoing maintenance of certification credits for the meeting, as well as important new initiatives, such as child care and innovative electronic options for the meeting, designed to make the experience “easy” on attendees in New Orleans - The Big Easy.

CHEST Foundation Board of Trustees: Doreen Addrizzo-Harris, MD, FCCP, President of the Foundation, updated us on the quarterly activities of the foundation and guided the board through some of the novel fundraising opportunities, including the 6th Annual Irv Feldman Poker Night, the Inaugural CHEST Foundation Derby Dinner and Auction in New York, and the Popovich Endowment Dinner and future Gala. The Foundation is sponsoring a number of activities at CHEST in New Orleans, including a Lung Health Experience, Breakfast of Champions, Women & Pulmonary Luncheon, the Young Professionals Reception, and the Foundation Reception.

CHEST Board of Regents (BoR): The Board of Regents, led by Clayton Cowl, MD, FCCP, President of CHEST, had a packed session. The session started off with a unique team building exercise. The Board approved the Master Fellow Award selection that will honor Dr. Darcy Marciniuk. The Digital Strategy Task Force, led by Dr. Chris Carroll, Nicki Augustyn, and Ron Moen, reported on their findings, which led to a lively discussion on how to move forward with an innovative and successful digital plan. A report was also given on the membership recruitment and retention initiative. Finally, the BoR approved a new agreement with PA Consulting to assist in the ongoing CHEST Analytics program.

CHEST Congress Thailand concluded in Bangkok last month with more than 1,000 attendees from 56 countries. Attendees heard experts speak on several clinical tracks, including lung cancer, severe airway disease, pulmonary infections, interventional pulmonary management, and sleep-related disordered breathing. Panel discussions were held covering controversial topics across pulmonary, critical care, and sleep medicine, and close to 400 submitted abstracts were presented. Registration continues to build for the next CHEST international meeting to be held in conjunction with the Hellenic Thoracic Society in Athens, Greece, June 25-27. This meeting will feature clinicians and academicians providing relevant clinical updates to providers throughout that region in more of a “board review-like” format.

Why is it so important that CHEST spread its brand of education to an international audience?
 

Clinicians are yearning for up-to-date information regardless of geography

Having the opportunity to visit with clinicians from Southeast Asia and Australia, it became clear to me that there is a need for high quality educational opportunities to be shared across the globe. Many attendees in Bangkok had never had the opportunity to attend a CHEST annual meeting within North America; their exposure to state-of-the-art reviews using interactive audience participation was a format that was clearly appreciated. Hands-on educational opportunities through simulation, as well as novel interactive tools such as serious gaming, were modalities not previously available to many attendees and the reviews received were overwhelmingly positive.
 

Access to cutting-edge training in certain areas in the world has become more limited

Resources for international travel have become more limited. Industry sponsorship in certain regions has dwindled and, for certain countries, the ability to access medical meetings within the United States or other areas in Europe or North America has become burdensome, if not logistically impossible. Bringing the CHEST brand of education to members and other practicing providers outside North America within the represented specialties has allowed access to experts and the most effective formats for education without extended travel and excess cost.
 

Smaller international meetings allow for more tailored curricula designed to meet local needs

The ability to build the curriculum around specific requests of a national society has allowed for a more focused educational platform designed to meet the needs of what regional leaders feel is the most critical for the highest prevalence of patients seen in that specific area. The international strategy of CHEST calls for an annual congress outside of North America and at least one smaller “board review-type” meeting in a different region elsewhere across the world each academic year. Co-hosting more meetings will not only help address unmet educational needs outside of the United States and Canada but also extend our reach to participants who may not have otherwise had the ability to participate in the CHEST brand of education. During multiple sessions, there were literally dozens of questions for which there was time to address each in real time. The panel discussions were lively, well-moderated, and also stimulated multiple questions and comments from the audience.
 

Education by podium lecture is fast becoming outdated

Although a compelling lecture using a didactic format from a podium at the front of a room is not going to be replaced completely any time soon, educational delivery trends are moving toward virtual classrooms, use of simulation, problem solving online, serious gaming, and hands-on experiential education. As an innovator and leader in medical education, CHEST will continue to provide a variety of options for delivering education utilizing a variety of platforms. By opening a multimedia production studio at CHEST global headquarters in Glenview, Illinois, this past February, the organization is positioning itself to continue to refine its ability to produce and distribute a variety of courses available to all CHEST members in an archivable, easily accessible format. The Board of Regents has doubled down on its digital strategy toward improving communication across the entire user experience, and offering courses to our international members closer to home is one way to execute this strategy.
 

Networking and new friendships underscore what’s important

Meeting new colleagues from across the globe has made me realize that we are all focused on providing the very best care possible to our patients every day. Ultimately, education is communication. The ability to share how CHEST educates its membership will improve patient care worldwide and foster lifelong friendships with those we meet in other lands. Those opportunities to share ideas on health-care delivery will keep us on the cutting edge technologically and keep us focused on how to use resources responsibly and in a way that best serves the communities where we practice.
 

CHEST Congress Thailand concluded in Bangkok last month with more than 1,000 attendees from 56 countries. Attendees heard experts speak on several clinical tracks, including lung cancer, severe airway disease, pulmonary infections, interventional pulmonary management, and sleep-related disordered breathing. Panel discussions were held covering controversial topics across pulmonary, critical care, and sleep medicine, and close to 400 submitted abstracts were presented. Registration continues to build for the next CHEST international meeting to be held in conjunction with the Hellenic Thoracic Society in Athens, Greece, June 25-27. This meeting will feature clinicians and academicians providing relevant clinical updates to providers throughout that region in more of a “board review-like” format.

Why is it so important that CHEST spread its brand of education to an international audience?
 

