Dr. Hansen joined the program on July 1, 2014. Dr. Kea joined the program on September 1, 2014.
Matt Hansen, M.D.
Assistant Professor of Emergency Medicine
Dr. Hansen is an Assistant Professor of Emergency Medicine at OHSU. He received an MD degree from Case Western Reserve University in Cleveland, Ohio. Dr. Hansen completed an Emergency Medicine residency, a Pediatric Emergency Medicine fellowship, and a Master of Clinical Research at OHSU. Since joining the faculty in 2012, Dr. Hansen has served as an Assistant Program Director for the Emergency Medicine residency program.
Dr. Hansen's research interests focus on resuscitation and stabilization of ill and injured children in the prehospital and Emergency Department settings. There is very little evidence to guide care of children in the prehospital setting and the EMS system is largely structured to care for adults who are a majority of EMS transports. However, injury is the leading cause of death in children and EMS care has the potential to have a high impact on outcomes given the importance of care in the first minutes following a significant injury.
Since 2012, Dr. Hansen has been a co-investigator in the Children's Safety Initiative-EMS (CHI-EMS) which is the largest study to date evaluating patient safety in the prehospital care of children. Dr. Hansen is particularly interested in studying pediatric airway and respiratory management in the prehospital setting which are critical components of resuscitation in many common pediatric emergencies from both medical and traumatic causes. His K12 work focuses on understanding the epidemiology of airway and respiratory emergencies in the prehospital setting, describing the nature of safety events in management of these conditions, and exploring differences in care between urban and rural areas using geographic information systems analysis. This work will help broaden the currently limited understanding of prehospital pediatric respiratory emergencies and airway management and determine which aspects of care are most likely to benefit from an intervention study.
Mentors: Dr. Jeanne-Marie Guise M.D., M.P.H.;Dr. Craig Warden M.D., M.P.H.;Craig Newgard, M.D., M.P.H., Dr. William Lambert Ph.D. External advisors: Dr. Nathan Kuppermann M.D., M.P.H.;Henry Wang, M.D., M.P.H.
Bory Kea, M.D.Assistant Professor of Emergency Medicine
Dr. Kea is an Assistant Professor of Emergency Medicine at OHSU. She received her M.D. at Stanford University, and completed her residency training in Emergency Medicine at the University of California, San Francisco-San Francisco General Hospital. She obtained a Masters in Clinical Research during a Emergency Medicine Research fellowship at OHSU.
Dr. Kea's current research focuses on optimization of atrial fibrillation (AF) management strategies in the Emergency Department, from rate vs rhythm control, disposition, and oral anticoagulation (OAC) strategies. AF is the most common arrhythmia presenting to the ED, and is associated with significant morbidity and mortality. Although OACs may prevent strokes in appropriately selected AF patients, and is ideally prescribed by a primary care provider (PCP), up to two-thirds of all patients discharged from the ED do not follow up with a PCP within 30 days. Furthermore, current risk stratification and OAC guidelines are based on outpatient studies, and do not provide clear guidance for ED providers treating new-onset AF patients in the acute setting. Thus, significant variability in ED prescribing of OAC and adherence to existing clinical guidelines remains. This project will use national administrative data to (1) measure variability in ED prescribing of OAC in new-onset AF, (2) identify patient, provider, and hospital factors that predict compliance with existing clinical guidelines, and (3) determine how ED OAC prescribing in AF affects patient-centered clinical outcomes. This research will lead to prospective studies aimed at comparing the effectiveness of current ED strategies on OAC prescribing in recent-onset AF, in addition to acute treatment with rate vs rhythm control, and disposition strategies on important clinical outcomes for AF patients.
Mentors: Ben Sun, M.D., M.P.P., Dr. John McConnell, Ph.D., Dr. Gregory Lip, M.D., Brian Olshansky, M.D., Merritt Raitt, M.D.
Anna Marie Chang, M.D., M.S.C.E.
Dr. Chang joined the faculty in the Department of Emergency Medicine as an Assistant Professor in July 2012. She is a graduate of the Northwestern University Feinberg School of Medicine and completed a Master of Science in Clinical Epidemiology at the University of Pennsylvania Perelman School of Medicine.
Dr. Chang's research interests are in studying patients with acute cardiopulmonary conditions and transitions of care. Heart failure, asthma, chronic obstructive pulmonary disease (COPD), and ischemic heart disease account for a significant proportion of emergency department (ED) visits, hospital admissions (up to 70% of these patients are admitted through the ED) and repeat ED visits, and have a high rate of readmissions (up to 25% within 30 days). Furthermore, Medicaid enrollees less than 64 years old had 45.8 ED visits per 100 enrollees compared with 24.0 visits per 100 for privately insured people. Thus, reducing ED utilization and admissions for these conditions in the Medicaid population will greatly impact overall ED use, and present research has identified a lack of quality connections and transitions from hospital-to-home for patients with these specific conditions.
In 2012, the state of Oregon restructured its Medicaid program into Coordinated Care Organizations, which are local health entities that are accountable for health outcomes of the entire population they serve. Thus, Dr. Chang hopes to examine these unique changes to the model of care, and how they affect ED use for acute cardiopulmonary conditions. She will conduct a mixed-methods study to identify CCO, ED and patient level factors that lead to changes in ED utilization and hospitalizations. She will use the Oregon All Payers All Claims database to describe variation in repeat ED visit rates within CCOs. Using interviews and surveys, she will identify the key strategies as proposed by CCOs to reduce ED visits for asthma, heart failure, and COPD. Further interviews and surveys will determine how these key strategies are being implemented at the ED level.
