MUSC Catalyst 8-9-2013

August 9, 2013

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 31, No. 50

Inside Students challenged Global HealtH Grants

6

Five students and one resident each received $2,000 to support research and fieldwork in four foreign countries.

Mobile Heart DeviCe

7

Teen from Pelion became the state’s first HeartWare recipient so he can keep fishing while waiting for a transplant.

3 HEROIC funds 5 Meet Trish 9

Expecting Epic

t H e C ata ly s t online http://www. musc.edu/ catalyst

to create health apps

By Cindy ABole

plan and presentation. The program was a collaboration of the College of Nursing’s Public Relations Technology Application Center for select group of African-American high Healthful Lifestyles and MUSC’s Center for school and college computer science Innovation and Entrepreneurship. students from around the state were brought Eight computer science students from together to tap their innovative spirit and Claflin University, Vorhees College and explore the advantages and challenges of South Carolina’s Governor’s School for entrepreneurship. The effort paired Science and Mathematics participated in creativity with health care technology to the internship, which allowed them to use develop promising new patient-focused smart their computer programming experience phone applications that can improve people’s with today’s mobile phone technology to lives. create user friendly products.

The effort was part of an eight-week Additional sponsorship came from residential summer program that taught AT&T, Johnson Controls and private participants how to conduct team-based donations. product development and bring these ideas to The students, according to Tom Finnegan, market. director of the MUSC Center for Innovation MUSC’s Summer Entrepreneurial and Entrepreneurship and program coand Medical Apps Internship Program director, represented a range of ages and taught the basics of app development, experiences. entrepreneurship, project management, “We recognized how challenging it team-building and business operations using would be to bring students from different hands-on experiences, lectures, speakers backgrounds, education levels, skillsets and working in teams to develop a business and personalities together in this effort.

Eight weeks later, they have all emerged as confident and knowledgeable individuals who together made one big family.

I’m confident that everyone who leaves this program has gained something from it,” said Finnegan.

The programming curriculum was taught and led by Sachin Patel, research instructor, TACHL systems architecture and internship co-director, and Finnegan, who conducted the entrepreneurship section.

MUSC President Dr. Ray Greenberg, from left, Patel’s section focused on AT&T President of S.C. Operations Pamela Lackey and AT&T External Affairs Director Ted Creech talk the development, evaluation and commercialization of to Michelle Frazier and Adaya Sturkey.

A

GSSM graduate Michelle Frazier listens while Claflin University student Joshua Goodwin shares his impressions of the internship program. technologies relating to prevention and management of chronic disease. While Finnegan’s piece introduced students to management and entrepreneurial skills and best practices.

From the start, students were placed in teams and assigned a project to develop and integrate a mobile technology clinical app that would promote either disease prevention and management of a chronic disease affecting African-Americans.

Working with Patel and TACHL staff, the students were introduced to software and information systems that could be used with medical devices, smart phones, web-based computer assisted programs and interactive call centers to support disease prevention and management technologies.

The three teams collectively selected a diverse set of applications that related to a physical exercise and activity tracker, physician communications and medication reminder.

See Challenged on page 10

2 The CATAlysT, August 9, 2013

Waring Historical Library announces essay winners J

enny M. Luke, R.N., a master’s in history candidate at the University of Texas at Arlington, won the MUSC Waring Historical Library’s 2013 W. Curtis Worthington Jr. research paper competition in the graduate category for her paper titled “Asafetida to Aureomycin: AfricanAmerican NurseMidwives, 19301950.”

Luke Luke, who was also awarded the title of university scholar as a graduate student and was the recipient of the 2012 Wolfskill Award for Excellence in Master’s Studies in History, has an interest in the history of childbirth practices and maternity care.

First prize in the undergraduate category was awarded to John Scaringi, a senior history major at the College of Charleston. His winning paper was titled “Physicians, Paupers, and the Peninsula: The Emergence of Public Health Policy in Charleston, South Carolina.”

Scaringi, a Greenville native, plans to apply to medical school after

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 Ashley Barker, barkera@musc.edu

Scaringi

studying cardiac electrophysiology in the lab of Martin Morad, Ph.D. Both first-prize winners received $1,500, and their papers will be published in an upcoming issue of the Journal of the South Carolina

Medical Association.

