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Winter 2016 Standing Up to Prostate Cancer Making Labor & Delivery Special—and Safe Helping Cancer Survivors Thrive A Publication of Greenville Health System

Chest Pain Center Helps the Beat Go On

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CONTENTS

Restoring Lives at the Human Performance Lab 2 Cancer survivors can enjoy quality of life again.

Pinpointing Prostate Cancer 6

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GHS is helping men live longer with a new technology that zeroes in on prostate cancer.

Having Your Baby Your Way 9 Delivering her child at GHS’ new birth center was the experience of a lifetime for this young mother.

The Beat Goes On … and On … and On 14 GHS’ Chest Pain Center is the go-to place for those who think they may be having a heart attack.

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Departments Message from the President and CEO 1 Spotlight 2 What’s Right in Health Care 3 Clinical Trials 16 Q & A 17

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Practice Profile 18 Physician Directory 19

We welcome your comments, suggestions and ideas. Call (864) 797-7541 or email nparker@ghs.org.

PRESIDENT’S MESSAGE

Changing Times The new year—the time when we look forward to change—is upon us. We’re ready to change our habits, our routines, ourselves. We aim to lose weight, watch less TV and make more time for family.

Experts remind us that to make lasting changes we need to plan specific, attainable steps to reach goals that we’ve clearly defined.

At Greenville Health System (GHS), we embrace change—change is both continuous and an indicator that we are living our mission to heal compassionately, teach innovatively and improve constantly.

In this issue of Inside Health, we share stories of patients who benefit because of GHS’ focus on improvement. On our cover is Simon Kitizo, who was brought to GHS’ Chest Pain Center after a heart attack. He has recovered thanks to the center, which is recognized for outstanding results stemming from outcomes measurements and fine-tuned processes.

We also bring you Beth Davis, who chose a different labor and delivery option for her second child: GHS’ new Midwifery Care & Birth Center. GHS created the center to expand how and where women deliver—safely.

Finally, you’ll meet Fe Arvis, who faces an optimistic prognosis for prostate cancer because of GHS’ new technology, which enables our urology oncologists to better detect and more precisely treat tumors.

In addition to clinical advances, GHS believes constant improvement is fundamental to good management and good governance so that the system remains in a strong position to offer 1 Inside Health

advanced health care to the Upstate.

Here is a brief overview of the proposed governance changes: The GHS Board of Trustees has approved a series of resolutions this fall to create a new private not-for-profit entity that, together with the governmental body, will provide local and strong care in the Upstate. This structure will provide the flexibility needed to survive in today’s changing healthcare environment.

The current structure, a governmental not-for-profit, hinders GHS’ ability to partner with other entities—both public and private—that share similar missions and visions. The new model will allow GHS to partner with healthcare and academic organizations to provide expanded services, achieve the needed size and scale to support health and wellness, be financially resilient and remain the strong local healthcare option.

“As a public not-for-profit health system,” said Jim Morton, chair of the GHS Board of Trustees, “GHS serves as the safety net hospital for the region, providing care to patients regardless of their ability to pay.

It is our role as board members to ensure this important resource remains available to our community for years to come.”

Change isn’t always easy, but carefully considered, well-executed change can lead to better ways of functioning, better outcomes and better health.

Michael C. Riordan President and CEO Learn more at ghs.org/governance.

SPOTLIGHT

Restoring Lives at the Human Performance Lab The words “human performance lab” may conjure images of an elite facility catering to world-class athletes. But the 1,000-square-foot Human Performance Lab (HPL) at the Cancer Institute of Greenville Health System (GHS) is different.

Run collaboratively with the University of South Carolina (USC) School of Medicine Greenville, HPL staff is committed to understanding human performance for those with injury or illness who want to achieve their best, whether they are paralympic athletes or patients combating debilitating fatigue after cancer therapy. Since opening in early 2014, the HPL has performed numerous research studies and tested several clinical populations at GHS. This HPL testing is first in the country to be fully embedded in a cancer research and treatment program. In one ongoing study, participants are recruited from Moving On, GHS’ oncology rehabilitation program. Designed to assess the effects of exercise on patients after cancer treatment, this study is showing the profound impact that exercise has on recovery and recurrence.

The study begins by creating a baseline for patients with cancer who have completed treatment (chemotherapy, radiation therapy or stem cell transplant) at GHS within the past six months. The first step is a body composition scan, conducted at GHS’ Outpatient Radiology, to gauge lean muscle and fat content. Back at the HPL, muscular strength, endurance, and cardiorespiratory and metabolic fitness also are measured.

Participants then join Moving On, meeting three times weekly at the GHS Life Center® Health & Conditioning Club to work with an oncology nurse and oncology-certified exercise trainers.

In addition to two weekly strength-training classes, they also receive 150 minutes of aerobic conditioning each week. Participants are retested at the conclusion of the 12-week program.

“Exercise is the very thing that survivors of cancer need to decrease their chances of recurrence or second cancers independent of the first,” said exercise physiologist Jennifer Trilk, PhD, HPL director and assistant professor at the USC School of Medicine Greenville.

“Preliminary research also is showing that it may protect, and even reverse, some of the muscle wasting that occurs as a result of cancer therapy.”

“By determining how exercise affects survivors’ health and outcomes, we can develop new cancer management techniques to help patients overcome the crippling fatigue that often accompanies treatment.”

