MUSC Catalyst

June 1, 2012

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 30, No. 40

New procedures transform heart care Treatment helps 91-year old patient get back in game

What’s the latest?

he residents at Bishop Gadsden better watch out. Henry Brawner, 91, is back to the poker table and more like his old self thanks to a transcatheter aortic valve replacement procedure that was done March 29.

MUSC was the first in South Carolina to perform the implant, done through a minimally invasive procedure that is now a new option for patients previously considered too sick to undergo traditional valve replacement surgery. The procedure can be done instead of traditional, open-heart surgery.

Brawner said his results have been very close to a miracle and he has been amazed by the transformation in his energy and activity levels following the procedure by Drs. Daniel H. Steinberg and John S. Ikonomidis. Having recovered quickly, Brawner said he’s glad he opted to try the new procedure.

He has enjoyed resuming a more active lifestyle and looks forward to celebrating his 70th wedding anniversary in December.

Ikonomidis, a cardiothoracic surgeon and director of the South Carolina Heart Valve Center at MUSC, said the new valve enables doctors to treat a new population of patients with aortic valve disease. “Since it involves a minimally

MUSC became the first in South Carolina to implant a new pacemaker that offers more customized treatment for heart patients that can translate to fewer surgeries.

The Unify Quadra Cardiac Resynchronization Therapy Defibrillator and Quartet Left Ventricular Quadripolar

New pacing technology device better regulates heart rhythm

T

4

See PACING on page 10 Phase 3 Clinical Trial shows promise for LAPTOP-HF care

Henry Brawner (right) takes a stroll with his wife, Francis. He likes that he can be more active now since his TAVR procedure. invasive procedure, TAVR allows us to operate on patients who are too frail or sick for open valve replacement surgery.”

The good news for patients is that the Centers for Medicare and Medicaid

BATTLING DRUG SHORTAGES Physicians collaborate to ensure safe, adequate drug supply.

6

Services decided May 1 to reimburse clinicians for transcatheter aortic valve replacement (TAVR) in inoperable patients with severe aortic stenosis.

That will open the door for more of

Two MUSC doctors hope results from a 75-site, multinational clinical trial will confirm a promising new treatment for patients hoping to prevent congestive heart failure.

MUSC’s Michael Craig, M.D., and Frank Cuoco, M.D., serve as principal investigators for

See GAME on page 10

See LAPTOP on page 10

SPORTS MEDICINE ENTERS NEW ERA

3

Town Hall Meeting

Going beyond just treating injuries, athletic trainers up their game.

5

Meet Derrelle

8

ER Records Exchange

READ THE CATALYST ONLINE - http://www.musc.edu/catalyst

2 THE CATALYST, June 1, 2012

HEALTH PROFESSIONS CELEBRATION

Students enjoy activities at the College of Health Professions’ campus services fair May 23. Occupational and physical therapy students and physician assistant studies students were eager to see their schedules, meet the faculty and enjoy some freebies.

Inaugural Radiology Research day June 9 The Department of Radiology and the Center for Biomedical Imaging are hosting a Radiology Research Day June 9.

The event starts at 8:30 a.m. and will be held in the Bioengineering Building, room 110. Radiology residents and post-doctoral scholars will present their research.

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425.

843-792-4107 Fax: 843-792-6723 Editor: Kim Draughn catalyst@musc.edu Catalyst staff: Cindy Abole, aboleca@musc.edu Dawn Brazell, brazell@musc.edu

The Catalyst is published once a week.

Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.

Nursing associate dean named Robin L. Bissinger, Ph.D., R.N., becomes the College of Nursing’s new associate dean for academics June 1.

The advanced practice registered nurse, neonatal nurse practitioner and associate professor replaces Sally Stroud, Ed.D., R.N., who retired after 19 years at MUSC, on May 31.

In this position, Bissinger will provide leadership in managing various facets of the college’s academic nursing programs including faculty and student affairs, program coordination and resource development and allocation.

In her previous position at the College of Nursing, Bissinger was the director of graduate programs (a role she will continue to perform) and led the Doctor of Nursing Practice and master’s degree programs. In addition to her academic duties, Bissinger also functioned as the manager for the neonatal nurse practitioner team at the Children’s Hospital and dedicated her clinical work to support, educate and advance the role of the neonatal nurse practitioner.

College of Nursing Dean Gail Stuart, Ph.D., said she is proud to bring someone of Bissinger’s leadership and clinical and academic experience to the role.

“Dr. Bissinger is an excellent addition to my leadership team as she bring exceptionally strong skills in clinical practice, national nursing leadership and expertise in quality care and patient safety. I anticipate continued academic growth and outstanding outcomes in the days to come.”

