System News

Volume 12

Issue 5

May 2013

SYSTEMnews F or the first time in

CEO’s corner

four years, my arms and hands were almost the same size. `` Far Left: The lymphedema following breast cancer surgery caused throbbing and dramatic swelling in Jeannette Aspden’s right arm. (Her hand shows markings from the bandaging she needed to wear to help control her lymphedema).

Ralph W. Muller

CEO, University of Pennsylvania Health System

The line of descent from Benjamin Franklin to the Penn Medicine of today is a long and celebrated one. And you

before

After

can be a part of it! Another opportunity to display your innovative thinking — much as Dr. Franklin did — is now in high gear.

The Your Big Idea Challenge encourages members of the Penn Medicine community to propose ideas for improving operating efficiencies and lowering costs … while of course maintaining the Penn hallmarks of excellence in patient care, research, and education.

Last year’s Your Big Idea — our innovation tournament to improve the patient experience — proved so successful that we’ve brought it back in a new version this year.

Nearly one-third of our workforce took part in the 2012 tournament by submitting, commenting on, or rating ideas. This year we’re aiming to climb even higher than that impressive participation rate.

We’re conducting the Challenge to help ensure that we retain our strong fiscal health in increasingly difficult times. The health care industry nationwide is facing growing financial demands, and Penn Medicine is not immune from these pressures. Lower governmental payments, fewer inpatient admissions, expected cuts in medical education and research funding, and growing information technology costs for meaningful-use requirements are compelling health care organizations everywhere to take new measures to adapt. In our case, the goal is clear and basic: identify new cost-savings opportunities so that we can continue to reinvest in the future of Penn Medicine.

Whether it’s performing procedures more wisely and efficiently, using less-costly supplies, or making the best use of technology — and almost anything in between — we welcome all ideas to help improve value while continuing Penn’s best-of-class standard. (continued on page 6)

A New Procedure Offers Hope to Patients with Lymphedema Seeing your knuckles may not seem like much to get excited about. But for patients such as Jeannette Aspden, knuckles represent progress — significant progress.

Aspden has lymphedema — throbbing, dramatic swelling in her right arm. It developed after some of her lymph nodes were removed following breast cancer surgery four years ago. The distension got so bad that she literally could not see her knuckles or the veins in her hands for years. Forget about wearing a ring. “It’s painful, it severely hinders your ability to do everyday things, and it’s not particularly pleasant to look at,” she said.

The lymphatic system circulates lymph fluid throughout the body to vacuum up and expel unneeded bacteria, viruses, and waste products. But surgeons are often forced to remove lymph nodes from the armpit area to ensure that breast cancer doesn’t spread. If the remaining nodes can’t pick up the slack, bodily detritus builds up and lymphedema may result. Bacteria can also accumulate, resulting in serious infection — which is what repeatedly happened in Aspden’s case.

To address Aspden’s symptoms, Suhail Kanchwala, MD, of Plastic Surgery, performed a vascularized lymph node transfer, a new approach to treating lymphedema in the US. The complex, microvascular surgery entails relocating lymph nodes to a region where lymph nodes were removed due to previous cancer surgery. In Aspden’s case, Kanchwala transplanted lymph nodes from her abdomen to her axilla. “Our hope is that once everything is connected, the newly transplanted nodes pick up where the old nodes left off,” he said.

Regaining a Good Quality of Life

Inside Simply Because.........................2

Inside

Spoof 2013 Leaves Audience in Stitches.................2 Rubenstein to Penn Medicine@Work..............3 Step Down.................................2 Newsmakers..............................4 From Pastels to PDA’s...............2 It’s Good to Be Green................5 RoundtableFree Skin CCU at Presby Turns 50!...........5 Cancer Screening......................3 Hand Sanitzer & Shortakes...................................4 Thermometers Save Lives.......5 Awards Accolades.............6 Anotherand Title..............................5

Left: Now, months after the vascularized node transfer, the swelling not only decreased significantly, but has remained so. Much to her delight, her wedding band slides easily onto her finger.

In this country, lymphedema has been primarily managed by physical therapists. Since the disease can’t be cured, the goal has been to reduce pain and swelling while increasing limb strength. Therapists use compression bandaging (typically a sleeve that covers the entire arm and hand) and manually apply light pressure to the the lymph system, which lies just below the surface of the skin, to help drain the fluid and reduce the swelling.

“The traditional physical therapy treatments can be extremely effective,” said Kanchwala. “But many patients with serious, repeated infections and severe symptoms need additional help.”

In 2011, to learn more about the procedure, Kanchwala observed Dr. Corinne Becker carry out the surgery on several patients. She has been performing the procedure in Europe and other parts of the world for years. He then went to France and participated in her clinic and other surgeries as well.