— Larry Gluck, MD Medical Director GHS Cancer Institute

Results of the “Moving On” study to date are impressive: Participants average a 25 percent improvement in cardiorespiratory fitness and up to 30 percent improvement in muscular strength and endurance. “Patients have less fatigue, perform daily tasks better, sleep better and feel better emotionally,” stated Dr. Trilk.

The HPL primarily works with cancer survivors but is open to all clinical populations at GHS. Currently, an eight-week study is testing the effects of exercise on those with spinal cord injuries. The HPL is one example of a movement throughout GHS to look beyond treating disease merely to help patients survive but also to thrive in a life that’s healthy and fulfilling.

Learn more about the HPL and programs such as the Lifetime Clinic that help cancer survivors at ghs.org/cancer.

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W H AT ’ S R I G H T I N H E A LT H C A R E

Here’s a snapshot of what’s going on at GHS as we live our mission to heal compassionately, teach innovatively and improve constantly.

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Patewood Medical Campus nurses who participated in the process that led to the campus being designated a “Pathway to Excellence” organization by the American Nurses Credentialing Center. This designation recognizes a healthcare organization’s commitment to creating a positive nursing practice environment.

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High schools and middle schools throughout the Upstate who have received the National Athletic Trainers’ Association Safe Sports School award. The award champions safety and recognizes secondary schools that provide safe environments for student athletes. GHS athletic trainers meet the sports medicine needs of more than 15,000 student athletes across the Upstate and were instrumental in helping the schools achieve this award.

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Times the GHS Breast Health Center has received three-year accreditation from the National Accreditation Program for Breast Centers. This accreditation is the seal of approval for breast centers from the American College of Surgeons and formally acknowledges GHS’ commitment to providing multidisciplinary, high-quality, patient-centered care. To learn more, visit ghs.org/breasthealth.

4,000

Copies sold of the delightful children’s book Goodnight Greenville since its May debut. Proceeds from the sale of the book, written by GHS pediatrician Joe Maurer, MD, and illustrated by local artist Joseph Bradley, benefit GHS Children’s Hospital. To learn more, including information about where the book may be purchased, visit goodnightgreenville.com.

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45 72%

The percentage of victims of domestic violence who visit emergency rooms but are not identified as victims of abuse. To address this issue, GHS partnered with Safe Harbor and other participants to develop a training video for healthcare providers to recognize and effectively respond to patients who present signs of domestic violence.

20%

The amount by which GHS hospitals have reduced readmissions for Medicare patients over a two-year period.

Age the American Cancer Society recommends that women at average risk for breast cancer start routine mammograms.

What does this mean for you?

Brian McKinley, MD, GHS surgical oncologist, discusses this issue in his blog Changes in Mammogram Recommendations. ghs.org/acs.

90%

The percentage of injuries to children that could be prevented if families took some simple steps. Safe Kids™ Upstate, led by GHS Children’s Hospital, just celebrated 20 years of working to prevent injuries to upstate children by promoting safety “at home, at school, at play and on the way.”

This reduction applies to Medicare patients with acute myocardial infarction, chronic obstructive pulmonary disease, heart failure and pneumonia. For specific reductions by hospital,

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Our first priority: taking care of patients and their families.

please visit ghs.org/news.

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“This technology has enabled us finally to find out what’s going on and to catch it at a stage where we have options.” — Fe Avis (pictured with wife Shawn Kelly)

Pinpointing Prostate Cancer Greenville Health System is the first in the state to offer the Artemis, a new technology that brings detailed, threedimensional imaging to bear on a common cancer in men.

By Robin Halcomb

The Artemis: 3D Imaging and Navigation (photo used courtesy of Eigen)

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t is probably not surprising to learn that the most common cancer affecting men (after skin cancer) is prostate cancer, and that about one man in seven will be affected in his lifetime.

What is news—and very good news for upstate men and those who love them—is GHS’ Artemis, a new imaging and navigation system that detects prostate cancer. The system fuses an MRI with a real-time ultrasound to create a threedimensional (3-D) image, providing GHS physicians with a much more detailed picture of the prostate.

3-D image fusion, similar to that used in animation and video gaming, combines the relevant data of three dimensions in two or more images into a single 3-D image, which is more

informative than either of the images separately. GHS is the only facility in the state and one of few in the region offering the technology.

“Artemis allows us to more accurately biopsy the prostate and find cancers that are more aggressive or clinically relevant and which need to be treated on a more consistent basis,” said Erik Busby, MD, urologic oncologist with GHS Regional Urology. “It can eliminate repeat biopsies because the catch rate is more accurate. The system can go as high as 70 percent to 75 percent in detecting cancer in initial biopsies and also reduce false negatives by about 50 percent.”

One of the first to benefit from the technology is Fe (pronounced Fay) Avis, now a resident of Asheville, N.C. Avis Inside Health 6

had a long history of abnormal levels of prostate-specific antigens (PSA), a possible indication of prostate cancer.

While living in Texas in 2006, his levels started rising and he was diagnosed with chronic prostatitis, an inflammation of the prostate gland. When his PSA levels fell after being treated with an antibiotic, it further confirmed the diagnosis. In 2012, when antibiotics failed to lower his levels, he underwent his first prostate biopsy, which came back negative.

After moving to South Carolina in 2013, Avis’ PSA levels again spiked, a second biopsy was conducted that also was negative, and he was placed under active surveillance through 2014. A biopsy in June of this year with GHS’ new Artemis imaging system located a tumor on the anterior, or front, side of his prostate. Because tumors on the anterior side are rare, they are almost never routinely biopsied.