First appointed to the College of Nursing faculty in 1994, Bissinger is board certified by the National Certification Corporation as a neonatal nurse practitioner. She also is founder and past chair of the National Association of Neonatal Nurse Practitioners, past president of the National Association of Neonatal Nurses, past president and executive director of the Carolina’s Association of Neonatal Nurse Practitioners and liaison to the perinatal executive board for the American Academy of Pediatrics.

Currently, Bissinger is president of the National Certification Corporation and

Drs. Robin L. Bissinger (left) and Sally Stroud at the 2012 Commencement vice-chair of the Congress on Nursing Practice and Economics. She is an active member of the National Alliance and LACE groups which are moving the advanced practice registered nurse toward a consensus model.

Bissinger earned a B.A. in biology and psychology from the University of North Carolina at Asheville and a Bachelor of Science in nursing from Western Carolina University. In 1991, she was certified as a neonatal nurse practitioner from the University Medical Center.

Bissinger received her master’s and doctoral degrees in nursing from MUSC College of Nursing. She was presented with the Distinguished Leadership in Neonatal Nursing Award and the South Carolina League of Nursing Excellence Award.

The author of numerous publications and posters, Bissinger’s clinical and research interests involve the study of secondary surfactant dysfunction and deficiency in neonates. She also is very involved in process improvement in the Neonatal Intensive Care Unit. She is active in the South Carolina Neonatal Medical Consortium and has worked to help the state initiate and publish process improvement efforts on “The Golden Hour: A resuscitation strategy for very low birth weight infants.”

THE CATALYST, June 1, 2012 3

Town hall meetings praise achievement, outlook for future Jim Brook, Oncology Service Line administrator, and Kim Phillips, Transplant Service Line Administrator, shared information at the quarterly town hall event.

Service – Serving the public with compassion, respect and excellence Even though results in the 2nd and 3rd quarters are exceptional, low results in the first quarter of Fiscal Year 2012 have challenged the hospital to achieve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) composite and patient perception goals during this period. The AVATAR patient perception goals are on target with 92.10 (Goal 92.34) so far in May. People – Fostering employee pride and loyalty We are awaiting final results from both the Employee Commitment and Physician Satisfaction surveys.

Quality – Providing quality patient care in a safe environment The hospital’s achievements for hand hygiene compliance continue to impress as results have surpassed set goals and climbed to 92 percent (stretch goal: 90 percent). Unfortunately, recent results for ideal care goals came up short this quarter at 2.85 (goal: 3.5).

Finance – Providing the highest value to patients while ensuring financial stability Staff continue to work on improving our costs per discharge efforts which stands at $9,269 as of March (goal: $8,750). Net income is projected to be

significantly below goal this year.

Growth – Growing to meet the needs of those we serve Projected growth in both inpatient admissions and outpatient visits will meet goal this year.

Brook reviewed the HCAHPS composites in detail and verified that patient feedback had improved from second quarter than first quarter FY2012. There is room for improvement in the composites, responsiveness of staff; cleanliness and quietness of hospital. It is expected that if the hospital maintains its current performance through May then we can close the fiscal year with achieving 5-6 composites in the 75th percentile.

Meeting the 2012 Year to Date budget is expected to be challenging. Through March, the hospital is $6.4 million behind and net income is expected to be lower than expected this quarter. The remainder of the fiscal year is expected to be extremely tight, which is somewhat influenced by the Epic Electronic Medical Record rollout in clinics and a temporary change in clinic schedules.

MUSC Health Strategic Plan Phillips reminded employees of MUSC’s alignment with the College of Medicine, MUSC Physicians and MUHA to establish the MUSC Health Strategic Plan. The plan will guide the organization’s three-year goal to be ranked among the top 25 academic medical centers in the country. It outlines seven core strategies that will help the institution reduce costs,

provide the highest quality of patient care and cutting-edge research and raise MUSC’s stature as a premier center.

Phillips reviewed what employees can do to support the plan: be informed and involved, and most importantly continue the focus on great clinical care, service and controlling cost. To read more about the plan, visit http:// academicdepartments.musc.edu/com/ clinicalaffairs/Strategic_Plan/.

Magnet update The medical center’s commitment with the Magnet designation journey continues to make progress. Magnet designation is an award for health care organizations in recognition of high standards for quality of patient care and excellence in nursing practice.

Employee Commitment Survey MUHA’s Employee Commitment Survey was conducted April 16-27 and the organization achieved a record 80 percent overall response rates compared to 72 percent in 2011. Organization level and unit level scores will be available in June.

