Innovations in Military Medicine: Interview with leaders from Mayo Clinic Military Medicine

Innovations in Military Medicine (Part 2 of 2): Interview with Mayo Clinic’s Christopher Russi, D.O.

July 13, 2022 – By Amrika Ramjewan, Principal Business Strategist – Mayo Clinic Innovation Exchange

Mayo Clinic has a long and enduring history of supporting our nation’s military. Military collaborations range from cutting-edge, immersive educational programs and co-developing innovative products through research, to providing serious and complex medical care to veterans and their family members.

Mayo Clinic Military Medicine (established as the Center for Military Medicine in 2018) provides high-quality educational experiences for service members, and partners with military and federal teams on initiatives across Mayo Clinic’s education, practice, and research shields.

Last winter, the Exchange spoke with Pierre Noel, M.D., and Thomas Flipse, M.D. who lead Military Medicine’s work at the enterprise level, and at Mayo Clinic’s campus in Florida, respectively. This summer, the Exchange connected with Christopher Russi, D.O., associate medical director for Mayo Clinic Military Medicine in the Midwest. Dr. Russi discussed telehealth innovation, as well as career development and educational programs for transitioning service members. This article is part two of a two-part series featuring the work of Mayo Clinic Military Medicine. Read part one for more innovations in military medicine.

Christopher Russi, D.O. is a Major in the United States Army Reserves Medical Corp (AMEDD) with the 945th Forward Resuscitation Surgical Team based in Fort Snelling, Minnesota. He also serves as a consultant in Mayo Clinic’s Department of Emergency Medicine. As an active-duty U.S. Army Emergency Medicine physician, Dr. Russi provides care to wounded service members in far forward and austere environments.

In addition to leading Mayo Clinic Military Medicine’s work in the Midwest, Dr. Russi is an associate professor of Emergency Medicine within the Mayo Clinic College of Medicine and Science. He serves as the director of Mayo Clinic’s Emergency Medicine Telehealth Strategies team, where he leads development and growth of emergency medicine telehealth and digital care strategies.

Dr. Russi started his career with Mayo Clinic in 2007 as director of research for Mayo Clinic Medical Transport, then served as division chair for Community Emergency Medicine, overseeing the clinical, personnel, and financial integration of twenty emergency departments across the Midwest practice. Dr. Russi is a graduate of Iowa State University and Des Moines University School of Medicine and Health Sciences.

Q: How have your experiences as an active-duty service member shaped your approach to driving emergency medicine telehealth innovation at Mayo Clinic?

CR: Military service has allowed me to observe the parallels between battlefield and civilian medicine, opening my eyes to a world of possibilities with respect to innovation in both realms. I serve as a US Army Emergency Medicine physician on a Forward Resuscitation Surgical Team — a small, mobile unit of medical/surgical military personnel responsible for treatment, stabilization, medical evacuation, and transportation of injured service members. In austere environments, there are limited personnel and resources available during a mission. These limitations allow you to see the gaps and opportunities for innovation. Interestingly, the military medicine approach to patient care is identical to our core philosophy: “The needs of the patient come first.”

This experience-driven, observational approach has been core to driving innovation in emergency medicine care delivery at Mayo Clinic. In 2019, prior to the pandemic, we launched the Emergency Medicine Telehealth (TeleEM) program to connect and support our network of rural, community-based emergency departments across the Midwest. In 2020, with the regulatory flexibilities afforded by the national public health emergency declaration by the federal government, we expanded the program to support our own academic medical center. This enabled a virtual approach to integrated, multispecialty patient care. These flexibilities allowed us to mitigate exposure to the virus for our patients and staff and conserve supplies of personal protective equipment (PPE).

Many innovations developed for military applications can also be translated into civilian contexts, and vice versa. For example, since the onset of the pandemic, civilian emergency medical services teams have faced unique challenges, including limited supplies of PPE and the need to make difficult resuscitation and transportation decisions in the field. In both military and civilian settings, use of synchronous telehealth services for field-based clinical decision support can be a game-changer for improving the timeliness of medical care delivery.

Q: Mayo Clinic has been recognized by Military Friendly® as a ‘Military-Friendly Employer.’ What initiatives has Mayo Clinic invested in to create sustainable and meaningful opportunities for service members, veterans, and military families?

CR: Mayo Clinic has a rich, longstanding tradition of supporting our nation’s military, and we are honored to have been recognized as a Military Friendly® organization.

Each year, over 200,000 service members transition out of the military. Last year, in collaboration with the U.S. Department of Defense, Mayo Clinic launched the SkillBridge Program for active-duty service members seeking to transition into civilian careers. This program provides internship opportunities for transitioning service members to gain valuable civilian work experience during the last 180 days of their active-duty service. Although the internships are unpaid, participating service members continue to receive their military pay and benefits.