“I had been dealing with this for several years,” remarked Avis. “To live with this anxiety and then finally be able to understand why it’s been so difficult to locate it—and get a clear answer early enough to deal with it— has really been helpful to me.”

“Fortunately, for this patient and many others, this use of MRI has found tumors we typically would not be able to identify or access by two-dimensional technology that is standard in the U.S.,” said Patrick Springhart, MD, division chief of GHS Urology. “The technology that GHS has brought to the Upstate precisely locates and precisely biopsies those suspicious areas that are likely to be significant prostate cancer.”

Understanding Prostate Cancer The prostate is a small, walnut-sized gland located in the male urinary tract that undergoes two periods of growth. The first occurs early in puberty, followed by a second growth period at around age 24 that continues for life. While more than half of men in their 60s and even more in their 70s and 80s have some symptoms related to benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate, the American Cancer Society says over 220,000 new cases of prostate cancer are diagnosed each year.

It is rare for men to have symptoms of prostate cancer. In those limited cases, symptoms may include a need to urinate frequently, especially at night, difficulty starting or stopping urination, a weak or interrupted flow of urine, painful or burning urination, difficulty in having an erection, painful ejaculation, blood in urine or semen, and frequent pain or stiffness in the lower back, hips, or upper thighs.

(l-r) GHS urologic oncologists Erik Busby, MD; Patrick Springhart, MD; and William Flanagan, MD; believe that the new Artemis technology is helping save lives in the Upstate and beyond.

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Because prostate cancer may have either no symptoms or symptoms that don’t show up for months or years, screening (which typically begins at age 50) is the only reliable way to detect abnormal prostate growth. By the time urinary symptoms develop, a tumor may be quite advanced. Screening usually starts with a digital rectal exam along with tests for increased PSA levels. Patients with an abnormal digital exam or those with recurring elevated PSA levels typically have then undergone ultrasound-guided biopsies—sometimes multiple ones.

“People tend to have two misconceptions about prostate cancer: Number one, that it will kill you in all scenarios, and number two, that it will not kill you and doesn’t need to be treated,” Dr. Busby noted. “Still, over 30,000 men die yearly from the disease. While it’s true that some men have cancer that does not need to be treated, we need to figure out their particular risk. We don’t exclude anyone from screening, but do screen those who are younger with higher risk, African Americans and those with a family history.”

Precision Targeting The Artemis system helps decrease random biopsies and provides a way to find higher-grade tumors and more thoroughly biopsy them. This benefit allows physicians to not only know there is cancer, but also where it is and precisely modify surgery or radiation therapy to minimize damage to the surrounding area while maximizing the chance of removing all of the cancer. The system represents the state of the art in contemporary prostate cancer detection and is another example of GHS’ constant search for new technologies that make real contributions to the medical care of patients.

“GHS embraces things in a novel way, whether it’s new technology or new approaches, and sets the standard in the Upstate,” Dr. Busby observed. “We understand that it’s important to not just jump in without scrutinizing it. You don’t want to use something just because you have it—you need to use the most effective treatment for each particular patient.”

Upper photo shows ultrasound image of the prostate including the area of concern (outlined in red). Lower photo demonstrates the 3-D result of the MRI and ultrasound fusion. Also shown are the biopsy locations that include the “red” area of concern.

For Fe Avis and other patients like him, the technology represents a significant step forward in removing doubt from diagnosis.

“Without this technology, I could have been going through standard procedures and getting negative results while the cancer was growing in different locations of the prostate and potentially metastasizing to other parts of my body,” said Avis. “This technology has enabled us finally to find out what’s going on and to catch it at a stage where we have options.

That innovative spirit and willingness to move forward with new technology is something to be commended.”

For more information on prostate cancer, please visit ghs.org/prostate.

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Having Your Baby Your Way GHS’ midwifery services and new birth center support moms-to-be in crafting their birth experience.

By Lark Reynolds

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hen Beth Davis had her first child in 2011, she was given both pain medication and an epidural during labor. The effects left her feeling foggy as her daughter entered the world.

“Mentally, I wasn’t there because of the pain medication,” Davis recalled. “I felt like I missed out on that moment when you meet your new child.”

The experience motivated her to try a different route when she became pregnant a second time. Last year, Davis connected with Greenville Midwifery Care & Birth Center, part of Greenville Health System (GHS). When the time came for her second daughter to be born in June, she delivered the baby at the practice’s new birth center—one of three accredited birth centers in the state and the only one in the Upstate using certified nurse-midwives.

Beth Davis is glad she chose GHS’ new birth center for the arrival of Marlow.

The birth center offers three birth suites, each with a queensize bed, Jacuzzi-style tub and full bathroom. It offers expectant moms a relaxed, homelike environment—and more.

“I was in that zone of trying to stay relaxed,” Davis recounted, “and being at the birth center set me up for that, definitely, because it was like going to the spa.”

Birth suites also are equipped with starlight projectors, and moms in labor can take advantage of aromatherapy and essential oils. A small serenity garden with gurgling waterfall offers moms a place to walk outside as they await their baby’s arrival.

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“It’s nice because moms can get outside and walk around during labor,” said Bethany Smith, CNM, midwifery director of Greenville Midwifery Care & Birth Center. “They’re not strapped to monitors or IVs—they’re working with their bodies and laboring on their own.”

Midwives encourage the use of positioning during labor to minimize discomfort, so tools such as the birth sling—a large fabric “swing” suspended from the ceiling—along with birth stools and birthing balls offer women support as they try different positions.

