Kotarski Delves Into the Records To Enhance Student Health Care
By Katy Rank Lev
Beth Kotarski loves data — it’s helping her to improve health care for students at Carnegie Mellon University.
The Executive Director of University Health Services joined CMU in 2015 and has been leading collegiate health care services for almost 30 years. During that time, the adoption of electronic medical records has provided Kotarski with the data she needs to make a difference.
"The ability to cull more data has been so helpful," said Kotarski, who cited administering flu shots as an example. She said electronic tracking helps her and her staff map out a plan to help vaccinate the university community and to quantify the benefits of doing so.
"We have a small staff and a small space and can only offer a finite number of shots during appointment hours," Kotarski said. "I really wanted to make sure our most vulnerable student population gets served first [for flu shots]."
Kotarski was able to partner with Human Resources to bring Giant Eagle to campus for faculty and staff vaccination clinics so she and her staff were able to serve more students.
"Our goal this year is to have 1:4 of our total student population vaccinated, to provide a robust herd immunity," she said. "Flu shots are real-time savings of sick days from school, projects completed … there are so many secondary effects, from protecting our students with asthma or who might be undergoing chemotherapy. We have an empathetic group of students here at CMU that understands protecting each other is important."
Kotarski loves when small changes can make a big impact. Her own research interests center around eating disorders, and she has been working to shine the light on some of these challenges with female-identified students at CMU.
"We have an empathetic group of students here at CMU that understands protecting each other is important."
Treatment is complex and very important once a student is in the throes of an eating disorder, Kotarski said. Her aim is improve prevention and screening. A search of the electronic medical records found that less than 1% of female-identified students were screened for eating disorders in the clinic. After adopting a screening tool for eating disorders, Kotarski identified nearly 10% of female-identified students as having risk for disordered eating.
"This has been profound," Kotarski said. "We are hopeful that more uniform screening, such as the type we do for eating disorders, will help students share their concerns more readily with us as their health care provider."
The higher number of students with eating disorders is in line with national averages for university populations, which can range from 12-20% for female-identified students struggling with binge eating, bulimia, purging or excessive exercising. Kotarski said many eating disorders are related to violence or other traumas in the home, intimate partner violence or even genetic causes. The culture, which puts high value on appearance and beauty ideals, also plays a role.
"We are hopeful that more uniform screening ... will help students share their concerns more readily with us as their health care provider."
In 2016, Kotarski was invited to speak before Congress about the stressors in the college student population related to adverse childhood experiences and trauma.
"It was an honor," she said, "and what I realized from that experience is that we need to start intervening and advocating for children long before they get to college."
Kotarski began to think about community building and how a sense of belonging can contribute to positive outcomes.
"We just started something at CMU called the Peer Body Project," she said. "It's a big deal."
The project is part of a national, evidence-based campaign offering training to students, helping peer educators push back against appearance ideals.
"This 'thin ideal' can make us feel objectified," said Kotarski, who is optimistic that the Peer Body Project will help bring campus together as a learning community to change the culture. "This is one of the few programs known to reduce eating disorder risk on college campuses."
She is looking ahead to expanded capabilities once University Health Services can relocate to the new building being planned for student health and wellness services.
“The new space will allow us to connect students more fluidly to the services of our collaborating campus partners,” Kotarski said, noting that the shared space and shared resources can offer more comprehensive care. "There's lots to do."
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