Clinicians are yearning for up-to-date information regardless of geography

Having the opportunity to visit with clinicians from Southeast Asia and Australia, it became clear to me that there is a need for high quality educational opportunities to be shared across the globe. Many attendees in Bangkok had never had the opportunity to attend a CHEST annual meeting within North America; their exposure to state-of-the-art reviews using interactive audience participation was a format that was clearly appreciated. Hands-on educational opportunities through simulation, as well as novel interactive tools such as serious gaming, were modalities not previously available to many attendees and the reviews received were overwhelmingly positive.
 

Access to cutting-edge training in certain areas in the world has become more limited

Resources for international travel have become more limited. Industry sponsorship in certain regions has dwindled and, for certain countries, the ability to access medical meetings within the United States or other areas in Europe or North America has become burdensome, if not logistically impossible. Bringing the CHEST brand of education to members and other practicing providers outside North America within the represented specialties has allowed access to experts and the most effective formats for education without extended travel and excess cost.
 

Smaller international meetings allow for more tailored curricula designed to meet local needs

The ability to build the curriculum around specific requests of a national society has allowed for a more focused educational platform designed to meet the needs of what regional leaders feel is the most critical for the highest prevalence of patients seen in that specific area. The international strategy of CHEST calls for an annual congress outside of North America and at least one smaller “board review-type” meeting in a different region elsewhere across the world each academic year. Co-hosting more meetings will not only help address unmet educational needs outside of the United States and Canada but also extend our reach to participants who may not have otherwise had the ability to participate in the CHEST brand of education. During multiple sessions, there were literally dozens of questions for which there was time to address each in real time. The panel discussions were lively, well-moderated, and also stimulated multiple questions and comments from the audience.
 

Education by podium lecture is fast becoming outdated

Although a compelling lecture using a didactic format from a podium at the front of a room is not going to be replaced completely any time soon, educational delivery trends are moving toward virtual classrooms, use of simulation, problem solving online, serious gaming, and hands-on experiential education. As an innovator and leader in medical education, CHEST will continue to provide a variety of options for delivering education utilizing a variety of platforms. By opening a multimedia production studio at CHEST global headquarters in Glenview, Illinois, this past February, the organization is positioning itself to continue to refine its ability to produce and distribute a variety of courses available to all CHEST members in an archivable, easily accessible format. The Board of Regents has doubled down on its digital strategy toward improving communication across the entire user experience, and offering courses to our international members closer to home is one way to execute this strategy.
 

Networking and new friendships underscore what’s important

Meeting new colleagues from across the globe has made me realize that we are all focused on providing the very best care possible to our patients every day. Ultimately, education is communication. The ability to share how CHEST educates its membership will improve patient care worldwide and foster lifelong friendships with those we meet in other lands. Those opportunities to share ideas on health-care delivery will keep us on the cutting edge technologically and keep us focused on how to use resources responsibly and in a way that best serves the communities where we practice.
 

CHEST Congress Thailand concluded in Bangkok last month with more than 1,000 attendees from 56 countries. Attendees heard experts speak on several clinical tracks, including lung cancer, severe airway disease, pulmonary infections, interventional pulmonary management, and sleep-related disordered breathing. Panel discussions were held covering controversial topics across pulmonary, critical care, and sleep medicine, and close to 400 submitted abstracts were presented. Registration continues to build for the next CHEST international meeting to be held in conjunction with the Hellenic Thoracic Society in Athens, Greece, June 25-27. This meeting will feature clinicians and academicians providing relevant clinical updates to providers throughout that region in more of a “board review-like” format.

Why is it so important that CHEST spread its brand of education to an international audience?
 

Clinicians are yearning for up-to-date information regardless of geography

Having the opportunity to visit with clinicians from Southeast Asia and Australia, it became clear to me that there is a need for high quality educational opportunities to be shared across the globe. Many attendees in Bangkok had never had the opportunity to attend a CHEST annual meeting within North America; their exposure to state-of-the-art reviews using interactive audience participation was a format that was clearly appreciated. Hands-on educational opportunities through simulation, as well as novel interactive tools such as serious gaming, were modalities not previously available to many attendees and the reviews received were overwhelmingly positive.
 

Access to cutting-edge training in certain areas in the world has become more limited

Resources for international travel have become more limited. Industry sponsorship in certain regions has dwindled and, for certain countries, the ability to access medical meetings within the United States or other areas in Europe or North America has become burdensome, if not logistically impossible. Bringing the CHEST brand of education to members and other practicing providers outside North America within the represented specialties has allowed access to experts and the most effective formats for education without extended travel and excess cost.
 

Smaller international meetings allow for more tailored curricula designed to meet local needs

The ability to build the curriculum around specific requests of a national society has allowed for a more focused educational platform designed to meet the needs of what regional leaders feel is the most critical for the highest prevalence of patients seen in that specific area. The international strategy of CHEST calls for an annual congress outside of North America and at least one smaller “board review-type” meeting in a different region elsewhere across the world each academic year. Co-hosting more meetings will not only help address unmet educational needs outside of the United States and Canada but also extend our reach to participants who may not have otherwise had the ability to participate in the CHEST brand of education. During multiple sessions, there were literally dozens of questions for which there was time to address each in real time. The panel discussions were lively, well-moderated, and also stimulated multiple questions and comments from the audience.
 

Education by podium lecture is fast becoming outdated

Although a compelling lecture using a didactic format from a podium at the front of a room is not going to be replaced completely any time soon, educational delivery trends are moving toward virtual classrooms, use of simulation, problem solving online, serious gaming, and hands-on experiential education. As an innovator and leader in medical education, CHEST will continue to provide a variety of options for delivering education utilizing a variety of platforms. By opening a multimedia production studio at CHEST global headquarters in Glenview, Illinois, this past February, the organization is positioning itself to continue to refine its ability to produce and distribute a variety of courses available to all CHEST members in an archivable, easily accessible format. The Board of Regents has doubled down on its digital strategy toward improving communication across the entire user experience, and offering courses to our international members closer to home is one way to execute this strategy.
 

