St. Luke's Research and Innovation

2018 RESEARCH &   I N N O V AT I O N

MO V IN G MED IC INE F ORWARD

MOVING MEDICINE

FORWARD

1 Message From Research & Innovation Leadership 2 St. Luke’s Introducing First-of-its-Kind Vital Signs Monitoring Program Marshaling Artificial Intelligence and Standard Patient Surveillance Devices

4 Database Access & Outcomes Enhance Bariatric Surgery 6 Reducing Acute Kidney Injury in Hospitalized Patients 8 Department of Surgery Highlights 9 Evaluating Innovative Technologies through Membership in AVIA t 10

Picture of Health St. Luke’s Researchers Pilot Weight-loss Phone App

12

St. Luke’s Cancer Teams Helping Lead Search for Cure

14

Novel Program for Patient Engagement Brings Improved Clinical Outcomes

16

St. Luke’s Awarded as High-Performing Clinical Trials Site for Second Year

18

ew PriceChecker Feature Heightens Financial Transparency N & Convenience for Patients

19

St. Luke’s Offers Convenient On-line Behavioral Health Services to Employees

20

New MRI Technology Monitors Prostate Conditions, Detects Cancer Earlier

22

St. Luke’s Contributes to Promising Ovarian Cancer Research

24

Big Help for Network Micro-preemies

26 Awards & Accolades

A MESSAGE FROM

RESEARCH & INNOVATION

LEADERSHIP

We’re pleased to invite you to explore this 2018-19 Research and Innovation report describing how St. Luke’s is advancing clinical care and community health through the discovery and development of new knowledge to enhance the health of our patients and neighbors.

In his book Better: A Surgeon’s Notes on Performance, acclaimed surgeon, author and industry thought leader Atul Gawande, MD, wrote, “Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”

Woven into the narrative of our institution’s focus on “better” is the steadfast support and generous funding by our leaders, administrators and industry colleagues for the pursuit of wonder and questioning the routine. We seek those answers with a zeal and diligence that have long been proved enriching and effective in the discipline of discovery.

Each year our researchers participate in some 200 clinical trials with the goal of advancing the science of screening and preventing disease, treating acute illness and controlling chronic conditions. Our talented, committed and resourceful staff of physicians, nurses and allied health professionals strive to identify and explore areas deserving inquiry and innovation.

We address confounding medical challenges that loom as ominous threats in the path of health and quality of life: Cancer, cardiovascular disease, premature birth and unexpected mortality, to name a few.

We’ve recently widened this scope to include engaging with our patients in their own pursuit of better health, specifically the management of lifestyle diseases. This new frontier is promising to be exciting and exhilarating!

Our St. Luke’s culture is imbued with a passion for looking beyond the horizon and daring to explore the science from different angles and through asking different questions. We are questioning convention, embracing innovation, and empowering our patients and community members to take more responsibility for their health.

This Herculean task demands diligence, clarity, courage and a willingness to try unceasingly.

And, as we celebrate our victories, big and small, we do so in the name of our patients for whom we hold our unwavering resolve to always try to make “better” possible.

With regards,

Stanislaw Stawicki, MD Chair, Department of Research & Innovation

Matthew Fenty Director of Innovation and Strategic Partnerships

1

S T. L U K E ’ S I N T R O D U C I N G

FIRST-OF-ITS-KIND

V I TA L S I G N S M O N I T O R I N G

Marshalling Artificial Intelligence and Standard Patient Surveillance Devices S T. L U K E ’ S I S T H E F I R S T H E A LT H O R G A N I Z AT I O N I N T H E U . S . T O TA K E T H I S MAJOR LEAP TO KEEP PAT I E N T S S A F E R I N T H E H O S P I TA L .

30% 25% 40%

DECREASE IN MORTALITY

DROP IN TRANSFERS TO THE ICU

REDUCTION ON RAPID RESPONSE CALLS

2

M O V I N G M E D I C I N E F O R WA R D

Shortly after the start of 2019, St. Luke’s launched a novel patient safety program.

The Enhanced Monitoring Initiative harnesses the latest in healthcare technology hardware and software to revolutionize the surveillance of hospitalized patients’ vital signs. Continuous 24/7 physiologic monitoring will alert clinicians to patient deterioration with the goal of decreasing mortality and morbidity.

This project will build on a Dartmouth University Hospital-led initiative in continuous patient monitoring. Some 60 critical variables reflecting a patient’s condition will be measured continuously in real time by interfacing common monitoring devices with the Epic electronic health record. St. Luke’s is the first health organization in the U.S. to take this major leap to keep patients safer in the hospital. This magnitude of monitoring far outpaces the traditional practice of taking blood pressure, heart and respiratory rates periodically throughout a patient’s stay. The program was piloted on the 34-bed P9 general medical unit at the Bethlehem campus of St. Luke’s.

PROGRAM Here at St. Luke’s, we are breaking new ground with this innovative program that marshals the use of artificial intelligence.

Aldo Carmona, MD Chairman of the Department of Anesthesia and Critical Care Senior Vice President of Clinical Integration

“Because of the unpredictability of which patients will deteriorate, continuous and in-depth vital signs monitoring provides a valuable level of data that can be acted upon quickly to save lives,” says Aldo Carmona, MD, chairman of the department of anesthesia and critical care, and senior vice president of clinical integration, who is leading the initiative.

This constant monitoring of changes in patient conditions will alert doctors and nurses when gradual deterioration is sensed, enabling quicker therapeutic response and avoiding emergent situations.

“With the higher acuity levels of many hospitalized patients, taking vital signs over four or eight hours is no longer effective in many cases, and developing conditions are missed until they become critical threats sometimes resulting in poor outcomes,” Dr. Carmona says.

“Dartmouth’s continued monitoring and earlier treatment process brought a 30 percent decrease in mortality, 25 percent drop in transfers to the ICU and 40 percent reduction on rapid response calls.” The system at St. Luke’s will enhance the process used at Dartmouth, with more vital signs being monitored and added surveillance from the electronic health record.

The monitoring system consists of a wireless armband and pulse oxygen sensor that continuously transmit vital scores to caregivers when signs of trouble arise. An acoustic respirator monitor sends breathing measures second-by-second, increasing the accuracy of surveillance in patients with pneumonia, sepsis and other illnesses for which respiratory rates changes are critical symptoms “Here at St. Luke’s, we are breaking new ground with this innovative program that marshals the use of artificial intelligence,” Dr. Carmona says.