The competition was named for W. Curtis Worthington Jr., M.D., the current director of the Waring Historical Library, and was established to encourage students to contribute to the history of medicine.

Papers were judged by Kurt Boughan, Ph.D., professor of history at The Citadel and a scholar in medieval medicine; Peter McCandless, Ph.D., professor emeritus in the Department of History at the College of Charleston; and Charles S. Bryan, M.D., professor emeritus at the University of South Carolina School of Medicine and former editor of the Journal of the South Carolina Medical Association.

For more information or to find out how to support the library, visit http:// waring.library.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.

Heart Health participants Tyquan Hill, Alayna Ancrum, Taiquez Lee and Tamia Ancrum get a cooking lesson from Janet Carter, outpatient dietitian and Heart Health Program manager.

Inaugural Heart Health camp deemed a success

By JAneT CArTer Heart Health Program

T

he Boeing Center for Children’s Wellness Heart Health program has been dreaming of beginning a summer camp for years.

As the pediatric weight management program at MUSC, it seemed a perfect adjunct to the program’s popular and successful offerings. This year, that dream finally came to fruition.

Though it needed to be small, due to limited space and staff, it was a success.

The camp was held twice per week for two weeks (four days total) for two sessions. The first session was for 8 to 12 year olds and the second for the 13 and older crowd.

During their time at camp, the participants were able to learn how to cook, do some gardening, listen to inspiring and educational guest speakers, build on the nutrition and exercise knowledge that they learn at Heart Health, and get in a lot of physical activity through the day.

Another important piece of the camp was group counseling sessions and the positive reinforcement of good behavior.

They earned stickers, which were “cashed in” for prizes at the end of each day, and the teens earned fake money to be redeemed for a $5 Walmart gift card.

The best part of the camp was it was free to Heart Health participants.

In order to determine the success of the camp, a pre- and post-test was administered. The tests were exactly the same questions each time, and improvement was measured based on the number of correct responses.

For the 10 participants in the 8 to 12 year-old range who attended the camp, the average improvement on the test was 21.4 percent, and for the 13 to 18 year olds, it was 25 percent.

An anonymous feedback questionnaire was given out to the parents, which revealed that “the most important improvement we could make for next year was for them to be longer.”

For more information, call Heart Health at 792-4717 or visit MUSCKids. com/Heart/Health.

The CATAlysT, August 9, 2013 3

Center receives funds, improves care for minority vets

By Cindy ABole Public Relations Charleston’s Health Equity and Rural Outreach Innovation Center received funding to conduct research on health disparities and access to care for minority veterans.

In May, Charleston’s Ralph H. Johnson Veterans Affairs Medical Center was named among 19 nationally funded Veteran Health Administration Centers of Innovation that have committed to promote research and facilitate partnerships that can impact health services research among veterans.

Charleston’s HEROIC program focuses on three areas – equity, access and rural health.

The research will cover a range Egede of medical and psychiatric outcomes targeting both the patient and provider.

Twenty-two core investigators, who share appointments at both MUSC and the VA medical center, will explore factors that influence the medical

care veterans receive including geography, finances, culture, permanent versus temporary location, and other services.

HEROIC program director Leonard Egede, M.D., who is an Allan Johnson Endowed Chair and Professor of Medicine in addition to being the director of the Center for Health Disparities Research, said the program will improve access to care using telehealth technologies and products.

“One of the greatest strengths of Charleston’s HEROIC is the dynamic team of young researchers who are passionate about their work and dedicated to eliminating disparities. As a result, we are a diverse group across expertise, race/ethnicity and gender, leading to our ability to develop innovative ideas with relevance to the field. Our diversity of disciplines and integration with clinical operations provides balance and insight, and creates an environment where we can investigate and impact real world problems,” said Egede.

The team will also be examining web-based, in-home video-conferencing and smartphone applications as a way of accessing patients.

