Rheumatologists are known for their interest in caring for patients with unusual diseases, and so it’s perhaps fitting that S. Louis “Lou” Bridges, Jr., MD, PhD, would begin his tenure as rheumatology division chief at HSS under the most unusual of circumstances – in quarantine during a global pandemic.

Dr. Bridges, who most recently served as Director of the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham (UAB) from 2008 to 2020, joined HSS on September 1 as HSS Physician-in-Chief, Chair of the Department of Medicine and Chief of the Division of Rheumatology.

We spoke with Dr. Bridges to learn a little more about what led him to HSS and what he hopes to do now that he’s here.

1. What was it like starting in a new role virtually?

I was hired before the pandemic hit New York City. I planned to fly up a few times before I started. When everything went virtual, I found that I had a lot more access to people because no one was traveling and virtual meetings became the norm. That part has been great; the drawback, of course, was not getting to meet people in person.

2. What drew you to HSS?

First of all, HSS has a phenomenal clinical reputation, not only as one of the most highly regarded rheumatology programs in the nation but as the top orthopedic hospital in the nation. I have the privilege of getting to build on that greatness. For me, this is a rare opportunity to stand on the shoulders of giants.

I’m also thrilled to join an organization whose sole focus is musculoskeletal care. At most academic medical centers, musculoskeletal care takes a back seat to other specialties. But at HSS, musculoskeletal care is in the mission statement. It’s what we all have in common.

Aside from that, the faculty and training programs are tremendous. I also like the close interactions with the Department of Orthopedics as well as the HSS Research Institute. The opportunities for collaborative research among specialists in orthopedics, rheumatology, and other areas are much greater than at most traditional academic institutions, and this was very appealing to me.

3. What are some of your priorities in your first year at HSS?

One of my top priorities is to build upon the already distinguished legacy of clinical research in rheumatology at HSS. This will involve accelerating development of the research infrastructure at HSS. If we can accomplish this, then we will be able to translate more quickly discoveries made in the lab into new therapeutic approaches for patients.

A second and related goal involves developing our faculty. I would like to enhance mentoring opportunities between our junior clinical investigators and our established successful faculty members. I’m also looking forward to recruiting accomplished researchers who are focused on clinical and translational research. This will allow us to enhance our clinical research portfolio and provide additional mentoring opportunities to junior investigators.

Actively enhancing diversity, equity and inclusion among our faculty and trainees is very important. This is a goal I share with other leaders in the organization. It is imperative that we seek out talented clinicians, investigators, and educators from a variety of backgrounds, including underrepresented groups. Concurrent with that, we need to enhance the welcoming, inclusive culture that already exists at HSS. 

4. What research do you find most promising in the field of rheumatology right now?

There’s a lot to be excited about in rheumatology right now. Two areas that I believe are highly promising are big data analyses and artificial intelligence approaches such as machine learning.

Big data involves the use of huge datasets like those provided by the Medicare claims databases or the American College of Rheumatology’s RISE (Rheumatology Informatics System for Effectiveness), as well as genomic data, proteomic data, and radiographic data. When integrated with clinical, demographic, and other information available in electronic health records, these big datasets can be analyzed to address previously unanswerable questions in patient care. For example, in one recent study, investigators were able to create a model based on electronic health record data to predict future flares of RA in individual patients. Ultimately we hope to build similar models to advance the goals of precision medicine, such as choosing the best drug for an individual patient.

The use of machine learning in image analysis is another promising area of research. For example, my colleagues and I are currently completing a DREAM Challenge in which teams from all over the world are competing to generate a computer algorithm that can automatically quantify the degree of joint space narrowing and erosions in hand and foot radiographs of rheumatoid arthritis.

5. How do you see rheumatology patient care changing in light of the pandemic?

The COVID era has given us a unique opportunity to reinvent the way we deliver patient care. Many of the changes we have seen, such as the exponential growth in telehealth, will be with us for the foreseeable future.

The pandemic has also escalated interest in optimizing the capabilities of mobile technologies. Smartphones and other devices offer significant opportunities for patient education, enable patients to communicate symptoms to their doctor in real time, and can enhance clinical research studies.

A challenge of virtual care unique to rheumatologists involves the ongoing need to assess patients for joint tenderness and swelling. There are a number of possible ways to address this without seeing patients face-to-face. One potential method that may be helpful in the future involves the use of infrared cameras to measure small changes in the temperature of joints as an indicator of inflammation.

6. What do you like most about the culture of HSS?

One thing I’ve really enjoyed about the culture of HSS so far is how friendly everyone is. As someone who has lived in the Deep South for most if his life, I am very appreciative that everyone has been so welcoming to me. I greatly look forward to being part of the HSS family. I want to enhance the culture at HSS by supporting the goals of the organization as well as each individual, shared governance, and mutual accountability, while promoting a welcoming, caring and supportive environment.

Hear from Dr. Bridges for more about the HSS Division of Rheumatology here and follow him on Twitter at @HSS_PIC.