There also is a family waiting area with a specialty coffeemaker and shaved ice machine. A large community room offers space for classes such as Hypnobabies and yoga.

Your Way: Birth Center or Hospital The center’s certified nurse-midwives believe that childbirth is a normal, natural life event for which a woman’s body is designed. They help patients achieve their goals for childbirth, whether that means a natural delivery without pain medication or something different.

Although epidurals and pain medications are not administered at the birth center, they are available at GHS’ Greenville Memorial Hospital—a mere half mile away.

Patients at Greenville Midwifery Care have the option of giving birth in the birth center or at the hospital, and Smith said the majority of their patients still choose to deliver at the hospital.

“To be at the birth center, a different mindset and preparation has to happen,” Smith said.

“That’s not for everybody. We understand that, and we definitely want to be supportive of women in giving them options.”

For patients who choose to give birth at the hospital, the midwife will support their labor, just as she would at the birth center—guiding the patient in the use of the same labor aids, including a birthing tub if desired.

Safety First Several risk factors, if present, rule out the option of giving birth in the birth center. These include high blood pressure, preeclampsia and diabetes requiring medication.

“If there’s someone who we as midwives feel isn’t a great candidate for the birth center, we have those conversations as early as possible,” Smith said.

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S.C. state law requires that all women desiring out-of-hospital birth must visit with a doctor within the last six weeks of the pregnancy. In fact, only low-risk births following normal, uncomplicated pregnancy are permitted at a birthing center, and a physician must make a written determination that the birth is low risk. So Lauren Demosthenes, MD, FACOG, medical director of the birth center, visits the practice monthly to meet with patients who want to use the birth center and make sure they’re good candidates.

For women who deliver at the birth center— about a third of the practice’s patients—they can take comfort in knowing that systems are in place to handle emergencies and other situations that arise. Some women who originally choose to give birth at the birth center end up deciding that they want an epidural to manage the pain. In such cases, Smith said, the hospital is just a short ride away. Emergencies follow a similar—but more urgent—protocol.

“Safety-net” protocols led Heidi Thiry to choose the birth center when her son was born in August. Thiry had given birth to her oldest child at a birth center in Savannah, Ga., but that center was not connected with a hospital.

“It made me feel more secure knowing that the close connection with the hospital and specialists was in place if I needed it,” Thiry noted.

In fact, Thiry liked the comfort and security offered at the birth center so much that she chose to make the hour drive from her family’s home north of Spartanburg over closer birthing options.

Donald W. Wiper III, MD, chair of GHS’ Department of Obstetrics & Gynecology, said the birth center offers more choices for expectant moms without compromising safety.

“There’s always been a strong, if small, drive for expectant moms to have the baby out of the hospital,” Dr. Wiper said.

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“We worked on maximizing safety and choice for our patients because those two things don’t have to be in conflict.”

He continued, “In the past, hospitals have been hesitant to address how to work alongside those who offer out-of-hospital birth experiences. We wanted to change that conversation and start having relationships with those who can offer safe, out-ofhospital births.”

Of note, the American College of Obstetricians and Gynecologists now endorses out-of-hospital birth centers with qualified birth attendants as Level I maternity care centers for healthy, low-risk women.

Special Delivery Before her second daughter was born, Beth Davis wasn’t sure where she was going to give birth, even up to the last hours before labor.

“I had my bags packed for the hospital or the birth center, because I really wasn’t sure which one I was going to go to,” she said. “I was scared about handling the pain.”

In the end, she decided to go to the birth center.

“It’s all about staying relaxed,” she said. “The whole environment at the birth center allows you to do that.”

She continued, “The support of the midwives is wonderful.

They encourage you, and right when you think you can’t do it anymore, they’re right there. Then, all of a sudden, you meet your baby.”

Although the atmosphere at the birth center is inviting, Smith said the majority of moms who give birth there don’t stay very long once the baby is born.

“As long as the mom and baby are doing well, most families stay between four and six hours, on average, after the birth,” she said. “They’re usually ready to go home—they haven’t had any drugs, they’re feeling great, and they want to go home and sleep in their own bed.”

Davis had been concerned about going home so early, but it turned out to be just what she wanted. Overall, she said, the experience was everything she had hoped for, and it helped her achieve her goal of feeling more present at her daughter’s birth.

To take a virtual tour of the birth center, visit greenvillemidwiferycare.com.

“It was a special, magical time that I’ll never forget.”

— Beth Davis

The Davis family—Beth, Jason, Julia and baby Marlow—bond together over books.

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With the help of GHS, Simon Kizito plans to stay healthy for wife Kimberly and daughters Tess (9) and Sasha (2).

The Beat Goes On … and On … and On Chest Pain Center earns honors for providing prompt, high-quality patient care.

By Leigh Savage

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imon Kizito was a 39-year-old who watched what he ate and exercised regularly. When he felt light-headed at the gym, it didn’t occur to him that he could be having a heart attack. But he was.

“I couldn’t get my words out,” said Kizito, a chemical engineer who lives in Simpsonville. “I was feeling a lot of pain in my arm and realized something big was going on.”

Fortunately, a gym staffer called 911 immediately. Within minutes, Kitzio was on his way to receiving a stent at Greenville Memorial Hospital (GMH), flagship facility of Greenville Health System (GHS).