“I became comfortable with the idea of performing the surgery but only in cases where patients had no other options for regaining a good quality of life,” Kanchwala recalled. “Any surgery should be a last resort, particularly lymph node transfers, which have very little history in this country and few formal studies to rely on to assess effectiveness.” A major worry is removing too many lymph nodes from the donor site. “The last thing you want to do is cause lymphedema in another limb,” he noted. “We prevent this by being extremely careful. By using special dyes, we are able to avoid nodes that drain the arm or the leg. In this way the risk of causing donor site lymphedema is negligible.”

She literally could not see her knuckles or the veins in her hands for years.

Another concern is damaging nerves and blood vessels.

“Before you transfer nodes to their new location, you have to scrape away scar tissue at the destination site which may be obstructing the lymphatic channels and hampering fluid circulation,” he said. “Too much scouring can destroy important tissue and cause serious damage.”

Satisfied that he was fully prepared, Kanchwala performed his first lymph node transfer on the leg of a 38-year old melanoma patient. After the surgery, the patient’s leg went from being badly deformed to only moderately swollen a few weeks later. “She had achieved the kind of results we were looking for. This surgery is not intended to be a cure for lymphedema but to see such a significant improvement in our first case was very encouraging.”

(continued on page 2)

HUP Earns Comprehensive SOM Ranked #2.........................6 Stroke Center Status................ 6

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It’s Good to be Green Penn Medicine at Radnor is officially ‘green,’ thanks to the efforts of the staff of its General Internal Medicine and Cardiology practices. It is the first medical office in the Health System to achieve the Level 1 Green Office Certification by the Penn Green Campus Parnership.

How did they do it? According to Carol Fleischman, MD, of General Internal Medicine, who led the effort, they made small systematic changes, based on information using the Penn Sustainability website (www.upenn.edu/sustainability). For example, they ordered patient gowns in bulk rather than having them individually wrapped in plastic. Printers were programmed to print both sides of a page. Bulk sugar replaced individually packaged sugar on the coffee cart. New recycling containers throughout the offices were clearly marked with what could be recycled. “We re-educated everyone on what goes where.”

To encourage staff participation, they created weekly themes — like ‘Mug Shot Week.’ “We banned styrofoam cups and everyone got their own mug for Christmas,” Fleischman said. Photos were taken of staff members proudly holding a mug and then entered into a raffle. The end results: “No one is missing the styrofoam!”

“Flip the Switch February” encouraged staff to turn off their power strips — not just the computer — at the end of the day.

They also held an Earth Day event for the entire building, with tables set up for people to recycle old batteries and cell phones; a plant giveaway, to improve air quality in the office; and a display of how the building environmental controls work. As a result, “other practices are showing interest in starting their own Green Teams!”

Not resting on their laurels, they’re switching many bulbs for LEDs and getting costs for motion sensors in the office. They’re also planning to re-do the kitchen area with an energy-star rated refrigerator and a sink with a water filter to eliminate bottled water deliveries. `` Holding examples of their ‘green’ efforts are (l. to r.) Karen Smith, Christine Kopistansky, Carol Fleischman, Shamica Brown, and Sarah Yaun.

`` Left: Lawrence Meltzer, MD, works with Rose Pinneo in the newly created CCU. Right: Brian Drachman, MD, and Erin Kuhn work as a team in the current state-of-the-art CCU.

CCU at Presby Turns 50!

In the 1960s, as the knowledge of cardiology expanded, so did the skills needed to care for these patients. During this time, with the inception of the CCU, nursing had to assume the skills needed for cardiac monitoring and defibrillation, breaking down the barriers between the scope of nursing and physicians. Having a nurse recognize a fatal arrhythmia and saving a patient’s life by defibrillation without the guidance of a physician was the first step in advancing and expanding the role of the CCU nurse. This was done for the very first time at Penn Presbyterian.

In 1963, Dr. Lawrence E. Meltzer and then chief of cardiology, Dr. J. Roderick Kitchell, proposed a research plan for a new two-bed cardiac unit at Presbyterian. It was a nursefocused study investigating if 24-hour nurse monitoring and intervention could reduce mortality in patients with acute myocardial infarction. The experiment was a huge success. The nursing role expanded beyond just caring for patients to include curing them as well. This great experiment became the platform for a continued expansion of the role of nursing.

Newest Penn Medicine CAREs Grant Winners

Hand Sanitizer & Thermometers Save Lives

Congratulations to the third-quarter winners of the Penn Medicine CAREs grant:

For Eileen Agiya, RN, BSN, and Veleta Boswell, RN, MSN, NP, CRNI, saving lives is sometimes as simple as a bottle of hand sanitizer or a thermometer.

 Alessia Bhargava, PSOM Diabetes and Hypertension Clinic, University City Hospitality Coalition

As Home Infusion nurses for Penn Home Care and Hospice Services, they know that preventing infection and monitoring body temperature is imperative when delivering care during regular house visits to patients.