Kenneth J. Ruggiero, Ph.D., associate professor in the Department of Psychiatry & Behavioral Sciences and HEROIC associate director, is equally supportive of this effort.

vHa Center of innovation The Health Equity and Rural Outreach Innovation Center – Leonard Egede, M.D., director (internal medicine); Kenneth Ruggiero, Ph.D., associate director (psychiatry); Ron Acierno, Ph.D. (psychiatry); Neal Axon, M.D. (internal medicine); Libby Dismuke, Ph.D. (internal medicine); Mulugeta Gebregziabher, Ph.D. (biostatistics & epidemiology); Anouk Grubaugh, Ph.D. (psychiatry); Michael Horner, Ph.D. (psychiatry); Chanita Hughes-Halbert, Ph.D. (psychiatry); Kelly Hunt, Ph.D. (biostatistics); Flo Hutchison M.D. (medicine); Rebecca Knapp, Ph.D. (biostatistics); Cheryl Lynch, M.D. (internal medicine); Kathy Magruder, Ph.D. (psychiatry); Charlene Pope, Ph.D. (nursing); Sandip Prasad, M.D. (urology); Shakaib Rehman, M.D. (internal medicine); Liz Santa Ana, Ph.D. (psychiatry); Lisa Sternke, Ph.D. (nursing); Nichole Tanner, M.D. (pulmonary); Peter Tuerk, Ph.D. (psychiatry); and Janet York, Ph.D. (nursing) “This is a tremendous opportunity for us to continue to move the health disparities field forward. Our Center

See Vets on page 8

4 The CATAlysT, August 9, 2013

MUSC medical center communications corner Physician engagement survey results now available n May, the medical center’s physicians were asked to complete the annual Iwithphysician engagement survey. In an effort to improve overall engagement our employees and physicians, we are paying closer attention this year

2013 results MOST IMPROVEMENT (Compared to 2012 survey)

2013

2012

to our survey results and are using the results to drive changes within the organization and improve alignment and engagement of our physicians.

5. Patient care between shifts is adequate at this hospital.

3.76

+.09

41. I am satisfied with the timeliness of obtaining results and/or key information from radiology services.

4.11

+.08

We are examining the relationship between employee engagement, physician engagement and key patient outcomes to assess how engagement pertains to excellence in care.

42. Overall, I am satisfied with the performance of radiology services.

4.08

+.06

45. I am satisfied with the efficiency of patient flow in my clinic.

2.97

+.05

50. I am satisfied with the teamwork demonstrated between the operating room services nursing staff and technical staff.

3.82

+.05

GREATEST DECLINE (Compared to 2012 survey)

2013

2012

30. This hospital treats physicians with respect.

3.17

-.33

29. I have adequate input into decisions that affect my medical practice.

2.96

-.29

47. I am satisfied with the degree of input I have with my clinic schedule.

3.42

-.27

49. The amount of job stress I feel is reasonable.

3.30

-.25

58. I am satisfied with the amount of time I can spend with my patients.

3.76

-.21

17. I have opportunities to learn and grow at this hospital.

3.88

-.21

The leadership team is committed to listening carefully to what our physicians have told us and to use the results of this survey to enact plans to respond to the issues identified.

Please watch for updates on plans and activities in future communications.

response rATe The physician engagement survey was sent to 815 physicians; 339 completed the survey, giving an overall response rate of 42 percent.

Response rates above 30 percent are considered statistically valid, and all but one of the departments had a 30 percent or above response rate.

Though the results give a statistically valid picture of the physician engagement, MUSC will continue to strive for 100 percent participation in order to give leaders a more complete understanding of key issues.

Response Rate

# of Respondents

Anesthesiology

28%

17

Dermatology

62%

8

Family Medicine

36%

9

Medicine

36%

82

Neurosciences

38%

18

Obstetrics & Gynecology Services

50%

19

Ophthalmology

38%

8

Oral & Maxillofacial Surgery

43%

3

Orthopaedic Surgery

56%

9

Otolaryngology

46%

11

Pathology & Lab. Medicine

59%

17

Pediatrics

43%

55

Psychiatry

35%

18

Radiation Oncology

50%

3

Radiology

50%

23

Surgery

56%

34

Urology

36%

5

The CATAlysT, August 9, 2013 5

MEET TRISH

Patricia “Trish” Totaro, R.N. Department Surgical Services, main OR educator How you are changing what’s possible at MUSC I am currently very dedicated to improving surgical safety. I am collaborating with various other departments and the main OR to facilitate better communication and, as a result, provide safer surgical care.