Swift response time is just one of the reasons GMH has earned the Mission: Lifeline Gold Receiving Quality Achievement Award, which is given to facilities that implement specific quality improvement measures outlined by the American Heart Association to treat patients with severe heart attacks. For those having a heart attack, every second counts, and the goal of the Mission: Lifeline program is to reduce barriers to prompt treatment.

GMH also has been honored with the Mission: Lifeline GoldPlus award, which recognizes hospitals with an achievement score of 75 percent or greater for treating STEMI (ST-segment elevation myocardial infarction) transfer patients within 120 minutes. Each year in the U.S., approximately 250,000 people experience a STEMI, which occurs when a blood clot completely blocks an artery to the heart. Immediately restoring blood flow through surgery or medication is critical for survival.

Although the Chest Pain Center is located at Greenville Memorial Hospital, it reaches out to include any facility where treatment begins. “The ER, an EMS company, another hospital, transfer center or urgent care center are examples,” said Christina Freeman, BSN, RN, regional STEMI coordinator.

“We sometimes have patients coming from North Carolina and Georgia.”

Craig Hudak, MD, medical director of the center, pointed out that its mission is to care for the spectrum of chest pain. “On one end, you have a STEMI, a true medical emergency. On the other end, there may be chest discomfort that has nothing to do with the heart but needs to be treated.”

Craig Hudak, MD, is part of the interdisciplinary team that delivers high-quality care at GHS’ Chest Pain Center.

Call 911—don’t delay!

Educating the community about getting help quickly is key.

He and his team provide community education through Inside Health 14

newspaper editorials, radio spots and events such as the annual heart forum each February.

“We can do our job when patients come to us,” stated Dr. Hudak. “We can’t if they sit at home and wait. Patients need to know when to come in.”

Many patients hesitate to call 911 because they want to deny having a heart attack or will be embarrassed if it is a false alarm. “We have to overcome that natural human inertia and not wanting to get other people involved,” Dr. Hudak noted.

Kizito is glad he was in a public place and surrounded by people with medical knowledge when he had his heart attack.

“I feel very fortunate,” he said. “I was five miles from the hospital.”

The quick call to EMS meant he had an IV right away, and he began to feel better almost immediately. A mobile EKG unit found a blockage, and he was whisked to GMH so quickly that he wasn’t able to call his wife before getting his stent. “She is still upset with me,” Kizito recalled with a laugh.

He was surprised to learn that not only can younger people with no risk factors have a heart attack, but also that chest pain is not necessarily the warning sign. “I was light-headed and had a funny feeling,” he said. “It was just shortness of breath that wouldn’t go away.”

In July, Greenville Memorial Hospital also received the ACTION Registry-GWTG Gold Performance Achievement Award, which recognizes hospitals that have achieved high scores on performance measures for all acute myocardial infarction patients, which includes STEMI, non-STEMI and unstable angina.

According to Freeman, garnering honors and awards from medical organizations is a beneficial way to keep the staff focused on providing stellar patient care. “We can’t improve what we don’t measure,” she observed. “So, we measure everything. Through that process, we seek to improve care.”

“The staff at GHS took excellent care of me, and the cardiology team I worked with has been very good at keeping up with me and answering my questions,” Kizito remarked.

It’s been more than five years since Kizito experienced his heart attack, and he’s done everything he can to prevent one from happening again, including improving his diet, reducing stress and stepping up his exercise. He participated in a rehab program soon after discharge and takes medication to manage blood pressure and cholesterol. He has two children, ages 9 and 2, who are counting on him.

“I have a lot of motivation to stay healthy. It’s become a way of life.” — Simon Kizito

“Not everyone will have a textbook presentation,” Dr. Hudak explained. “It might be pressure, tightness or heartburn. Pain may be radiating to the arms or jaw. Any of these ought to get your attention. And women may just experience extreme fatigue or nausea.”

Patients often try to drive themselves to the doctor’s office or hospital, which Dr. Hudak discourages. “Get EMS to where you are,” he emphasized. “Calling 911 starts the diagnosis and treatment process.”

Measuring Success One reason the Chest Pain Center is so effective is that it represents teamwork at its best, and Dr. Hudak collaborates with other doctors to enhance the quality of care at GHS. “It’s a complex enterprise to combine emergency medicine, critical care services, cardiology and sometimes also neurology. We all work together to deliver top performance levels.”

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To learn important information about your heart health, take a quiz at ghs.org/heart.

CLINICAL TRIALS

Participants Needed

Hundreds of clinical trials are conducted throughout Greenville Health System on a variety of drug therapies, surgical devices and other treatments in all areas of medicine.

Cancer Survivors for Registry GHS Cancer Institute’s Cancer Survivor Registry is a database of cancer survivors that includes demographics, contact information, and tumor and treatment information. Survivors can receive information about cancer issues, as well as surveys and studies on subjects such as quality of life and survivorship challenges. Survivors may enroll by completing a consent form and a registration form. Contact John, (864) 455-5119 or jhanna3@ghs.org.

Survivors of Cancer The GHS Cancer Institute’s heart rate variability biofeedback (HRVB) study is for survivors of cancer who have completed radiation therapy and/ or chemotherapy. The purpose is to reduce symptoms of stress, pain, fatigue, depression, distress and insomnia among survivors. Participants will attend four to six weekly hour-long sessions, during which they will receive one-on-one coaching and individualized breathing techniques at no cost. Contact John, (864) 455-5119 or Jhanna3@ghs.org.