Looking ahead q Hospital employees are invited to nominate a colleague or coworker for 2012 Employee of the Year. Nominees must demonstrate exceptional work for going above and beyond in their jobs.

Online nominations will begin June 18 via the MUHA intranet. q The medical center is preparing for an unannounced full hospital and behavior health survey visit by the

Joint Commission beginning late May through December 2012. Educational information will be available in the coming weeks to help hospital staff prepare for the survey. q The South Carolina House of Representatives and State Senate are currently reviewing two bills that may impose changes to the S.C. Retirement System. Once the bill is confirmed, the medical center will provide sessions for employees to explain changes.

Celebrating successes q Several inpatient and outpatient units were recognized for hand hygiene excellence. Inpatient: Platinum -NSICU (98.3 percent); 7West (98.3 percent); Gold – STICU (97 percent) and 2 JRU (96.3 percent); Outpatient: Platinum – HCC Phlebotomy Lab (100 percent) and Gold – Infectious Disease Clinic (96.77 percent) and OB/GYN Resident’s Clinic (95.87 percent) q MUSC Children’s Hospital became the first in the state to be certified as a Level 1 Pediatric Trauma Center; CPM HealthGrades , an online health care provider rating organization, recognized MUSC with the “Outstanding Patient Experience Award.” q 2011 Annual With Out One Fall (WOOF) Awards – Fewest injuries, NSICU and CCU; Fewest falls – MICU; and Most improved—IOP. Town hall meeting schedule The next meetings will be May 31 at 7:30 a.m., ART auditorium; 11 a.m., 2 West Amphitheater and 1 p.m., ART Auditorium; and June 1 at 10 a.m., 2 West Amphitheater.

4 THE CATALYST, June 1, 2012

Physicians collaborating to cope with drug shortages A “Such marketers s patients, we don’t think too much about where our drugs come from.

We just expect them to be available when we need them.

But what if a new, potentially lifesaving drug for your condition were not yet available for human use because its development had become bogged down because of financial or other pressures? Even worse, what if a standby drug, one long used to successfully treat someone with your condition, were suddenly not Kimberly McGhee available?

MUSC is working hard on both fronts to ensure that the drugs you need will be available. As two articles in the April/May issue of Progress Notes show, MUSC is working both to discover and develop the new drugs of tomorrow and to ensure an adequate and safe supply of today’s standby medications.

capitalize on shortages to charge exorbitant prices for drugs ...”

Frontiers

DRUG DISCOVERY Patents on drugs last only 20 years and it can take 8 to 12 years to bring a drug to market, leaving a pharmaceutical company only 8 to 12 years to commercialize the drug. In that time, it must try to recoup its initial investment, estimated to be about $1.3 billion for a new compound. With many of its “blockbuster” patents expiring, the pharmaceutical industry has become wary of investing that much time and money into the development of a novel compound that could prove to be a dead end. Instead, it has begun to collaborate more with academic medical centers and biotechnology startup companies to do the initial legwork.

MUSC is now able to perform most of the functions typically performed by a drug company, including identification of a target (a molecular or cellular entity important to the pathology of a disease that can be influenced by a drug), identification and optimization of a compound, preclinical studies of

Credit: The Partnership for Safe Medicines

This graphic shows the path of the ownership and sale of counterfeit cancer medicine. Grey marketers wash drug pedigrees through multiple sales and resales making it difficult to track a drug’s source, chain of custody and proper storage. For more information, visit www.safemedicines.org. The organization provides a free, LEADERs guide to educate health professionals how to fight for patient safety. the compound’s efficacy and safety and clinical trials in humans. The further down the development pipeline that a researcher can take a promising compound, the more “de-risked” and therefore attractive it will be to a pharmaceutical company. Because commercializing a drug is prohibitively expensive, the project is usually passed off to industry before any phase 3 trials (large multicenter trials) are undertaken.

Industry benefits from this collaboration with academia by assuming a project after some of its risk has been removed, and academic medical centers like MUSC benefit by seeing their research translated more rapidly into patient care and by recouping their research investment. And, of course, patients benefit by having access to cutting-edge treatments more quickly.

ENSURING SAFE, AMPLE SUPPLY In the best of times, the profit margin for manufacturers of generic drugs is narrow. Recent changes to Medicare reimbursement have further narrowed

or erased that margin, leaving generic manufacturers with little incentive to continue producing some drugs.

Injectable drugs, which can be more difficult and therefore expensive to manufacture because sterile conditions must be maintained, have been the most affected. These include standard-ofcare oncology, anesthetic and antiviral medications, many of which are currently in critical shortage nationwide.

Manufacturers either shut down production of such drugs to focus on more lucrative medications or dedicate only one production line to them.