Networking and new friendships underscore what’s important

Meeting new colleagues from across the globe has made me realize that we are all focused on providing the very best care possible to our patients every day. Ultimately, education is communication. The ability to share how CHEST educates its membership will improve patient care worldwide and foster lifelong friendships with those we meet in other lands. Those opportunities to share ideas on health-care delivery will keep us on the cutting edge technologically and keep us focused on how to use resources responsibly and in a way that best serves the communities where we practice.
 

Get a glimpse of the rich southern culture of New Orleans this October by checking out a few of these locations and events.

Visit a Mini Museum – Backstreet Cultural Museum

The Backstreet Cultural Museum is located in a small, former funeral home in the historic Treme neighborhood. The museum displays the permanent collection of Mardi Gras Indians costumes, second-line parade outfits, jazz funeral photos, and music memorabilia from curator Sylvester Francis. Interested in upcoming parades and festivals happening nearly every weekend in New Orleans? Learn about these at the museum, as well as more NOLA arts and traditions.
 

View the Local Art in Jackson Square

Jackson Square is an area where you’ll see tarot readers, street performers, and artists. It has an open-air artist community where their works are hung on the iron railings around the square. Spend time getting your portrait done, buy a new art piece from a local, or have fun watching a street performance.
 

Enjoy the architecture of the French Quarter

Explore New Orleans’ oldest neighborhood, The French Quarter, with its mix of French Creole and Spanish influenced architecture. You’ll find hints of this on old tiled street names and the French Fleur de Lys emblem noticeable all around the city. There are also Caribbean, African, and other European influences throughout the area. Take in the gorgeous mansions, the colorful Creole houses with their porches and swing chairs, the townhouses with beautiful ironwork balconies, and more!
 

Head to Oktoberfest

New Orleans also has a rich German history. You can celebrate this October with the city’s own version of Oktoberfest, which takes place the first three weekends in the month. Experience some of the best of German culture by drinking a rare beer, trying authentic cuisine, and listening to live music during this celebration.
 

New Orleans Film Festival

From October 16-24, the New Orleans Film Society will be hosting the 2019 New Orleans Film Festival (NOFF). You can check out showings in different venues throughout the city. Local filmmakers are showcased during the festival, and their films and any shown during NOFF can qualify for the Oscars in all three Academy-accredited categories: Narrative Short, Documentary Short, and Animated Short.



Check out more things you can do in NOLA (https://tinyurl.com/yxnqswv5).

Get a glimpse of the rich southern culture of New Orleans this October by checking out a few of these locations and events.

Visit a Mini Museum – Backstreet Cultural Museum

The Backstreet Cultural Museum is located in a small, former funeral home in the historic Treme neighborhood. The museum displays the permanent collection of Mardi Gras Indians costumes, second-line parade outfits, jazz funeral photos, and music memorabilia from curator Sylvester Francis. Interested in upcoming parades and festivals happening nearly every weekend in New Orleans? Learn about these at the museum, as well as more NOLA arts and traditions.
 

View the Local Art in Jackson Square

Jackson Square is an area where you’ll see tarot readers, street performers, and artists. It has an open-air artist community where their works are hung on the iron railings around the square. Spend time getting your portrait done, buy a new art piece from a local, or have fun watching a street performance.
 

Enjoy the architecture of the French Quarter

Explore New Orleans’ oldest neighborhood, The French Quarter, with its mix of French Creole and Spanish influenced architecture. You’ll find hints of this on old tiled street names and the French Fleur de Lys emblem noticeable all around the city. There are also Caribbean, African, and other European influences throughout the area. Take in the gorgeous mansions, the colorful Creole houses with their porches and swing chairs, the townhouses with beautiful ironwork balconies, and more!
 

Head to Oktoberfest

New Orleans also has a rich German history. You can celebrate this October with the city’s own version of Oktoberfest, which takes place the first three weekends in the month. Experience some of the best of German culture by drinking a rare beer, trying authentic cuisine, and listening to live music during this celebration.
 

New Orleans Film Festival

From October 16-24, the New Orleans Film Society will be hosting the 2019 New Orleans Film Festival (NOFF). You can check out showings in different venues throughout the city. Local filmmakers are showcased during the festival, and their films and any shown during NOFF can qualify for the Oscars in all three Academy-accredited categories: Narrative Short, Documentary Short, and Animated Short.



Check out more things you can do in NOLA (https://tinyurl.com/yxnqswv5).

Get a glimpse of the rich southern culture of New Orleans this October by checking out a few of these locations and events.

Visit a Mini Museum – Backstreet Cultural Museum

The Backstreet Cultural Museum is located in a small, former funeral home in the historic Treme neighborhood. The museum displays the permanent collection of Mardi Gras Indians costumes, second-line parade outfits, jazz funeral photos, and music memorabilia from curator Sylvester Francis. Interested in upcoming parades and festivals happening nearly every weekend in New Orleans? Learn about these at the museum, as well as more NOLA arts and traditions.
 

View the Local Art in Jackson Square

Jackson Square is an area where you’ll see tarot readers, street performers, and artists. It has an open-air artist community where their works are hung on the iron railings around the square. Spend time getting your portrait done, buy a new art piece from a local, or have fun watching a street performance.
 