Women with Heavy Menstrual Bleeding Related to Fibroids This study evaluates the ability of a new investigational device, the Sonata System, to reduce heavy menstrual bleeding related to fibroids. The Sonata System is considered investigational in the U.S. This study device allows

a physician to view fibroids with ultrasound and to treat them by heating with radiofrequency energy. The device is placed into the uterus through the vagina and cervix so that no incisions are needed. Participants must be premenopausal, between 25 and 50 years old, have had heavy menstrual bleeding related to fibroids for at least three months, have no desire to become pregnant and have had no disruptive chronic pelvic pain for the last six months. Call Cheryl, (864) 455-5951.

nieces, nephews, aunts, uncles and grandchildren (ages 1-20) can be tested for their risk of developing type 1 diabetes free of charge. Benefits of participation include finding out your family members’ risk level for developing diabetes, possibly receiving an early diagnosis of diabetes that would allow for early treatment and contributing to the fight against type 1 diabetes. Adult patients or their relatives may call Shirley at (864) 455-3261. Relatives of pediatric patients may call Lisa at (864) 454-5168.

Women with Stress Urinary Incontinence

Children and Adolescents with Functional Constipation

GHS’ Department of Urology is conducting a study to evaluate the safety and effectiveness of an investigational cell therapy in women with stress urinary incontinence (accidental leakage with exercise, laughing, sneezing). For more information about the study, please go to ResearchMySUI.com or call toll free (855) 344-1074.

Children between 6 and 17 years old diagnosed with functional constipation and who have not responded well to other therapies may be eligible to take part in a clinical trial to evaluate the safety and effectiveness of Amitiza.

Participants must be able to swallow capsules and have fewer than three spontaneous bowel movements a week.

Contact Amy, (864) 845-5591 or ahayes@ghs.org.

Relatives of People with Type 1 Diabetes This study is searching for ways to prevent and quickly medically intervene in those newly diagnosed with diabetes.

Researchers are seeking to test family members of people with type 1 diabetes to determine if they show signs of developing the disease. Parents, brothers, sisters and children of those who have type 1 diabetes (ages 1-45), and cousins,

To learn more about research at GHS, please visit ghs.org/research.

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Q & A

What is a Patient-Centered Medical Home (PCMH)?

The way primary health care is being delivered is rapidly changing from a fragmented, volume-driven, and costly system to a holistic, coordinated, and compassionate approach that emphasizes the overall needs of patients and their health outcomes. Because of this changing landscape, the PCMH has emerged as an innovative model of primary care.

Please describe PCMH. PCMH incorporates five core attributes: • Patient-centered: Practitioners respect each patient’s unique needs, preferences, and cultures, embracing partnerships among themselves, patients, and their families • Comprehensive: A team of healthcare providers is accountable for a wide range of services that includes prevention and wellness, acute care, chronic care, and mental health needs • Accessible: Patients can access services with shorter waiting times through expanded hours, around-theclock access for routine and urgent needs, and enhanced communication with the healthcare team through email and telephone • Coordinated care: Care is coordinated throughout all elements of the complex healthcare system among hospitals, specialty care, home health, community services and other places of care • Quality and safety: Providers practice evidence-based medicine, use information technology for performance measurement and improvement, and constantly review data to improve clinical outcomes and patient satisfaction

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How does a PCMH benefit patients?

Benefits include having a personal clinician to help with a spectrum of medical needs throughout all stages of life, seeing one’s personal clinician in a timely manner, being managed by not just a doctor but a healthcare team of professionals who coordinate care, and feeling safe in knowing that providers are using the most up-to-date standards of care and are constantly improving quality and efficiency. In addition, these benefits are backed by research showing that a PCMH is associated with better outcomes, fewer hospitalizations, lower emergency department visits and less healthcare spending.

How has Greenville Health System (GHS) established PCMHs across the system?

The primary care practices of GHS chose to become PCMHs by adhering to standards developed by the National Committee for Quality Assurance (NCQA), a private non-profit organization dedicated to improving healthcare quality. A rigorous, yearlong process entailed creating new policies, procedures, work flows and quality improvement activities. Primary care practices that applied totaled 31.

The project was successful, with NCQA awarding 26 primary care practices Level 3 PCMH Recognition (the highest distinction) and five at Level 2. This prestigious distinction demonstrates that these practices provide care built on evidence-based, nationally recognized clinical standards of care.

All six of Baptist Easley’s primary care practices also earned PCMH Recognition (GHS is half-owner of this hospital).

Why did GHS embark on the PCMH process?

The PCMH process aligns with GHS’ vision to transform health care for the benefit of the people and communities we serve. The PCMH model is a better way to deliver primary care that improves clinical outcomes and patient experience and lowers overall healthcare costs. The PCMH is a proven framework that GHS is engraining in the culture of its primary care practices.

To find a PCMH at GHS, see pages 19-20.

Sean T. Bryan, MD, is chair of the GHS Department of Family Medicine.

PRACTICE PROFILE

(l-r) Douglas Whitehead, MD; Sara Velky, PA-C; and Mark Zeigler, MD, practice patient-centered care.

Greer Family Medicine

From the day in 1994 that Greer Family Medicine (GFM) opened its doors, it has been a patient-centered practice focused on taking care of the whole patient and the whole family.

“The patient’s whole person and all of his or her concerns, and the concerns of the family, are important to us,” said founding partner Douglas Whitehead, MD. “We believe people are more than the sum of their medical problems. We take into consideration patients’ personal beliefs and health philosophy as we connect them to the most up-to-date medical knowledge and practice.”

