Advancing Health Equity With Data: Improving Patient Care in the Emergency Department

Updated on Jun 17, 2024 | Community, Diversity and Inclusion, Featured

At Mount Sinai, active collaboration with department stakeholders drives the efforts of the Health Equity Data Assessment (HEDA) team to advance health equity through data-driven initiatives.

Yvette Calderon, MD

Yvette Calderon, MD, Vice President and Dean for Equity in Clinical Care at the Icahn School of Medicine at Mount Sinai, recently discussed how the Emergency Department (ED) partnered with the HEDA team to apply an equity lens to evaluate Left Without Being Seen (LWBS) patients.

Together, they are reviewing data integrity in emergency medical records and applying an equity lens to effect meaningful change.

“This commitment underscores Mount Sinai’s ongoing dedication to fostering health equity through collaborative, data-informed strategies,” said Pamela Y. Abner, MPA, CPXP, Senior Vice President and Chief Diversity Operations Officer in the Office for Diversity and Inclusion, and Health Equity Officer for the Mount Sinai Health System.

LWBS is defined as a patient leaving the ED before completing a medical screening exam. When this metric is not met, it can represent quality and safety concerns, according to Lyndia Hayden, Senior Director, Data Integrity and Equity Analytics.

LWBS patients may also have an undiagnosed medical condition and may experience undesirable health outcomes outside of the hospital. Hospitals can also face penalties if they fail to meet certain quality metrics, like LWBS. The Centers for Medicare & Medicaid Services can reduce reimbursement rates for hospitals that do not meet these standards, having a direct impact on the hospital revenue stream.

On average, non-white patients tend to have a disproportionally higher rate of LWBS than white patients. As such, LWBS must be examined through an equity lens to ensure optimal patient outcomes for all patients.

Dr. Calderon emphasized the critical role of data integrity as a foundational step before delving into metrics analysis. With invaluable support from the HEAD Hub, the Department of Emergency Medicine at Icahn Mount Sinai implemented a comprehensive dashboard system, empowering ED service lines across the Mount Sinai Health System to closely monitor performance indicators, identify key drivers, and establish clear accountability measures.

For example, guided by these insights, each ED tailored interventions to their unique context, with initiatives such as Provider-in-Triage (PIT) protocols, mandatory unconscious bias training, and enhanced education for registration staff on demographic data collection emerging as effective strategies at Mount Sinai Beth Israel.

This work was presented to the Joint Commission during the Mount Sinai Downtown survey. It impressed the surveyors to see that Mount Sinai had already started integrating the new standard from the Joint Commission.

“The data integrity piece had to happen first before we could look at any of the metrics,” said Dr. Calderon. “Through diligent implementation, these interventions have proven instrumental in addressing pertinent issues within the emergency departments that identified a need.”

New Teen Lounge Unveiled at Mount Sinai Kravis Children’s Hospital

Updated on Jun 14, 2024 | Community, Featured

The Mount Sinai Child Life and Creative Arts Therapy team recently opened a newly constructed Teen Lounge at the Mount Sinai Child Life Zone at the Mount Sinai Kravis Children’s Hospital. The team celebrated the opening with a ribbon-cutting ceremony on Thursday, June 6.

Thanks to a generous gift from the Garth Brooks Teammates for Kids Foundation, a longtime partner and collaborator, the lounge meets the unique developmental needs of teenage patients and helps to minimize the stressors that they feel during a hospital stay. Promoting creativity, self-expression, and connectivity, the lounge offers teenage patients a place to socialize and connect, escape from their patient room, explore creative outlets, and relax and unwind.

The newly designed Teen Lounge features pods for patients to relax, read, and take photos; gaming stations with gaming systems and seating; and lounge seating for patients to watch movies and entertainment. There are also two large communal tables for art, games, and other activities, three colorful wall murals, and additional storage cabinets for art, music, play, and technology supplies.

“Being in the hospital, whether as an inpatient or outpatient, can be difficult and overwhelming for a teenager,” said Lisa M. Satlin, MD, Chair of Pediatrics for the Mount Sinai Health System and Pediatrician-in-Chief of the Mount Sinai Kravis Children’s Hospital. “We are delighted that we can give all of our adolescent patients a chance to unplug, forget why they are at the hospital, feel inspired, and have fun, even though they are in the hospital.”

