2017/2018 EDITION
R E S E A R C H . I N N O VA T I O N . K N O W L E D G E . The power of enhancing clinical care.
TABLE OF CONTENTS
President & CEO Richard A. Anderson Vice President, Marketing & Public Relations Ken Szydlow Editorial Director Stephen Andrews Art Director Jen Rimonneau
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• ABOUT US
Editor and Writer Mary DeHaven, MBA
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• RESEARCH
Contributing Writer Anjanette Oberholzer
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• S PECIAL FEATURE: REGIONAL BREAST CENTERS
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• INNOVATION
18
• KNOWLEDGE
22
• QUALITY
Our Mission The mission of St. Luke’s University Health Network is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient’s ability to pay for health care.
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Research Contributors Tracy Butryn Stanislaw Stawicki Jill Stoltzfus Contributing Photographers Anita Sergent Tom Volk
MESSAGE FROM SENIOR LEADERSHIP Our focus on clinical research, innovation and knowledge has helped establish our organization as a progressive health system recognized nationally for quality. Looking beyond traditional clinical areas, we continue to push the boundaries until our pursuit of excellence permeates every department and energizes every employee. Over the past several years our ability to increase the number of available clinical trials provided our patients with leadingedge, life-saving treatments. The number of manuscripts authored by St. Luke’s physicians and staff increased 70 percent between 2013 and 2017 and continues to grow. Recently, we established an undergraduate college internship program and have expanded our post-doctoral research fellowship program. St. Luke’s is committed to leading the region in health care innovation. Even though we are the area’s biggest hospital system – adding two hospitals in 2017 and one in 2018 – we continue to redefine how our patients both access and participate in their care. We embrace emerging technologies that combine patient convenience, quality and affordability of care. Through these efforts, we empower patients to obtain needed care – when, where and how they want it. For example, we recently launched the St. Luke’s App. We are expanding our reach to include voice-activated and smarthome devices. Through our focus on providing affordable care, our bundled care program is one of the nation’s most advanced and has resulted in improved care and lower costs. We also lead the nation in price transparency. Our pioneering, online PriceChecker tool provides patients with their out-of-pocket costs for health care services and offers them a discounted, bundled price – all at their fingertips.
Our commitment to knowledge and education is epitomized by our expanding medical school – the region’s first and only – residencies, fellowships and other highly competitive programs. Our goal is to develop outstanding health care professionals who will serve our community long into the future.
Jeffrey Jahre, MD
We are committed to our role as stewards of health care, never satisfied with our accomplishments but constantly embracing research, innovation and knowledge as a means to continuously improve the breadth and quality of the care we provide. Stanislaw Stawicki, MD, MBA
Jeffrey Jahre, MD Senior Vice President, Medical & Academic Affairs
Stanislaw Stawicki, MD, MBA Chair & Network Medical Director, Department of Research & Innovation
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ABOUT US St. Luke’s University Health Network (SLUHN) is a nonprofit, regional, fully integrated, nationally recognized Network providing services at nine hospitals and more than 300 sites, primarily in Lehigh, Northampton, Carbon, Schuylkill, Bucks, Montgomery, Berks and Monroe counties in Pennsylvania and in Warren County, New Jersey. EVEN EASIER. ACCESS. NOW. INTRODUCING THE NEW ST. LUKE’S APP St. Luke’s now offers a one-of-a-kind application that puts health care management tools at the tips of our patients’ fingers. See page 14.
PRICE Anticipate your health care costs
Learn more about St. Luke’s Research & Innovation at research.sluhn.org. 4 • RESEARCH. INNOVATION. KNOWLEDGE. • RESEARCH.SLUHN.ORG
St. Luke’s University Hospital – Bethlehem
St. Luke’s has won the IBM Watson Health™ 100 Top Hospitals Award in the major teaching hospital category for four years in a row, widely regarded as one of the highest honors in the health care industry. See page 24.
BY THE NUMBERS St. Luke’s Allentown Campus
St. Luke’s Anderson Campus
10
Campuses
300+
Outpatient Facilities St. Luke’s Gnaden Huetten Campus
St. Luke’s Miners Campus
1,400+
Physicians & Providers
St. Luke’s Monroe Campus
St. Luke’s Palmerton Campus
St. Luke’s Quakertown Campus
St. Luke’s Warren Campus
1,600+
Volunteers
14,000+ Employees
The region’s second largest employer
65,000+
Inpatient Admissions & Observations
250,000+ Annual Emergency Room Visits
THE POWER OF ENHANCING CLINICAL CARE • 5
RESEARCH “ Research is creating new knowledge.” – Neil Armstrong
RESEARCH INSTITUTE The Research Institute was founded in 1992 to nourish the academic environment required by the accrediting body that certifies graduate medical education programs. Under the leadership of Jill Stoltzfus, PhD, the Research Institute serves as an internal resource to assist St. Luke’s University Health Network medical students, residents, fellows, attending physicians, nurses and other administrative, clinical and managerial staff with their research-related needs, including: • Planning, designing and implementing research projects • Statistically analyzing data and summarizing results • Writing and editing abstracts, manuscripts and other documents • Providing lectures and workshops on various research topics • Assisting with grant writing
Jill Stoltzfus, PhD
Network Director, Research Institute; Co-Director, PostDoctoral Research Program
St. Luke’s Post-Doctoral Program trainees, coordinators, and leadership
Tracy Butryn, MS, CCRP, CHRC CLINICAL TRIALS AND RESEARCH St. Luke’s University Health Network has a long tradition of participation in high-impact, high-quality clinical trials. Supported by the St. Luke’s University Health Network Clinical Trials Office (CTO) under the leadership of Tracy Butryn, MS, CCRP, CHRC, the CTO serves as the clinical, operational and administrative shared resource for the conduct and management of all clinical research across St. Luke’s. Since its inception in 2012, the St. Luke’s CTO has demonstrated consistent growth, and has been the true engine of research at the Network. With clinical trials spanning a multitude of therapeutic areas including cardiology, pulmonology, surgery, orthopedics, infectious disease, neurology, trauma, critical care, emergency
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Senior Network Director of Clinical Trials and Research
medicine and oncology, our team of expert and dedicated clinicians and staff conduct research supported by industry and government sources in both outpatient and inpatient settings throughout our nine-hospital system. St. Luke’s also offers clinical trials that involve newly FDA-approved drugs, as well as expanded access trials (awaiting FDA approval). Patients at St. Luke’s are among the first in the region to receive leading-edge, novel therapies available only through clinical trials. In diverse areas like cancer, necrotizing fasciitis, pulmonary embolism, wound care and neurosurgery, our physicians are now able to offer options not available anywhere else in the region. Among the leading-edge, innovative, research endeavors currently available to our patients through the efforts of the CTO are: • Numerous oncology protocols • Highly specialized immunotherapy trials • Cardiovascular interventions • National databases and registries • New devices and health care software applications • Novel management approaches to necrotizing soft tissue infections • Pioneering research in neurostimulation B. BRAUN MEDICAL INC. HELPS FUND POST-DOCTORAL RESEARCH FELLOW St. Luke's University Health Network has received a grant from B. Braun Medical Inc. for a Post-Doctoral Research Fellow in Health Care Quality and Value. The focus of this fellowship is on research to improve patient outcomes, health care cost optimization, community service and education outreach. B. Braun Medical firmly believes that the long-term benefits of establishing this research fellowship at St. Luke’s will lead to increased production of relevant research results that inform best clinical practice to improve patient care, minimize clinical practice variability, improve patient outcomes and identify areas of health value creation.