 Anthony Bracey, PPMC Presby Give Back Volunteer Program

The duo help cover patient care in the five county Philadelphia area and much of South Jersey. They also visit HUP and the Perelman Center for Advanced Medicine to prepare patients waiting for a transplant, for chemotherapy or other types of infusions, before being discharged.

 Bruce Kloss, HUP Magnet Community Outreach Program  Karen Wagner, Abramson Cancer Center UC Green Corps Greening Maintenance Program

Most of their infusion patients, though, are at home or in a residential care facility in the community. For example, after a colon cancer patient is discharged from Penn to go home, a Home Infusion nurse will follow that patient for lab draws, hydration if the patient needs it, antibiotics to fight infection, and more. “We see these patients when they come back home from the hospital,” said Agiya. “Families are anxious. We’re walking in as soon as they are walking in.”

Thanks to a Penn Medicine CAREs grant, Penn Home Infusion can now supply many of its patients with sanitizer and thermometers. “We tell them, wash your hands, but on top of that, every time you touch the PICC [peripherally inserted central catheter] line, you need to use hand sanitizer.”

 Leah Seifu, PSOM Penn Human Rights Clinic  Rebecca Kimmel, HUP & PSOM Bladder Health Class for the Prevention of Urinary Incontinence in Women

`` Eileen Agiya (l.) with Veleta Boswell

Knowing a patient’s temperature is especially important for patients on IV total parenteral nutrition. The nurses may draw blood cultures when the patient’s body temperature is greater than 100.4 F, but some patients cannot afford a thermometer and also may not have running water in their residence, making this grant even more important.

This supply of sanitizer and thermometers may also prevent 30-day readmissions. “It’s not just home infusion. If we can keep them out of the hospital, we’re fulfilling our role in the continuum of care,” said Boswell.

 Rhonda Holmstrom, HUP Strategies to Reduce Falls in the Community  Sharon Lockett, CPUP HELP, The Health Exposure and Longevity Project, Inc.  Steven Allen, HUP Improving Bicycle Safety in the Penn Community

“We love our jobs, it’s so rewarding,” said Agiya. “Think of how many lives this grant is going to save.”

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penn medicine

work

`` Samantha Okoorian

Penn Medicine Academy On-Site Degree Program: a

profile

> > >

Making the decision to go back to school while simultaneously having a full-time job can be daunting for many. Between juggling work, family life and a social calendar, it can be difficult to determine where schoolwork, group projects and studying for exams can fit into the mix.

Samantha Okoorian is no exception. Having worked as a financial counselor at the Abramson Cancer Center, along with a brief stint in HUP’s Emergency Department, Samantha never imagined she would enroll in a degree program after being out of the classroom for so long. “I was never a school person,” she admits. “I started working as soon as I turned 13. I had four different jobs from 13-18 years old. I put myself through high school.”

For Samantha, making the decision to go back to school and pursue an Associate’s Degree in Health Care Management was not initially her own. “I had a lot of great mentors at the Abramson Cancer Center that really pushed me to consider getting my degree.”

Samantha enrolled in Penn Medicine’s on-site degree program, offered through the Penn Medicine Academy. This program is a partnership with both Community College of Philadelphia (CCP) and Immaculata University, designed to bring the classroom to employees, with classes offered across Penn Medicine’s campus. She began her first semester with CCP in the winter of 2006. “I started taking two to three classes per semester, which I soon found overwhelming.

I wanted to actually understand what I was learning and take my time.” Fortunately for Samantha, the on-site program is designed for each individual student to be successful on his or her own educational journey. “I’ve tried it all! I began taking classes on-site at Penn Medicine, took a few classes on the main campus and even took some online courses.”

After seven years of enrollment in the on-site program with CCP, Samantha graduated with her Associate’s Degree on May 4, 2013. Samantha was content with going through the program at her own pace, on her own time, and she wants her story to be a positive reminder for prospective students who may be anxious about taking the necessary steps to go back to school. “It’s no surprise that Penn is growing! I want to be a part of its growing community and having these credentials gives me a leg to stand on.”

Ultimately, after first anxiously enrolling in the program and taking her time to complete it, Samantha is confident that getting her Associate’s Degree from CCP “was the best decision I have ever made.” Although she is looking forward to taking a much needed break from school, Samantha is positive that she will go back to pursue her Bachelor’s degree.

Penn Medicine Academy has formed partnerships with several local colleges and universities. The goal of having on-site college courses is to help employees achieve their personal and professional goals by making it easier for working professionals to go back to school. Classes are offered in the evenings at various sites across Penn Medicine.