“We have long recognized that adolescent patients face a unique set of challenges when coping with illness and hospitalization, and this new space allows us to provide a place that teens can call their own,”  said Morgan Stojanowski, MS, CCLS, Director of the Child Life and Creative Arts Therapy Department. “They can relax and interact with their peers and escape from the rest of the hospital. Especially for teens adjusting to a difficult illness or medical condition, this space gives them a safe haven to relax and be themselves.”

Learn more about Mount Sinai Kravis Children's Hospital

The Importance of Pathogen Surveillance Networks

Updated on Jun 6, 2024 | Featured, Infectious Diseases, Research

High school students working in the lab of Florian Krammer, PhD, as part of the New York City Virus Hunters program. Image credit: Christine Marizzi, PhD, BioBus.

The H5N1 bird flu virus was detected for the first time in cows in March, and in May, a third person tested positive for bird flu, presumably from exposure to infected dairy cattle. With viral fragments detected in dairy, the Food and Drug Administration tested and announced that pasteurized milk was safe to drink, and the Centers for Disease Control and Prevention (CDC) has been working with city and state health authorities and institutions nationwide to monitor any new spread of the pathogen.

What goes into ensuring that we remain safe from pathogenic outbreaks? Are we adequately equipped to monitor, prevent, and treat another pandemic?

The co-directors of the Center for Vaccine Research and Pandemic Preparedness at the Icahn School of Medicine at Mount Sinai—Florian Krammer, PhD, Mount Sinai Professor in Vaccinology, and Viviana Simon, MD, PhD, Professor of Microbiology; Pathology, Molecular and Cell-Based Medicine; and Medicine (Infectious Diseases)—tell us how the research community worked to shed light on bird flu in cows, pathogenic surveillance, and what Mount Sinai is doing in this field.

Left: Florian Krammer, PhD. Right: Viviana Simon, MD, PhD.

Were the bovine cases of bird flu expected and detected quickly?

Dr. Krammer: It took a while before H5N1 avian influenza was detected in cows for several reasons. Typically, cows do not get infected with influenza A virus. So nobody’s looking at cows, because why would you look if it has historically not been there? Compared to the poultry industry, where there is a good system in place for rapid detection of any outbreaks. Also, in cows, the H5N1 avian influenza is a slow disease. In avian species, when they get infected, they tend to die quickly. Other mammals, like bears, raccoons, or foxes that get infected with H5N1 via ingestion of infected birds, they often get neurological symptoms and die quickly too. It is different with the cows.

Are there adequate systems to prevent and protect against unexpected pathogenic outbreaks?

Dr. Krammer: From a scientific perspective, we have very good capabilities for detecting pathogens quickly. But preventing outbreaks is a complex task that takes more than just good science. Take the cases of avian influenza in dairy cattle, for example: When the outbreak occurred, there were no legal grounds for initial testing, or even for restricting movement of cows across state borders—there was not much the government could do. Academic networks like the Centers of Excellence for Influenza Research and Response, funded by the National Institute of Allergy and Infectious Diseases, produced the first reports of the recent cases, and are much more flexible and can respond quicker. These networks work very closely with government agencies to provide needed recommendations to handle unexpected outbreaks. One of these centers is located at Mount Sinai and we have also been very active with H5N1 surveillance and research.

Dr. Simon: Besides global and national surveillance networks, local efforts are important, too, especially for a large metropolitan city such as New York City. We have known for a long time that because New York is a very popular place for tourists to visit, that makes it a very likely entry point for any virus or pathogen. The city and state have various surveillance programs, and Mount Sinai also has a pathogen surveillance program that is more than 10 years old. This program is co-directed by Harm van Bakel, PhD; Emilia Sordillo, MD, PhD; and myself. We have been tracking nosocomial infections—picked up while in a hospital—and gaining information about circulating pathogens, including influenza virus strains, bacteria, and fungi. Our Pathogen Surveillance Program has resulted in Mount Sinai being the only site in the United States that is part of the Global Hospital Influenza Surveillance Network, which works to provide a unified protocol on covering hospitalized cases of severe influenza at a global level.