He expects this Enhanced Monitoring program to be rolled out Network-wide during 2019.

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D ATA B A S E A C C E S S & O U T C O M E S

ENHANCE

B A R I AT R I C S U R G E R Y

560

WEIGHT LOSS PROCEDURES PERFORMED EACH YEAR

G O I N G F R O M G O O D T O G R E AT I N M E D I C I N E R E Q U I R E S R E L I A B L E D ATA T O S U P P O R T D I S C I P L I N E D D E C I S I O N - M A K I N G F O R T H E B E N E F I T O F PAT I E N T S , P R O G R A M S A N D S C I E N T I F I C A D VA N C E M E N T.

4

M O V I N G M E D I C I N E F O R WA R D

I believe in using new, promising technology if it’s better for the patient and the institution. It positions St. Luke’s among other major institutions, like Johns Hopkins and the Mayo Clinic, on the national stage.

Maher El Chaar, MD, FACS Co-director of Bariatric Services

255

LAPAROSCOPIC SLEEVE GASTRECTOMY

218

LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS

St. Luke’s Comprehensive Weight Loss Center accesses process and outcomes data in the MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program) database to improve the patient experience, while reducing postsurgical length-of-stay, complications and costs, among other factors.

The Network also uploads to the national database of 200,000 patients its metrics from the 560 weight loss procedures the bariatrics surgery program performs each year, according to Maher El Chaar, MD, FACS, co-director of bariatric services.

“This data helps us determine the value, risks and other quality measures of each surgery and learn which procedure is best for each patient,” Dr. El Chaar adds.

He finds the database essential, too, for planning bariatric revisions and conversion surgeries, as well as comparing the benefits of new and conventional approaches, like robotic vs laparoscopic procedures. Dr. El Chaar is one of just 7 percent of bariatric surgeons nationally using and evaluating the relatively new Da Vinci Xi robot.

73

LAPAROSCOPIC REVISIONS/CONVERSIONS

14

OTHER PROCEDURES

“I believe in using new, promising technology if it’s better for the patient and the institution,” Dr. El Chaar says. “It positions St. Luke’s among other major institutions, like Johns Hopkins and the Mayo Clinic, on the national stage.

“However, we need to track critical metrics like safety, complications, expense and patient pain over the long term using the MBSAQIP database.”

Outcomes data are studied routinely, and the results published and presented at national and international conferences.

Dr. El Chaar’s recent retrospective research comparing four bariatric surgery techniques utilized data from the database, which was statistically analyzed by Jill Stoltzfus, PhD, senior Network director, GME data management and outcomes assessment. “Assessment of Sleeve Gastrectomy Surgical Technique: First 30 Day Outcomes Based on MBSAQIP Database,” was published in October’s Journal of the American College of Surgeons.

The study found that each sleeve surgery has advantages and drawbacks, depending on patient anatomy, symptoms, previous procedures and surgical technology used, among other variables.

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REDUCING

ACUTE KIDNEY INJURY

I N H O S P I TA L I Z E D

AKI REDUCTION – STARTING AT THE END 20%

15/89

18%

14/88

Project Implementation

16%

Initiated Electronic Nurse Hypotension Protocol

14% 12%

6% 4%

Network Dissemination

12/102 5/69 10/97 9/95

10% 8%

Failures in Protocol

7/88

9/117

6/89

7/108

7/97

6/102

6/98

10/120

1/99

5/87 4/100

3/83 1/108

2%

7/99

5/95

5/117

2/69

8/97 8/120

1/100

1/97 2/83

1/87

0/98

0/21

0% 2015 Q1

2015 Q2

2015 Q3

AKI

2015 Q4

2016 Q1

2016 Q2

Hypotension

2016 Q3

2016 Q4

2017 Q1

2017 Q2

2017 Q3

Peer Hypotension Rate

2017 Q4

2018 Q1

2018 Q2

2018 Q3

Peer AKI Rate

Acute Kidney Injuries may have serious, lifelong negative health implications for patients. A collaborative of 12 major academic medical centers, led by St. Luke’s, found that that acute kidney injuries (AKI) can be reduced in inpatients by some 60 percent. Using a multidisciplinary team approach in the pre-, intra- and post-operative periods, AKI can almost be eliminated.

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M O V I N G M E D I C I N E F O R WA R D

2018 Q4

PAT I E N T S Aldo Carmona, MD, chairman of the department of anesthesia and critical care, and senior vice president of clinical integration, and Donna Sabol, vice president and chief quality officer, presented these critical findings at the Institute of Health Improvement conference in December 2018.

The improvements were achieved through a pilot program focused on total joint replacement patients. Prior to implementing the Acute Kidney Injury Initiative, 7 percent of patients suffered kidney injuries, raising one-year mortality and increasing length of stay and readmissions.

WITHIN THE FIRST

ENGAGING PRE-SURGICAL PATIENTS

IMPROVES OUTCOMES St. Luke’s plans to launch a Surgical Optimization Program in 2019 centered on engaging all elective presurgical patients to bring improved post-surgical outcomes.

Fashioned after the evidence-based and successful Michigan Surgical Health Outcomes Program, St. Luke’s will collaborate with patients 30 days before elective surgery to improve nutrition and sleep hygiene, screen for and treat depression, encourage smoking cessation, and provide diaphragmatic training. Geriatric surgery and other high-risk patients with pre-existing conditions will receive vigorous screenings and interventions to reduce complications, length of stay and admissions to skilled nursing facilities.

CALENDAR YEAR 2018,

The program, sponsored by the Network’s Surgical Optimization Center and led by Dr. Carmona and Daniel Herman, MD, director of perioperative medicine, will maintain contact with elective patients through text and email.

INJURIES FELL TO

For more information, contact Dr. Carmona at 484.526.4685.

YEAR OF PROGRAM LAUNCH, DURING

0 . 4 P E R C E N T. The coalition will expand the initiative to vascular surgery patients in CY2019, and add predictive analysis scores from the Epic electronic health record.

2018 R E S E A R C H & I N N O VAT I O N

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D E PA R T M E N T O F S U R G E R Y

HIGHLIGHTS The division of thoracic surgery has earned a superior three-stars rating for its pulmonary lobectomy program from the Society of Thoracic Surgeons in its General Thoracic Surgery Database.

St. Luke’s joins an elite group of 12 North American health organizations, including Cleveland Clinic, Rush University Medical Center and Lenox Hill Hospital, whose lung cancer outcomes rank in the top-tier in the country.