The Clinical Trials Office Staff
ST. LUKE’S AND LEHIGH UNIVERSITY COLLABORATE ON NEW HEALTH TECHNOLOGIES St. Luke’s University Health Network and Lehigh University are collaborating on interdisciplinary research projects that combine such disparate disciplines as clinical medicine and mechanical engineering. William Delong, MD, chairman of Orthopedics at St. Luke’s University Health Network and his team are currently partnering with a mechanical engineering team at Lehigh. At present, the team is working toward clinical applications based on biomaterials for cartilage repair. But ambitions reach higher. The platform being developed can build polymeric structures that induce regeneration of tissue that can be applied to lots of different clinical therapeutic areas. Lee Riley, MD, Network Chairman of Oncology and the Director of Surgical Research, has worked with several Lehigh University research teams on the design and ergonomic limitations of some tools he currently uses in surgery. “The Lehigh teams developed a number of different devices,” Riley says, “all quite different, all very creative. We met with both teams periodically and reviewed the devices. The teams then moved forward and created new versions of the devices. This ultimately culminated in 3-D engineering/printing of the devices.”
THE POWER OF ENHANCING CLINICAL CARE • 7
RESEARCH cont. INDIVIDUAL HIGHLIGHTS Gbolabo Sokunbi, MD St. Luke’s Participates in Study Testing Efficacy of Spinal Fusion Allograft Traditionally, orthopedic surgeons performing spinal fusion – a complex procedure designed to eliminate painful or unstable movement of the spinal column – have used autologous cancellous bone graft (bone taken from the patient’s hip) due to its unique properties that facilitate bone growth. Unfortunately, harvesting of autologous (host) bone graft is associated with complications, including donor site pain, infection and injury to local structures. Bone graft alternatives have been created to offset these issues. St. Luke’s University Health Network is currently participating in a multisite clinical trial to test the effectiveness of one such product, an allograft designed to promote bone growth and healing following lumbar fusion. Orthopedic surgeon Gbolabo Sokunbi, MD, Trial Chief Investigator, explains that an allograft is a cadaveric or synthetic bone substitute that can be employed in fusion procedures. Referring to the five lowest bones in the back, lumbar fusion is commonly performed to address pain caused by degenerative changes, instability, trauma or cancer. Lumbar fusion techniques eliminate motion between unstable or painful vertebral segments. “Products like this use harvested and sterilized bone to decrease the risk of disease transmission to nearly zero while maintaining high levels of natural growth factors,” says Dr. Sokunbi. “The bone graft can be used in different structural forms such as putty or granules that, when placed around host bone, facilitate creation of a solid unit. The two-year study compares the efficacy of this allograft to similar products. St. Luke’s was selected due to its reputation for quality care, high volume of lumbar fusions and academic affiliation.” Specializing in spine surgery, Dr. Sokunbi completed a spinal surgery fellowship at the Hospital for Special Surgery in New York City and an internship and orthopedic surgery residency at Temple University Hospital after graduating from UMDNJ-Robert Wood Johnson Medical School. William R. Burfeind Jr., MD St. Luke’s Team Outperforms in Lung Device Clinical Trial Due to its high volume of lung cancer patients, St. Luke’s University Health Network was selected to participate in a clinical trial testing the effectiveness of a new mobile and digital chest drainage system. St. Luke’s team has enrolled the second highest number of patients among the participating health systems. Of 600 patients, 28 percent are St. Luke’s patients, says
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Gbolabo Sokunbi, MD
William Burfeind Jr., MD
William R. Burfeind Jr., MD, Chairman of the Department of Surgery, who is leading the St. Luke’s study. “After the lung cancer has been removed surgically, the surgeon inserts a tube into the patient’s chest to evacuate air and fluids, ensuring the lung stays inflated,” explains Dr. Burfeind. “The randomized trial compares a digital drainage system with traditional drainage devices to determine whether it reduces chest tube time, enables the patient to be mobile sooner and shortens the hospital stay.” Of note, 18 percent of lung cancer patients currently treated at St. Luke’s have been placed into a clinical trial. Also, St. Luke’s operates the region’s largest lung cancer screening program. Dr. Burfeind completed his general and thoracic surgery training and was on the faculty at Duke University Medical Center in Durham, NC. He completed medical school at Columbia University College of Physicians and Surgeons in New York City. St. Luke’s Trauma Network Expands to Three Hospitals A Regional Leader in Injury Care, Education and Research The Pennsylvania Trauma Systems Foundation Board of Directors in November 2016 approved St. Luke’s Quakertown Campus as a fully accredited Level IV Trauma Center. This past November, PTSF re-accredited St. Luke’s Miners Campus in Coaldale – the first Pennsylvania hospital to earn Level IV designation, states Rebecca Wilde-Onia, Trauma Program Manager. The Level IV accreditation process assesses hospital compliance with established standards for appropriate and timely care of injured patients, advanced levels of nursing and physician education, and rigorous review of trauma care delivery. William S. Hoff, MD, Network Director of Trauma Program Development, says this process assures that physicians and staff are well equipped to evaluate and treat injured patients and rapidly transfer patients as needed.