Are there any particular pathogens these networks are keeping an eye out for?

Dr. Simon: Some pathogens that the Mount Sinai Pathogen Surveillance Program is watching include bacteria like Staphylococcus aureus, Enterococci and Clostridioides difficile; viruses like influenza, RSV, SARS-CoV-2, and hantavirus; as well as fungi such as Candida auris.

What are some research questions these surveillance networks are trying to answer?

Dr. Simon: Some major questions include how influenza strains change in humans—their escape from the human immune system or their change of glycosylation (the process where sugar molecules attach to lipids, proteins, or other organic molecules); how to improve vaccines; and ensuring our diagnostics are able to pick up all the strains that can cause disease in humans.

Dr. Krammer: The tracking of the changes is not a problem. The World Health Organization does that on a regular basis, and we can do that too at Mount Sinai. A bigger challenge might be: can we catch up with seasonal viruses with our vaccines, or are we always a step behind? One way to tackle that is trying to design a vaccine that gives us broad protection, no matter if the viruses change, or if the strain is an H5N1 or an H1N1. Mount Sinai is very active in working on a vaccine that would work against any type of influenza—a universal influenza virus vaccine. As for diagnostics, there are so many subtypes of influenza viruses, but you never know which one presents a risk. We’re trying to find out what are the pathogenicity markers that make a strain dangerous for humans and make it transmit well. Or, what determines the risk of avian influenza jumping to humans? That’s why we have a program that looks at not only human influenza, but also avian influenza in animals in an urban space in New York City.

What does it take for such surveillance networks to succeed?

Dr. Krammer: You have to consider the fact that influenza viruses were not human viruses originally—they were bird viruses—and to tackle the vast topic of “One Health,” an approach that seeks to address the health of people, animals, plants, and the environment interconnectedly, you might need a wide range of expertise. This includes epidemiologists, immunologists, molecular virologists, structural biologists, doctors of veterinary medicine, and medical doctors. And that’s the nice thing about health systems like Mount Sinai, where we have a lot of those experts and they are able to come together to tackle this issue.

Beyond the science, collaboration is key. We have initiated the New York City Virus Hunters program, which is our science outreach surveillance program for H5N1. In this program, we work with local high school students to collect samples from birds in urban parks and greenspaces in the city, which are then screened for the presence of the virus. This is done in collaboration with Christine Marizzi, PhD, from the science education nonprofit BioBus and the wild bird rehabilitation center Wild Bird Fund. What’s important about getting high school students involved, especially those from backgrounds traditionally underrepresented in science, is getting them interested in science and steering them towards careers in science, technology, engineering, and math (STEM), specifically in molecular biology, virology, and so on. It’s about building the next generation of biologists and about involving the community in pandemic preparedness.

Mount Sinai does not exist in a vacuum—we help by sharing our information with the New York City Department of Health and Mental Hygiene, as well as with the government agencies. On the COVID-19 side of things, we are actively participating in the National Institutes of Health’s SARS-CoV-2 Assessment of Viral Evolution (SAVE), which tracks emerging variants. Our information feeds into the scientific community, but it also feeds into government agencies, who use that information to make their health policy decisions.

Dr. Simon: To be able to do what Dr. Krammer outlined, we need to keep our infrastructures intact. And that is really hard because we need all the funding and support we can get from the school, hospital, and government. But we are excited for what we can learn to continue keeping everyone safe from outbreaks.

The New York City Virus Hunters program works with local high school students not only to track the presence and spread of H5N1 virus in animals, but also to foster an interest in science and a career in STEM fields among students.

Image credit: Christine Marizzi, PhD, BioBus.

Read more about the New York City Virus Hunters program

What You Need to Know About Cataract Surgery and Choosing the Right Replacement Lens

Updated on Jun 5, 2024 | Featured, Your Health

Cataracts result naturally as a part of the aging process.  Beginning at age 50, your ophthalmologist will monitor your cataracts and advise when the time is right for surgery. During cataract surgery, the cloudy natural lens is removed and replaced with an intraocular lens (IOL) that will enable you to see more clearly.