Mergers between pharmaceutical companies are occurring more frequently, meaning that duplicate production lines can be shut down and overall capacity to produce the drug is decreased. Factories housing production lines for generics—sometimes the single production line for a given generic medication—are sometimes not properly maintained or updated, meaning that the shortage of a critical injectable drug is only a manufacturing hitch or bad

inspection report from the US Food and Drug Administration away.

MUSC physicians are collaborating to cope with such drug shortages. They monitor carefully the drug needs of patients and the current supply of such drugs, finding appropriate alternatives where necessary. They are also acting nationally to address drug shortages.

Michelle Hudspeth, M.D., chief of Pediatric Hematology/Oncology at MUSC’s Children’s Hospital, testified before Congress about the consequences of drug shortages for patient care and some potential underlying causes, and Heather Kokko, PharmD, director of Pharmacy Services at MUSC, helped write an expert panel recommendation on how to cope with such shortages.

That report warned against hoarding drugs, which could cause a patient in need at another hospital to go without the necessary treatment and against buying from grey marketers, who sell drugs of questionable origin and efficacy.

Such marketers capitalize on shortages to charge exorbitant prices for drugs that could be stolen, counterfeit or lacking in efficacy due to improper storage.

MUSC is working hard both to design the new, more effective drugs of tomorrow and to make sure that the drugs we depend on today are safe and available when we need them.

To read more about drug development at MUSC and other stories, visit the April/May issue of Progress Notes, available at http://www.MUSChealth. com/progressnotes.

Editor’s note: “Progress Notes” is a bimonthly publication produced by Business Development & Marketing Services and sent to all physicians licensed in South Carolina to inform them about clinical and research innovations at MUSC.

THE CATALYST, June 1, 2012 5

Meet Derrelle

Derrelle Green-Patrick Department Safety & Security How long at MUSC 4 years How are you changing what’s possible at MUSC I take my job seriously, and I don’t mind helping. I try to be as professional as I can be and get personal with people who I meet.

I try to be a positive influence.

Favorite part of being a sergeant in the Army National Guard Meeting people. When the new soldiers come in, I’m responsible for showing them the ropes and making sure they are squared away. I like doing that.

Favorite singer Patti LaBelle. We share the same birthday.

Best thing about living in Charleston Eating seafood Dream Vacation I’d love to go to Aruba.

Greatest moment of your life The birth of my children, each one. Three boys and the youngest is a girl. She makes my day when she tells me I am the best mommy in the world.

Meet Derrelle

6 THE CATALYST, June 1, 2012

Sports medicine helps athletes reach peak

BY DAWN BRAZELL Public Relations

S

ome of the athletes Michael J. Barr, DPT, trains he’d rather not meet in a dark alley. Given his job as sports medicine coordinator for MUSC Sports Medicine, that’s a good thing.

It means he and his athletic trainers are doing their jobs well, and in today’s world of sports medicine, that means going far beyond providing injury treatment and prevention. It extends into the area of peak performance and sports neurology as well.

That’s why Barr and the sport medicine’s seven athletic trainers are logging 70-plus hour workweeks and loving it, he said.

“I love dealing with athletes. I love treating them and helping them get stronger and faster and better than WATCH ever, and then getting to A VIDEO watch them play. Sports medicine is more than just http://bit.ly/MUSC the doctors and the surgeries SportsMedicine that happen. The athletic trainers are the workhorses of the group. They are the faces in the community.”

That’s a good thing.

An important community outreach they do is to provide pre-season concussion testing. Epidemiological studies have suggested an association between repeated sports concussions and late life cognitive impairment, but while this remains an area that needs more research, enough is known that these type injuries need to be taken more seriously.

Most adult patients, between 80 to 90 percent, recover from a concussion within seven to 10 days; however, there is evidence to suggest that the recovery time frame may be longer in children and adolescents. Some patients — children, adolescents, and adults — have more persistent symptoms, lasting weeks to Barr months.

Baseline testing takes some of the guesswork out of it.

MUSC Sports Medicine started providing baseline testing for the Charleston County School District last fall with plans to expand that service to private schools as well this fall. Barr said baseline testing allows MUSC sports neurologists know when an athlete, who has experienced a concussion, can safely return to competition. Historically, concussed athletes have returned too early or have been held out longer than necessary because the examination was more subjective, and there was no way of determining their cognitive

Athletic trainer Stephie Davey (background) directs drills for Academic Magnet High school students Emily Gossen, who plays soccer and Tyre Moore, who plays basketball.

level prior to the incident. Now with pre-season baseline testing, sports neurologists can use an objective measure to determine when it’s safe to return to play.