T H E D E PA R T M E N T OF SURGERY CONTINUES TO GROW IN NUMBER AND T E C H N O L O G Y, A N D GARNER ACCOLADES FOR ITS CLINICAL C A R E A N D S C H O L A R LY ACTIVITIES.

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M O V I N G M E D I C I N E F O R WA R D

With the recent recruitment of two vascular surgeons, two thoracic surgeons, two bariatric surgeons, a trauma surgeon and a neurosurgeon, the Department has increased its ability to perform more complex surgeries to meet the community’s needs.

In addition, with a third Da Vinci robot acquired this year by St. Luke’s, this expands surgeons’ capabilities to offer the latest cutting-edge procedures in general, bariatrics, ENT, GYN oncology, thoracic and urologic specialties close to patients’ homes. Da Vinci robots now are located at the Allentown, Bethlehem and Anderson campuses of St. Luke’s Network.

Volumes of robot-assisted surgeries totaled 755 at St. Luke’s in 2018.

Kudos are in order for several St. Luke’s medical students who researched and presented a paper demonstrating the innovative use of a model for predicting postoperative atrial fibrillation in thoracic surgery patients. Under the direction of chair of surgery, William Burfeind, MD, Charles Lee, Pharm. D., a Temple/St. Luke’s School of Medicine student, presented “Preoperative CHA2DS2-VASc Score Predicts Post-Operative Atrial Fibrillation After Lobectomy” at the 2017 Southern Thoracic Association meeting in San Antonio, TX. He was assisted by fellow medical students Lauren Stone and David Strauss, with key contributions from Jill Stoltzfus, PhD. The paper was accepted for publication in The Thoracic and Cardiovascular Surgeon.

INNOVATIVE TECHNOLOGIES

E VA L U AT I N G

THROUGH MEMBERSHIP IN AVIA NETWORK

This partnership helps St. Luke’s accelerate our adoption of new, valuable technologies to improve patient access and quality care, while controlling costs.

Matt Fenty Director of Innovation and Strategic Partnerships

As one of the earliest members of Avia Network, a 30+ health system consortium covering 400+ hospitals, St. Luke’s regularly partners with other progressive health organizations to evaluate the benefits and costs of new technologies for possible application in the health network. Many of the potential products are offered by start-ups and smaller technology companies.

“This partnership helps St. Luke’s accelerate our adoption of new, valuable technologies to improve patient access and quality care, while controlling costs,” says Matt Fenty, director of innovation and strategic partnerships for the health network.

“Interacting with these leading academic and non-academic health systems enhances our longterm competitive advantage.”

Other AVIA members include MD Anderson, Dignity Health, AdvocateAurora, and Christiana Care.

For more information on the AVIA partnership, contact Matthew.Fenty@sluhn.org.

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P I C T U R E O F H E A LT H : S T. L U K E ’ S

P I LOT

RESEARCHERS W E I G H T- L O S S P H O N E A P P

A M O N G T H E S E E M I N G LY E N D L E S S A R R AY O F O P T I O N S T O TA C K L E O B E S I T Y A N D ASSIST WITH WEIGHT L O S S I S A N E X P E R I M E N TA L SMARTPHONE-BASED, D I G I TA L - M E D I C I N E A P P T H AT H A S C A U G H T S T. L U K E ’ S R E S E A R C H E R S ’ I N T E R E S T.

10

M O V I N G M E D I C I N E F O R WA R D

Led by Parampreet Kaur, MD, the department of clinical research and innovation piloted the Picture It! app from software company Ayogo Health, of British Columbia, Canada. The Network’s departments of Bariatrics, Surgery and Innovation assisted in the research. The app helps users track key health behaviors and metrics, interact with fellow patients and dietitians, and envision themselves at desired stages of weight loss. The app is not yet commercially available.

Between January 2017 and February 2018, nearly 100 bariatric surgery candidates at St. Luke’s were enrolled in the prospective, randomized study. Patients were randomized to either smartphone-based gamification model (app) or no app. Their usage and clinical indicators were tracked for three months.

Digitally-enabled, evidence-based medicine is increasingly useful, as the health system harnesses the challenges and opportunities of this evolving technology.

Parampreet Kaur, MD Post-Doctoral Researcher Department of Clinical Research and Innovation

Dr. Kaur reports that weight loss was slightly higher among Picture It! users than nonusers, but not statistically significant among the Picture It! users during the pilot, though female subjects lost more than males. But she finds the platform promising on several fronts: 1 It allows social interaction and peer support among users, critical to long-term weight loss.

2 It promotes assistance from dietitians, who provide nutritional expertise, and enables users to track their eating history.

3 It can assist with healthy shopping options.

Also, patients who received more encouragement from dietitians and fellow app users lost more weight, which was statistically significant. User testimonials shared on the app added value, as well, the study found.

Personalization and customization of the weight-loss assisting technology are critical to maximize patient engagement and clinical outcomes, says Dr. Kaur.

“Digitally-enabled, evidence-based medicine is increasingly useful, as the health system harnesses the challenges and opportunities of this evolving technology,” she says. “It requires a commitment to research, which leads to innovation.”

Dr. Kaur presented the paper, “Prospective, randomized study of short-term weight loss outcomes using gamification-based strategy,” at the American Surgical Congress in February 2019.

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S T. L U K E ’ S C A N C E R T E A M S

HELPING LEAD SEARCH FOR

CURE

The “big bang” in cancer research that exploded within the industry in 2011 was the discovery of how to unleash the powers of immunotherapy and targeted therapy, in hopes of ushering in a cure. While immensely promising, the newest methodologies remain imperfect and needing further research and refinement.

Still, the advances over the past seven years are “like night and day,” compared to the previous decades’ research, says Sanjiv Agarwala, MD, chief of hematology and oncology at St. Luke’s and one of the nation’s leading melanoma authorities.

Long-term survival of melanoma patients has reached an average of 40 percent, versus 5 percent early in this century.

There’s reason for optimism, but more research obviously is needed.

Sanjiv Agarwala, MD Chief of Hematology and Oncology

12

M O V I N G M E D I C I N E F O R WA R D

“Long-term survival of melanoma patients has reached an average of 40 percent, versus 5 percent early in this century,” says Dr. Agarwala, the principal investigator of 15 current melanoma trials at St. Luke’s. “There’s reason for optimism, but more research obviously is needed.”

Scientists continue to pursue ways to defeat the vexing disease, as it cunningly resists, mutates or morphs uncontrollably in response to even the most advanced therapeutic assaults.