For more information about the On-Site Degree Programs offered through Penn Medicine Academy, please contact Kerry Nihill at 267.414.2838 or kerry.nihill@uphs.upenn.edu

Challenge

Last year, two ideas, Patient Services Kiosks and myPenn Scheduler, were selected as the winners of Your Big Idea: Penn Medicine’s Innovation Tournament. Today, both of these ideas are a reality, thanks to the hard work of the Your Big Idea winners and skilled collaborators from across Penn Medicine.

In addition to those winning ideas, Penn Medicine teams have implemented dozens of other ideas that were submitted.

Your Big Idea Challenge focuses on finding opportunities to be more efficient while continuing to excel at our tripartite mission of Patient Care, Teaching & Research.

One of the key goals for this year’s Challenge is to implement more ideas than last year, by providing faculty and staff with the training and resources to pursue their teams’ ideas independently.

The idea submission period, which started earlier this month, runs through June 7th.

Following the submission period is the idea rating period, where the entire Penn Medicine community is invited to rate ideas on the Your Big Idea website. Last year, over 1,200 Penn Medicine faculty and staff submitted more than 1700 ideas, and over 5,000 people rated their colleagues’ ideas on the website. We hope that this year, we can raise the bar even higher!  To submit your idea, rate ideas, or to learn more, go to www.pennmedicine.org/ YourBigIdea.

UPHS Benefits Open Enrollment

Open Enrollment 2013 Recap Open Enrollment has ended but, over the course of the two-week enrollment period, over 13,000 employees enrolled for benefits!

To kick off Open Enrollment, the UPHS Corporate Benefits team hosted health fairs at seven different UPHS locations: HUP, Penn Presbyterian, Pennsylvania Hospital, Penn Medicine at Radnor, Corporate Finance at 15th and Market Street, 3001 Market Street, and Home Care and Hospice Services. The health fairs were staffed by the UPHS Benefits Team and our vendor partners. Activities included blood pressure and BMI screenings, free healthy giveaways, and raffle prizes. Each of our vendors provided educational and informational materials to employees. Congratulations to all of you who received a blood pressure and BMI screening and took a healthy step to “Know Your Numbers!”

In our continuing effort to promote a healthy work environment and to encourage healthy behaviors, UPHS once again offered an earned premium discount on medical contributions for non-tobacco users and for those enrolled in a tobacco-cessation program. This year, the earned premium discount applied to employees, spouses and any covered dependents who are enrolled in a UPHS medical plan.

In addition, UPHS introduced a new “Healthy Rewards” Program that allows employees to earn $150 (paid out in a lump sum) for completing a well-being assessment, knowing their important health numbers like cholesterol, BMI, blood pressure, and blood sugar, and participating in healthy activities on the ”Healthy Rewards” website.

Employees can earn points all year long by participating in different challenges and continue to set personal goals

throughout the year. As employees accumulate more points and reach different levels, they will be entered in raffles to earn prizes! Find out more information about the Healthy Rewards program on the Wellfocused website located at www.uphshrandyou.com.

We will continue to bring new and exciting healthy workforce programs to UPHS. These initiatives, along with many others throughout the year, reflect the commitment that UPHS has to creating a culture of health and being one of the healthiest employers in the Philadelphia area.

The new benefit plan year will take effect on July 1st 2013. Please call the Benefits team with any questions 215.615.2675 prompt #4.

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Penn Medicine

NEWSmakers / / / A Better Road Map for Neurosurgeons The front page of Sunday’s Philadelphia Inquirer Health section reported that, while preparing to remove a malignant tumor from the Rev. Michael Prewitt’s brain, neurosurgeon Steven Brem, MD, worried that the surgery could affect his patient’s ability to speak or move.

He studied an MRI that showed the tumor in Prewitt’s left parietal lobe. But he also examined a new type of scan: diffusion tensor imaging. For surgeons like Brem, professor of Neurosurgery and director of Neurosurgical Oncology at Penn Medicine, the new technology is like going from knowing only where a city’s major buildings and parking lots are to seeing the network of roads that connect them. “That’s huge,” Brem said. “That is a groundbreaking paradigm shift.” Joshua Levine, MD, co-director of the NICU at HUP and assistant professor of Neurology, said his traumatic brain injury patients are getting DTIs as part of a study. “I think we’re all excited about the potential of this,” Levine said. “How to use it and how useful it is has not been established definitively.”

Though some experts say there was no proof the scans improved surgical outcomes, Brem found some evidence it does when he helped write a review of the science for the journal Neurosurgical Focus. A 2007 study from Shanghai found the median survival for patients with gliomas, a category of brain tumors that includes the type Prewitt has, was 21 months for patients whose surgeons had seen DTIs before the operation compared to 14 months for other patients. The work is done partnership with Penn Radiology.