In this Q&A, Kira Manusis, MD, Co-Director, Cataract Services, at the New York Eye and Ear Infirmary of Mount Sinai (NYEE), explains some of the options available to patients that may reduce dependence on glasses after surgery.

What is a cataract?

A cataract develops over time and causes your eye’s natural lens to become cloudy, making it hard to see clearly. If you experience poor night vision, see halos around lights, or notice that your vision is not as sharp as you would like, it is time to schedule an eye exam.

If surgery is needed, your ophthalmologist will meet with you and discuss your eye health and lifestyle needs to prepare you for the upcoming surgery. Your natural lens will be removed and replaced with an artificial intraocular lens. Your physician will explain the IOL options available and help you decide which lens is best suited for your visual needs.

What happens during cataract surgery?

Cataract surgery is a routine outpatient procedure that involves removing the cloudy natural lens and replacing it with an artificial lens.  There are several procedures for cataract removal. Your doctor will recommend the best surgical option for your cataract. Each eye is operated on separately, a few weeks apart, and most patients recover quickly.

Kira Manusis, MD

What are the different types of intraocular lens options (IOLs) available? What are the benefits of choosing premium lenses?

An intraocular lens is a permanent replacement for your natural lens. Our ability to see can be broken into three main zones: far distance, intermediate, and near. Some intraocular lenses can correct for only one of these distances while others can correct for multiple distances. At NYEE, we offer patients standard intraocular lenses and premium lens that not only correct for different visual zones, but can also permanently correct astigmatism. After a thorough examination and evaluation, you and your surgeon will discuss the various lens options based on your eye health and your personal lifestyle needs and wants. Here are four options:

Monofocal lens implants: This basic lens provides great quality vision and allows you to see clearly at one distance, either near or far.  If you choose to see distance, you will need to wear eyeglasses for close up activities such as reading or working on an iPad. This lens is typically covered by insurance.

Premium Lens Options:

Multifocal lens implants: These lenses allow vision correction at multiple distances. Patients who want to reduce dependence on eyeglasses or contact lenses may benefit from this type of a lens. There are many multifocal lenses to choose from.  Each lens has its advantages and disadvantages, which will be discussed with your surgeon.  Premium lenses are not covered by insurance, and patients need to weigh the cost vs. value when choosing a lens. People with an active lifestyle can benefit from these glasses-free options.

Extended depth-of-field implants: An extended depth-of-field lens is a type of lens that enables clear distance and intermediate vision. For most patients, this advanced lens technology reduces your dependence on glasses for most activities except reading small print.

Toric lens: These implants can permanently correct astigmatism at the time of cataract surgery. The toric lens implant corrects the irregularity in the curvature of the cornea.  Patients with astigmatism can achieve good distance vision with significantly less dependence on glasses.

What else should I discuss with my doctor?

During your exam, you and your doctor can discuss your eye health, consider your lifestyle needs, answer any questions, and help you decide which lens will provide optimal vision. When considering which type of lens to choose, you should consider the following lifestyle preferences:

  • What do you spend most of your time doing at work? At home?
  • What are your hobbies?
  • How important is distance vision to you? (Driving, golf, skiing, theatre)
  • How important is mid-range vision to you? (Computers, cooking, grocery shopping,)
  • How important is near vision to you? (Reading, smartphones, sewing, crafts, puzzles)
  • After surgery, will you mind wearing glasses for distance, mid-range, or near vision?
Learn more about cataract surgery at NYEE
Learn more about options for intraocular lens (IOLs)

TelePrEP? PrEP on Demand? Here’s the Latest on Pre-Exposure Prophylaxis for HIV.

Updated on Jun 6, 2024 | Featured, Your Health

We’ve come a long way in HIV medicine since the 1980s—the height of the HIV/AIDS epidemic in the United States, when contracting the virus was considered a death sentence. Today, not only can we prevent HIV with pre-exposure prophylaxis (PrEP), we can also treat HIV and manage it to undetectable levels, in which virus counts are so low that they cannot be transmitted sexually.

For LGBTQ+ Pride Month in June, Richard Silvera, MD, MPH, Assistant Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai, provides the latest developments on PrEP and explains how these medications are more convenient to access than ever. 