Studies like ENCORE-601, a multi-center national effort, are providing evidence and hope that combining immunotherapy and targeted therapies may hold the key to an eventual cure of melanoma and other cancers.

TUMOR CELL MDSC

TREG FIBROBLAST CTL

CTL

TREG

ENTINOSTAT

MDSC TAM

CHECKPOINT INHIBITORS

DENDRITIC CELL

Dr. Agarwala served as St. Luke’s principal investigator for the study and was primary author of the resulting paper, “Efficacy and safety of entinostat (ENT) and pembrolizumab (PEMBRO) in patients with melanoma progressing on or after a PD-1/L1 blocking antibody.”

St. Luke’s was the leading enrollment site for ENCORE-601, which included participation of Massachusetts General Hospital, Roswell Park Comprehensive Cancer Center, University of North Carolina Lineberger Comprehensive Cancer Center and other renowned sites.

The study, the results of which Dr. Agarwala presented at the 2018 American Society of Clinical Oncology meeting, found significant success in achieving anti-tumor activity when combing a selective histone deacetylase inhibitor, entinostat, with the antibody pembrolizumab in patients with progressive melanoma and lung cancer, for whom this therapy was a last resort. Some 30 percent of the 52 patients in the study experienced extended survival, a significant outcome that is undergoing further examination. The study was expanded to add cohorts for colorectal cancer as well.

PD-1 PD-L1

TUMOR CELL

ENCORE-601 found hope in combining immunotherapy and targeted therapy.

“This is one of many cancer studies we’re participating in at St. Luke’s,” Dr. Agarwala said. “Each study takes a team at each site to conduct.” At St. Luke’s, he collaborates with Robyn Rex, RN, OCN, CCRP, manager of oncology clinical trials, and disease-specific clinical trials teams dedicated to ensuring the safe and thorough coordination of care for the patients.

A veteran researcher who has participated in and led hundreds of cancer studies since 1995, Dr. Agarwala views the current focus on combining therapies and the development of “personalized medicine” as the future of cancer treatment. Still, he’s hesitant to predict a seismic shift in advancement of the science just yet, as occurred in 2011. Instead, he says the industry will continue to progress in slow and steady “baby steps.”

For more information, contact Robyn Rex, RN, OCN, CCRP, at Robyn.Rex@sluhn.org.

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N O V E L P R O G R A M F O R PAT I E N T

ENGAGEMENT

BRINGS IMPROVED CLINICAL Flinders is a generic, patient-centered and patient-activating intervention that may prove to be a key tool for improving patient outcomes in a cost-effective way.

Mark Kender, MD Vice President of Medical Affairs, St. Luke’s Miners Campus

When internist Mark Kender, MD, and his colleagues at St. Luke’s Miners Campus, saw that traditional methods for engaging patients in their diabetes and pre-diabetes care weren’t succeeding, he found an innovative solution Down Under. In 2015, Dr. Kender and the hospital launched the Flinders Chronic Condition Management Program, which has brought significant health improvements to patients and award-winning kudos to Miners.

Pioneered in Australia, the Flinders Program is an evidence-based protocol for involving patients in self-management of chronic health conditions, often focusing on the costly “high utilizers” of health services. With an alarmingly high incidence of diabetes and metabolic syndrome in the rural hospital’s service area, Carbon and Schuylkill counties, Dr. Kender hoped the Flinders model of scripted interviewing and coaching patients

FLINDERS PATIENTS’ RATINGS OF THEIR QUALITY OF LIFE BEFORE & AFTER INTERVENTION 1.6 1.39

1.4

1.22

1.2

Successfully Managing Chronic Disease

1.0 0.8

0.89 NOT Successfully Managing Chronic Disease

0.6 0.4 0.2 0

0.36

15 Q2

0.41

15 Q3

15 Q4

16 Q1

Flinders Intervention Time Period

14

M O V I N G M E D I C I N E F O R WA R D

16 Q2

ST. LUKE’S MINERS HEALTH CLINICS

WIN NATIONAL AWARD St. Luke’s Miners Rural Health Clinics received the 2018 Outstanding Rural Health Organization Award from the National Rural Health Association (NRHA).

OUTCOMES would ultimately gain their commitment to their health, and improve their HgA1C’s, reduce their emergency room visits and improve their BMI’s.

“We know that patients’ disease selfmanagement can break the cycle of poor clinical outcomes and resource waste, and help avoid the resulting co-morbidities,” Dr. Kender says. In many cases, however, lifestyle factors also play a major role as barriers to self-management, he explains.

“In addition to setting measurable clinical goals, we identify patients’ lifestyle-related challenges and set goals that address these factors, too.”

A 62-year-old man with uncontrolled chronic obstructive pulmonary disease, resulting in frequent ER visits, identified walking his dog weekly as his “life goal” during his Flinders conversation at the Miners Rural Health Clinic.

Today, his health is improving considerably: he keeps his appointments with his primary care doctor, has reduced his ER use, obtained an air conditioner to help his breathing and is on the path to achieving his dog-walking goal. His COPD is better managed, to the point that he can sometimes arrive at the clinic on foot.

“Flinders is a generic, patient-centered and patient-activating intervention that may prove to be a key tool for improving patient outcomes in a cost-effective way,” says Dr. Kender. “We are excited about many future possibilities as we continue our St. Luke’s Miners/Flinders research and education initiative.”

The award highlights St. Luke’s commitment to expanding and improving access to health care in Carbon and Schuylkill counties. It was presented at the NRHA’s Annual Rural Health Conference and Rural Hospital Innovation Summit in New Orleans, Louisiana. Nicole Geary, office coordinator for St. Luke’s Rural Health Clinics in Nesquehoning and Hometown, accepted the award on behalf of St. Luke’s.

“I am proud that our team was selected for the amazing work they do every day,” Micah Gursky, administrator, St. Luke’s Rural Health Clinics, said.

“In addition to providing top-quality and innovative clinical care, every one of our team members does truly care about our patients.”

St. Luke’s Rural Health Clinics provide over 12,000 patient visits annually, delivering high-quality primary care and community outreach programs to underserved populations in the two-county region. Among the innovative programs implemented by the Rural Health Clinics has been the Flinders Chronic Condition Management Program, an interventional initiative that has focused on improving the health of patients with diabetes and decreasing emergency department utilization among patients who had previously demonstrated unusually high rates of emergency department use.

