Meet the New Director of Our Center for Geriatric Medicine

Ardeshir Z. Hashmi, MD, came to Cleveland Clinic from Massachusetts General Hospital where he served as Medical Director of the Senior Health-Geriatric Medicine Unit. Dr. Hashmi has a track record of building bridges among specialties in the co-management of health needs in older adults.

At a Glance

Background brief: Dr. Hashmi completed his medical training at Aga Khan Medical College in Karachi, Pakistan (2003) and went on to pursue a two year postdoctoral research fellowship in Hepatology and Immunology at Yale. He completed his Internal Medicine residency at the Yale-affiliated Saint Mary’s Hospital in Connecticut (2011), where he served as Chief Medical resident. He then trained at Massachusetts General Hospital as a Clinical and Research Fellow in Geriatrics (2012), after which he accepted a position as Assistant in Medicine and Instructor at Harvard Medical School before becoming Medical Director of Senior Health-Geriatric Medicine (2015). Dr. Hashmi is a Diplomate of the American Board of Internal Medicine in Internal Medicine and Geriatrics.

Research interests: Geriatrics role in population health, geriatric co-management and redefining dementia screening and management

At Cleveland Clinic, Dr. Hashmi is focused on:

• Enhancing access to geriatric consultations and assessments
• Optimizing the application of geriatric principles to care across the health system
• Developing integrated practice units (IPUs) and cross-collaboration with specialists to best serve the patient
• Celebrating successful aging and ways to sustain it through healthy lifestyle and proactive disease prevention
• Using technology to better measure frailty and cognitive impairment in older adults

In His Own Words

What led you to pursue geriatrics as your specialty?

As geriatricians we must think about all dimensions of a patient, from medical and cognitive issues to functional abilities and psychosocial issues. This diagnostic challenge of decoding the complexity of multiple medical conditions and their interplay is fascinating.

How do you approach patient care?

To best serve the “silver generation” we have to ensure accessibility and deliver state-of-the-art geriatric medicine that is most relevant to the needs of seniors. If we do this while showing our compassion and respect every day, we can help revive the golden era of internal medicine. To be a successful geriatric medicine program, it’s also imperative for patients and families to help us in defining quality care measures and clinical priorities.

What is Cleveland Clinic doing right in geriatric care?

We are facilitating healthy aging in the community setting. With our multidisciplinary approach, we are working to prevent hospitalizations as we manage complex medication regiments and support frail and cognitively impaired patients. While using the latest technologies, we are making a return to the enduring hallmarks of old school medicine by following patients from the home to a clinician’s office to the hospital and finally to assisted living and nursing homes.

What excites you about being here?

Geriatricized healthcare systems are at the cutting edge of the new era of the accountable care organization. We have the potential to be a cornerstone of Cleveland Clinic’s population health efforts to maximize quality and decrease healthcare costs. We are expanding our geriatric consultation services across the state of Ohio by embedding geriatricians into multiple primary care service area (PCSA) “hubs.” This will make our physicians more accessible and further integrate them into the primary care team.

In the big picture, how can geriatric care be improved?

We need to continue to build relationships across specialties from cardiology to urology, oncology and orthopaedics and beyond. This will open up clinical, research and educational vistas for geriatrics in concert with specialists in a veritable “medical neighborhood.” We must also look at the next technological wave of cognitive and frailty screenings and consider process improvements to improve efficiencies and sustainability.

Any final thoughts?

Geriatrics is an idea whose time has come. We will continue efforts to design fiscal models to reward the value of geriatric patient care as opposed to volume-based care. Teamwork among specialists and community physicians really is the future.