For more serious injuries, the trauma teams stabilize patients for safe transfer via ground or helicopter to St. Luke’s University Hospital in Bethlehem, a Level I Trauma Center for nearly 20 years. Approximately one in five trauma patients seen at Quakertown and Miners Campuses are transferred to Bethlehem, says Peter Thomas, DO, Network Medical Director of Trauma. With three fully-accredited trauma centers, St. Luke’s leads the region in providing advanced injury care and education, adds James Cipolla, MD, St. Luke’s Chief of Trauma, Acute Care Surgery and Surgical Critical Care. Cancer Experts Published in Medical Journals Sanjiv Agarwala, MD, St. Luke’s Chairman of Medical Oncology, is the first author of “Phase III Randomized Study of High-Dose Interferon in Melanoma,” which was published in the March 2017 issue of the Journal of Clinical Oncology. Meanwhile, fellow St. Luke’s oncologist and Chief of Surgical Oncology, Darius Desai, MD, co-authored an article titled “Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma” that was published in the June 8, 2017, issue of the New England Journal of Medicine. Agarwala is an internationally recognized investigator in the field of melanoma and immunotherapy. The Eastern Cooperative Oncology Group Trial that he led included more than 1,400 patients across the United States — including a segment of St. Luke’s patients — and in Canada, South Africa and Australia. The study was designed for patients who had melanoma that was surgically removed and were potentially cured, but also had a high risk of the melanoma returning. In Desai’s international trial, his research team randomly assigned patients with sentinel-node metastases to either undergo removal of the other lymph nodes in the area (by a process known as completion lymph-node dissection) or to have the lymph nodes observed with ultrasonography. More than 3,600 patients participated in this trial.
THE POWER OF ENHANCING CLINICAL CARE • 9
SPECIAL FEATURE: REGIONAL BREAST CENTERS RESEARCH LEADS TO ESTABLISHMENT OF ST. LUKE’S REGIONAL BREAST CENTERS Third Center Opens January 2018 in Monroe County St. Luke’s University Health Network is a leader in providing outstanding breast care and cancer treatment. Crucial to its fight against cancer is effective screening to identify the disease in its early – and most treatable – stage. An important component of this effort is St. Luke’s three Regional Breast Centers focusing on diagnostic breast imaging. Envisioned first by radiologist Joseph Russo, MD, St. Luke’s Chief of Women’s Imaging, our imaging centers are equipped with state-of-the-art technologies and staffed by professionals who specialize in breast imaging. The establishment of these Regional Breast Centers began with research. “The research was twofold,” Dr. Russo says. “First, there were many professional journals that espoused the benefits of a centralized diagnostic center, specifically with regard to quality, turnaround times and patient satisfaction. Second, there was extensive market research that our management undertook, asking patients their preferences and desires for breast care. Our patient flow and physical design decisions were based in no small part on this feedback we received from patients.” The first center opened in 2008 in Center Valley, followed by Phillipsburg, NJ. Our third center will begin operating in February 2018 in the recentlyopened St. Luke’s Medical Office Building in Monroe County. All three are equipped with low-dose 3D mammography and automated breast ultrasound (ABUS) capability and are staffed by technologists and radiologists experienced in breast care. Breast MRI is available in the Network as needed. “We have an expert group of radiologists dedicated to reading mammograms, ultrasounds and MRIs of the breast,” Dr. Russo says. “Because they read a large volume of images, they are able to spot suspicious areas that less experienced radiologists might miss. They are also able to avoid unnecessary biopsies on benign findings. You really want someone reading your mammogram who looks at 5,000 scans a year, not 500.” The radiologists read scans not only for the Breast Care Centers, but for all of St. Luke’s 14 breast screening sites.
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Should a suspicious area be identified, the radiologist requests different views or tests while the patient is still in the center. If cancer is suspected, a radiologist can often perform a breast biopsy right away. “Having a positive screen provokes anxiety for most women,” says Helene Oplinger, St. Luke’s Radiology Administrator. “As a result, most prefer to have the biopsy performed that same day, but some prefer to come back another time. We always allow the patient to determine the timeline. Everything we do is patientdriven, patient-focused and designed to identify and address any breast-related health issues while eliminating unnecessary anxiety.” Dr. Russo Guides Physicians on Imaging Choices Great strides have been made in cancer screening, particularly for dense breasts, but with more options, many physicians are unsure what breast screening test to order. Dr. Russo has created an algorithm to guide gynecologists and other physicians in prescribing a personalized screening program implementing various innovative technologies. Dr. Russo’s algorithm considers breast density and a woman’s risk* in leading the physician to choose from among 2D mammography, 3D mammography, automated breast ultrasound, MRI or a combination of these various types of screening methods. He presented his algorithm
FACTS
• Breast density is a more significant risk factor than having a mother and sister with breast cancer • Mammography alone is 98 percent effective in fatty breasts, while only 48 percent effective in dense breasts • Dense breasts are 4 to 6 times more likely to develop cancer than fatty breasts • Cancer recurrence is 4 times more likely in women with dense breasts • Approximately 40-50 percent of women will fall into dense or heterogeneously dense categories to more than 500 health care professionals and breast health advocates at the National Consortium of Breast Centers annual conference in 2016. Latest GE Healthcare Technology and Exceptional Doctors and Staff Result in Better Care For decades, St. Luke’s has helped GE Healthcare develop new imaging technology. In the process, our radiologists and staff have gained experience in the latest imaging technologies. This knowledge, in the hands of radiologists with exceptional experience, has resulted in improved patient care and a better patient experience.