Because GFM has grown with Greer over the past 22 years, the practitioners have a history with the area and understand the people they are privileged to serve. “Family medicine” is exactly what GFM practices—its providers see family members of all ages, offering newborn care, well-woman care and total wellness care for all.

As family medicine practitioners, GFM providers see their strength—their “specialty”—lying in wide-ranging areas of medicine in which they are trained and practice.

“I sometimes call the family physician the specialist’s specialist,” noted Dr. Whitehead. “We often are able to provide patients

with the care they need without having to find another kind of physician to care for their family or medical need, which gives them a great deal of relief and confidence in us.”

Dr. Whitehead continued, “We want to maintain and to promote wellness in the person, the family and the community. The best part of our job is having an integral role in the lives of our patients and their families.”

Providers Douglas W. Whitehead, MD Mark R. Zeigler, MD Sara K. Velky, PA-C Greer Family Medicine 1107 W. Poinsett St. Greer, SC 29650 (864) 879-8886 Hours Mon.-Fri., 8 a.m.-5 p.m.

ghs.org/GreerFM

Editor’s note: In the Summer 2015 Inside Health, we featured GHS Eye Institute as our practice profile. In that piece, we misspelled the name of John D. Siddens, DO. We regret the error.

Inside Health 18

GHS PRIMARY CARE PRACTICES Having a personal physician with whom you can establish a lifelong relationship is as important as getting your screenings. If you need assistance finding one, here is a list of GHS primary care practices or call GHS Physician Finder at 1-844-GHS-DOCS (447-3627). To find out more about these practices, go to ghs.org/mydoctor. For a complete list of primary and specialty physicians, go to ghs.org.

CLEMSON Clemson-Seneca Pediatrics 208 Frontage Rd., Ste. 1, 29631 654-6034 CLINTON Advanced Family Medicine* 210 S. Broad St., 29325 833-0973

Christie Pediatric Group* 9 Mills Ave., 29605 242-4840 3911 S. Hwy. 14, 29615 522-1340 Cross Creek Internal Medicine* 50 Cross Park Ct., 29605 797-7035

Carolina Women’s Center 102 Medical Park Ct., 29325 938-0087

Cypress Internal Medicine–Patewood* 200 Patewood Dr., Ste. B460, 29615 454-2226

GHS Internal Medicine–Laurens (slated to open mid-January) 22725 Hwy. 76 E., 29325 833-4545

GHS Internal Medicine–Maxwell Pointe* 3907 S. Hwy. 14, 29615 522-1300

DUNCAN Palmetto Medical Associates* 500 Squires Pte., 29334 968-5123 Pediatric Associates–Spartanburg* 500 Squires Pte., 29334 582-8135 EASLEY Pediatric Associates–Easley* 800 N. A St., 29640 855-0001 GRAY COURT Laurens Family Medicine* 9100 Hwy. 14, 29645 876-4888 GREENVILLE Carolina Pediatrics of Greenville* 200 Patewood Dr., Ste. A120, 29615 454-2670 Center for Family Medicine* 877 W. Faris Rd., Ste. A, 29605 455-7800 The Children’s Clinic* 890 S. Pleasantburg Dr., 29607 271-1450 415 Duncan Chapel Rd., 29617 522-2600 Children’s Hospital After-hours Care (Urgent Care) 890 S. Pleasantburg Dr., 29607 271-3681 19 Inside Health

GHS Pediatrics & Internal Medicine* 1809 Wade Hampton Blvd., Ste. 120, 29609 522-5000 Greenville Family Medicine* 2-A Cleveland Ct., 29607 271-7761 Greenville Midwifery Care & Birth Center 35 Medical Ridge Dr., 29605 797-7350 Greenville Ob/Gyn Associates 2 Memorial Medical Dr., 29605 295-4210 1025 Verdae Blvd., Ste. F, 29607 286-7500 Greenville Pediatric Health Center*† 1350 Cleveland St., 29607 263-3012 Gynecology Specialists 890 W. Faris Rd., Ste. 510, 29605 101 Halton Village Circle, 29607 455-1600 (for both) Internal Medicine Associates of Greenville 1025 Verdae Blvd., Ste. A, 29607 242-4683 MD360® (Urgent Care) 1025 Verdae Blvd., Ste. B, 29607 286-7550 Piedmont OB/GYN 890 W. Faris Rd., Ste. 330, 29605 455-1270

3917 S. Hwy. 14, 29615 522-1360 Riverside Family Medicine–Eastside* 215 Halton Rd., 29607 454-2700 Riverside Family Medicine–Maxwell Pointe* 3909 S. Hwy. 14, 29615 522-1320 GREER The Children’s Clinic* 325 Medical Pkwy., Ste. 150, 29650 797-9300 Cypress Internal Medicine–Greer* 325 Medical Pkwy., Ste. 200, 29650 797-9550 Family Medicine–Mountain View* 406 Memorial Dr. Ext., 29651 877-9066 Greer Family Medicine* 1107 W. Poinsett St., 29650 879-8886 Greer OB/GYN 325 Medical Pkwy., Ste. 100, 29650 797-9200 MD360® (Urgent Care) 1305 S. Suber Rd., 29650 989-4609 Pediatric Associates–Greer* 318 Memorial Dr., 29650 879-3883 LAURENS Laurens Family Medicine* 106 Parkview Dr., 29360 984-0571 PIEDMONT/POWDERSVILLE Heritage Pediatrics & Internal Medicine– Wren* 1115 Wren School Rd., 29673 859-0740 (in collaboration with Baptist Easley) MD360® (Urgent Care) 11402 Anderson Rd., Ste. A, 29611 631-2799 (in collaboration with Baptist Easley)

