by: Aditi Risbud

Shelton_BTLErica Shelton, M.D., M.P.H. is an early-career investigator in patient and family engagement, part of the Patient Care Program's special projects.

At Johns Hopkins University, Erica is an assistant professor of emergency medicine. Her work is aimed at increasing patient and community engagement in the health care system to optimize emergency department access and service utilization for vulnerable populations.

In this installment of Beyond the Lab, Erica discusses her work enhancing patient-provider communication, especially among urban populations and communities of color, to overcome linkage barriers to follow-up care and self-management.

What inspired you to become a scientist/researcher?
My love of problem-solving and respect for the accomplishments gleaned from coalition-building has inspired me most. As my areas of expertise, population health and health services research, specifically, fundamentally require a multi-disciplinary approach and building of coalitions to solve problems. Research findings from these disciplines can, in turn, inform health policy.

Health policy then has the potential to impact the public — often impacting some of the most vulnerable members and communities in our society who have limited access to health care. So that draw to impact science and therefore potentially impact policy, and subsequently communities, is what attracted me to research in general and what attracted me to my areas of interest in particular.

What topics/areas/problems in science are you most interested in solving?
Disparities in health care access for socioeconomically disadvantaged populations directly impact the large patient volumes that many emergency departments (EDs) encounter. My long-term goal is to improve access to health services for these vulnerable populations, thereby achieving improvement in health outcomes and enhancing appropriateness and value of ED care.

My research is aimed at patient and family engagement, particularly improving patient-provider communication, to impact optimal ED access and service utilization. My short-term goal, through my current study funded by the Moore Foundation, is to empower ED patients to overcome linkage barriers to follow-up care and self-management. My work for this study uses a community health worker intervention. It focuses on enhancing patient-provider communication from a community-based perspective, which is designed explicitly to reach patients beyond the traditional ED encounter.

How do your colleagues, mentors, students/postdocs help you achieve your goals?
First and foremost, they help me achieve my own goals because of the inspiration they provide in the work that they do. For colleagues and mentors, they inspire me with their prior experience and contributions to the body of knowledge gained from research. For students and postdocs, they inspire me with their vision and tenacity to forge a path in research — it’s not an easy road to take.

Mentors and colleagues also lend their experience in terms of how to get things accomplished in research — like  lessons learned in terms of moving projects through academic channels both administratively as well as conceptually — even the nitty-gritty of tips and tricks for writing papers and grants is helpful. I cannot emphasize enough the value in having someone who has "been there, done that" to review one’s work and help steer new researchers, like myself, in the right direction while at the same time providing encouragement and freedom to pursue our own path and build new expertise. 

What gets you going every day (besides coffee) and how do you stay motivated?
A desire to understand how to empower patients to manage their own health. I want patients to feel empowered to take an active role in their own health and to see their relationship with their doctor and other members of their health care team as partnerships and not one-way discussions comprised of health care providers dictating all aspects of how to manage a patient’s health. Learning how to cultivate that partnership between doctor and patient, through community-based health services research, is what gets me going every day.

What are your greatest limitations/challenges as a scientist/researcher?
As a physician, much of the inspiration for my research comes from my interactions with patients. That being said, it’s no secret that the demand for health services, especially in the emergency department, can exceed available supply. Interventions to improve resource utilization are always in need and represent opportunities to better manage population health and contain health care costs. It is a continual challenge to learn ways to use finite resources to address what can seem like ever-expanding barriers for vulnerable populations to have access to needed health care.

As a researcher, my job is to examine the various aspects of how care is provided in our health care system and to then isolate a single study question to address any one of these particular aspects. Deciding how to frame my research question to address a given aspect and to then design and structure a study to answer that question is my greatest challenge…and at the same time my greatest motivation.

Learn more about Erica here, and read a recent story in CityLab about her community health worker intervention program to help patients who have been to the emergency room get the care they need to avoid going back.


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