Our dedicated women’s imagers call back fewer patients for additional imaging from their screening mammograms. In fact, St. Luke’s has a cancer detection rate that is 25 percent higher than the national average and false positives (benign biopsies) occur approximately 50 percent less than the national average. Finding more cancers, with less callbacks and less biopsies, illustrates the high-quality care for which St. Luke’s is known. *Based on the Tyrer-Cuzick Lifetime Risk Model
THE POWER OF ENHANCING CLINICAL CARE • 11
DREXEL UNIVERSITY HONORS ST. LUKE’S PIONEERING WORK IN POPULATION HEALTH A national leader in population health analytics, St. Luke’s University Health Network has been named among the top 50 analytics innovators in the United States by Drexel University’s LeBow College of Business. The university recognized these organizations at the 2017 “Analytics 50” awards ceremony in Philadelphia. St. Luke’s enterprise data warehouse crunches data from over 40 sources, cleansing and integrating it into a seamless, patient-centered view of the business. Powered by the Information Builders Omni Health Data platform, the enterprise data warehouse represents the next step in St. Luke’s long-standing commitment to management by data. Leveraging this new powerhouse of information, St. Luke’s has developed innovative applications including its own population health analytics tool called St. Luke’s Care Insights. St. Luke’s Care Insights is a comprehensive platform enabling the network to systematically identify opportunities to improve care and reduce healthcare costs – for example, more efficiently managing high-cost pharmaceuticals, or predicting which patients with chronic diseases require a higher degree of care coordination to head off expensive emergency department visits. ST. LUKE’S OFFERS DIEP BREAST RECONSTRUCTION AFTER MASTECTOMY St. Luke’s Plastic & Reconstructive Surgery now employs two fellowship-trained physicians who perform the highly sought after DIEP (deep inferior epigastric artery perforator) breast reconstruction. An advanced microsurgical technique, DIEP breast reconstruction rebuilds the breast lost to mastectomy by using tissue taken from another part of the patient’s body, usually the abdomen. Among its advantages, DIEP doesn’t require maintenance or repeat surgery, which often occurs with breast implants over time. Rather, when performing the DIEP procedure, our plastic surgeons rebuild the breast with soft, warm, living fat, as well as skin and vessels, obtained from the patient’s own abdomen. To ensure that the tissue will survive in its new location, our fellowship-trained surgeons use microsurgery to reattach the blood vessels in the tissue to blood vessels in the chest. The patient’s tissue is carefully reshaped into a breast mound and sutured into place. Unlike other breast reconstruction procedures that use the patient’s tissue, with DIEP no muscle is moved or repositioned.
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To perform the DIEP procedure, surgeons must have special training as well as expertise in microsurgery. St. Luke’s Plastic & Reconstructive Plastic Surgery physicians Lino Miele, MD, who joined the practice in 2015, and Juan Carlos Martinez, MD, who joined in September, are both trained in plastic and reconstructive surgery and are experienced in the DIEP procedure. Dr. Martinez received an additional year of training in microsurgery. ST. LUKE’S INTERNATIONAL SURGICAL STUDIES HELPS DEVELOPING NATIONS Under the direction of Richard P. Sharpe, MD, St. Luke’s University Health Network has developed the St. Luke’s International Surgical Studies (SLISS) Program. SLISS works to meet the health care needs of populations in developing nations through sustained improvements in care. The program’s teams also train the next generation of medical professionals to meet the needs of the international community. St. Luke’s International Surgical Studies program was designed specifically to partner with hospitals in host nations and provide supplies, equipment, training and visiting medical professionals. Since Spring 2014, the St. Luke’s International Surgical Studies Program (SLISS), has partnered with Mbingo Baptist Hospital (MBH) in Cameroon, Africa, to improve access and quality of health care for nearby villagers while also providing St. Luke’s surgical residents with a rewarding and eye-opening international medical experience. For the general surgery residents, the many benefits of the St. Luke’s International Surgical Studies program include
learning how to perform surgery in an austere setting where medical supplies are limited and ancillary support services are non-existent. They gain experience in diagnosing and treating common conditions that present much later in the course of the disease, as well as illnesses unique to the location. They develop logical and ingenious approaches to manage these patients in a resource limited environment and gain a clearer understanding of the term “Global Surgery” including disparities in the level of care that is available as well as access to that care. LAFAYETTE COLLEGE SAYS INNOVATIVE STUDENT HEALTH PARTNERSHIP IS HAVING AN IMPACT Pioneering a new, holistic approach to college student well being, St. Luke’s University Health Network has introduced a comprehensive array of 24/7 health care services at Lafayette College in Easton, Pa. “I believe our partnership with St. Luke’s will serve as a national model for higher education health care,” said Dr. Jeffrey Goldstein, Director of Health Services at Lafayette College. “Our students have immediate access to top-notch care – both physical and mental health services.” The St. Luke’s initiative, which launched this semester, has already had an impact on campus life. “With the extension of St. Luke’s services and the ability for students to use video visits when the Bailey Health Center is closed, students are getting better faster – and back into the classroom,” said Patricia Martino, a nurse who works at Lafayette’s Baily Health Clinic. St. Luke’s is uniquely situated to offer Lafayette students a comprehensive suite of health care options: • Health clinic staffing • Video visits • Preferred access to emergency care • Preferred access to urgent care services
THE POWER OF ENHANCING CLINICAL CARE • 13
INNOVATION “ Innovation distinguishes between a leader and a follower.” – Steve Jobs
ST. LUKE’S LAUNCHES REVOLUTIONARY HEALTH SYSTEM APP A trailblazer in using technology to enhance the patient experience, St. Luke’s University Health Network recently launched the St. Luke’s App, a one-ofa-kind application that puts health care management tools at the tips of our patients’ fingers. “Many people today use their cellphones to organize their lives,” says Chad Brisendine, St. Luke’s Vice President and Chief Information Officer. “Health care is so important. We felt the need to develop an app that would allow our patients enhanced access to the care they need, when and where they need it. We don’t know of any other hospital in the nation that has an app as comprehensive as ours. Our app is all about convenience – making it easier for patients to receive services and manage their health care.” FEATURES Find Locations including Walk-In Care The Find Locations feature locates the nearest walk-in care center, specialist, imaging center, primary care practice, lab and more. It provides easy access to phone numbers, directions and other important information. See a Physician The Video Visits feature enables patients to see physicians immediately right from their phones. Through video visits, the doctor can assess patients’ needs and send prescriptions as needed. The Find a Doctor feature allows search by specialty, location, gender and more and includes physician videos. Patients can schedule an appointment directly within the app, by selecting a date and time. Store Health Care Information The Profiles and Favorites feature stores basic information such as preferred doctors and locations. App users can save their favorites for quick and convenient access. Visit stlukesapp.org to learn more.