Mayo Clinic is pleased to offer internships in logistics, supply chain management, and surgical services at our locations in Arizona, and internships in nursing across our locations in Minnesota and Wisconsin. Currently, we are the only SkillBridge program partner to offer clinical roles. We are working to expand the program to our Florida campus in 2022. These internships serve as a talent pipeline for our workforce, bringing valuable skills to Mayo Clinic while creating professional development pathways for military service members. Nationally, the SkillBridge program has a 96% job acceptance rate, with 99% of participants staying with their employer after the first year.

Through the Army-Baylor Fellows program, one graduate student from the Army-Baylor Master of Health Administration (MHA) program can be accepted for a 52-week residency at each Mayo Clinic site per year. The residency is required for candidates enrolled in the program and must be completed for award of the program’s joint MHA and MBA degree. Students participating in the residency benefit from government funding, as salaries and benefits are covered by the military during the residency.

Mayo Clinic was also the first healthcare organization in Minnesota to be recognized as a Yellow Ribbon Company for its participation in the Beyond the Yellow Ribbon program — an initiative of the Minnesota National Guard. Beyond the Yellow Ribbon organizations coordinate resources in support of service members, veterans, and military families. We are enormously proud to be a part of this network.

As an active-duty service member, one of the most striking parallels I’ve observed between Mayo Clinic and the military is in the way my civilian duties mirror my service duties — balancing the need to successfully accomplish the mission, while keeping people safe.

This mission-driven, shared culture of service that runs deep within both institutions is evident in the tremendous number of veterans, reservists, and active-duty service members at Mayo Clinic who have served and still want to give back — whether through volunteering their time, or by championing initiatives to support fellow service members.

An example of this is the partnership between Mayo Clinic’s Office of Equity, Inclusion and Diversity and the Veterans Mayo Clinic Employee Resource Group to prepare service members for careers beyond the military. Services offered include coaching for behavioral interviews, and support with professional rebranding in preparation for job hunting. As a result of the pandemic, these services have been offered virtually over the past two years, with incredible impact. Many overseas deployed service members preparing for transition have connected with us, sharing their appreciation for having support to help peel back the layers of their military experiences to better understand the types of roles that will best match their interests and strengths.

Q: How has Mayo Clinic Military Medicine worked to expand partnerships within the communities it serves?

CR: Each year, Military Medicine runs a number of training programs for active service members, veterans, and community partners. Last summer, we successfully ran our Special Operations Tactical Medicine Training Program for the first time in the Midwest. Launched in Arizona in 2012, this program provides hands-on training to equip special operations personnel with the knowledge and skills to manage critically ill casualties of trauma in a tactical environment. Our vision is to bring this specialized course to Rochester, Minnesota twice per year starting in 2023.

In 2020, Mayo Clinic joined the U.S. Department of Veterans Affairs’ Community Care Network, expanding access to care for veterans across Mayo Clinic Health System sites. Through this agreement, more veterans can receive care closer to home. Those with complex care needs can be referred to be seen at any of Mayo Clinic campus locations in Minnesota, Florida, and Arizona.

Our Stop the Bleed program provides hands-on education for learning proper bleeding control techniques using hands, dressings, and tourniquets. This program is offered at our Minnesota and Arizona academic medical centers, with plans to expand to our Florida campus. In Minnesota, Mayo Clinic in Rochester also offers Stop the Bleed training to members of the American Legion twice a year.

K9 Rescue Simulation training is provided to local law enforcement agencies close to all three of Mayo Clinic’s destination locations in the U.S. This program equips dog handlers and field officers with the skills to respond to their K9 partner’s needs in the event of a medical trauma incident. K9 service dog mannequins are used to simulate real, commonly encountered medical emergencies in the field. Just like the mannequins used for patient care simulations, the K9 mannequins don’t merely mimic the size and weight of service dogs. They simulate dogs’ breathing, barking, and more — just like a real canine.

Q: What breakthrough innovations in healthcare delivery or technology excite you most?

CR: It’s been very exciting to help with the expansion of telehealth services in emergency medicine.

There have been significant gains and positive outcomes from the implementation of new clinical workflows and models of care delivery. Many of these innovations are enabled by remote monitoring and synchronous telehealth technologies. These advances translate directly to both military and civilian medical contexts, and there is ample potential to leverage the knowledge base developed during the past two years to push telehealth even further.

In the coming years, I look forward to further expansions in the use of telehealth, as we take emergency medicine well beyond the walls of our hospitals.

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