“Pride Month is a great time where the LGBTQ+ community gathers and celebrates our achievements, as well as commiserates over our shared struggles,” says Dr. Silvera. “It is important to know that despite our breakthroughs, HIV is still out there, and that we have excellent tools to treat and prevent it.”

There are now different methods for accessing and delivering PrEP. “These different methods are really about trying to find a strategy that will fit into someone’s life most easily,” says Dr. Silvera. He discusses three recent developments with PrEP, and how you can find one that best suits your needs.

Richard Silvera, MD, MPH, Assistant Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai.

What is PrEP?

PrEP is a prescription medicine taken to prevent getting HIV. It reduces the risk of contracting HIV from sex by 99 percent, and from injection drug use by at least 74 percent, according to the Centers for Disease Control and Prevention (CDC).

PrEP is suitable not only for LGBTQ+ populations, but also cisgender straight men and women, especially if they have unprotected sex, have a partner with HIV, or have used injected drugs.

What is TelePrEP?

Usually, people go into a doctor’s office to get a prescription for PrEP, and get their blood work and sexually transmitted infection (STI) tests done there, says Dr. Silvera. But for some people who don’t want, or are unable, to make the trip to a clinic, there’s an online option for them known as telePrEP, he adds.

Here’s how telePrEP works:

  • An individual fills out a medical and insurance inquiry to ensure they are covered for telePrEP services. Once done, they can begin scheduling video calls with a provider.
  • During the video call, the provider walks the patient through what PrEP is, how and when to take it, and required tests.
  • For the required lab tests, which includes a blood draw and other routine STI tests, the patient can go to any commercial lab or testing center covered by their insurance network.
  • The patient can then pick up the medication at a pharmacy, or have it mailed.

“We have an excellent telePrEP program available through our Institute of Advanced Medicine, which specializes in care for the LGBTQ+ community, people living with HIV/AIDS, and people who experience domestic violence,” says Dr. Silvera. “For people whose lifestyle might not allow them to take time off to go into a clinic for PrEP visits, telePrEP can be a convenient option.”

Learn more about Mount Sinai’s telePrEP program

What is PrEP on Demand (PrEP 2-1-1)?

For people who might have concerns about taking PrEP medications daily—or are unable to for health reasons—there is a dosing schedule called “PreP on demand,” says Dr. Silvera. Also called “PrEP 2-1-1,” this is where someone who knows they might be at risk of HIV exposure takes two pills anywhere between two hours and 24 hours before sex, then one pill 24 hours after sex, and then another pill 24 hours after that.

This dosing schedule has been shown in studies to be effective in preventing HIV for gay and bisexual men who have sex without a condom, according to the CDC. This benefit may also extend to transgender women, or those who were assigned male at birth, notes Dr. Silvera. However, for heterosexual couples and those assigned female at birth, the evidence for this method of PrEP is not conclusive, he adds.

Accessing PrEP on demand works similar to daily PrEP: the patient makes an appointment with their provider, and lab tests will need to be done every three months.

[Sidebar: What have studies shown about the effectiveness of PreP on demand?](See below for full text)

Although the CDC has provided a guideline for this dosing schedule, it is not approved by the U.S. Food and Drug Administration (FDA).

What is Long-Acting PrEP?

Instead of taking a pill every day, there is now an injectable PrEP that lasts longer called Apretude® (cabotegravir). Currently the only long-acting PrEP approved by the FDA, Apretude is given first as two initiation injections administered one month apart, and then every two months thereafter.

“Apretude has the advantage of not being excreted through the kidneys, unlike oral PrEP,” says Dr. Silvera. “So if someone has kidney disease, Apretude might be suitable for them.”

What have studies shown about the effectiveness of PreP on demand?

PrEP on demand has been long studied for its effectiveness. In 2012, a randomized, placebo-controlled study named IPERGAY was one of the first studies on this dosing schedule. It enrolled 400 men and transgender women, with a median follow-up of 9.3 months. Findings were published in The New England Journal of Medicine in 2015. Here’s a summary of the findings:

  • Taking PrEP on demand reduced the risk of contracting HIV by 86 percent among participants.
  • The most common side effects of those who took the treatment were related to the digestive tract and kidneys.
  • There was no significant difference in how often people had unprotected sex before and after they had PrEP on demand.
  • The proportion of people who had STIs before and after they had PrEP on demand remained similar.