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ST. LUKE’S HARNESSES VOICE-ENABLED TECHNOLOGY TO CONNECT PATIENTS WITH SERVICES One of Only a Few Health Systems in the Country Interfacing with Smart-Home Technology By using technology in every aspect of health care, St. Luke’s continues to provide patients with convenient access to the best health care whenever and however they need it. St. Luke’s is expanding digital capabilities through the use of voice-enabled, smart-assistant devices. Experts predict that half of searches will use voice by 2020. So, along with our current mobile application, St. Luke’s is expanding its range of digital access point options to include smart-home devices. Patients using voice-activated devices like Amazon Alexa, Google Home and Apple’s HomePod will soon be able to ask the device to book a lab appointment or get directions to the nearest urgent care center – thus building into and enhancing the user’s smart-home capabilities. Additional features will continue to be rolled out as these devices become integrated into the St. Luke’s App and other patient-facing technologies. “We’re always working to be proactive about how we enable our patients to better communicate with us and that means utilizing technology-based access points for patients,” says Matthew Fenty, St. Luke’s Director of Innovation and Strategic Partnerships. “Seamless experiences allow us to provide a digital touchpoint for virtually anyone – perhaps the person is not even a patient yet, but soon will be thanks to the connection we provide.” Our app and website already provide patients with video-based clinician visits via smartphone, computer or tablet. The emerging voice-activated technologies will provide additional convenience and more efficient access to care options for our patients with a streamlined digital connection to St. Luke’s facilities.
Growth in Voice Search and Smart-Home Devices Predicted Juniper Research reported that by 2022 smart devices like Amazon Echo and Google Home will be installed in 55 percent of U.S. households (70 million). Analysts agree that voice search will continue to become more prominent. Gartner Inc. predicts that 30 percent of Web browsing sessions will be done without a screen by 2020, while comScore forecasts that half of all searches will be voice searches by then.
“We are the first in the region to deliver these voiceactivated, smart-home services to our patients,” explains Josh Howard, Manager of Consumer Technologies for St. Luke’s University Health Network. Although there are fewer than 10 health care systems in the country who offer this kind of technology, the ones that do frequently require users to log in with health-system credentials before accessing any kind of information; St. Luke’s approach does not make such requirements of users so it is available to anyone, patient or not. Since technology is ever-changing, plans for the near future include allowing St. Luke’s patients to use their smart-home devices to check in to appointments and services prior to coming in for their visit, thereby reducing wait time. “St. Luke’s strives to make it frictionless and convenient for anyone to interact with us in their home, in the car, anywhere,” says Fenty. “The focus is on easy access and convenience for our current and future patients – delivered seamlessly on any technology platform available.”
THE POWER OF ENHANCING CLINICAL CARE • 15
INNOVATION cont. ST. LUKE’S LEADS THE WAY IN PROVIDING PATIENT COST INFORMATION One deterrent to securing needed care is not having the means to cover the cost of services – either through lack of insurance, high out-of-pocket payments or a combination of both. In recent years, the costs of health care have shifted more and more to employees through co-pays and high-deductible plans. As a result, patients are paying directly for more services than ever before. With the goal of keeping patients healthy and informed in mind, body and wallet, St. Luke’s has developed a web-based tool, PriceChecker, that puts price transparency in the users’ hands. Listed on the PriceChecker tool is a unique pricing program which provides patients a pre-payment, bundled pricing option and presents a clear description of upfront financial liability – even before showing up for a test or procedure. The bundled option is available for certain procedures, services and tests. For example, the bundled fee for a colonoscopy covers the combined cost of the operating room, surgeon, radiologist, anesthesiologist and imaging tests.
St. Luke’s introduced additional features to the tool that not only provide patients the price of bundled options, but also a personalized estimation of their out-of-pocket costs if using their insurance coverage and paying after the service.
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“Price transparency is a trend sweeping the country,” says Matthew Fenty, Director of Innovation and Strategic Partnerships. “At St. Luke’s, we are well ahead of the curve in providing pricing information to patients. We understand that health care expenses affect a family’s budget, and ultimately may influence which critical tests or procedures our patients may or may not choose to have done. We are committed to providing our patients with the information they need to manage their care knowing that out-of-pocket expenses are a reality.” By paying upfront, patients are able to lock in a price – similar to how people can pre-pay for a hotel room versus paying for it after their visit. Because everyone’s insurance is different – regarding premiums, deductibles, co-insurance and other limits – listing exact out-of-pocket expenses is difficult to do, so an estimation is provided. With the ability to check their estimated out-of-pocket expenses using their own insurance, St. Luke’s is able to truly offer personalized pricing options which allow patients to make better informed decisions depending on their own personal financial situation. Patients can use the online tool to compare costs or they may call 1-844-SLPRICE to speak to a financial counselor. The portion of the bundled fee paid by the patient can then be submitted to the insurance company so that it goes toward meeting the patient’s deductible. The service is available only to patients covered by commercial insurance or paying out-of-pocket, not those using Medicare or Medicaid. PriceChecker offers price transparency for these and many additional services: • Common elective procedures such as ear tubes, bunion removal, lumpectomy, tonsillectomy and screening colonoscopy • Imaging including mammography, X-rays, CT scans, ultrasounds and MRIs • Testing including EKGs, sleep studies and blood studies • Physical and occupational therapy evaluations
St. Luke’s PriceChecker Adopted by Software Developer as Its Payment Platform Impressed by PriceChecker, software developer Simplee, a leader in patient payment and engagement software, has partnered with St. Luke’s University Health Network to co-develop PriceChecker as part of its health care payment platform. In turn, St. Luke’s incorporated features of the Simplee platform into its PriceChecker tool in November. With more than 230 leading health care systems around the country using its platform, Simplee reports that hospitals and physician groups have experienced an average 40 percent of patients paying online, a 20 percent decreased cost per payment and more than 80 percent of patients recommending their provider due to the Simplee payment experience.
St. Luke’s PriceChecker Wins eHealthCare Leadership Award St. Luke’s University Health Network and design firm Kraemer Schurman Advertising & Design, Inc., won an eHealthcare Leadership Award in November 2016 for the PriceChecker website. The PriceChecker site provides up-to-date pricing to all patients in an aesthetically pleasing fashion – within a matter of just a few clicks. Within the first month after launching PriceChecker, the site had received just shy of 18,000 pageviews.