The department also offers a comprehensive list of resources for parents and coaches about concussions and when it’s safe to return to play. (Visit http:// www.muschealth.com/neurosciences/about/sports_ neurology/resources/).

“The more we know what they can do before an injury, the better assessments we can provide and the

better treatment we can provide them.”

Another new area of community outreach is the start of MUSC Sports Performance Training Camps this summer for teen athletes. There will be two sessions, June 11-28 and July 9-26, 1 to 4 p.m., for athletes ages 13 to 18. All skill levels are welcome, with the program being tailored to meet the needs of the athletes who enroll.

The sessions, which will be held at the MUSC Wellness Center, cost $180 for one session and $300 for both. Space is limited to 10 athletes per group.

Each session includes baseline performance and skills testing, customized training plans for the athlete’s sport and goals, sport specific exercises and education and nutrition and injury prevention strategies. For registration information, visit www.muschealth.com/ sportscamps or call 843-876-1890.

Barr said the program focuses on treating the whole athlete and teaching them to train smarter with sports specific drills and conditioning that have been shown to improve performance. Gone are the days of high repetitions of weights in the gym as a generic way of training, he said. That doesn’t necessarily produce the best performance results.

“We can teach the principles that will help athletes to jump higher and run faster — whatever the needs are for their sport.”

MUSC athletic trainers work with athletes ranging from local high school squads to professionals teams such as The Charleston Battery. MUSC Sports Medicine also works with a number of semi-professional teams such as the Lowcountry High Rollers, Charleston Outlaws Rugby and the newly developed Charleston Man-of-War Football team. The combination of the youth, professional and semi-professional teams in the lowcountry is what makes Charleston unique in the realm of sports, Barr said.

Trainers Lindsay Clarke and Stephanie Davey both said they love the switch in their profession to treating the whole athlete. Clarke said being able to treat the complete athlete is gratifying. “The schools and organizations we work with are fantastic. We’re there to make sure the athletes stay healthy and on the field.

Implementing the sports performance program is one more piece of the puzzle.”

Barr agreed.

The teen athletes who come to the summer performance camps won’t magically be turned into elite athletes in three weeks, but they will learn to move correctly, train smarter and fuel their bodies better.

“And those are lifelong concepts that will make them into healthy, elite athletes.”

For more information about MUSC Sports Medicine, visit http://www.muschealth.com/mski/about/sports/.

The Catalyst, June 1, 2012 7

Everyone wins at department’s weight loss contest It’s amazing what employees will do for a little extra money.

Just ask Catherine Sandifer, an accountant/fiscal analyst II with the Department of Pediatrics, who came up with the idea for her department to do a Biggest Loser contest a few months back.

“My husband told me that someone was thinking of starting a biggest loser program at his office. I thought it was a fantastic idea and started asking around the office to see if anyone was interested. The idea Susan Johnson received some mixed reviews, but once we had a real plan in place it caught on quickly.”

The first weigh in was Feb. 28, which also included an analysis with a body

Health at work

mass calculator in case anyone wanted to track that measurement as well. No stranger to tracking numbers, Sandifer conducted weekly Friday weigh-ins during a 10-week period and then notified the group. Participants agreed to weigh in weekly and pay for pounds gained.

Having to pay helped inspire people, she said. She sent out emails each week with the results, the amount in the prize fund and general dieting tools and tips.

“Some of the tips I searched were on fitness/diet sites, but for the most part people were just sharing what worked for them. I sent the group a blank copy of the spreadsheet that I was using to track our percentages so that everyone could track their own progress. As the coordinator I kept the updates and emails positive and encouraging. Among the group there was a lot of ribbing and jokes about donuts in the kitchen.

Watching the banter was a lot of fun.”

Sandifer said one of the best effects

of the competition is that it got everyone discussing weight loss and exercise.

“I think it worked well because we kept it simple, easy and positive.”

The initial prize pot was $210 and the winner took home $295.40. The group used an application on their smart phones to measure how far they walked, which they did frequently together.

The final weigh in was May 4 with a total group weight loss of 172.3 pounds.

“Everyone who finished was a winner as they had either lost weight or gained muscle.”

The results: Katie Castello won first place and received a basket full of items provided by Fresh healthy vending; Sandifer, 2nd place; Mandy Lewis, 3rd.

David Geddings was the 1st place male for most of the competition. Plans are in the works for Round 2.

Feeling motivated and up for some competition? Email emp-well@musc. edu if your department is ready to battle Sandifer and her winning team.

Katie Castello won first place in the Department of Pediatrics weight-loss contest.

