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Gezzer Ortega, MD, MPH
Instructor, Harvard Medical School

Brigham and Women's Hospital
Department of Surgery
75 Francis Street
Boston, MA 02115

Research Location: One Brigham Circle

Email: gortega1@bwh.harvard.edu

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Research Narrative:

Gezzer Ortega, MD, MPH is an Instructor at the Center for Surgery and Public Health in the Department of Surgery, Brigham and Women’s Hospital. Dr. Ortega’s mission is to promote education and health through leadership, innovation, and service. As a physician-scientist his focus is to contribute to the field of surgery and eliminate health disparities through research and humanitarian efforts. Metrics for Equitable Access and care in SURgery (MEASUR) Funded by the NIMHD, the Metrics for Equitable Access and care in SURgery (MEASUR) project is a collaboration led by the American College of Surgeons (ACS) in conjunction with Eastern Virginia Medical School, Brigham and Women’s Hospital, the National Quality Forum (NQF), and
the University of California – Los Angeles. Through research and expert consensus, this project
will identify and develop measures that capture disparities in access and across the five phases of
surgical care. These disparities-sensitive metrics (DSM) will facilitate the development of
targeted interventions aimed at eradicating surgical disparities. MEASUR’s vision is to
ensure optimal access and equitable healthcare for all surgical patients, in every setting,
and across the entire continuum of care.

 Provider Awareness and Cultural Dexterity Toolkit for Surgeons (PACTS): Funded by the NIMHD, Provider Awareness and Cultural Dexterity Toolkit for Surgeons (PACTS), is a curriculum designed for surgical residents, focused on improving care for surgical patients of different cultural backgrounds. The four main modules of the curriculum are building trust, exploring informed consent, working with patients with limited English proficiency, and proper pain management. The trial will be conducted at nine academic medical centers in the US and Canada. This study involves several important innovations including shifting the paradigm of cultural competency to a more practical model of cultural dexterity. The study will provide new
knowledge on the efficacy of cultural dexterity training on provider- and patient-outcomes. If
successful, this program will be disseminated through the ACS, American Board of Surgery, and other
stakeholders, affecting the training of over 10,000 surgical residents each year and the millions
of patients they serve.

Evaluation of Patients with Limited English Proficiency Surgical Outcomes: National & Regional
Assessments: Health disparities have been demonstrated across many surgical specialties. Among these
disparities, patients with Limited English Proficiency (LEP) are at higher risk for
worse health outcomes than their non-LEP counterparts. Poor communication for patients with
LEP is also associated with disparities in quality of and satisfaction with care, increased length
of stay, medical errors, and misdiagnoses. In 2015, almost 62 million people in the US spoke a
language other than English at home. While many were proficient in English, 40% of these had LEP.
The LEP population has risen from 14 million in the 1980s to almost 25 million in 2015, which
reflects the diversity of individuals migrating to the United States. This poses a significant
challenge to providing focused, patient-centered care to all patients. Few studies (Figure 1) have examined the impact of LEP on outcomes during inpatient care, and fewer among surgical patients. Furthermore, some studies have reported that patients with LEP experienced longer lengths of stay compared to non-LEP patients. Given that communication between providers and patients is paramount to patient-centered care, further research into LEP is necessary to address a concerning dearth of data in this field. The impact of LEP on surgical outcomes is not understood and there is a need to identify factors that lead to disparities at the national and regional level and to develop interventions. The plan is to address this gap through the Brigham Research Institute (BRI) Pilot

Funding Award and create interventions through funding mechanisms aimed at eliminating
LEP-associated surgical disparities. Thus, the overall aim of our study is to evaluate outcomes of
LEP and non- LEP patients undergoing surgical procedures in large national and regional datasets.
AIM#1 National: To compare surgical outcomes between LEP vs. non-LEP patients using the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost Utilization Project (HCUP)
State Inpatient Databases (SID). AIM#2 Regional: To perform an in-depth study of the factors associated with potential disparities in LEP patients within the Partners Healthcare Research Patient Dataset Registry (RPDR) for patients undergoing surgery.

 


Education:
Johns Hopkins Bloomberg School of Public Health, 2012, MPH
Howard University College of Medicine, 2011, MD
Syracuse University, 2003, BS