/ / / Ovarian Cancer Vaccine Made From Tumors Yields Responses Researchers from Penn Medicine’s Abramson Cancer Center and the Ovarian Cancer Research Center reported that a new immunotherapy approach using patients’ own tumor tissue and dendritic cells is helping make headway against a formidable foe — late-stage ovarian cancer. The Philadelphia Inquirer, Bloomberg News, U.S. News & World Report, USA Today (via HealthDay News), and MedPageToday reported on the findings. A therapeutic vaccine – tested in 31 patients so far — was the first step in a two-part process that involved teaching the woman’s blood cells to recognize the cancer, then infusing an army of her own infectionfighting immune system cells to attack the tumor. “We are preventing progression of already existing disease,” said Lana Kandalaft, PharmD, PhD, MTR, director of Clinical Development and Operations in the Ovarian Cancer Research Center. “Most of the patients are now on a maintenance vaccine, just to keep the system going. We haven’t seen them recur. We are seeing how long they can go.” Janos Tanyi, MD, PhD, an assistant professor of Obstetrics and Gynecology, is the principal investigator of the trial. TV stories about the new research also aired on NBC and FOX news affiliates in 106 cities across the nation, including Boston, New Orleans, Philadelphia, and Washington, DC.

/ / / Immune System Versus Cancer Carl June, MD, director of Translational Research in the Abramson Cancer Center, is quoted in The Scientist about research on new immunotherapies presented at the American Association for Cancer Research meeting. He said that researchers are now working out which extra genes they can insert into T cells to further promote target specificity, potency, and persistence in trials that modify patients’ cells to attack their cancers.

But he cautioned that this type of cell therapy requires researchers to tailor genetically modified cells to individual patients, so it’s not currently practical for large-scale application. These cells are already potent and durable enough to be effective, he said, but to make them “for the masses,” researchers must create automated culturing systems. “We need to get robots to make them,” said June. “We need mass manufacture.”

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/ / / Less-Used HIV Treatment for African Children More Effective A new study published in JAMA by Robert Gross, MD, MSCE, an associate professor of Infectious Diseases and Epidemiology, and colleagues at the Children’s Hospital of Philadelphia, found that the less-used antiretroviral drug efavirenz produced better outcomes than nevaprine, the least expensive of the two drugs, in children from age three to 16 in Botswana. The findings were reported by several outlets, including Voice of America. This was the first large-scale study to compare the two treatments for HIV-infected children, and could change the standard of care in sub-Saharan Africa, where most of these children live, said Gross.

“More work should be done to make efavirenz a more financially viable option for children on anti-retroviral therapy in these resource-limited settings,” he said.

Yahoo! News, MSN, and the GlobalPost (via AgenceFrance Presse), and Infection Control Today also covered the study.

/ / / Penn Medicine Experts Discuss Boston Marathon Explosion Injuries and Emergency Response  Experts from Traumatology and Surgical Critical Care helped explain the medical response and type of injuries that the runners and bystanders experienced. Patrick Kim, MD, Trauma Program director, told 6ABC that blast injuries are extremely challenging to treat. Patients can suffer breathing problems, blunt injury from the blast or flying debris, and they can suffer skin burns. Steven Allen, MD, assistant professor of Surgery, said that the quick action of first responders and good samaritans helped save lives.  CBS 3 spoke with Steven Berkowitz, MD, director of the Penn Center for Youth and Family Trauma Response and Recovery, about coping with high emotions in the aftermath of the attacks. He also was a guest on WHYY’s Voices in the Family to discuss the emotional vulnerability that stretches beyond Boston and ways to transcend this national trauma.  The Huffington Post spoke with John Vasudevan, MD, assistant professor of Physical Medicine and Rehabilitation, and David Yusko, PsyD, clinicaldirector at the Center for the Treatment and Study of Anxiety, to get both a physical and mental health perspective.  CBS 3 also reported on the medical response and type of injuries that the runners and bystanders may have experienced. “The injuries most commonly seen are head injuries, followed by injuries from that primary blast wave where you will see injuries to the lungs and the chest cavity itself,” said Niels Martin, MD, assistant professor of Traumatology, Surgical Critical Care, & Emergency Surgery.

/ / / Obama Seeks $100M for Brain Mapping President Obama proposed an effort to map the brain’s activity in unprecedented detail, as a step toward finding better ways to treat such conditions as Alzheimer’s, autism, stroke, and traumatic brain injuries. “We’re at this really transformative time,” added Frances Jensen, MD, an epilepsy expert who left Harvard last summer to run Penn’s Neurology Department. The Philadelphia Inquirer reported via the Associated Press that Penn is “well positioned” to receive some of the new funding due to its emphasis on integrating scientists from different disciplines, including engineering and medicine, said Jensen. “In order to do a project, you need biologists, physicists, engineers and computer science people to push collaborations,” said Amita Sehgal, PhD, co-director of the Penn Comprehensive Neuroscience Center, to NBC10.com. “I’m really, really excited about it. This will get more attention from the public and nationwide. It’s finally happening — this is the decade of the brain and figuring out how it works,” said Sehgal.