Wellness Events q MUSC’s Pitch the Pack Program: Free smoking cessation program offered to MUSC employees and students. Classes, counseling and a one-month supply of medications are available to eligible participants. Enroll online at: http://ceii. muschealth.com/SCP/SCPRegistration.aspx. q MUSC Urban Farm: Work & Learn — Learn through working with the soil and seeds in the MUSC Urban Farm on Family workday Sat., June 2, 9 a.m. – 11 a.m. and Wed. June 6, noon – 1 p.m. Bring a plastic bag and take home some fresh produce. The harvest should include kale, chard, totsoi, radishes and peas. Bring water, sunscreen and wear closed toe shoes. Email musc-empwell@ musc.edu for more information and to register for this event. q Discounted state park annual passes: Ranger Jayson Sellers from Charles Towne Landing State Historic Site will be at the Ashley River Tower (ART) lobby from 11 a.m. — 1 p.m. selling park passes to employees at a 20 percent discount off the $75 price. q Farmers market: Fresh fruits and vegetables are available from local farmers from 7 a.m. to 3:30 p.m. every Friday in the Horseshoe and in the area next to ART behind Charleston Memorial Hospital.

q Worksite Screening: June 12 in 2W classroom (North Tower). This screening, valued at about $350, is available to employees with the state health plan for only $15 (covered spouses can also participate for $15). Employees and spouses without this insurance can participate for $42. The screening includes: height, weight, blood pressure and a blood draw for a blood chemistry profile, hemogram, and a blood lipid profile. To register, go to www.musc.edu/ medcenter/health1st and click “Worksite Screening.” q MUSC Employee Fitness Series:There will be a free sprint intervals class June 20 from 4:15 p.m. — 4:45 p.m. Registration is required and space is limited. Sign up today by sending your name and email to: musc-empwell@musc.edu. Please see MUSC Wellness Center Membership Desk for signin and directions to the classroom. q Mammograms: The Hollings Cancer Center will be conducting digital mammograms in its mobile van June 20, 9 a.m. to 6 p.m., behind the Clyburn Research Center off President Street. Call 792-0878 to schedule an appointment.

Contact Susan Johnson at johnsusa@musc.edu to become involved in employee wellness at MUSC. Events, speakers, classes, or any other ideas are welcome.

8 THE CATALYST, June 1, 2012

Patients protected by records exchange at hospital ERs The Carolina eHealth Alliance (CeHA) announced in April that the 11 emergency departments of all major Charleston-area hospitals are now connected through a patient health information exchange that links electronic medical records, saving critical time and reducing costs.

Karen Kriza, M.D., director of emergency services, Trident Health, said that all of the emergency departments have had instances where a patient is incapacitated and cannot discuss symptoms or medical history. “Now through the exchange, we can quickly locate key electronic portions of their medical records such as discharge summaries, lab/pathology, radiology results and medications and drug allergies. That allows us to provide effective treatment more rapidly.”

During a news conference at Roper Hospital leaders from all of the hospitals stood side by side. CeHA chairman and MUSC President Ray Greenberg, M.D., Ph.D., and David Dunlap, former CeHA chairman and Roper St. Francis Healthcare president and CEO, outlined the status of the alliance. Greenberg said East Cooper Medical Center is the newest member using the system; Naval Health Clinic, Charleston, will come online in May, and the Ralph H. Johnson VA Medical Center will follow in the near future.

Dunlap said the next step in the program is to expand CeHA to more than 875 primary/ambulatory care physicians across the Lowcountry by the end of 2012 with the overarching goal of eliminating critical delays in emergency care. “This is a connectivity of health care that has never existed, and it’s been made possible through the collaborative spirit of the local health providers.”

Thornton Kirby, president of the South Carolina Hospital Association (SCHA), applauds the early success and unity of the Alliance.

“Carolina eHealth Alliance is on the leading edge of patient care and is protecting patients by keeping them connected to a network of providers with no concern for the competition that is inherent in the health care industry,” said Kirby. “CeHA has implemented a model we hope will be followed by healthcare providers in other communities and eventually statewide.”

At the announcement, alliance members shared details from an on-going clinical study analyzing the utilization and impact of CeHA. Greenberg noted that in the first six months of the CeHA impact study, thousands of patient visits were tracked. During those visits, the clinicians using the system said that significant time was saved in 75 percent of the cases where a patient had visited more than one emergency room. “That time saved to the patient averaged about 29 minutes per case. The savings in costs to patients and to the providers annually will be in the millions of dollars. For example, almost $900,000 is

MUSC President Ray Greenberg speaks at a press conference about the importance of a patient health information exchange system among ERs.

“That time saved to the patient averaged about 29 minutes per case.”

