Kurt Herzer, a senior public health major and Woodrow Wilson scholar, has a prodigious research résumé that contains co-authored book chapters, awards from international conferences and accolades from physician scientists and clinicians with whom he has worked.
Surprisingly, Herzer's interests were initially in finance, but after attending a Hopkins summer program as a high school student, his interest in medicine quickly began to grow.
Much of his research has centered on improving health care quality and patient safety. His projects have ranged from using simulations to test out new surgery therapies, analyzing records of medical errors and designing models to demonstrate the burden of particular diseases on certain countries.
"What interested me in these kinds of issues is that things are routinely killing patients that need not happen. They're not dying from their diseases: they're dying from things that can be prevented - from infections they shouldn't have gotten, sponges or devices being left inside of them, things that are preventable," he said.
Woodrow Wilson scholars are permitted to pursue multiple research projects throughout the course of their studies. While some students pursue research across several disciplines, Herzer has focused his work on closely-related topics.
In describing his projects, Herzer divided them into "macro" and "micro" levels. Two of his main large-scale projects include his work in the United Kingdom and Geneva.
Herzer cited his "main" Woodrow Wilson project as his work with the National Health Service in the U.K., which has the world's largest medical error reporting system. The system contains some two million reports of medical errors that range from benign to fatal. The database contains a wide variety of errors, including improper medication prescription and mistakes in the operating room.
Unfortunately, the most important aspect of each report, a written account of the error typed by a doctor or nurse, did not have a standardized format. This made it essentially impossible for clinicians to find related cases in the database.
Herzer developed a system that used text analysis algorithms to identify medically relevant terms within each account, allowing doctors to search through the database for a particular type of error and see all the instances where it occurred.
"The notion was that if we knew which areas were the most risky, the government could focus their attention on reducing the risk in these areas as opposed to what every country typically does, which is usually just shooting in the dark," he said.
Herzer piloted the model using a subset of the database containing airway management issues. After achieving initial success, he began to apply it to other areas of the database. Later this month, he is scheduled to give a talk on the project's success in the U.K.
Another of Herzer's projects focused on developing a model for estimating the burden of particular diseases on a country. Given the data for a particular country, the model provides a way to compare the effect of different diseases with one another.
"The idea of the project was to develop disease-burden estimates for health care-associated infections in the same way that we do for traditional disease. We can then take these data to other countries and say, 'These are your estimates for disease burdens, and here it is stacked against your other public health priorities,'" he said.
"Then they can determine how much of their resources they want to allocate to prevention."
The model is versatile in that it allows different countries to analyze a particular disease or infection specific to that country. Herzer also noted that since the model is based on each country's data, the results are more useful to policy makers.
Another project, one that Herzer described as a "micro" project, used human patient simulators to test new, unproven therapies. The patient simulators are elaborate models of actual human beings that range in cost from $40,000 to $400,000. Some simulators are extremely realistic and able to speak, exhale carbon dioxide and react just like an actual patient would.
Herzer likened the simulators to "test dummies" for unproven treatments. One surgical therapy that was first tested using the simulators was intraoperative radiation therapy, in which the surgeon implants radioactive seeds and administers radiation directly into the tumor bed of a cancer patient.
Testing the treatment on the dummies first paid off.
"Sure enough, when we did it, the Geiger counter on the wall was miscalibrated, radiation was leaking from the room because the lead door wasn't placed right - stuff that would endanger not only the patient but also the healthcare team," he said.
After realizing the potential hazards of the treatment, Herzer and his team at the hospital fixed the problems. Since then, the therapy has been performed on about 15 human patients without incident.
While proud of the research that he has performed as an undergraduate, Herzer feels that his greatest achievements to date are the relationships that he had forged with his mentors, particularly Peter Pronovost and Lynette Mark, both doctors from the Anesthesiology and Critical Care Division of the Hopkins Hospital.
Herzer offered advice to Hopkins students interested in pursuing research. While he felt that each situation was unique, he thought that there were three important components to any successful research experience.
First, he recommended that students receive formal training in whatever area they wish to research. This training includes acquiring a general knowledge of the subject that they are interested in, both through hands-on research experiences and coursework.
Second, he felt that it was important to find a good mentor. Although he admitted that the process could be difficult, he emphasized its importance and the role that his own mentors played in the success of his own research and his development as a scientist.
Finally, he stressed that achieving significant results takes time, and that often the more time students put in, the more likely they will have a rewarding experience.
Herzer is no stranger to success with his research. He was named a Truman scholar last year, and also has big plans for the future. He will be spending the next two years at Oxford through his Marshall scholarship. Afterward, he will be earning his MD/Ph.D degree from the Hopkins School of Medicine and the Bloomberg School of Public Health.
He plans to continue his research in the future, with a particular focus on maintaining health quality and access to care in developing countries and in countries that have been disrupted by war or civil unrest, such as Afghanistan and Iraq.