Enjoy the architecture of the French Quarter

Explore New Orleans’ oldest neighborhood, The French Quarter, with its mix of French Creole and Spanish influenced architecture. You’ll find hints of this on old tiled street names and the French Fleur de Lys emblem noticeable all around the city. There are also Caribbean, African, and other European influences throughout the area. Take in the gorgeous mansions, the colorful Creole houses with their porches and swing chairs, the townhouses with beautiful ironwork balconies, and more!
 

Head to Oktoberfest

New Orleans also has a rich German history. You can celebrate this October with the city’s own version of Oktoberfest, which takes place the first three weekends in the month. Experience some of the best of German culture by drinking a rare beer, trying authentic cuisine, and listening to live music during this celebration.
 

New Orleans Film Festival

From October 16-24, the New Orleans Film Society will be hosting the 2019 New Orleans Film Festival (NOFF). You can check out showings in different venues throughout the city. Local filmmakers are showcased during the festival, and their films and any shown during NOFF can qualify for the Oscars in all three Academy-accredited categories: Narrative Short, Documentary Short, and Animated Short.



Check out more things you can do in NOLA (https://tinyurl.com/yxnqswv5).

Editor’s Picks

By Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

John Heffner, MD, FCCP



ORIGINAL RESEARCH

The Landscape of US Lung Cancer Screening Services-Figure 1By M. S. Kale, et al.



Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved

Spirometry in SPIROMICSBy S. Garudadri, et al.Prevalence of Atrial Fibrillation in Hospital Encounters With End-Stage COPD on

Home Oxygen:

National Trends in the United States

By X. Xiao, et al.

Editor’s Picks

By Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

John Heffner, MD, FCCP



ORIGINAL RESEARCH

The Landscape of US Lung Cancer Screening Services-Figure 1By M. S. Kale, et al.



Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved

Spirometry in SPIROMICSBy S. Garudadri, et al.Prevalence of Atrial Fibrillation in Hospital Encounters With End-Stage COPD on

Home Oxygen:

National Trends in the United States

By X. Xiao, et al.

Editor’s Picks

By Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

John Heffner, MD, FCCP



ORIGINAL RESEARCH

The Landscape of US Lung Cancer Screening Services-Figure 1By M. S. Kale, et al.



Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved

Spirometry in SPIROMICSBy S. Garudadri, et al.Prevalence of Atrial Fibrillation in Hospital Encounters With End-Stage COPD on

Home Oxygen:

National Trends in the United States

By X. Xiao, et al.

Editor’s Picks

Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

David C. Zavala, MD, FCCP



Original Research

Accuracy of Algorithms to Identify Pulmonary Arterial Hypertension in Administrative Data:

A Systematic Review. By K. R. Gillmeyer, et al.

Editor’s Picks

Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

David C. Zavala, MD, FCCP



Original Research

Accuracy of Algorithms to Identify Pulmonary Arterial Hypertension in Administrative Data:

A Systematic Review. By K. R. Gillmeyer, et al.

Editor’s Picks

Richard S. Irwin, MD, Master FCCP



Giants in Chest Medicine

David C. Zavala, MD, FCCP



Original Research

Accuracy of Algorithms to Identify Pulmonary Arterial Hypertension in Administrative Data:

A Systematic Review. By K. R. Gillmeyer, et al.

In late January, your Board of Regents met for its first face-to-face quarterly meeting under the leadership of new President Clayton Cowl, MD, MS, FCCP. One of the most valuable aspects of serving on the Board is an opportunity to take an overall look at the direction of the organization. The Board makes a concerted effort not to get too deep into the weeds planning out specific tactics for achieving goals; we have a great many outstanding volunteers serving on dozens of our committees who do an incredible job of making things happen. The Board tries to focus on overall organizational strategy. Are we going in the right direction? Are there opportunities of which we should be taking better advantage? Are there efforts in which we are currently engaged that may not be yielding outcomes as we expected? To better answer these questions, Dr. Cowl and his team asked all members of the Board of Regents and the Strategic Planning Subcommittee members of the Foundation Board of Trustees, as well as senior CHEST staff, to engage in an environmental scan to take an aggressive look at where we are and where we are headed. The output from our first environmental scan is currently being curated into a list of highest priority items that will be shared with the general membership in the coming months.

A review of our accomplishments over the last 6 months came next. Our new Executive Vice President and Chief Operating Officer, Dr. Robert Musacchio, has superseded all expectations in his first few months in the role. In addition to continuing to push the organization toward the “One CHEST” model by better integrating the Foundation with the College, as well as refining our operating principles in working with industry, Bob is further developing our international reach—exploring collaborations with a number of large international societies and planning meetings abroad later this year (CHEST Congress Thailand and CHEST Regional Congress Athens) and into the next (in Italy, with the regional meeting location to be determined). We are also in the process of recruiting for a new position, Chief Learning Officer, a role that will serve not only to better organize the educational activities of CHEST, but to also serve as a visionary to better imagine what future projects we should be pursuing to be of better service and value to our members.

We took a few moments to recognize the new, incoming Editor in Chief of the journal CHEST®; Peter Mazzone, MD, FCCP, will have some huge shoes to fill in taking the editor’s chair from Richard Irwin, MD, Master FCCP, who has served the journal in this role for more than a decade. Under Dr. Irwin’s leadership, CHEST has been the most-read publication amongst practicing pulmonary specialists; he is also responsible for having launched CHEST’s social media presence, including both video series that integrated directly with the journal (such as Ultrasound Corner) and podcasts. Richard also spoke beautifully about his passion for patient-centered care as a keynote speaker at CHEST 2018. Peter has outlined a number of different areas of focus for the journal in the next year, including putting a high priority on improving the reader experience and crafting an even better web and multimedia presence. We look forward to great things from the journal!