Dr. Ray Greenberg projected to be saved in just one of the larger hospital’s ER.” East Cooper Medical Center’s CEO Jason Alexander said the data provided positive reinforcement to support the expansion of the program. “The early data indicate that overall patient wait and treatment times will be reduced by a least 15 percent for all ED patients. That is a significant improvement in patient care that helps underpin plans to expand the system to include clinics and physicians’ offices.”

To date, each of the hospital systems has supported the program with thousands of donated hours by administrative and technical staffs.

“When we first saw that our colleagues at Vanderbilt University had set up a health information exchange in Memphis, we believed that we could do the same thing here,” said Greenberg. “Thanks to multiple generous grants from The Duke Endowment, and the enthusiastic response from all of the local hospitals, we have been able to achieve a real win for the Charleston community that is sustainable.”

The list of participating CeHA emergency departments includes: q East Cooper Medical Center q Medical University of South Carolina (3 EDs)

q Roper St. Francis Healthcare (5 EDs) q Trident Health (2 EDs) q Naval Health Clinic, Charleston (May 2012) q Ralph H. Johnson VA Medical Center (Summer 2012)

THE CATALYST, June 1, 2012 9

Dr. Albert Reece speaks at the College of Medicine Dean’s Diversity Colloquium April 24 held at the Drug Discovery Building auditorium.

Leader promotes diversity, excellence in healthcare

BY CINDY ABOLE Public Relations Maternal fetal medicine specialist and University of Maryland-Baltimore School of Medicine Dean E. Albert Reece, M.D., Ph.D., stressed the importance of diversity in medicine and the potential advantages that a diverse workforce can bring to achieve economic and professional success at the College of Medicine Dean’s Diversity Colloquium.

The colloquium was held April 24 at MUSC’s Drug Discovery Building auditorium. Reece, who is the John Z. and Akiko K. Bowers Distinguished Professor and a professor in the departments of Obstetrics and Gynecology, Medicine, and Biochemistry and Molecular Biology, was the invited guest of MUSC medicine colleagues and Deborah Deas, M.D., senior associate dean for medical education, College of Medicine (COM) and chair of the college’s diversity committee.

In his keynote address, Reece defined diversity to be fundamental in nature

from its presence in human genetics to differences found in a person’s ethnicity, age and beliefs. He spoke about how diversity and excellence complement each other in producing better outcomes in medical education and the workforce.

To Reece, diversity at all levels should be seen as a catalyst to achieve excellence.

“I see diversity as a fabric of our environment. It is an enhancer to achieving an ultimate goal that can make a difference in the lives of individuals and communities as it relates to health and managing disease. Commitment, engagement, promotion and practice are qualities of successful diversity programs.”

He also gave an overview of the diversity profile at the University of Maryland’s School of Medicine and compared that with his school’s student academic and research achievement profile and shared steps and ideas that programs can take to achieve and maintain diversity in their own practice and work environment.

See DIVERSITY on page 12

10 THE CATALYST, June 1, 2012

GAME Continued from Page One these procedures to be done.

TAVR involves an artificial valve being threaded through a small incision in the leg, and then guided up to the heart through the arteries. A small inflatable balloon on the tip of the catheter places the artificial valve in place at the aortic opening, replacing the natural heart valve. The device is made from cow tissue and polyester supported by a steel frame.

Up to 1.5 million people in the U.S. suffer from aortic stenosis, a narrowing of the aortic valve, which forces the heart to work harder to pump blood and can lead to heart failure, blood clots and sudden death.

Without an aortic valve replacement, more than half of patients diagnosed with aortic stenosis would die within two years after the onset of symptoms, according to the FDA. “We’ve been performing open-heart valve replacements in patients for decades, and for those patients, the surgery can be life-changing—significantly improving and prolonging their lives,” said Ikonomidis.

“Now we can offer new hope to some of our sicker valve patients, providing them with a chance to live longer and feel better, thanks to this new procedure.”

Brawner and his wife, Francis can attest to that. His wife said her husband was facing the prospects of a motorized wheelchair, but now he’s back to all his usual activities, including helping her cook. “I was all for it because I knew he was going downhill.”

Meanwhile, in addition to his poker games, Brawner said he’s back to shopping with his wife, using the gym and just being more active in general. He decided to try the new procedure because he was so fatigued and short of breath all the time.

“I was having a hard time just getting out of bed without pushing up with my hands.

Now I can just pop up. It’s a remarkable difference.”

Dr. Frank Cuoco’s team implanted a defibrillator into patient Amy Gibson as part of the LAPTOP Study Protocol. To see a video about her procedure, visit http://tinyurl.com/7n75br6.