How long at MUSC I started at MUSC in January 2010.

First thing you notice about people First I notice the eyes and then a person’s smile. Working 33 years in the operating room with everyone wearing a mask may have influenced that.

What do you do on rainy days?

I sew operating room hats, and I cook soup.

What music is in your player?

The Clash, London Calling Children and pets I have three children – Jessica, an OB anesthesiologist working in Boston; Justin, an MUSC research assistant and medical student; and Jared, who starts at the College of Charleston this fall. We have three cats – Shadow, Skitty and (bad) Elvis.

6 The CATAlysT, August 9, 2013

Grant supports global health research, fieldwork

By BilAn WilliAms Public Relations

T

he MUSC Center for Global Health awarded five students and one resident with $2,000 each to support global health research and fieldwork projects this year in four countries.

The Trainee Global Health Travel Grant Program was established to give students and trainees the opportunity to help enhance their clinical skills in low- or middle-income countries. This is the first year the Center for Global Health has administered the travel grant program.

The recipients were Cameron Bell, Catherine Foster, Ruwan Ratnayake and Sara Winn of the College of Medicine, Geoff Bloomquist of the College of Dental Medicine, Sarah Logan of the College of Graduate Studies and Catherine Foster,

a pediatric resident from the College of Medicine.

Kathleen Ellis, the director of operations for the Center of Global Health, said MUSC is only one of many universities emphasizing the importance of receiving global experience.

“Most of the top academic medical centers and research universities in the United States have put global health at the forefront and have become dedicated to global health,” said Ellis.

Each year more students become involved in international health care.

Nationally, 30 percent of all medical students go overseas at some time during their medical education, and those numbers continue to grow.

Recent Association of American Medical College data revealed that more than 65 percent of incoming medical students have a strong desire to pursue global

Dr. Cindy Swenson, from left, joins Dr. Sarah Logan, Chief Powerful (with the Okurase village), Dr. Eve Spratt, Logan Roof, Cameron Bell, Kim Lewis and Laura Fields. The MUSC Center for Global Health awarded five students and one resident with $2,000 each to support global health research.

learning opportunities.

MUSC too recognized the significance of giving students the opportunity to expand their skills by traveling abroad, which is why the Center for Global Health created the grants.

“There’s a huge interest here on campus, and fieldwork can be life-changing experiences for students who undertake them,” said Ellis. “Students who go overseas gain a deeper understanding of public health and return with a much greater understanding of not only the populations they are serving, but also the challenges involved in limited resources.”

Winn said she hopes to continue doing global health trips later in her career, and the experience from the grant just furthers the ambition.

“It’s difficult for students who are already living off loans to attend trips like these,” Winn said. “Having the Center for Global Health provide the trainee travel grant is fantastic.”

The application process includes a two-page proposal depicting the applicants’ objectives, the activities they plan on engaging in, their background and experience, as well as a timeline showing how they plan on accomplishing their goals. Out of 17 applicants, Ellis said six were chosen.

“I went to China and Cambodia on medical trips the summer after my first year, and I wish I had the chance to apply at that time too,” said Winn.

MeetinG tHe objeCtives Using her grant to travel to a rural village called Okurase located in Ghana, Logan

Sara Winn holds a young Haitian child as he is tended to by Dr. Terry Dixon, assistant professor in Pediatrics Infectious Disease. participated in an annual Village Health Outreach event where medical professionals and volunteers from the states collaborated with local Ghanaian leaders to provide health care services to members of the Okurase community who present a host of medical concerns.

“My objectives were to demonstrate an awareness of the ethical issues involved in crosscultural health care delivery by developing a compassionate relationship with members of the village and those from the states,” she said.

Logan traveled with her 16-year-old son who was diagnosed with autism at the age of three.