Chris Carroll, MD, FCCP, who chairs CHEST’s Digital Strategy Task Force, presented to the Board on their progress to date. The goal of this group is to evaluate the user experience for CHEST’s content delivery platforms, including the website, apps, and our social media platforms to identify opportunities for improvements that will enable us to better provide our members with on demand, high quality information to improve patient care through a personalized, seamless digital user experience. The team is being co-led by Nicki Augustyn, Senior Vice President for Marketing, Communications, and Publishing, and Ron Moen, Chief Information Officer. We look forward to further updates on this important project.

As I stated in my opening, many of the good things that CHEST does can only happen with the participation of our great members, and so I want to take the time to recognize the NetWorks and everything that they do for the College. In the past year, under the leadership of Council of NetWorks Chairs Hassan Bencheqroun, MD, FCCP, and David Zielinski, MD, FCCP, the NetWorks produced more than 60% of the content at the 2018 CHEST meeting and are actively working on projects ranging from creating educational videos for public consumption to CHEST guidelines proposals and crafting a donor registry for lung transplantation. Our volunteer leaders are our most valuable resource; if you are not currently engaged in the NetWorks, please consider getting involved this spring during the nomination process!

It remains a privilege for the Board to serve this great organization. If you are interested in hearing more, or getting more engaged, please send me an email at [email protected].

David A. Schulman, MD, FCCP

In late January, your Board of Regents met for its first face-to-face quarterly meeting under the leadership of new President Clayton Cowl, MD, MS, FCCP. One of the most valuable aspects of serving on the Board is an opportunity to take an overall look at the direction of the organization. The Board makes a concerted effort not to get too deep into the weeds planning out specific tactics for achieving goals; we have a great many outstanding volunteers serving on dozens of our committees who do an incredible job of making things happen. The Board tries to focus on overall organizational strategy. Are we going in the right direction? Are there opportunities of which we should be taking better advantage? Are there efforts in which we are currently engaged that may not be yielding outcomes as we expected? To better answer these questions, Dr. Cowl and his team asked all members of the Board of Regents and the Strategic Planning Subcommittee members of the Foundation Board of Trustees, as well as senior CHEST staff, to engage in an environmental scan to take an aggressive look at where we are and where we are headed. The output from our first environmental scan is currently being curated into a list of highest priority items that will be shared with the general membership in the coming months.

A review of our accomplishments over the last 6 months came next. Our new Executive Vice President and Chief Operating Officer, Dr. Robert Musacchio, has superseded all expectations in his first few months in the role. In addition to continuing to push the organization toward the “One CHEST” model by better integrating the Foundation with the College, as well as refining our operating principles in working with industry, Bob is further developing our international reach—exploring collaborations with a number of large international societies and planning meetings abroad later this year (CHEST Congress Thailand and CHEST Regional Congress Athens) and into the next (in Italy, with the regional meeting location to be determined). We are also in the process of recruiting for a new position, Chief Learning Officer, a role that will serve not only to better organize the educational activities of CHEST, but to also serve as a visionary to better imagine what future projects we should be pursuing to be of better service and value to our members.

We took a few moments to recognize the new, incoming Editor in Chief of the journal CHEST®; Peter Mazzone, MD, FCCP, will have some huge shoes to fill in taking the editor’s chair from Richard Irwin, MD, Master FCCP, who has served the journal in this role for more than a decade. Under Dr. Irwin’s leadership, CHEST has been the most-read publication amongst practicing pulmonary specialists; he is also responsible for having launched CHEST’s social media presence, including both video series that integrated directly with the journal (such as Ultrasound Corner) and podcasts. Richard also spoke beautifully about his passion for patient-centered care as a keynote speaker at CHEST 2018. Peter has outlined a number of different areas of focus for the journal in the next year, including putting a high priority on improving the reader experience and crafting an even better web and multimedia presence. We look forward to great things from the journal!

Chris Carroll, MD, FCCP, who chairs CHEST’s Digital Strategy Task Force, presented to the Board on their progress to date. The goal of this group is to evaluate the user experience for CHEST’s content delivery platforms, including the website, apps, and our social media platforms to identify opportunities for improvements that will enable us to better provide our members with on demand, high quality information to improve patient care through a personalized, seamless digital user experience. The team is being co-led by Nicki Augustyn, Senior Vice President for Marketing, Communications, and Publishing, and Ron Moen, Chief Information Officer. We look forward to further updates on this important project.

As I stated in my opening, many of the good things that CHEST does can only happen with the participation of our great members, and so I want to take the time to recognize the NetWorks and everything that they do for the College. In the past year, under the leadership of Council of NetWorks Chairs Hassan Bencheqroun, MD, FCCP, and David Zielinski, MD, FCCP, the NetWorks produced more than 60% of the content at the 2018 CHEST meeting and are actively working on projects ranging from creating educational videos for public consumption to CHEST guidelines proposals and crafting a donor registry for lung transplantation. Our volunteer leaders are our most valuable resource; if you are not currently engaged in the NetWorks, please consider getting involved this spring during the nomination process!

It remains a privilege for the Board to serve this great organization. If you are interested in hearing more, or getting more engaged, please send me an email at [email protected].

David A. Schulman, MD, FCCP

In late January, your Board of Regents met for its first face-to-face quarterly meeting under the leadership of new President Clayton Cowl, MD, MS, FCCP. One of the most valuable aspects of serving on the Board is an opportunity to take an overall look at the direction of the organization. The Board makes a concerted effort not to get too deep into the weeds planning out specific tactics for achieving goals; we have a great many outstanding volunteers serving on dozens of our committees who do an incredible job of making things happen. The Board tries to focus on overall organizational strategy. Are we going in the right direction? Are there opportunities of which we should be taking better advantage? Are there efforts in which we are currently engaged that may not be yielding outcomes as we expected? To better answer these questions, Dr. Cowl and his team asked all members of the Board of Regents and the Strategic Planning Subcommittee members of the Foundation Board of Trustees, as well as senior CHEST staff, to engage in an environmental scan to take an aggressive look at where we are and where we are headed. The output from our first environmental scan is currently being curated into a list of highest priority items that will be shared with the general membership in the coming months.