LAPTOP Continued from Page One the phase 3 Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy (LAPTOP-HF) trial. The St. Jude Medical-manufactured device for measuring left atrial pressure tested in this trial could change the way heart failure is managed by providing real-time management of heart failurerelated congestion.

The device helps doctors prevent the peaks and valleys in left atrial pressure by closely monitoring the subtle hemodynamic changes in the heart so that doctors can quickly adjust medication to ward off when a patient may be at risk for the congestive symptoms of too much fluid and of organ damage from too little blood flow

PACING Continued from Page One Pacing Lead is a new pacing technology developed by St. Jude Medical. It offers additional pacing options that can reduce the need for another operation to reposition a lead and offers physicians the ability to more effectively manage the individualized needs of patients with heart failure.

Robert B. Leman, M.D., implanted the Unify Quadra quadripolar pacing system to regulate and resynchronize the heartbeat of a heart failure patient December. Since then MUSC has handled six cases. “It’s a great new

to the organs.

Craig said a little prevention can go a long way, especially given that congestive symptoms are the most common cause of heart failure hospitalizations that generate a staggering $40 billion spent on heart failure management in the nation annually.

“If you can identify a fire when it starts, you have a chance to contain it - if we can keep patients’ LAP within the normal range, we can improve their quality of life and have a better chance of keeping them out of the hospital.”

The LAPTOP-HP trail has a target enrollment of about 730 patients. Craig hopes to enroll as many as 20 patients at MUSC before the study ends in 2013.

technology,” he said.

The defibrillator has a pacing lead with four electrodes, which can improve how the heart is paced, improve heart muscle function and reduce common problems that could otherwise lead to more surgeries for heart patients.

Multiple pacing configurations allow the physician to implant the lead in the most stable position without making trade-offs in electrical performance.

This includes pacing closer to the base of the left

The LAP monitoring system includes the following components: q A small, pacemaker-sized, standalone implantable LAP monitoring device, or a cardiac rhythm management device (CRT/ICD) with LAP monitoring capabilities q A lead, or thin wire, from the device to the heart, with an LAP sensor q Patient Advisor Module (PAM), a portable, wireless, handheld device that is used by the patient to check LAP status and which directs the patient to take specific medicines or make lifestyle adjustments based on the LAP measurement q DynamicRX, a software system that provides patients twice-daily feedback on their therapies, based on physicianprescribed treatment parameters.

ventricle, which recent studies associate with better patient outcomes and that may be more difficult with traditional bipolar leads. The quadripolar pacing electrodes also provide physicians more options, such as pacing around scar tissue in the heart.

Frank Cuoco, M.D., a specialist in electrophysiology who also has performed the procedure, said he’s excited about the new technology and how it may help doctors avoid common complications and maximize the clinical benefits for their heart failure patients.

THE CATALYST, June 1, 2012 11

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12 THE CATALYST, June 1, 2012

GETTING FLOCKED

Dean’s diversity speaker Dr. Albert Reece joins College of Medicine Dean Dr. Etta D. Pisano and Plastic Surgery physician Dr. Milton Armstrong following the April 24 address.

DIVERSITY

Continued from Page Nine

Earlier in the day, Reece met with COM faculty, medical students and members of the COM Diversity Committee to discuss diversity strategies.

He reminded these groups that they should be proud of their efforts and the progress that has been made and that MUSC is regarded as one of leading institutions in the country for its diversity accomplishments.

“MUSC has a strong track record in diversity education and practice.

What’s particularly impressive is the commitment of institutional leadership from top leadership to deans, senior and associate deans to faculty. It’s most impressive.”

Originally from Jamaica, West Indies, Reece received his undergraduate degree from Long Island University, medical

degree from New York University School of Medicine, doctorate in biochemistry from the University of the West Indies and an MBA degree from Temple University. An accomplished clinician and active researcher with an emphasis on diabetes in pregnancy, birth defects and prenatal diagnosis, Reece has held leadership positions at Temple University and the University of Arkansas College of Medicine before joining the University of Maryland in 2006.

On a national level, Reece was chair of the Committee on the Opportunity to Address Clinical Research and Workforce Diversity Needs – Division of Policy and Global Affairs, NRC and National Academies in 2010. And since 2007, he has served on the Academic Institute Leader’s Group for the Institute of the Advancement of Multicultural and Minority Medicine.

Physical therapy professor and division director Dr. David Morrisette was “flocked” with pink flamingoes by colleagues in efforts to raise money for the March of Dimes.

The College of Health Professions faculty and staff flocked each other enough to raise $1,400 in donations, nearly tripling the amount raised in 2011 of $510.