“We were told he would never be mainstreamed. Today, he is thriving at a nice private school

and enrolled in several AP classes,” she said.

Logan’s son contributed to the trip by creating a network to facilitate on-site data collection by wirelessly transferring data to the main computer.

“He spent weeks before the trip writing the code, beta testing the data entry process, and ensured it would work on any device with a web browser,” Logan said. “It doesn’t require any Internet, just a solar battery to keep it charged since there is no electricity in the village.”

Winn used her grant money to travel to Haiti with the student group MUSC Service Learners International, which she said is made up of a group of students who want to participate in student-driven global health trips.

See Grant on page 8

The CATAlysT, August 9, 2013 7

Teen receives state’s first mobile HeartWare device

By Ashley BArker Public Relations

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teen from Pelion became South Carolina’s first recipient of a new FDA-approved device called HeartWare®.

Jake Paul, 16, was diagnosed in November 2012 with dilated cardiomyopathy, a condition when a weakened heart doesn’t pump blood to the rest of the body properly.

By April, he began experiencing shortness of breath, and he survived a surgery to implant a defibrillator to avoid sudden cardiac arrest.

The self-proclaimed outdoorsman, who lost more than 20 pounds in the hospital and was admitted to MUSC four times, also had kidney and liver failure, which resulted in an emergency surgery to implant a CentriMag temporary left ventricular assist device.

Three days later, he was finally fit enough to have the HeartWare device put into his chest by a team led by cardiothoracic surgeon Minoo Kavarana, M.D. While waiting for a heart transplant, the HeartWare System will keep the blood pumping throughout Jake’s body.

A pump was put into Jake’s chest to push blood from the left side of the heart to the aorta, which carries the blood to other parts of his body.

A line connected to the device passes through the skin in Jake’s abdomen and is powered by two batteries.

Jake carries the batteries and a small computer, only Kavarana weighing a little more than two pounds, in a case around his waist.

He’s able to leave the hospital, although he doesn’t stray too far in case of an emergency, and is allowed to do some of his favorite activities, like fishing.

Larenda Paul, Jake’s mother, said that when her son was first admitted to the children’s hospital, she rarely could afford to pay for a hotel room. She ended up sleeping many nights in her truck and tried to nap as often as possible in the ICU where Jake stayed.

She did that for two weeks until the Ronald McDonald House, just a block away on the corner of Calhoun and Gadsden streets, accepted her application and had an open room. Jake joined her at the RMH just a few weeks ago and the pair still makes regular visits to see Kavarana and Andrew J. Savage, M.D., a heart failure cardiologist in the Department of Pediatrics.

Jake Paul fishes from the Mount Pleasant Pier. The 16-year-old from Pelion chose to have the HeartWare device implanted rather than going with the Berlin Heart so that he could continue to live a normal life outside of the hospital while he waits for a heart transplant. Photo provided.

“Thank God for MUSC and for the Ronald McDonald House,” she said. “MUSC is remarkable.

I’m amazed that all of the doctors and nurses talk to each other and know what’s going on.”

Kavarana said MUSC took a leap of faith by purchasing the HeartWare System, which is much more expensive than the Berlin Heart, an older device that helps the heart pump blood.

HeartWare’s advantage over the Berlin Heart is its mobility. Berlin Heart patients are required to stay in the hospital under constant supervision while HeartWare patients are able to live relatively normal lives outside of the hospital.

“The HeartWare device is a win-win on many different fronts,” Kavarana said. “It’s an expensive device but it’s a huge cost saving to the hospital by not having the patient in the ICU for six months. Jake is now a functional young man while he waits for his new heart.”

Being the first hospital in the state to utilize the HeartWare device speaks to the commitment MUSC has to its community, according to Kavarana.

“It opens doors to other patients who need it,” he said. “I’d like to see it used more often in the future.”

Larenda Paul is focusing now on making sure Jake gains more weight and stays healthy.

“Jake spent 53 days in the hospital. He couldn’t eat solid foods for two months, but he’s getting back to normal and healthier now,” she said. “Only God knows when a heart with the right blood type will come in, but we want to be ready for it.”

