My name is Michelle Peng, and I am a first-year student at MIT planning on majoring in materials science and engineering with a focus on bioengineering. For the month of IAP, I participated in PKG IAP Health Catalyst, a program dedicated to researching unmet medical needs in the healthcare system through the development of problem definitions. I had the opportunity to work with multiple teams of fellows that consisted of clinicians, engineers, researchers, and businesspeople from around the country, many of whom are involved in the Veterans Health Administration. Every week, I was involved in a different topic and researched the developed problem definition by reading medical journals, articles, data reports, and conducting interviews with stakeholders.
The first problem definition I researched was on food allergies and anaphylaxis. During the week of intensification where the fellows and scholars came together in-person to practice the process of identifying problem definitions, my team and I researched the following topic: Numerous restaurants and stores neglect to implement precautions against cross-contamination; it is difficult for people with severe allergies to test or sample their food, so even minute traces of allergens can induce severe and potentially life-threatening reactions. From the research process, we learned shocking statistics about how significant of a problem food allergies are for the American population and how a concerning amount of this group does not consistently carry their prescribed Epipen around with them because of inconvenience, financial reasons, or negligence. We as a team concluded that the target of intervention, given that lack of cross-contamination cannot always be confirmed, should be giving patients control of their own safety.
The second problem definition I researched was an issue in orthopedic surgery, a field I had no prior knowledge about before IAP Health. My team and I researched periprosthetic fractures (fractures associated with an orthopedic implant) following total hip arthroplasty (hip replacement). There are two main types of prosthetics placement, cemented and press-fit, both of which can become loose and lead to patient instability and higher risk of falling. There are many causes of the loosening of the periprosthetic, including inadequate fixation at the initial surgery, infection, osteolysis, outliving the life expectancy of the implant, and more. If the periprosthetic loosens and increases the risk of the patient falling and fracturing their implant, the patient receives a revision surgery. Our proposed target of intervention was a more effective method of bonding the bone and the implant, whether that meant the utilization of a new material or procedure.
The third and final problem definition I researched explored the accessibility of medication for opioid use disorder (OUD) for veterans, a more policy-based topic. The Veterans Health Administration addressed the issue of high rates of opioid overdose by encouraging VA providers to offer veterans with OUD buprenorphine, a cost-effective and evidence-based medication. The current approach is for veterans with OUD to self-present to a CA primary care clinic or ER and request treatment. This approach falls short for several reasons, as 95% of veterans are unmotivated to seek treatment in the first place, and the other 5% who are motivated are unable to receive medication because of key barriers such as cost, wait-time, travel distance, and anonymity. During this stage of the Catalyst process of beginning to think about solutions, my team and I acknowledged the need for easily accessible (same-or-next-day availability), affordable, non-stigmatizing, and discrete clinical services for veterans with OUD to access buprenorphine.
The Catalyst experience solidified my aspiration to pursue a career in healthcare, as I am inspired by the fact that this multifaceted and dynamic field presents numerous avenues for making impactful contributions. I am truly impressed by how much the Catalyst experience taught me, not only about different processes and policies in healthcare but also about the power of group collaboration especially when the group members come from a diverse range of careers and backgrounds. It was exciting to see how fellows and scholars working in separate fields brainstormed different approaches to a problem definition. The diversity of the whole Catalyst team undoubtedly contributed to the thorough development of the problem definitions, and I am excited to read about what the team produces in Phase 2 of the Catalyst program. The process also helped me grow as a researcher, student, and team player. Collaborating within a group of seasoned researchers and experts can be intimidating, yet the fellows I collaborated with were exceptionally welcoming and patient, fostering an environment where questions were encouraged and feedback was embraced. The process taught me to always speak up with questions and communicate my concerns — an invaluable lesson that will carry with me throughout my years at MIT.