Mentors: John McConnell, PhD, Deborah Cohen, PhD, Devan Kansagara, MD, and Honora Englander, MD
Holly Hinson, M.D., M.C.R.
Assistant Professor of Neurology and Neurocritical Care
Dr. Hinson is an Assistant Professor of Neurology and Neurocritical Care at OHSU. She received her MD at the University of Texas in San Antonio and completed internship and residency training in Neurology at the University of Maryland in Baltimore, followed by a fellowship in Neurologic Critical Care at Johns Hopkins Hospital. At OHSU, she attends in the Neuroscience Critical Care Unit. In 2012, she was the recipient of the American Brain Foundation Practice Research Training Fellowship for her project entitled Quantifying Paroxysmal Sympathetic Hyperactivity. In 2016, she completed her Masters in Clinical Research (MCR) at OHSU.
Dr. Hinson's research focuses on autonomic nervous system dysfunction after acute brain injury, especially after traumatic brain injury (TBI). Despite advances in both prevention and treatment, TBI remains one of the most burdensome diseases; 2% of the US population currently lives with disabilities resulting from TBI. Primary brain injury occurs at the time of the trauma as a direct result of the physical forces acting on the body and can only be avoided by injury prevention. However, secondary brain injury, resulting from a complex sequence of events that begins at the initial insult and continues into the acute hospitalization, may be mitigated by intervention.
To explore the mechanism underpinning early fever after TBI, she designed an observational study to test the hypothesis that early fever after severe TBI was associated with neurologic deterioration, and/or promoted the production of pro-inflammatory cytokines. She was awarded the Oregon Multidisciplinary Training Program for Emergency Medicine Clinical Research K12 for her project, entitled "Fever and Inflammation in Neurotrauma (FAINT)". She submitted an abstract entitled "Differences in Inflammatory Dysregulation in TBI versus Major Trauma" to the 2014 Resuscitation Science Symposium, based on analysis of the first 40 patients enrolled in FAINT. Dr. Hinson received the American Heart Association Young Investigator Award for this abstract. She also presented preliminary findings at the National Neurotrauma Society meeting in 2015 and the International Neurotrauma Society meeting in 2016. Finally, she was selected as 1 of 12 "Emerging Leaders" by the American Academy of Neurology.
Mentors: Dennis Bourdette, M.D., Martin Schreiber, M.D., Mary Stenzel-Poore, Ph.D., and Cynthia Morris, Ph.D., M.P.H.
Susan Rowell, M.D., M.C.R.
Dr. Rowell is an Associate Professor in the Division of Trauma, Emergency Surgery, and Acute Care Surgery at OHSU. A graduate of the University of California Davis School of Medicine, she completed a residency in surgery at UC Davis and served as Chief Resident there before coming to OHSU in 2006. At OHSU, she completed a fellowship in Surgical Critical Care, joining the faculty in 2007. She serves as Director of OHSU's Surgical Critical Care Fellowship Training Program. In 2011 she chaired the committee for the Eastern Association for the Surgery of Trauma, which re-wrote national guidelines for the management of mild traumatic brain injury.
Dr. Rowell's research interests focus on coagulation changes after traumatic brain injury (TBI), the number one cause of death and disability due to trauma. Management of TBI focuses on preventing secondary brain injury. Therefore, Dr. Rowell's initial study will examine the hypothesis that TBI induces an early and significant hypocoagulable state that can be characterized by thromboelastography, and that the severity of the derangement in coagulation is associated with progression of intracerebral hemorrhage. She will test this hypothesis in a prospective observational study of adult patients admitted to the Trauma Intensive Care Unit at Oregon Health & Science University with blunt TBI. The second aspect of this study will begin to explore the mechanism involved in TBI-associated coagulopathy using samples collected from the initial phase of the study. In addition to support from this K12, Dr. Rowell received the American Association for the Surgery of Trauma Research Fellowship Award.
Mentors: Nabil Alkayed, MD, PhD and David Farrell, PhD
Eric Stecker, M.D., M.P.H.
Associate Professor, Knight Cardiovascular Institute
Dr. Stecker is an Associate Professor in the Knight Cardiovascular Institute at OHSU. He received an MD from the University of Wisconsin School of Medicine and Public Health as well as an MPH from the University of Michigan School of Public Health. He completed an Internal Medicine residency, a Cardiovascular Medicine fellowship, and an Electrophysiology fellowship at Oregon Health & Science University.
Dr. Stecker has worked with the Oregon Sudden Unexpected Death Study (SUDS) since 2002. Early work defining the role of ejection fraction in sudden cardiac death risk led to him receiving the 2005 American College of Cardiology's Young Investigator Award. Dr. Stecker's current research focuses on the role of underlying cardiac pathophysiology on survival after resuscitation of sudden cardiac arrest. He will use logistic modeling as well as binary recursive partitioning methods to test hypotheses regarding the importance of coronary artery disease and left ventricular dysfunction. Dr. Stecker hopes to identify factors that may allow for resuscitation efforts tailored to underlying causes of sudden cardiac arrest with the goal of improving survival.
Mentors: Jon Jui, M.D., M.P.H., Craig Newgard M.D., M.P.H., Jonathan Lindner M.D., and Sumeet Chugh M.D.