5 Questions: Robert Harrington on research, health equity and the gender gap in cardiology

Robert Harrington, the new president of the American Heart Association, recently discussed his views on technology and diversity in medicine.

Robert Harrington

Last November, at the start of the American Heart Association 2019 Scientific Sessions in Philadelphia, cardiologist and current AHA president Robert Harrington, MD, sent out a tweet to his 14,200 followers: “No MANELS! There are no all-male panels at #AHA2019.”

Within an hour, the post had amassed hundreds of likes and retweets, as scientists and physicians from all over the country chimed in to express their support. “Outstanding! Let’s continue to support our young women in STEM and to increase the number of #WomeninMedicine,” replied a preventative cardiologist from USC. “The best part? This wasn’t hard for @AHAMeetings to accomplish. Because #WeAreEverywhere,” a cardiologist who specializes in myocardial infraction also tweeted in response.  

Harrington, the Arthur L. Bloomfield Professor in Medicine and chair of the Department of Medicine at Stanford, has shown a commitment to amplifying diverse voices and leveraging innovative technologies and policies to improve health equity. And it’s these values that drive his work at Stanford and the AHA. Recently, Lindsey Baker, communications manager in the Department of Medicine, spoke with Harrington about his views on technology and diversity in medicine.

1. You’ve taken up several initiatives during your tenure as AHA president — including health equity and diversity, and research. How did you choose these topics, and why were they important to you? 

Harrington: One of the great things about being the AHA president is that you realize you have a big public platform. It provides an opportunity to think about the things that matter to you.

I’m a clinician and a clinical researcher, so one of the key themes of my 2019 AHA presidential address was the idea that evidence matters — that it’s really important to have an evidence base to guide what we do in clinical medicine, and in order to generate that evidence base we need to support research. And in order to support research, we have to think about health equity: How do we make research more approachable for people in communities where they’ve been understudied and underserved?

We now include the word equitable in all of our goal statements. And we just recently announced our 2030 impact goals, which emphasize how we improve overall “whole person” health in the U.S. and globally. 

We’re also committed to supporting young investigators. Right now, over 70% of all of our new research awards go to early career investigators. I’ve mentored residents and fellows for a long time now, so there’s overlap with my day job. I’m also a first-generation college student, and we’re passionately committed to supporting that group as well. 

2. Fewer than 15% of cardiologists are women. How are you closing the gender gap?

Harrington: I was raised by a single mother. I have one sister, I have a wife, I have four daughters. I’m surrounded by women. And yet cardiology as a field is not known for being women-friendly.

So, I decided that I was going to make it part of my AHA presidency. We now have a lot of initiatives to address this: We’ve created a new group called Research Goes Red, which builds on our Go Red for Women campaign, which is focused on understanding heart disease in women. We’ve also created a women’s research working group designed to make sure that we’re reviewing submitted grants in a gender-equitable way, and that we’re including more women as part of all of our science committees. Right now, our committees are roughly 42% women, and we’ve made a public commitment to get to 50% in the next few years.

And in 2019, we made the official decision to stop hosting manels, which are scientific panels comprised solely of men. When we were planning the 2019 scientific sessions, I told colleagues that I will no longer serve on a panel that only contains men, and I asked them to stop hosting panels at the AHA scientific sessions that only include men. 

3. You’re involved in the Apple Heart Study, which saw record participant enrollment and the widespread introduction of digital technology into clinical research. What in your opinion makes this study so groundbreaking? What have been some takeaways? 

Harrington: All credit for Apple Heart goes to others — to Mintu TurakhiaMarco PerezKen MahaffeyManisha Desai and their teams. My role has been supportive. 

Here are the real takeaways for me: Apple Heart was intended to be a technical feasibility study: Might the watch be able to detect atrial fibrillation using the sensors in the watch and algorithms? Because it’s not actually detecting a-fib; it’s detecting an irregularity that has a probability of being a-fib based on a variety of characteristics. And I think the group achieved that. 

The second takeaway, and to me the most interesting part of the study, is that in only eight months we convinced 400,000 people to give us informed consent to collect their health data. That’s the power of the technology. If we can engage almost a half-million people in research the way we did the Apple Heart Study, that could change the paradigm of how we do research. These are extraordinary tools that can allow us to have reach into numbers that we just can’t do in conventional research. 

4. Studies like this make it clear: Technology in research is here to stay. How can we use it in ways that are more supportive and democratic, and less intrusive?

 Harrington: The biggest thing that I’ve been talking about recently is how do we use the watch, the phone and the web to collect data that can be used for research purposes. And if you don’t have to go to the doctor’s office and see your clinicians or the study coordinators, wouldn’t that help to democratize research so that research could reach more people?

Right now, to be involved in research you’ve got to be willing to come to campus or go to a clinic. What if we could do a lot of it remotely? Might we be able to engage a group of people that’s more representative of the population? That to me would be a really important step.

5. You’re very active on social media — particularly Twitter. What appeals to you about this platform? 

Harrington: I’m a big consumer of information. And I largely use Twitter as my social media conduit. I use it to engage in conversations about things I find interesting in cardiovascular medicine, and to keep up with what’s going on in the field. I now track all of my academic journals through Twitter — that’s how I stay current.

I really enjoy the conversations around science, and Twitter makes me read things I might not otherwise read in journals that I haven’t subscribed to. I think that the crowdsourcing of ideas is really helpful and informative — people throw stuff out and ask what you think about it. And all of the sudden you have 50, 100, 200 different voices weighing in. 

Twitter democratizes medicine — you don’t have to be a professor to have an opinion. In fact, some of our early-career investigators are much more facile than established professors on Twitter. Now when I travel around the country to different places for conferences and meetings, I always meet some young person I know from Twitter. I’ve met new people, made new friendships and encountered new ideas. 

I just tell people to decide how they want to use it. I use it professionally, and there are a few things I do regularly that people know about. For example, I’m always showing pictures of my socks, particularly during heart month. I wear a lot of red socks! And everyone knows I love the Boston Red Sox because I tweet about them. 

In a new “1:2:1” podcast, Harrington discusses the latest advances in cardiovascular medicine, as well as efforts to address gender inequities in the field of cardiology, with Paul Costello, Stanford Medicine's senior communications strategist and adviser. 



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