Other community outreach and health promotion initiatives include “Adopt-A-School” programs, connecting students and families to the health care system; a dental health improvement program; ongoing mobile health van services for schools; in-school programming for students on such topics as depression, tobacco cessation and substance abuse; the Walk with a Doc program; health education at local health fairs and farmer’s markets; and a communitysupported agricultural program that provides fresh produce to residents.

2018 R E S E A R C H & I N N O VAT I O N

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S T. L U K E ’ S AWA R D E D A S

HIGH-PERFORMING FOR SECOND YEAR

P R O V I D ING PATIENTS ACCE S S T O I NN O VAT I V E T HE RAP I E S A N D N EW M EDICAL DISCOVE RI E S T HRO UG H CL IN ICAL T R I A L S AND RESEARCH IS A RE WARD IN I T S E L F F O R R E S E A RCHERS AND CLINICI AN S AT S T. L UK E ’ S , AND BE I NG R E C O G NIZED AND FINANCIAL LY AWARD E D F O R T H E S E A C H I E V EM ENTS ENHANCES T HI S S E NS E O F S AT IS FACT IO N .

St. Luke’s was awarded $63,000 as a “High-performing” clinical trials site by the National Clinical Trials Network, a program of the National Cancer Institute (NCI).

The High-Performing Site Initiative compensates high-performing sites recognizing that the “per-case management funding” provided by the NCI is significantly lower than the actual costs incurred by the member institutions/sites to participate on a trial. The Network participated in 58 NCI-sponsored clinical trials during the award period, March 1, 2017 through February 28, 2018.

The amount of the award was based on St. Luke’s overall Trials Network participation, evidence of integration activities and data quality within the program. The funds will be used to cover costs related to continued successful participation in national clinical trials at St. Luke’s.

“We are very honored to have been selected to participate in the High Performing Site Initiative for the second year in a row,” says St. Luke’s senior network director of clinical trials and research, Tracy Butryn, MS, CCRP, CHRC. “The grant recognizes our commitment to bringing leading edge treatments to our patients through our participation in clinical trials at a national level, as well as our high quality standards for clinical trial conduct.”

16

M O V I N G M E D I C I N E F O R WA R D

The grant recognizes our commitment to bringing leading edge treatments to our patients through our participation in clinical trials at a national level, as well as our high quality standards for clinical trial conduct.

Tracy Butryn, MS, CCRP, CHRC Senior Network Director of Clinical Trials and Research

200+

200+

CLINICAL TRIALS AT ST. LUKE’S

PATIENTS ENROLLED YEARLY IN CLINICAL TRIALS AT ST. LUKE’S

NCI NATIONAL CLINICAL TRIALS NETWORK STRUCTURE

Alliance

SWOG

COG (Pediatric)

NCTN Centralized Functions

ECOGACRIN

NRG Oncology

Canadian Network Group

Centralized Functions: • Centralized Institutional Review Board • Cancer Trials Support Unit • Imaging and Radiation Oncology Core (IROC Group) • Common Data Management System Central Hosting 30 Lead Academic Participating Sites (LAPS) Operations Statistics & Data Management

NCORP Site Participation

Tissue Banks Member Sites

The St. Luke’s Clinical Trials Office is the clinical and administrative shared resource for conducting and managing sponsored clinical research across St. Luke’s. The Trials Office promotes a centralized and streamlined approach to all sponsored-research conducted throughout the Network by integrating both the clinical operational team and the research administration team into one centralized office. This infrastructure ensures that both the clinical and administrative operations involved in clinical research comply with all regulations and policies, and that the workflow among sponsors, physicians, clinical support staff and other ancillary departments is streamlined and efficient.

St. Luke’s participates in more than 200 clinical trials, enrolling an average of 200+ patients in any given year.

To learn more about clinical trials at St. Luke’s, visit Research.slhn.org/Clinical-Trials.

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N E W P R I C E C H E C K E R F E AT U R E

HEIGHTENS

FINANCIAL TRANSPARENCY & CONVENIENCE FOR PATIENTS St. Luke’s has added another level of pricing transparency for patient convenience to its highly popular web-based PriceChecker pricing and bill-paying system.

Patients scheduled for common procedures, surgery, tests, or other services receive good-faith cost estimates for their final bills before they ever show up. These details are delivered via email or texts, on web-based or mobile apps. This initiative complements existing price transparency initiatives within St. Luke’s, including select discounts for early pre-payment, proactive and personalized payment plans, and easy to understand and navigate bills.

“Providing personalized pricing and financial liability information helps our patients understand and plan for their upcoming procedures,” says Matthew Fenty, director of innovation and strategic partnerships for St. Luke’s. “Patients tell us this uncommon layer of transparency and convenience in healthcare is hugely useful, when forecasting costs and making payment arrangements.”

St. Luke’s built this feature with its technology partner, Simplee, for the ease of patient planning, says Fenty. It’s among only a few programs of its type in the nation. The ability to provide patientspecific pricing is highly complex, and requires a strong commitment from all leaders across the Network to work well.

The cost estimates now cover 20 common services, such as knee and hip replacement, colonoscopies, as well as blood tests, drugs, imaging scans, and other routine services.

Unusual procedures like cardiac surgery are not included yet within this service.

“Providing this type of information is the right thing to do to help our patients make informed decisions and plan financially for the costs of their healthcare,” Fenty says.

St. Luke’s PriceChecker tool has been featured in the Philadelphia Inquirer and on CBS This Morning.

For more information, contact Matthew.Fenty@sluhn.org.

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S T. L U K E ’ S O F F E R S

CONVENIENT ON-LINE BEHAVIORAL HEALTH SERVICES TO EMPLOYEES Since 2017, all St. Luke’s employees and spouses have had access to online mental health services to help manage some of the some of the most common mental health issues — stress, anxiety and depression. “Emotional health is an important part of our overall health and wellbeing that is often ignored or overlooked because of stigma. SilverCloud enabled us to start a valuable conversation about self-care and mental health with our employees,” said Amy Previato, network director of employee wellness.

This program is designed to enable our staff to access mental health services through an innovative technology forum, which has been proven to be clinically beneficial and well adopted.

Phil Mazur, MSW Employee Wellness Supporter

“We see that access to mental health care services is challenging, both regionally and nationwide. This program is designed to enable our staff to access mental health services through an innovative technology forum, which has been proven to be clinically beneficial and well adopted,” said Matthew Fenty, director of innovation and strategic partnerships for St. Luke’s.