/ / / Culprit in Heart Disease Goes Beyond Meat’s Fat The New York Times reported that a new study in Nature Medicine, with Penn co-authors, revealed that carnitine, a compound abundant in red meat that also is sold as a dietary supplement and found in some energy drinks, may play a large role in heart disease. The research team hypothesized that what damaged hearts was not just the fat on red meat. In fact, these scientists suspected that saturated fat and cholesterol made only a minor contribution to the increased amount of heart disease seen in red-meat eaters. Researchers say the work could lead to new treatments for heart disease. “It’s really a beautiful combination of mouse studies and human studies to tell a story I find quite plausible,” said Daniel J. Rader, MD, chief of Translational Medicine and Human Genetics, who was not involved in the research. Rader was also quoted in Nature.com/Scientific American and Cleveland Plain Dealer articles on the research.

/ / / Medical Research Threatened by Sequestration A Philadelphia Inquirer article details the potential impact of federal sequestration cuts on area hospitals and medical schools. Though some other area biomedical research institutions have begun announcing plans for layoffs within labs, Susan Phillips, SVP for Public Affairs, said Penn Medicine’s researchers were trying to reduce costs and seek new grants. “We are as worried as our colleagues, but Penn Medicine, given its high success rate in grants, is likely more able to weather this than others.”

/ / / Group Cash Rewards Provide Greater Weight Loss Incentives Can cash rewards help people lose weight at work? A new study from Penn Medicine finds it can, but it’s even better when employees compete for the money, CBS 3 reported.

Employees at the Children’s Hospital of Philadelphia took part in a study about how much weight people can lose when offered money as a reward. Those in the study lost three times as much weight when awards were based on the group’s performance — not just their own. “No question, hands down the individuals in the group incentive did much better,” said study co-author David Asch, MD, MBA, executive director of the Penn Medicine Center for Innovation. Researchers, including senior study author Kevin Volpp, MD, PhD, director of the Center for Health Incentives and Behavioral Economics, looked at two strategies. Some individuals were offered $100 each month they met or exceeded weight loss goals. Other groups split $500 among five people, but those who did not lose the weight had to give their share of the money to those who did. “If you didn’t lose the weight, and everyone else did, you would have this sort of unhappy circumstance of watching everyone else share the winnings you could have earned,” said Asch. Under the Affordable Care Act, employers will soon be able to offer even larger financial rewards to promote a healthy lifestyle. The segment ran on CBS affiliates across the country and was also a featured story on 6ABC, TIME.com, and The Los Angeles Times.

To reach the Penn Medicine news website, go to www.PennMedicine.org/news

Simply Because...

“The needs that call Penn Medicine to action in the community are profound. Twentyfive percent of Philadelphians live in poverty — that’s nearly 400,000 adults and children — and one in seven city residents have no health insurance. Hunger and homelessness remain, still, throughout the city. These societal problems only make health problems that much harder to address, but doing whatever we can to help is in our nature here.”

That rather sobering paragraph introduces the reader to the 2013 edition of Simply Because, the community benefit report of the Perelman School of Medicine and the University of Pennsylvania Health System. But as the introduction goes on to say, Penn Medicine’s physicians, scientists, nurses, staff, students, and partners in the Philadelphia community come together “to serve those who might otherwise go without.”

Below are two examples from this year’s edition:

 A Sight to Behold With five minutes, an ophthalmoscope, and eye drops, Prithvi Sankar, M.D., can prevent blindness. He can quickly check a patient’s vision, field of vision, and eye pressure. The ophthalmoscope allows him to evaluate changes to the optic nerve. The eye drops treat glaucoma, a leading cause of blindness.

Detecting glaucoma and other opthalmological diseases is the mission of the Penn Sight Savers. Sankar, director of Student Education at Penn’s Scheie Eye Institute, leads the group — a team of Scheie doctors and medical students. This small band of eye experts holds free screenings at community health fairs throughout West Philadelphia.

 An Ounce of Prevention Pregnancy, poverty, and a lack of access to health care — especially when compounded by language barriers — make for a dangerous combination. In 2008, to help women facing that exact situation, Jack Ludmir, M.D., chair of Obstetrics and Gynecology

`` Jack Ludmir with one of his many patients in Latina Community Health Services.

at Pennsylvania Hospital, created Latina Community Health Services. The program operates as part of Puentes de Salud and Pennsylvania Hospital’s Women & Children’s Health Services, serving Hispanic patients, many of whom are recent immigrants, often undocumented, to the United States.