A review of our accomplishments over the last 6 months came next. Our new Executive Vice President and Chief Operating Officer, Dr. Robert Musacchio, has superseded all expectations in his first few months in the role. In addition to continuing to push the organization toward the “One CHEST” model by better integrating the Foundation with the College, as well as refining our operating principles in working with industry, Bob is further developing our international reach—exploring collaborations with a number of large international societies and planning meetings abroad later this year (CHEST Congress Thailand and CHEST Regional Congress Athens) and into the next (in Italy, with the regional meeting location to be determined). We are also in the process of recruiting for a new position, Chief Learning Officer, a role that will serve not only to better organize the educational activities of CHEST, but to also serve as a visionary to better imagine what future projects we should be pursuing to be of better service and value to our members.

We took a few moments to recognize the new, incoming Editor in Chief of the journal CHEST®; Peter Mazzone, MD, FCCP, will have some huge shoes to fill in taking the editor’s chair from Richard Irwin, MD, Master FCCP, who has served the journal in this role for more than a decade. Under Dr. Irwin’s leadership, CHEST has been the most-read publication amongst practicing pulmonary specialists; he is also responsible for having launched CHEST’s social media presence, including both video series that integrated directly with the journal (such as Ultrasound Corner) and podcasts. Richard also spoke beautifully about his passion for patient-centered care as a keynote speaker at CHEST 2018. Peter has outlined a number of different areas of focus for the journal in the next year, including putting a high priority on improving the reader experience and crafting an even better web and multimedia presence. We look forward to great things from the journal!

Chris Carroll, MD, FCCP, who chairs CHEST’s Digital Strategy Task Force, presented to the Board on their progress to date. The goal of this group is to evaluate the user experience for CHEST’s content delivery platforms, including the website, apps, and our social media platforms to identify opportunities for improvements that will enable us to better provide our members with on demand, high quality information to improve patient care through a personalized, seamless digital user experience. The team is being co-led by Nicki Augustyn, Senior Vice President for Marketing, Communications, and Publishing, and Ron Moen, Chief Information Officer. We look forward to further updates on this important project.

As I stated in my opening, many of the good things that CHEST does can only happen with the participation of our great members, and so I want to take the time to recognize the NetWorks and everything that they do for the College. In the past year, under the leadership of Council of NetWorks Chairs Hassan Bencheqroun, MD, FCCP, and David Zielinski, MD, FCCP, the NetWorks produced more than 60% of the content at the 2018 CHEST meeting and are actively working on projects ranging from creating educational videos for public consumption to CHEST guidelines proposals and crafting a donor registry for lung transplantation. Our volunteer leaders are our most valuable resource; if you are not currently engaged in the NetWorks, please consider getting involved this spring during the nomination process!

It remains a privilege for the Board to serve this great organization. If you are interested in hearing more, or getting more engaged, please send me an email at [email protected].

David A. Schulman, MD, FCCP

Occupational and Environmental Health

Black lung disease in the 21st century

Inhalation and deposition of coal dust particles cause a range of lung injury from coal workers’ pneumoconiosis (CWP) to dust-related diffuse fibrosis to COPD. Despite workplace standards and improved environmental controls to limit dust exposure within coal mines, incidence of “black lung disease” in the United States has increased since the turn of the century (Antao VC, et al. Occup Environ Med. 2005;62[10]:670). Coal miners working in the Appalachian Mountains have been particularly vulnerable to developing rapidly progressive and severe pneumoconiosis. In 2018, three black lung clinics in central Appalachia uncovered the largest cluster of progressive massive fibrosis (PMF) ever reported (Blackley DJ, et al. JAMA. 2018;319[5]:500). An investigation by National Public Radio (NPR) and the Public Broadcasting Service (PBS) program Frontline identified more than 2,000 Appalachian coal miners suffering with PMF from 2011 to 2016, while only 99 cases of PMF were identified by the current federal monitoring program during the same period (https://goo.gl/ZJXp1W). Only about one-third of coal miners may participate in screening for black lung disease, and lack of participation could result from barriers such as fear of retaliation from employers (Siddons A. CQ-Roll Call, Inc. March 1, 2019; https://goo.gl/5mfVFvl). Ongoing research is studying factors leading to the resurgence in CWP. Increasing silica content in coal dust is a likely culprit that has escaped mine safety regulations. Given the rising incidence and the increasing morbidity and mortality of black lung disease, there is a need to educate and engage pulmonologists and others to improve surveillance and early recognition of the spectrum of coal-dust-related lung diseases to decrease morbidity and mortality among this vulnerable occupational group.

Drew Harris, MD
Amy Ahasic, MD, MPH, FCCP
Steering Committee Members

Palliative and End-of-Life Care

Importance of language and word choice when discussing cardiopulmonary resuscitation (CPR)

Words matter. Whether spoken or written, the words we choose when communicating with each other are fundamentally important, both by intention of the originator and the understanding of the audience, whether or not the meaning is imparted faithfully.