THE POWER OF ENHANCING CLINICAL CARE • 17
KNOWLEDGE “ Tell me and I forget. Teach me and I remember. Involve me and I learn.” – Benjamin Franklin
MEDICAL EDUCATION Temple/St. Luke’s School of Medicine St. Luke’s and the Lewis Katz School of Medicine at Temple University partnered to develop the first and only medical school campus in the Lehigh Valley. The 32 students of the third class graduated on May 12, 2017, in Philadelphia and went on to match at St. Luke’s University Health Network as well as other prestigious institutions. These include Case Western/University Hospital of Cleveland, Duke University Medical Center, Temple University Hospital, Vanderbilt University Medical Center, Dartmouth-Hitchcock Medical Center and UCLA Medical Center. For the second year in a row, a St. Luke’s student was awarded the Joseph C. Doane Memorial Prize for the member of the graduating class with the highest grade point average throughout all four years of medical school. In 2017, Matthew Mullarkey, MD, achieved the highest average.
Joel Rosenfeld, MD, Med, FACS Chief Academic Officer
James P. Orlando, EdD Associate Chief Academic Officer
Sandra Mesics, RN, MSN, CNM Director, St. Luke’s School of Nursing Class of 2017
• 120 medical students • Average MCAT: 85.32
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BY THE NUMBERS
24 accredited graduate
medical education programs
178
residents
22
fellows
186
nursing students
Graduate Medical Education Health education is a major focus of St. Luke’s University Health Network. Teaching staff hold faculty appointments at Temple University, The University of Pennsylvania, Philadelphia College of Osteopathic Medicine, Johns Hopkins University and East Stroudsburg University of Pennsylvania. Nurse Residency Program Prepares Nursing Graduates to Excel in Careers St. Luke’s Nurse Residency Program educates, develops and empowers newly-hired RNs and provides them with the skills, confidence and resources to excel in their careers. The program lasts one year and consists of monthly didactic experiences with extensive simulation and expert instruction, as well as individual mentoring provided by a nurse preceptor. Residents also complete an evidence-based research project.
In 2017, St. Luke’s School of Nursing was ranked fifth out of 76 programs in Pennsylvania – RegisteredNursing.org ACGME APPROVES ST. LUKE’S GASTROENTEROLOGY FELLOWSHIP Noel Martins, MD, Founding Program Director First Match Results Announced – Fellows to Start July 1, 2018 The Accreditation Council for Graduate Medical Education (ACGME) has granted St. Luke’s University Health Network’s request to create a Gastroenterology Fellowship Program, one of only 21 new programs approved in the past 17 years. The three-year program, which will begin July 1, 2018, will accept two new fellows each year. “To earn approval, St. Luke’s proved that it offered the volume, variety and complexity of GI cases necessary to provide fellows with a rich educational experience,” says Noel Martins, MD, Chief of Gastroenterology and Founding Program Director. “In addition, we have demonstrated that we have an exceptional clinical faculty with extensive clinical and research interests and a commitment to teaching.” Besides Dr. Martins, faculty members are Kimberly Chaput, DO, assistant program director, and gastroenterologists Berhanu Geme, MD; Ayaz Matin, MD; Ronak Modi, MD; and Sinan Kutty, MD. The program will provide fellows with didactic training and increasingly more complex and autonomous inpatient and outpatient care opportunities. Fellows will gain extensive experience in performing procedures and will have a one-month rotation with the Temple Liver Transplant Program.
Learn more about St. Luke’s Research Education & Research at www.sluhn.org/Medical-Education. THE POWER OF ENHANCING CLINICAL CARE • 19
KNOWLEDGE cont. ST. LUKE’S – MORAVIAN COLLEGE INNOVATIVE PARTNERSHIP OFFERS SPORTS MEDICINE EDUCATION AND RESEARCH For nearly three years, the St. Luke’s Sports Medicine and Moravian College Department of Rehabilitation Sciences graduate program, the first of its kind in the Lehigh Valley, has been leading the way in sports medicine research. DANCE MEDICINE SYMPOSIUM St. Luke’s athletic trainer and Moravian College graduate student Kelly Hoots collaborated with colleagues and faculty from both St. Luke’s and Moravian to study which collegiate dance performers were at the greatest risk for injury. She and her team studied factors like foot type, endurance level and dance-specific function. They found that only one variable, foot posture, was statistically significant in predicting injury. These findings can ultimately be used to help dancers maximize function and minimize injury. Kelly was the lead author in the dance medicine study, which was accepted for presentation at the Eastern Athletic Trainers Association (EATA) Symposium and won the EATA Graduate Presentation Award. YOUTH FOOTBALL HELMETS
Photo: Courtesy of Moravian College
James Scifers, Chair, Moravian College Department of Rehabilitation Sciences, and a team of St. Luke’s clinicians and graduate students, co-authored an abstract regarding youth football helmet fitting. In 2017, the abstract was accepted for presentation at both the Mid Atlantic Athletic Trainers’ Association (MAATA) and National Athletic Trainers’ Association (NATA) conferences. The team found that only 16 percent of football helmets fit by youth football coaches were fitted correctly and safe enough for use; the other 84 percent needed some degree of modification. The risk for ill-fitting helmets was especially true for younger athletes. These findings led to an increased emphasis on education for coaches in charge of fitting the protective equipment.
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ST. LUKE’S EXPERT DELIVERS KEYNOTE AT GLOBAL FITNESS SUMMIT IN CHINA
ST. LUKE’S PHYSICIAN RECEIVES NATIONAL CARDIOLOGY TEACHING AWARD
Known internationally for being at the top of his game, John Graham, St. Luke’s Senior Director for Fitness and Sports Performance, spoke at the 5th annual Global Fitness Summit at Wuhan University, China June 9-11.
Jamshid Shirani, MD, Director of the general cardiology fellowship program at St. Luke’s University Health Network, was selected to receive the prestigious Parker J. Palmer Courage to Teach Award from the Accreditation Council for Graduate Medical Education (ACGME).
Graham delivered three presentations, including the keynote “Program Design and Assessment for Achieving Fitness and Sports Performance Excellence.” “I discussed how to develop evidence-based assessment and programming protocols for populations ranging from youth to seniors and from the highly fit to the chronic disease populations. Additionally, I provided scientifically-proven practices for assessment and programming for tactical populations (firefighters, police, emergency medical professionals and military) where a high level of fitness is required,” Graham said.