The circumstances Ludmir’s patients grapple with may be dire, but they are no match for the strength of a Latina mama. “Pregnancy gives them the motivation and the power to take charge of their health for the sake of their babies,” he said. “They are excellent patient with high compliance rates.”

And then they show other women how to do it. Ludmir and members of Puentes, in conjunction with a nurse liaison to the community, recruit former patients to become “promotoras.” After receiving basic training, they teach health and wellness to their own communities.

 The full Simply Because is accessible at www.uphs.upenn.edu/news/publications/ simply_because_2013.pdf

Spoof 2013 Leaves Audience in Stitches Writing skits, lyrics, choreography, and more, a group of Perelman School of Medicine students took a break from training and studying to make fun of themselves and the medical school experience in a performance of Spoof 2013: Game of Crohn’s.

The comedic performers took a look at what influences hospital rankings in “HUP Rank Tango” (to the tune of Chicago’s “Cell Block Tango,”) and shared the journey from nervous medical student to confident and prepared physician in “Call Me MD” (to the tune of Carly Rae Jepsen’s “Call Me Maybe”). Spoof 2013 answered questions on the minds of many medical students, such as “How do I give a pediatric exam to a baby who gained 168 pounds in two weeks?”

The show’s three directors, Josh Kiss, Claire Nordeen, and Christina Pasick, made time for the event as fourth-year students who already matched for residency. Kiss explained that the show helps encourage peer-to-peer mentoring with students from different years working together on the production and is also a chance “for students to let off some steam from the occasionally stressful environment of med school.” `` Holding classes right after lunch can give them a bad rep. In ‘What Up with That,’ med students suggest ways to re-energize them! (L. to r.): Caroline Kieserman-Schmokler, Michael Nakazawa (seated), Oze Henig, Katy Flynn-Meketon (back), Darryl Powell, Claire Nordeen, Christina Pasick (back), and BA Sillah.

As the directors now set their sights on their residencies, they will always remember that sometimes laughter is the best medicine.

A New Procedure Offers Hope to Patients with Lymphedema (continued from cover)

Significant Decrease in Swelling Meanwhile Jeannette Aspden was being treated for yet another lymphedema infection in Washington, D.C., where she and her husband live. Their daughter Rebecca, then a psychiatry resident at Penn, learned about the Penn Lymphedema Team, a specialist unit widely recognized as a national leader in treating the condition.

She discussed what she learned with her mother, who soon came to Penn for treatment with physical therapist Joy Cohn, the team’s leader.

“I recommended Jeannette to Dr. Kanchwala for his second procedure,” Cohn said. “She is a very smart person and had realistic expectations. While we knew

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this wasn’t a complete cure, it could reduce the pain and swelling and make the disease easier to deal with.

Lymphedema is like having diabetes. You have to take care of it every day or serious problems can result. That would still be the case with Jeannette after the surgery.”

and hands were almost the same size. The week after the surgery, while I was recovering at a nearby hotel, I had a visiting nurse to help with my recuperation. She said that if I hadn’t told her I had lymphedema, she wouldn’t have believed it. Dr. Kanchwala did an outstanding job.”

Aspden recalled, “I know that one of the first things you ordinarily ask a surgeon is how many times he or she has done the procedure. In this case, however, that question was irrelevant, and as Dr. Kanchwala and I talked I became even more confident that he would do an excellent job. He’s extremely thorough and very detail-oriented.”

For the first month after surgery, Aspden returned to Cohn three times a week for manual lymph drainage; the sessions then dropped to twice a week and eventually will become weekly. “The swelling is still down and the pain is almost gone. Joy is terrific to work with. She’s a pro in her field and has enormous empathy for the patient,” she said. “Dr. Kanchwala is simply the best. Between the two of them, Penn has got it right!”

After the surgery she was amazed how much the swelling had gone down. “For the first time in four years my arms

AWARDS AND ACCOLADES HUP Earns Comprehensive Stroke Center Status HUP was recognized by The Joint Commission and the American Heart Association/American Stroke Association as meeting The Joint Commission’s standards for Disease-Specific Care Comprehensive Stroke Center Certification.

It is the first center in Philadelphia — and among a select few hospitals in the US — to be so named. Comprehensive Stroke Centers are recognized as industry leaders and are responsible for setting the national agenda in highlyspecialized stroke care.

To receive this recognition, HUP underwent a rigorous onsite review with Joint Commission experts reviewing its compliance with the Comprehensive Stroke Center standards and requirements, including advanced imaging capabilities, 24/7 availability of specialized treatments, and staff with the unique education and competencies to care for complex stroke patients.

Shelley Berger, PhD, director of the Penn Epigenetics Program, and Virginia Man-Yee Lee, PhD, director of the Center for Neurodegenerative Disease Research, have been elected to the American Academy of Arts and Sciences. One of the nation’s most prestigious honorary societies, the Academy is also a leading center for independent policy research. Current membership includes some of the world’s most accomplished leaders from academia, business, public affairs, the humanities and the arts.