Respiratory Care

Low-tidal volume ventilation

Respir CMechanical ventilation in postoperative (post-op) patients is essential in care because it can determine the patient’s overall outcome, especially in post-op cardiovascular surgery patients. The risks of hemodynamic instability and consideration of total body organ function make choosing the correct strategy of mechanical ventilation vital (Ball, et al. Crit Care. 2016;22[4]:386). The current standard of practice for mechanically ventilated patients is to use low-tidal volume (LTV) ventilation, meaning administering 6-7 mL/kg of ideal body weight (Hoegl, et al. Anesthesiology. 2016;29[4]:94). The benefits of LTV ventilation include significantly decreased risk in lung injury, decreased risk of developing ARDS, and lessening of hemodynamic compromise (Hoegl, et al. 2016); (Stephens, et al. Crit Care Med. 2015;43:1477). Also, due to its high efficacy in terms of cost-effective care, such as shorter ICU stays and less number of days supported by mechanical ventilation, many hospitals have incorporated LTV strategy into the care of almost all post-op patients (Stephens, et al. 2015). However, no randomized controlled trials have been conducted in post-op cardiovascular patients undergoing mechanical ventilation to determine if LTV ventilation (6-7 mL/kg) has superior efficacy over higher levels of ventilation (8-10 mL/kg). This patient population tends to have normal lung function and, therefore, a LTV strategy could possibly be too conservative, whereas larger tidal volumes may be more comfortable and provide better ventilation considering the increased dead space in post-op cardiovascular patients. In order to address this gap in the literature, it is essential to determine if significant differences exist in patient mortality, ventilator days, hospital stay, and incidence of pulmonary complications for this population undergoing ventilation volumes of approximately 6 mL/kg or 8 mL/kg of ideal body weight.

Bethlehem Markos
Fellow-in-Training

Sleep Medicine

In case you missed it: Recent findings in obstructive sleep apnea

Lauren Tobias, MD
Steering Committee Member

Occupational and Environmental Health

Black lung disease in the 21st century

Inhalation and deposition of coal dust particles cause a range of lung injury from coal workers’ pneumoconiosis (CWP) to dust-related diffuse fibrosis to COPD. Despite workplace standards and improved environmental controls to limit dust exposure within coal mines, incidence of “black lung disease” in the United States has increased since the turn of the century (Antao VC, et al. Occup Environ Med. 2005;62[10]:670). Coal miners working in the Appalachian Mountains have been particularly vulnerable to developing rapidly progressive and severe pneumoconiosis. In 2018, three black lung clinics in central Appalachia uncovered the largest cluster of progressive massive fibrosis (PMF) ever reported (Blackley DJ, et al. JAMA. 2018;319[5]:500). An investigation by National Public Radio (NPR) and the Public Broadcasting Service (PBS) program Frontline identified more than 2,000 Appalachian coal miners suffering with PMF from 2011 to 2016, while only 99 cases of PMF were identified by the current federal monitoring program during the same period (https://goo.gl/ZJXp1W). Only about one-third of coal miners may participate in screening for black lung disease, and lack of participation could result from barriers such as fear of retaliation from employers (Siddons A. CQ-Roll Call, Inc. March 1, 2019; https://goo.gl/5mfVFvl). Ongoing research is studying factors leading to the resurgence in CWP. Increasing silica content in coal dust is a likely culprit that has escaped mine safety regulations. Given the rising incidence and the increasing morbidity and mortality of black lung disease, there is a need to educate and engage pulmonologists and others to improve surveillance and early recognition of the spectrum of coal-dust-related lung diseases to decrease morbidity and mortality among this vulnerable occupational group.

Drew Harris, MD
Amy Ahasic, MD, MPH, FCCP
Steering Committee Members

Palliative and End-of-Life Care

Importance of language and word choice when discussing cardiopulmonary resuscitation (CPR)

Words matter. Whether spoken or written, the words we choose when communicating with each other are fundamentally important, both by intention of the originator and the understanding of the audience, whether or not the meaning is imparted faithfully.

Respiratory Care

Low-tidal volume ventilation

Respir CMechanical ventilation in postoperative (post-op) patients is essential in care because it can determine the patient’s overall outcome, especially in post-op cardiovascular surgery patients. The risks of hemodynamic instability and consideration of total body organ function make choosing the correct strategy of mechanical ventilation vital (Ball, et al. Crit Care. 2016;22[4]:386). The current standard of practice for mechanically ventilated patients is to use low-tidal volume (LTV) ventilation, meaning administering 6-7 mL/kg of ideal body weight (Hoegl, et al. Anesthesiology. 2016;29[4]:94). The benefits of LTV ventilation include significantly decreased risk in lung injury, decreased risk of developing ARDS, and lessening of hemodynamic compromise (Hoegl, et al. 2016); (Stephens, et al. Crit Care Med. 2015;43:1477). Also, due to its high efficacy in terms of cost-effective care, such as shorter ICU stays and less number of days supported by mechanical ventilation, many hospitals have incorporated LTV strategy into the care of almost all post-op patients (Stephens, et al. 2015). However, no randomized controlled trials have been conducted in post-op cardiovascular patients undergoing mechanical ventilation to determine if LTV ventilation (6-7 mL/kg) has superior efficacy over higher levels of ventilation (8-10 mL/kg). This patient population tends to have normal lung function and, therefore, a LTV strategy could possibly be too conservative, whereas larger tidal volumes may be more comfortable and provide better ventilation considering the increased dead space in post-op cardiovascular patients. In order to address this gap in the literature, it is essential to determine if significant differences exist in patient mortality, ventilator days, hospital stay, and incidence of pulmonary complications for this population undergoing ventilation volumes of approximately 6 mL/kg or 8 mL/kg of ideal body weight.