The SilverCloud behavioral health program is sponsored by Rochelle Schaller, vice president of human resources, Dr. Bonnie Coyle, chair of community and employee health, and Virginia Wagner, network administrator – behavioral medicine, along with St. Luke’s innovation program (retired). St. Luke’s Employee Wellness Department oversees day to day operations, with a dedicated social worker, Phil Mazur, MSW, who administers the platform and programs.

Any St. Luke’s employee can access these services for free. The self-paced programs provide online cognitive behavioral therapy (CBT) — a clinically-validated protocol to identify, support, and treat mental health issues. This service is designed to be as convenient as possible for employees and spouses.

According to Fenty, SilverCloud originated from St. Luke’s partnership with the AVIA Innovation Network. Over 2,400 accounts have been created since the program launched, “ said Mazur, “with the majority of users reporting that the program is interesting, relevant and helpful.

Objective evaluation also demonstrates clinical improvement in the majority of participants.”

For more information or assistance with signing up, email SilverCloud@sluhn.org.

2018 R E S E A R C H & I N N O VAT I O N

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NEW MRI TECHNOLOGY MONITORS

PROSTATE CONDITIONS & DETECTS CANCER EARLIER

N E W S TAT E - O F - T H E - A R T M R I T E C H N O L O G Y AT S T. L U K E ’ S E N A B L E S U R O L O G I S T S T O S A F E LY A N D E F F E C T I V E LY D I A G N O S E P R O S TAT E C A N C E R E A R L I E R , N O N - I N VA S I V E LY A N D W I T H M O R E S P E C I F I C I T Y, O R T O M O N I T O R S U S P I C I O U S P R O S TAT E C O N D I T I O N S .

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This MRI technology provides doctors with detailed, state-of-the-art prostate imaging to diagnose and manage prostate cancer to ensure the best possible outcome.

Zachariah Goldsmith, MD, PhD Urologist

IT IS ESTIMATED THAT MORE THAN

3 MILLION AMERICAN MEN ARE LIVING WITH PROSTATE CANCER.

ABOUT 1 MAN IN 7 WILL BE DIAGNOSED WITH PROSTATE CANCER DURING HIS LIFETIME

Traditionally, men with elevated PSAs needed a combination of blood tests and biopsies to monitor signs of prostate cancer. The new MRI capabilities, called multiparametric imaging, provide more detailed anatomical and functional details about the prostate, such as size, shape and location of tumors, and whether or not the cancer has spread beyond the walls of the prostate. This advanced MRI capability images the entire pelvic region, not just the prostate.

“Prostate cancer is not only the most common cancer in men, it’s also highly curable when detected early,” explains Zachariah Goldsmith, MD, PhD, urologist, St. Luke’s Center for Urology. “In fact, it’s one of the most curable internal cancers, but it’s also asymptomatic, so screening is our best chance of detection and cure. This MRI technology provides doctors with detailed, state-of- the-art prostate imaging to diagnose and manage prostate cancer to ensure the best possible outcome.”

Dr. Goldsmith, in collaboration with the St. Luke’s innovation program, sponsored this effort to test and validate its effectiveness and benefits for its patients.

Before this technology became available, doctors could not image the inside of the prostate accurately. With recent technological advancements and the development of specific imaging techniques, MRI has emerged as the gold standard to effectively visualize the prostate gland, aiding in prostate cancer surveillance and detection.

“MRI of the prostate has now evolved to a point where it is significantly improved in its ability to detect and help stratify risk for underlying prostate cancer,” says Laurie Sebastiano, MD, St. Luke’s diagnostic radiologist. “It now plays an important role in management of patients on active surveillance who are at increased risk for prostate cancer.”

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S T. L U K E ’ S C O N T R I B U T E S T O

PROMISING

OVARIAN CANCER RESEARCH A landmark clinical trial in which St. Luke’s cancer researchers took part concludes that a targeted treatment enhances progression-free survival in patients with advanced ovarian cancer, when the drug is taken as a first-line maintenance monotherapy.

The AstraZeneca and Merck-sponsored, randomized, double-blinded, placebo-controlled, international multicenter study, SOLO-1, achieved positive results in the adjuvant treatment of BRCA-mutated ovarian carcinoma with Lynparza (olaparib).

“Lynparza appears to be promising when treating patients whose cancer is linked to a BRCA mutation,” says Nicholas Taylor, MD, St. Luke’s chairman of oncology and chief of gynecologic oncology. Dr. Taylor, who serves as the Network’s principal investigator for the study, notes that approximately 15 percent of ovarian cancer patients have germline mutations in BRCA-1 or 2.

The results of the study were presented first at the European Society of Medical Oncology in Berlin, Germany on October 22, 2018.

NEWLY DIAGNOSED OVARIAN CANCER

BRCA1 BRCA2

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M O V I N G M E D I C I N E F O R WA R D

OLAPARIB

Lynparza appears to be promising when treating patients whose cancer is linked to a BRCA mutation.

Nicholas Taylor, MD Chairman of Oncology and Chief of Gynecologic Oncology

A N N U A L LY, 1 . 5 P E R C E N T OF WOMEN ARE DIAGNOSED W I T H O VA R I A N C A N C E R , A H I G H LY L E T H A L CONDITION WITH AN

60%

OF 200 PATIENTS WERE PROGRESSION-FREE AT 3 YEARS

8 5 P E R C E N T M O R TA L I T Y R AT E W H E N F O U N D I N A N A D VA N C E D S TA G E .

According to Dr. Taylor, Lynparza is among a new class of drugs called poly ADP ribose polymerase (PARP) inhibitors that can be taken orally, following surgery and/or chemotherapy as first-line treatment for stage III or IV ovarian cancer. The drug prevents the cancer cells from repairing DNA damage from chemotherapy, thereby promoting cell death.

Sixty percent of the nearly 200 patients randomized to take Lynparza in the study were progression-free at three years when taking the drug versus 26.9 percent of those taking a placebo. Subject enrollment is closed, and five-year follow-up patient surveillance is underway. St. Luke’s enrolled two patients in the study.

“With these results, Lynparza could change the standard of care for women with germline mutation,” Dr. Taylor explained. “There is ongoing research as to whether women without a germline BRCA mutation will benefit from PARP inhibitor maintenance therapy after first-line treatment.”

Annually, 1.5 percent of women are diagnosed with ovarian cancer, a highly lethal condition with an 85 percent mortality rate when found in an advanced stage.

With the success of SOLO-1, Taylor says clinical trials of ovarian cancer in the near future will be designed to answer the question, “Will combining check-point immunotherapy and PRAP inhibitors further improve the treatment of ovarian cancer patients at all stages?” St. Luke’s is poised to participate in such a study.