Garret FitzGerald MD, FRS, chair of Pharmacology and director of the Institute for Translational Medicine and Therapeutics, has been awarded the 2013 Grand Prix Scientifique by the Institut de France. FitzGerald shares the prize with Carlo Patrono MD, chair of Pharmacology at the Catholic University, Rome. The Grand Prix Lefoulon-Delalande, valued at 500,000 euros ($650,000), is one of the largest prizes for scientific accomplishment and is considered the world’s most prestigious prize for cardiovascular research. FitzGerald and Patrono share the prize for their development of low-dose aspirin for the prevention of cardiovascular disease.

Susan Mandel, MD, MPH, associate chief of Endocrinology, Diabetes and Metabolism has been elected vice president, Physician-in-Practice, of The Endocrine Society. In addition, Mitchell Lazar, MD, PhD, chief of Endocrinology, Diabetes and Metabolism, and director of the Institute for Diabetes, Obesity and Metabolism, was elected to serve as a council member, at-large. They will collaborate with other newly elected officers and council members to lead the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology.

Jon Morris, MD, vice chair of Education in Surgery and associate dean for Student Affairs at the Perelman School of Medicine, has been named president-elect of the Association of Program Directors of Surgery. Among its many functions, the organization provides a forum for discussions on post-graduate surgical education and promotes high standards of surgical residency training.

Peter C. Nowell, MD, of Pathology and Laboratory Medicine, is one of three physician scientists to receive the Albany Medical Center Prize in Medicine and Biomedical Research, for landmark research that helped transform the treatment of cancer. The $500,000 award, one of the largest prizes in medicine and science in the United States, is given to those who have altered the course of medical research. This year, the prize will recognize groundbreaking research into the nature of cancer, which has led to the development of a new generation of cancer drugs, most notably Gleevec for chronic myeloid leukemia that, unlike chemotherapy, target specific genetic defects causing cancer.

Ran Reshef, MD, was recognized as the 2013 scholar in the Amy Strelzer Manasevit Research Program. The program is one of the largest and most coveted fellowships in the field of transplantation, supporting the research endeavors of scientists and clinicians early in their careers.

Reshef’s research focuses on graft-versus-host and graft-versus tumor-effect to improve post transplant outcomes in patients with hematologic malignancies.

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CEO’s corner (continued from cover) Here’s a summary of how Your Big Idea works (full details at www.pennmedicine.org/YourBigIdea).

First, identify your best idea (or ideas) for increasing value while preserving quality. Next, complete the short form on the website. Ideas will be rated by your colleagues on the Your Big Idea website. Those ratings, along with the evaluation of an official review team, will determine what happens next. Ideas will be pegged as a quick fix (can be easily implemented with immediate savings opportunities); commissioned idea (shows promise but needs further development and coordination to recognize savings potential); or prove us wrong (doesn’t appear to have savings potential but we’d welcome additional evidence).

Results will be announced the week of June 24th.

The Challenge is being conducted in the same spirit as last year: having fun while achieving a serious purpose.

So once again we’ll be randomly awarding great prizes such as Phillies and Art Museum tickets to people who submit ideas.

As you probably know, last year’s winning ideas, patient services kiosks and myPenn Scheduler, are both in operation today. Just as importantly, we’re also implementing dozens of other ideas, including electronic paychecks and blanket warmers for chemotherapy patients. So if your idea is sound, you can be sure we’ll figure out a way to make the most potent use of it.

I’m confident that the Your Big Idea Challenge will generate the freshness of thought and vision for which Penn Medicine is so well known. The deadline is June 7th.

I can’t wait to read your suggestions.

Systemnews Editorial Staff: Sally Sapega, M.A. Editor

Annual Total Compensation Statements

Now Available Online!

Administration:

Your annual Total Compensation Statement gives you a “big picture” view of the value of your UPHS pay and benefits. The newest statement, showing the total value of your benefits and compensation for the period January 1, 2012 – December 31, 2012, is now available online. Visit the Human Resources website, www.uphshrandyou.com and click on one of the links for the Total Compensation Statement.

Let Us Hear From You:

NEW this year: It’s easier to access your statement! Just use your network ID and password.

Did you know your statement is also a valuable tool to use in retirement planning? Review the Retirement section to be sure you’re participating in all the retirement plans that you’re eligible to join and that you’re making the most of your opportunities to plan for your future.

In order to receive a Total Compensation Statement, you must be a UPHS employee, enrolled in UPHSflex benefits, and have a hire date on or before June 30, 2012.

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Susan E. Phillips Senior Vice President, Public Affairs

3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 Please feel free to share your thoughts and ideas for improving System News! E-mail the editor at sally.sapega@uphs.upenn.edu.