Pediatric Associates–Powdersville* 207 Three Bridges Rd., 29611 220-1110

Cypress Internal Medicine–Simpsonville* 1409 W. Georgia Rd., Ste. D, 29680 454-6540

Premier Women’s Care 209 Three Bridges Rd., 29611 220-4209

Family & Internal Medicine–Simpsonville 727 S.E. Main St., Ste. 300, 29681 522-1170

SENECA Between the Lakes Primary Care 106 Ram Cat Alley, 29678 888-4445

Greenville Ob/Gyn Associates 727 S.E. Main St., Ste. 120, 29681 454-6500

Blue Ridge Women’s Center 103 Carter Park Dr., 29678 482-2360 10110 Clemson Blvd., 29678 985-1799 Clemson-Seneca Pediatrics 207 Main St., 29678 888-4222 Mountain Lakes Community Care (Urgent Care) 100 Omni Dr., Ste. B, 29672 885-7425 Mountain Lakes Family Medicine 10110 Clemson Blvd., 29678 482-3148

Heritage Pediatrics & Internal Medicine– Simpsonville* 727 S.E. Main St., Ste. 320, 29681 454-6440 Hillcrest Family Practice* 717 S.E. Main St., 29681 963-1548 Keystone Family Medicine* 1409 W. Georgia Rd., Ste. B, 29680 454-5000 MD360® (Urgent Care) 300 Scuffletown Rd., 29681 329-0029

Inside Health is published

by Greenville Health System as a community service. This information is for educational purposes solely—it should not take the place of medical advice or diagnoses made by healthcare professionals.

Greenville Health System is known for its comprehensive services and world-class physicians, in addition to being an academic health center and conducting leading-edge research.

However, our compassion and strength come from our people—14,000 dedicated professionals, your neighbors, who work together to care for you and your family.

Editor-in-chief Jerry R. Youkey, MD Executive VP, Medical and Academic Affairs, Greenville Health System Founding Dean, USC School of Medicine Greenville USC Associate Provost for Health Sciences Greenville

Dr. Timothy Sanders Family Medicine 100 Omni Dr., Ste. A, 29672 885-7520

SPARTANBURG Children’s Hospital Spartanburg Night Clinic*† 201 E. Broad St., Suite 210, 29306 804-6998

Seneca Medical Associates 11082 N. Radio Station Rd., 29672 882-2314

Pediatric Associates–Spartanburg* 249 N. Grove Medical Park Drive, Ste. 100 582-8135

Art Direction GHS Creative Services

Upstate Family Medicine 12016 N. Radio Station Rd., 29678 882-6141

Skylyn Medical Associates 1776 Skylyn Dr., 29307 577-9970

Contributing Photographer George Reynolds

SIMPSONVILLE The Children’s Clinic* 727 S.E. Main St., Ste. 100, 29681 454-6520

Spartanburg Pediatric Health Center*† 201 E. Broad St., Suite 210, 29306 707-2135

Christie Pediatric Group* 1409 W. Georgia Rd., Ste. A, 29680 454-5062

TRAVELERS REST Travelers Rest Family Medicine* 9 McElhaney Rd., 29690 834-3192

*The National Committee for Quality Assurance (NCQA) Recognition Programs assess whether clinicians and practices support the delivery of high-quality care and are built on evidence-based, nationally recognized clinical standards of care. †Most insurances accepted, including S.C. Medicaid program and Medicaid Managed Care.

The practices listed here are part of Partners In Health Inc. and affiliated with Greenville Health System.

Contributing Writer Kathleen Stevens For more information, contact Nancy Parker, Editor, Marketing Communications Greenville Health System 701 Grove Road Greenville, SC 29605-5601 (864) 797-7541 nparker@ghs.org © 2015 Greenville Health System 15-21503228 12/15

701 Grove Road • Greenville, SC 29605-5601

NONPROFIT ORG. U.S. POSTAGE PAID GREENVILLE SC PERMIT NO. 842

GHS Vision Transform health care for the benefit of the people and communities we serve.

GHS Mission Heal compassionately. Teach Innovatively.

Improve constantly.

GHS Values Together we serve with integrity, respect, trust and openness.

For information on other services offered

by GHS in the Spartanburg area, please see pages 19-20 (primary care) or visit ghs.org/spartanburg (all services).

GHS Care Is Right for Spartanburg County GHS’ vision to transform health care for the benefit of the people and communities we serve includes offering advanced, convenient care to those who live or work in Spartanburg County. While GHS has served Spartanburg communities for over a decade, more than ever we want to provide them the right care at the right time in the right place.

The “right care” includes prevention and wellness services. GHS is excited about its new partnership with Middle Tyger YMCA that will encourage exercise, a key factor in achieving and maintaining good health. Look for details about this partnership that will be announced in early 2016.

The “right place” is exemplified by GHS Children’s Hospital Outpatient Spartanburg, a new facility that brings together Pediatric Associates–Spartanburg, Kidnetics® (pediatric therapy services), Pediatric Surgery, Spartanburg Pediatric Health Clinic and Spartanburg Night Clinic. Locating these practices under one roof makes the healthcare experience less stressful for parents— and their children.