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BIG HELP

FOR NETWORK MICRO-PREEMIES Giving the tiniest newborns the best chance for survival and normal development is the passion of St. Luke’s NICU team and its international partners, who comprise the Vermont Oxford Network’s (VON) Micro-Preemie Collaborative.

The 10 health organizations in the consortium contribute to and share a confidential database of research projects, clinical processes, quality outcomes and best practices for the care of babies whose birthweight is less than three pounds. The entire VON Network, which concentrates on neonatal health improvement, totals 1,200 organizations from across the globe.

St. Luke’s multi-disciplinary team joined the group in 2016, and since then has designed and conducted several innovative, quality improvement initiatives that were shared within the collaborative: THE “GOLDILOCKS PROJECT” Focused on improving thermo-regulation adherence as a best practice in these micro-preemies before they are admitted to the NICU. This collaboration between the labor and delivery staff, obstetricians, nursing, parents and the NICU team brought improved outcomes and reduced length of stay in the unit. “This tremendous success required team engagement, including administration, physicians, advanced practitioners, nurses, members of our quality department, respiratory therapy and NICU parents,” says Jennifer Janco, MD, chief of pediatrics at St. Luke’s.

“DON’T JUST DO SOMETHING, STAND THERE” Takes a watch-and-wait approach before deciding if starting invasive respiratory suport is needed, which reduced incidence of pneumothoraces in newborns at St. Luke’s. “We found that it’s important to let the baby have time to transition to extra-uterine life, rather than begin treatment right away,” says Kim Costello, DO, director of neonatology at St. Luke’s. This year, the project won the first NICU-based HAP (Hospital Association of Pennsylvania) award in the history of the competition.

“JUST IN THE NIC OF TIME” Specifies key activities to be performed on micro-preemies within the first 60 minutes after admission to the NICU. These include placement of central lines, starting IV dextrose, initiation of respiratory support whether via ventilator or CPAP if necessary, family interaction with the infant and administration of surfactants to enhance lung function.

The thermo-regulation and pneumothoraces projects are complete, with ongoing monitoring and fine-tuning taking place. Golden Hour process data and improvement cycles are still occurring and being analyzed.

Team composition for these efforts includes representation by family members who have had infants in the NICU, says Dr. Costello. “They help the clinicians see things from the family viewpoint, as we tend to consider mainly medical aspects of the experience.”

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THE GOLDILOCKS PROJECT Average of Temperature at Admission to NICU (Degrees Centigrade) - 1500 gms Newborns PDCA CYCLES 3, 4 & 5

38.4

Less Variation 4 Months “Just Right”

Average Temperature

37.9 37.4 36.9

NEW NICU COMING 2020!

36.4 35.9

PDCA CYCLES 6 & 7

Adjusted for a Few Out of Range Temperatures

35.4 34.9 34.4 33.9

AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUNE JULY AUG

2016 2016 2016 2016 2016 2017 2017 2017 2017 2017 2017 2017 2017

DOB Month

DON’T JUST DO SOMETHING – STAND THERE Pneumothorax Rates Expanded Population 6%

CYCLE 1

Switched to VTV

5%

CYCLE 2

Extubation Criteria

CYCLE 4

Using Porcine-Derived Surfactant for all Infants

4% 3% 2% CYCLE 3

1% 0%

Switched to Porcine-Derived Surfactant for Infants <1500g

2015 2015 2015 2015 2016 2016 2016 2016 2017 2017 2017 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3

Plans also are under way by the team to design the NICU that will be opened at the St. Luke’s Anderson Campus in 2020. This “Petite Suite,” as it is being referred to, will be single patient rooms to foster developmentally appropriate environment for the micropreemies. The NICU will consist of both private rooms and an open pod area to enhance healing and wellness in the babies.

“Commitment and collaboration from the team members and leadership are critical to success in achieving the very best outcomes for the babies,” says Dr. Costello. “They just don’t happen by accident.”

“And we can always do better,” adds Dr. Janco.

JUST IN THE NIC OF TIME % of Infants with Tasks Completed within 60 munutes of Admission CYCLE 1

100% 90% 80% 70% 60% 50% 40% 30% 20% 10%

Vanilla TPN in Accudose

CYCLE 2

New Golden Hour Checklist

CYCLE 3

Notifying X-ray in Advance

CYCLE 4

Keeping Infancts in Plastic Wrap & MEasuring HC in DR

CYCLE 5

Revided Data Intake Form

Jennifer Janco, MD Chief of Pediatrics

Kim Costello, DO Director of Neonatology

0% JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC JAN

2018 2018 2018 2018 2018 2018 2018 2108 2018 2018 2018 2018 2019

2018 R E S E A R C H & I N N O VAT I O N

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AWA R D S & ACCOLADES

LEAPFROG AWARDS ST. LUKE’S HOSPITALS ‘A’ GRADES FOR PATIENT SAFETY

The Leapfrog Group, a national nonprofit health care ratings organization, today released new Leapfrog Hospital Safety Grades, awarding top marks to St. Luke’s hospital campuses.

The Safety Grade assigns letter grades of A, B, C, D and F twice annually – in the spring and fall – to hospitals nationwide based on their performance in preventing medical errors, infections and other harms. Five of St. Luke’s University Health Network campuses – Bethlehem, Anderson, Miners, Monroe and Warren – were among those hospitals awarded an “A” for their commitment to keeping patients safe and meeting the highest safety standards in the U.S. “This A rating is an important validation of St. Luke’s continued focus on and commitment to patient safety,” St. Luke’s Vice President and Chief Quality Officer Donna Sabol said. “I couldn’t be prouder of our doctors, nurses and other staff, who have earned Leapfrog’s top honors by making patient safety their overriding priority in everything they do.”

Developed under the guidance of a Blue Ribbon National Expert Panel, the Leapfrog Hospital Safety Grade uses 27 measures of publicly available hospital safety data to assign A, B, C, D and F grades to more than 2,600 U.S. hospitals twice per year. It is calculated by top patient safety experts, peer reviewed, fully transparent and free to the public.

“The good news is that tens of thousands of lives have been saved because of progress on patient safety. The bad news is that there’s still a lot of needless death and harm in American hospitals,” said Leah Binder, president and CEO of the Leapfrog Group. “Hospitals don’t all have the same track record, so it really matters which hospital people choose, which is the purpose of our Hospital Safety Grade.”

To see St. Luke’s full grades, and to access patient tips for staying safe in the hospital, visit www.HospitalSafetyGrade.org.