Studies have shown that the long-acting drug, injected once every eight weeks, is safe and more effective than daily oral PrEP at preventing HIV acquisition among both cisgender women and cisgender men and transgender women who have sex with men, according to HIV.gov, an official U.S. government site.

Accessing long-acting PrEP and its testing is slightly different: the patient has to go to the clinic every two months to receive the injection, as it cannot currently be self-administered. The patient would also do the required lab tests.

Discontinuing long-acting PrEP is also slightly more complicated than stopping daily oral PrEP, notes Dr. Silvera. “When someone wishes to stop long-acting PrEP, there will continue to be some amounts of medication in their body after stopping the injections.” The patient will be switched to daily oral PrEP until it is certain the long-acting medication has been cleared from the body, and then the oral PrEP can be stopped. “What we want to avoid is someone having enough medicine in their body such that if someone were exposed to HIV, the virus can learn to avoid that medicine, but also not having enough medicine in the body to prevent an infection,” he says.

Pride Month is a time for great joy and celebration, and LGBTQ+ people should keep themselves safe—and not just from HIV, says Dr. Silvera. Mpox (formerly known as monkeypox) cases have been increasing in New York City and other major cities in the United States, and other STIs are important too. “PrEP works great for protecting against HIV, but it does not protect against other things out there too,” he says.

Kenneth L. Davis, MD, at Commencement: A Career of Driving Change

May 31, 2024 | Featured

Kenneth L. Davis, MD, at Commencement: A Career of Driving Change

Kenneth L. Davis, MD, Executive Vice Chairman of the Mount Sinai Health System Boards of Trustees, giving the Commencement address

A career in medicine or research can be much more than just a doctor healing a patient, or a scientist generating new discoveries. Every individual graduating from the Icahn School of Medicine at Mount Sinai has the potential to drive change and fix a broken health system, said Kenneth L. Davis, MD, Executive Vice Chairman of the Mount Sinai Health System Boards of Trustees, speaking at the school’s 55th Commencement, held at the David Geffen Hall at Lincoln Center on Friday, May 10.

As the outgoing students discussed their experiences during their time at medical and graduate school, and their dreams of their futures, Dr. Davis highlighted how the graduates can improve health care, drawing on a lifetime’s experience at Mount Sinai, beginning at the medical school and including 20 years’ service as Chief Executive Officer of the Mount Sinai Health System. In recognition of his contributions, he received a Doctor of Humane Letters from Icahn Mount Sinai.

“Class of 2024, 51 years ago, I was sitting in your seat, as a graduate of the class of 1973,” said Dr. Davis. “At that time, I couldn’t wait to get up and get moving with my career. Nowadays, I’m glad to take a seat whenever I can.”

The torch Dr. Davis was passing was this: health care in the United States is not serving those who need it the most—many barred by income, race, language, citizenship, and insurance. And as a new generation entering the field, Icahn Mount Sinai’s graduates can—and should—strive to close those gaps. Here’s a look at the themes Dr. Davis brought up in his speech, which reflect his career-long efforts to improve the U.S. health care system.

Restoring Social Safety Nets

The United States pays some of the highest costs—if not the highest—for health care compared to other nations around the world, yet health outcomes remain inadequate. Medical expenditures add up to 17 percent of the country’s gross domestic product, compared with an average of nine percent for other advanced economies. Despite that spending, among large wealthy nations, the United States has the lowest life expectancy, said Dr. Davis.

The answer, he said, is restoring the social safety net, and addressing social determinants of health. “Inequity runs deep in U.S. health care. Communities of color have higher levels of serious disease, higher rates of infant mortality, and shorter lifespans than other Americans,” Dr. Davis said.

Increasing spending on social programs is not just about reducing crime or increasing productivity, but also has an effect on lowering federal health care costs, Dr. Davis said, a theme he raised in an Op-Ed for The New York Times.

Similarly, more funding is needed for Medicaid to help provide care for low-income Americans. Its underfunding has led to inadequate access and has left health systems under-reimbursed, he said, pointing out that health systems like Mount Sinai lose 35 cents on every dollar spent to take care of Medicaid patients.