Shirani was honored at ACGME’s annual meeting held in Orlando, Florida, in March 2018. He was selected from more than 250 nominations. Shirani was a finalist for the award in 2008. He also was awarded a certificate of recognition from the American Medical Group Association (AMGA) in 2008 (Marvin R. Dunn Poster Session) for his work in reinventing the learning environment. Shirani has been a program director for more than 20 years, joining St. Luke’s in 2008. He was recruited to help launch and direct the general cardiology fellowship program. An additional program in interventional cardiology was added in 2015. ST. LUKE’S BARIATRIC SURGEON PRESENTS RESEARCH Maher El Chaar, MD, St. Luke’s bariatric surgery fellowship director and co-medical director of bariatric surgery, was recognized by the American College of Surgeons (ACS) in 2017 for his research into the safety and outcomes of bariatric surgery patients. El Chaar used the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database to review revisional – or follow-up – bariatric surgeries. This first-of-its-kind study of more than 150,000 patients was presented at an American College of Surgeons convention in New York City, during an exclusive session for distinguished research work on the safety of surgical patients.
THE POWER OF ENHANCING CLINICAL CARE • 21
QUALITY “ Quality is not an art, it is a habit.” – Aristotle
ST. LUKE’S INVESTMENT IN BUNDLED CARE PROGRAM HAS YIELDED LOWERED COSTS AND IMPROVED CARE St. Luke’s has always been a trendsetter in developing ways to reduce costs while maintaining or improving quality. Consequently, when the Centers for Medicare & Medicaid Services (CMS) announced the voluntary Bundled Payments for Care Improvement Initiative (BPCI), St. Luke’s welcomed the challenge, confident in its ability to fare well in the experimental managed care project. In fact, when the program was introduced in 2013, St. Luke’s had the largest bundled care program in the nation. An innovative project of the Accountable Care Act, BPCI is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. The bundles incorporate services provided from the time of hospital admission to 90 days afterwards. St. Luke’s works with post-acute care providers to manage patients discharged to skilled nursing facilities, rehabilitation centers and homes with home health services. Under the initiative, organizations enter into payment arrangements that incorporate financial and performance accountability for episodes of care. The expectation is that these models would lead to higher quality and more coordinated care at a lower cost to Medicare. CMS used historic data to determine the amount of money it would pay health care providers for delivering a “bundle” of services for specified procedures and treatments. Hospitals electing to participate in the bundled care project are paid that amount regardless of their actual costs. If they provide cost-effective care, the hospital keeps the difference. Conversely, if the cost is higher, the hospital absorbs the loss.
Donna Sabol
Vice President and Chief Quality Officer
Laura Kohler
BPCI Program Director
“The Truven 100 Top Hospitals Award judges an organization’s ability to thrive regardless of the constantly changing environment of today’s health care industry, and national imperatives that continue to demand the highest value of care. That means St. Luke’s provides the highest quality of care at lower cost,” says Donna Sabol, St. Luke’s Vice President and Chief Quality Officer. St. Luke’s has 72 bundles across its hospitals. Bundles include heart failure, heart attack, lower extremity joint replacement, sepsis, chronic obstructive pulmonary disease (COPD), major bowel procedures and pneumonia. The
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Walter “Chip” Harrison Senior Director, Quality and Patient Safety
bundles incorporate all services, such as hospital fees, physician fees, laboratory tests, imaging, inpatient and outpatient therapy, home health care and often postacute facility fees. Most importantly, however, the experimental project has been successful in reducing lengths of stay and readmissions. In 2014, St. Luke’s average length of stay for Medicare fee-for-service patients in the bundles was about 38 days. As of the first quarter of 2017, the preferred skilled-nursing facilities have reduced length of stay to 19 days on average. St. Luke's 90-day readmission data for skilled-nursing facilities was anywhere from 34 percent to 45 percent in 2014, and now is 27 percent as of the first quarter of 2017. “It definitely has improved care and decreased cost,” says Laura Kohler, BPCI Program Director. “We assumed a lot of risk but it has paid off thanks in part to close partnering with skilled nursing and rehabilitation facilities in our community.”
CMS GIVES ST. LUKE’S HOSPITAL HIGH RATINGS The Centers for Medicare & Medicaid Services (CMS) has rated St. Luke’s University Health Network higher than any other health system in the region. Every St. Luke’s hospital eligible for rating received at least four out of a possible five stars and three received five stars. CMS rated 4,579 Medicare-certified hospitals throughout the country and gave five stars to 7.36 percent (337) of them. The only hospitals in the Lehigh Valley – as well as Warren and Hunterdon Counties, New Jersey – to receive five-star ratings in CMS’ national ratings of hospitals were: • St. Luke’s Hospital – Anderson • St. Luke’s Hospital – Miners • St. Luke’s Hospital – Warren
Nationally, 25.22 percent (1,155) of hospitals rated received four-star ratings, including: • St. Luke’s Hospital – Allentown and St. Luke’s University Hospital – Bethlehem • St. Luke’s Hospital – Quakertown The recently opened St. Luke’s Monroe Hospital has not yet accrued enough data to be rated. The new rating summarizes up to 57 quality measures including mortality, safety of care, readmission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging. (www.medicare.gov/ hospitalcompare) CMS’ Overall Hospital Star Rating is an extremely helpful tool in assisting consumers to choose the best hospital. The agency is committed to transparency and accurate reporting of the quality measures that show how hospitals compare in terms of their performance on the star ratings. “We are proud of this significant accomplishment. Our ability to achieve five- and four-star ratings across our hospitals is a testament to the high quality care we provide,” says Donna Sabol, St. Luke’s Vice President and Chief Quality Officer. “CMS analysis shows that all types of hospitals have both low performing tiers and high performing leaders. We are honored to be among the most highly rated health systems in the country,” Sabol adds.