Bethlehem Markos
Fellow-in-Training

Sleep Medicine

In case you missed it: Recent findings in obstructive sleep apnea

Lauren Tobias, MD
Steering Committee Member

Occupational and Environmental Health

Black lung disease in the 21st century

Inhalation and deposition of coal dust particles cause a range of lung injury from coal workers’ pneumoconiosis (CWP) to dust-related diffuse fibrosis to COPD. Despite workplace standards and improved environmental controls to limit dust exposure within coal mines, incidence of “black lung disease” in the United States has increased since the turn of the century (Antao VC, et al. Occup Environ Med. 2005;62[10]:670). Coal miners working in the Appalachian Mountains have been particularly vulnerable to developing rapidly progressive and severe pneumoconiosis. In 2018, three black lung clinics in central Appalachia uncovered the largest cluster of progressive massive fibrosis (PMF) ever reported (Blackley DJ, et al. JAMA. 2018;319[5]:500). An investigation by National Public Radio (NPR) and the Public Broadcasting Service (PBS) program Frontline identified more than 2,000 Appalachian coal miners suffering with PMF from 2011 to 2016, while only 99 cases of PMF were identified by the current federal monitoring program during the same period (https://goo.gl/ZJXp1W). Only about one-third of coal miners may participate in screening for black lung disease, and lack of participation could result from barriers such as fear of retaliation from employers (Siddons A. CQ-Roll Call, Inc. March 1, 2019; https://goo.gl/5mfVFvl). Ongoing research is studying factors leading to the resurgence in CWP. Increasing silica content in coal dust is a likely culprit that has escaped mine safety regulations. Given the rising incidence and the increasing morbidity and mortality of black lung disease, there is a need to educate and engage pulmonologists and others to improve surveillance and early recognition of the spectrum of coal-dust-related lung diseases to decrease morbidity and mortality among this vulnerable occupational group.

Drew Harris, MD
Amy Ahasic, MD, MPH, FCCP
Steering Committee Members

Palliative and End-of-Life Care

Importance of language and word choice when discussing cardiopulmonary resuscitation (CPR)

Words matter. Whether spoken or written, the words we choose when communicating with each other are fundamentally important, both by intention of the originator and the understanding of the audience, whether or not the meaning is imparted faithfully.

Respiratory Care

Low-tidal volume ventilation

Respir CMechanical ventilation in postoperative (post-op) patients is essential in care because it can determine the patient’s overall outcome, especially in post-op cardiovascular surgery patients. The risks of hemodynamic instability and consideration of total body organ function make choosing the correct strategy of mechanical ventilation vital (Ball, et al. Crit Care. 2016;22[4]:386). The current standard of practice for mechanically ventilated patients is to use low-tidal volume (LTV) ventilation, meaning administering 6-7 mL/kg of ideal body weight (Hoegl, et al. Anesthesiology. 2016;29[4]:94). The benefits of LTV ventilation include significantly decreased risk in lung injury, decreased risk of developing ARDS, and lessening of hemodynamic compromise (Hoegl, et al. 2016); (Stephens, et al. Crit Care Med. 2015;43:1477). Also, due to its high efficacy in terms of cost-effective care, such as shorter ICU stays and less number of days supported by mechanical ventilation, many hospitals have incorporated LTV strategy into the care of almost all post-op patients (Stephens, et al. 2015). However, no randomized controlled trials have been conducted in post-op cardiovascular patients undergoing mechanical ventilation to determine if LTV ventilation (6-7 mL/kg) has superior efficacy over higher levels of ventilation (8-10 mL/kg). This patient population tends to have normal lung function and, therefore, a LTV strategy could possibly be too conservative, whereas larger tidal volumes may be more comfortable and provide better ventilation considering the increased dead space in post-op cardiovascular patients. In order to address this gap in the literature, it is essential to determine if significant differences exist in patient mortality, ventilator days, hospital stay, and incidence of pulmonary complications for this population undergoing ventilation volumes of approximately 6 mL/kg or 8 mL/kg of ideal body weight.

Bethlehem Markos
Fellow-in-Training

Sleep Medicine

In case you missed it: Recent findings in obstructive sleep apnea

Lauren Tobias, MD
Steering Committee Member

Michelle Cao, DO, FCCP

Dr. Michelle Cao is a Clinical Associate Professor in the Division of Sleep Medicine and Division of Neuromuscular Medicine, at the Stanford University School of Medicine. Her clinical expertise is in complex sleep-related respiratory disorders and home mechanical ventilation for chronic respiratory failure syndromes. She oversees the Noninvasive Ventilation Program for the Stanford Neuromuscular Medicine Center. Dr. Cao also holds the position of Vice-Chair for the Home-Based Mechanical Ventilation and Neuromuscular Disease NetWork with CHEST and is a member of the Scientific Presentations and Awards Committee.

Michelle Cao, DO, FCCP

Dr. Michelle Cao is a Clinical Associate Professor in the Division of Sleep Medicine and Division of Neuromuscular Medicine, at the Stanford University School of Medicine. Her clinical expertise is in complex sleep-related respiratory disorders and home mechanical ventilation for chronic respiratory failure syndromes. She oversees the Noninvasive Ventilation Program for the Stanford Neuromuscular Medicine Center. Dr. Cao also holds the position of Vice-Chair for the Home-Based Mechanical Ventilation and Neuromuscular Disease NetWork with CHEST and is a member of the Scientific Presentations and Awards Committee.

Michelle Cao, DO, FCCP

Dr. Michelle Cao is a Clinical Associate Professor in the Division of Sleep Medicine and Division of Neuromuscular Medicine, at the Stanford University School of Medicine. Her clinical expertise is in complex sleep-related respiratory disorders and home mechanical ventilation for chronic respiratory failure syndromes. She oversees the Noninvasive Ventilation Program for the Stanford Neuromuscular Medicine Center. Dr. Cao also holds the position of Vice-Chair for the Home-Based Mechanical Ventilation and Neuromuscular Disease NetWork with CHEST and is a member of the Scientific Presentations and Awards Committee.