High Cost of Drugs

Americans pay three times what citizens of other wealthy nations pay for pharmaceuticals, said Dr. Davis. “Why do we have to subsidize the cost of drugs for the rest of the world?”

The United States is the source of virtually all pharmaceutical companies’ profits, and that needs to change, he said, adding that the United States’ trading partners need to pay their fair share for pharmaceuticals.

One way to achieve that is increasing the ability of the government to purchase drugs and negotiate prices, and another is including drug prices in trade talks, points Dr. Davis previously raised in Becker’s Hospital Review. “In trade negotiations with other countries, our country must request foreign governments raise their drug prices and then tell pharmaceutical companies not to just put this money in their pockets, but pass the savings on to Americans.”

Making Insurance Work

Fighting denials from insurance companies, paying outrageous prices for needed medications because they might not be covered, or traveling long distances and waiting months to see an in-network specialist are signs that the current insurance system isn’t working, said Dr. Davis.

“Denial of care is not an ethical business model,” he said. “That has to change.”

As graduates of Icahn Mount Sinai, the audience will be more than doctors who heal patients, and more than researchers who generate innovative science, said Dr. Davis. “Whether you’re at a dinner party or community meeting, testifying before a state legislature or a Congressional committee, engaged in a political campaign or leading a major health care organization, I want you to raise your voice and speak out.”

As CEO of the Mount Sinai Health System, Dr. Davis was known for his role in what has been characterized as one of the largest financial turnarounds in academic medicine—forming one of the largest nonprofit systems in the country through the combination of the Mount Sinai Medical Center and Continuum Health Partners. The Health System in 2022 generated $11 billion in revenue and comprised 48,000 employees, eight hospitals, the Icahn School of Medicine at Mount Sinai, the Mount Sinai Phillips School of Nursing, and more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester County, Long Island, and Florida.

In addition to the honorary degree conferred at Commencement, Dr. Davis’s achievements were celebrated at the 39th annual Crystal Party, held Tuesday, May 21. Here’s a look at his career, and how it all started at Mount Sinai.

1973

Graduated from the Mount Sinai School of Medicine (now Icahn Mount Sinai), valedictorian of the second graduating class, received the Harold Elster Memorial Award

1979-1987

Chief of Psychiatry at Bronx Veterans Affairs Medical Center

1987-2003

Chair of Psychiatry at the Mount Sinai School of Medicine

2003-2007

Dean of the Mount Sinai School of Medicine

2003-2023

President and CEO of the Mount Sinai Medical Center, which became the Mount Sinai Health System in 2013

2024-present

Executive Vice Chairman of the Boards of Trustees of the Mount Sinai Health System

Before becoming an executive, Dr. Davis was also known for his contributions to research and psychiatry, particularly in Alzheimer’s disease and schizophrenia. Here’s a look at some of his research milestones:

  • Discovering the links of acetylcholine to Alzheimer’s disease, and the benefits of using cholinesterase inhibitors such as physostigmine in patients with Alzheimer’s disease, in the 1980s.
  • Designed the original Alzheimer’s Disease Assessment Scale, published in the American Journal of Psychiatry in 1984. The cognitive measure is used as a primary measure for Alzheimer’s disease clinical trials in the United States even today, either in its original or modified form.
  • Key roles in proof-of-concept studies and clinical trials that led to the approval of four of the first five compounds for the treatment of Alzheimer’s disease.
  • Beginning in the late 1980s and through the 1990s, key studies that identified dopamine dysregulation in schizophrenia, and dopamine as a drug target for schizophrenia.
  • The creation of a brain bank for postmortem studies in schizophrenia, leading to findings that schizophrenia is not characterized by classical, histologically identifiable neuropathology, and that chemical markers that are altered in Alzheimer’s disease and other dementia were also abnormal in schizophrenia: choline acetyltransferase, catecholamines and indolamines, neuropeptides, and synaptic proteins.
  • Elected to the prestigious National Academy of Medicine in 2001 for his contributions to neuroscience and brain disorders, and his leadership led to him being awarded the Yale University George H.W. Bush Lifetime of Leadership Award in 2009.

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