THE POWER OF ENHANCING CLINICAL CARE • 23
QUALITY cont. ST. LUKE’S NAMED AMONG NATION’S 100 TOP HOSPITALS FOR FOURTH STRAIGHT YEAR St. Luke’s University Health Network has, for the fourth year in a row, been ranked one of the nation’s 100 Top Hospitals® by IBM Watson Health™ in the Major Teaching Hospital category. No other hospital in the region has ever been named a 100 Top Hospital. The IBM/Watson Health 100 Top Hospitals® study identifies hospitals and leadership teams that provide the highest level of value to their communities, based on a national balanced scorecard. This is the sixth time St. Luke’s has been named among the IBM/Watson Health 100 Top Hospitals®. IBM/Watson’s process is the most comprehensive, academically driven study of its kind. It evaluates clinical and operational performance in 11 areas, addressing: inpatient mortality; 30-day mortality rate; complications; core measures; 30-day risk-adjusted readmission rate; severity-adjusted average length of stay; mean emergency room throughput; inpatient expense per discharge; Medicare spending per beneficiary; adjusted operating profit margin; and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score (patient rating of overall hospital performance). “The IBM/Watson 100 Top Hospitals Award judges an organization’s ability to thrive regardless of the constantly changing environment of today’s health care industry, and national imperatives that continue to demand the highest value of care. That means St. Luke’s provides the highest quality of care at lower cost,” says Donna Sabol, Vice President and Chief Quality Officer. “This award is solely based on clinical outcomes, efficiencies of care and financial performance unlike other awards such as US News.”
From left to right: Richard A. Anderson, President & CEO, St. Luke’s University Health Network; Donna Sabol, Vice President and Chief Quality Officer; Carol Kuplen, Chief Nursing Officer and President, St. Luke’s University Hospital – Bethlehem; Jeffrey Jahre, MD, Senior Vice President, Medical & Academic Affairs; Frank Ford, President, St. Luke's Hospital – Allentown Campus
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To conduct the 100 Top Hospitals study, IBM/Watson Health researchers evaluated 2,740 short-term, acute care, non-federal hospitals. They used public information — Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website. Hospitals do not apply for these awards, and winners do not pay to market this honor. 2018 “The hospital industry’s ongoing transition from fee2017 for-service to value-based care appears to be bearing some positive results for both patients and payers,” says Jean Chenoweth, Senior Vice President at IBM/ 2018 2018 Watson Health Analytics. “The magnitude of improvement 2017 we’ve observed 2017 over the last five years is greater than any other five-year period we’ve tracked. On top of that, this year’s winners have reached new highs in performance in comparison to peers across the country, which suggests that improvement in value from hospitals is likely to continue.”
STRENGTH IN NUMBERS If every other hospital in the Nation cared for you like St. Luke’s does, hundreds of thousands of additional lives and billions of dollars in health care costs could be saved every year.
100
St. Luke’s was named one of the
100 Top Hospitals in the Nation by IBM/Watson Health for 2018...
15
St. Luke’s was named one of the 15 Top Major Teaching Hospitals too…
6
St. Luke’s is a six-time recipient of the 100 Top Hospital Award, and in 2018 won the award for the 4th year in a row...
1
St. Luke’s is the ONLY hospital in the region to win this award. The only one. In fact, no other hospital in the region has EVER been recognized by IBM/Watson.
IN 4 YE A A RO RS W !
THE POWER OF ENHANCING CLINICAL CARE • 25
QUALITY cont. ST. LUKE’S WINS NATIONAL AWARDS FOR STROKE TREATMENT St. Luke’s University Health Network received top honors from the American Heart Association and the American Stroke Association. The Allentown and Bethlehem Campuses received the Get With The Guidelines – Stroke Gold Plus Target: Stroke Honor Roll Elite Plus Award, which is the highest level awarded. The Get With The Guidelines Gold Plus Achievement Award recognizes hospitals that have reached an aggressive goal of treating stroke patients with 85 percent or higher compliance to core standard levels of care as outlined by the American Heart Association/American Stroke Association for 24 consecutive months. In addition, those hospitals have demonstrated 75 percent compliance to seven out of 10 stroke quality measures during the 12-month period. The Target: Stroke Honor Roll Elite Plus recognizes hospitals achieving Time to Intravenous Thrombolytic Therapy within 60 minutes in 75 percent or more of applicable acute ischemic stroke patients treated with intravenous tPA and door-to-needle Time to Intravenous Thrombolytic Therapy within 45 minutes in 50 percent of applicable acute ischemic stroke patients treated with intravenous tPA to improve quality of patient care and outcomes. Other St. Luke’s hospital campuses receiving awards were: • Anderson Campus • Quakertown Campus • Miners Campus • Warren Campus According to the American Heart Association/American Stroke Association, stroke is the number five cause of death and a leading cause of adult disability in the United States. On average, someone in the United States suffers a stroke every 40 seconds, someone dies of a stroke every four minutes, and nearly 800,000 people suffer a new or recurrent stroke each year. A stroke patient loses 1.9 million neurons each minute stroke treatment is delayed. This recognition further demonstrates St. Luke’s commitment to delivering advanced stroke treatments to patients quickly and safely.
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ST. LUKE’S UNIVERSITY HEALTH NETWORK NAMED ‘MOST WIRED’ ‘Most Wired’ Hospitals Use Technology to Partner with Patients on Health St. Luke’s University Health Network has been named among the “Most Wired” health care institutions in the nation by the American Hospital Association. The recognition comes on the heels of HIMSS Analytics honoring St. Luke’s with its Stage 7 designation, the highest recognition for electronic medical record adoption. St. Luke’s is the first network in the Lehigh Valley region
to earn the prestigious designation at all of its hospitals, including St. Luke’s Warren Campus, which is the first hospital in New Jersey to achieve Stage 7. Nationwide, technology is making it easier for patients and providers to interact, thus improving communication, safety and patient-provider relationships. New tools are helping patients become more actively involved in their care and maintaining their health, according to results of the 19th Annual Health Care’s Most Wired survey.
“ St. Luke’s is reaching our patients in ways we never thought of before, from the ability to make appointments via your cell phone to implementing Epic Ambulatory, making our Network completely integrated with shared patient data.” — Chad Brisendine, St. Luke’s Chief Information Officer
AWARDS At St. Luke’s, our vision is to lead the region in clinical quality and safety performance. St. Luke’s has been honored with more than 120 health care quality awards including, but not limited to:
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RESEARCH.SLUHN.ORG 2017/2018 EDITION