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CMS GIVES ST. LUKE’S HOSPITAL

HIGH RANKINGS

The Centers for Medicare & Medicaid Services (CMS) has rated St. Luke’s University Health Network higher than any other health system in the region. In fact, only 15 hospitals in Pennsylvania and New Jersey combined received 5 stars… St. Luke’s has three of the 15: • St. Luke’s Anderson Campus • St. Luke’s Miners Campus • St. Luke’s Warren Campus St. Luke’s Allentown Campus, St. Luke’s Quakertown Campus and St. Luke’s University Hospital in Bethlehem each earned four stars.

The new ratings summarize up to 57 quality measures including mortality, safety of care, re-admission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging.

CMS’ Overall Hospital Star Ratings is an extremely helpful tool in assisting consumers to choose the best hospital. The agency is committed to transparency and accurate reporting of the quality measures that show how hospitals compare in terms of their performance on the star ratings.

“We are proud of this significant accomplishment. Our ability to achieve fourand five-star ratings is a testament to the high-quality care we provide,” says Donna Sabol, vice president and chief quality officer, St. Luke’s University Health Network.

“CMS analysis shows that all types of hospitals have both low performing tiers and high performing leaders. We are honored to be among the most highly rated health systems in the country.”

ST. LUKE’S HONORED FOR INNOVATION

St. Luke’s University Health Network was recently recognized for its innovative programs by Becker’s Healthcare. This honor highlights organizations’ commitment to “staying on the forefront of change in healthcare,” through research, development and innovation, according to Becker’s.

In addition to St. Luke’s, the Becker’s list comprises 65 leading hospitals and health systems nationwide with innovative programs, including MD Anderson, Massachusetts General, Memorial Sloan Kettering and Mayo Clinic.

In 2015, St. Luke’s University Health Network launched its innovation program, St. Luke’s Technology Ventures, which focuses on patient quality and care developments and applies them in St. Luke’s 10 hospitals and more than 315 care locations. St. Luke’s Technology Ventures is piloting new technology aimed at providing a look into real-time movement in its emergency room and online mental health tools.

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AWA R D S & ACCOLADES ST. LUKE’S ACHIEVES MULTIPLE 100 TOP HOSPITAL DESIGNATIONS

N O T O N LY A R E S T. L U K E ’ S H O S P I TA L S T H E O N LY O N E S I N T H E R E G I O N T O H AV E E A R N E D T H E 1 0 0 T O P H O S P I TA L S D E S I G N AT I O N , T H E Y A R E T H E O N LY O N E S T O H AV E D O N E S O I N P E N N S Y LVA N I A I N 2 0 1 9 IN THEIR RESPECTIVE C AT E G O R I E S .

St. Luke’s University Hospital (Bethlehem and Allentown campuses) have been named one of the nation’s 100 Top Hospitals in the Major Teaching Hospital category by IBM Watson HealthTM for the fifth year in a row and the seventh time. Additionally for the first time, St. Luke’s Anderson Campus was named a 100 Top Hospital (one of 20 in the Medium Community Hospital category), and for the second time St. Luke’s Quakertown Campus was named a 100 Top Hospital (one of 20 in the Small Community Hospital category).

IBM Watson Health 100 Top Hospitals is one of the health industry’s most prestigious honors.

Unlike many other health care awards, it is based entirely on an independent, scientific review of objective data from government and other publicly available sources.

St. Luke’s University Hospital in Bethlehem is proud to be the only hospital in the region to ever have been named one of the nation’s 100 Top Hospitals in the Major Teaching Hospital category.

ST. LUKE’S ARE THE ONLY HOSPITALS IN LEHIGH VALLEY TO ACHIEVE THIS HONOR. ST. LUKE'S UNIVERSITY HEALTH NETWORK HAS WON THREE IBM WATSON HEALTH 100 TOP HOSPITAL AWARDS– AN UNPRECEDENTED ACHIEVEMENT.

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“The 100 Top Hospitals award recognizes an organization’s ability to thrive regardless of the constantly changing environment of today’s health care industry and national imperatives that continue to require the highest value of care.

That means St. Luke’s is one of the nation’s best at providing the highest quality of care at a lower cost,” said Richard A. Anderson, president and CEO. “This award is solely based on clinical outcomes, efficiencies of care and financial performance,” Anderson added. “It is a credit to St. Luke’s leadership team, the most talented and experienced team of health care administrators in the country, and to our outstanding physicians, nurses and other staff who day in and day out maintain an unwavering focus on quality and patient satisfaction.”

If other Lehigh Valley hospitals were able to match St. Luke’s “100 Top Hospital” performance, Allentown, Bethlehem, Easton and surrounding communities would enjoy not only improved health outcomes but also lower health care costs.

Based on the results of this year’s study, IBM Watson Health extrapolates that if all Medicare inpatients nationwide received the same level of care as those treated in the award-winning facilities such as St. Luke’s: More than 103,000 additional lives could be saved More than 38,000 additional patients could be complication-free More than $8.2 billion in inpatient costs could be saved

Approximately 155,000 fewer discharged patients would be readmitted within 30 days

Kyu Rhee, MD, MPP, vice president and chief health officer at IBM Watson Health, said: “From small community hospitals to major teaching hospitals, these diverse hospitals have demonstrated that quality care, higher patient satisfaction, and operational efficiency can be achieved together. In this era of big data, analytics, transparency, and patient empowerment, it is essential that we learn from these leading hospitals and work to spread their best practices to our entire health system.”

IBM Watson Health uses independent and objective research to analyze hospital and health system performance.

CREDITS PRESIDENT & CEO Richard A. Anderson VICE PRESIDENT & CHIEF MARKETING OFFICER Ken Szydlow EDITORIAL DIRECTOR Stephen Andrews ART DIRECTOR Lori Diehl WRITER & EDITOR Robert Stevens RESEARCH CONTRIBUTORS Tracy Butryn, MS, CCRP, CHRC Stanislaw Stawicki, MD Jill Stoltzfus, PhD GRAPHIC DESIGNER Trissy Laurito PHOTOGRAPHERS Anita Sergent Tom Volk

THIS BOOK WAS PRODUCED BY St. Luke’s University Health Network 801 Ostrum Street Bethlehem, PA 18015 For printed copies, please contact: St. Luke’s Marketing & Public Relations Department

484.526.4130

St. Luke’s University Health Network 801 Ostrum Street Bethlehem, PA 18015

Non-Profit Org. US Postage

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