Jake Paul eats lunch with his friend Turrell Thompson, 17, in the dining area of the Ronald McDonald House. Jake and his mother, Larenda, have been staying at the RMH while he waits for a heart and receives treatment at MUSC.

8 The CATAlysT, August 9, 2013

GrAnT

Continued from Page Six

“We provide MUSC students with a unique opportunity of planning and executing an international service trip,” Winn said. “We work hard all year round to put our trip together. From fundraising to planning our clinic schedule and booking flights, our students make it happen.”

As curriculum chair within her group, Winn created a brief curriculum before the trip citing diseases they may encounter, pre-trip information and resources they may need.

“We had several curriculum meetings with guest MUSC faculty members who spoke about their time working with international medicine and/or Haiti in particular,” Winn said. “I think it’s valuable for us to hear how attending physicians have stayed involved in global work at various stages of their career.”

Another of Winn’s objectives was to initiate a nightly informal conference known as the “evening report” where students and attending physicians would present and discuss some of the cases from clinic.

“This is a format of teaching that is commonly utilized in residency and academic medicine in general,” said Winn. “It was a great addition to the debriefings we had in the evenings, and cases often led us to discuss various other medical topics.”

Having the opportunity to do some overseas learning is believed to be extremely beneficial for students and trainees. Upon returning, most have learned skills and immeasurable experience valuable for their chosen field of medicine.

“Students often describe their global health

“Students often describe their global health experience as a defining moment in their training. That’s why we’re making it a priority to establish this type of grant program.”

Kathleen Ellis

College of Medicine student and a recipient of a travel grant from the Center for Global Health, Sara Winn, takes the temperature of a child while serving overseas. experience as a defining moment in their training,” said Ellis. “That’s why we’re making it a priority to establish this type of grant program.”

“Someone once told me when there is divine chaos, embrace it and move forward,” said Logan. “Until one

witnesses those conditions, it seems hard to imagine.

But it gets into your heart, draws you back and makes one realize how lucky we are.”

Logan said the trip was a huge growing experience for her. “It’s important to communicate when working in an interdisciplinary environment in unfamiliar places with unfamiliar people.”

According to statistics, it is not uncommon for students to feel that way. It has been found that students who go to developing countries and do some type of work are more likely to return and serve in underserved populations in their own country.

“The grant encourages students and residents to consider international rotations that they otherwise couldn’t afford,” said Winn. “In addition, the grant is structured so students and residents come back and share their work with the MUSC community.”

Study finds disparities in bariatric surgery

VeTs

national study led by MUSC’s Arch G. Mainous III, Ph.D., Department of Family Medicine, examined trends of bariatric adult surgery focusing on race and access to health care.

The study found that despite a higher percentage of eligibility for blacks to receive surgeries, eligible whites were more likely to receive them.

Mainous and his colleagues analyzed subjects eligible for bariatric surgery in the National Hospital Discharge Survey and the National Health and Nutrition Examination Survey in the period of 1999-2010 for black and white patients aged 20 to 64 years.

A higher percentage of black than white women (22 vs. 12

of Innovation team is passionate about this work and has been successful in developing new ways to bring high quality care to veterans,” said Ruggiero.

A key role of COIN is to facilitate productive partnerships between researchers and those who validate findings.

HEROIC’s research team will test and share interventions, improve methodologies for analyzing data, develop an equity report card using VHA administrative data and refine metrics used to measure access to care.

VA partners in this project include the Offices of Rural Health, Health Equity, Informatics and Analytics, Health Equity and other federal and national organizations.

HEROIC also benefits from a strong partnership with MUSC through the Center for Health Disparities Research, Department of Medicine, Division of Biostatistics and Epidemiology, College of Nursing, College of Health Professions and the Clinical and Translational Science Awards program.

A

percent) and of black than white men (11 vs. 8 percent) were eligible for bariatric surgery, but twice as many white men and women received the surgery.

The study also found that 70 percent of white men and women had private health insurance compared to 50 percent of black men and women.

“Bariatric surgery has been shown to be an effective treatment for moderate to clinically severe obesity, and, more importantly, it has the benefit of successfully resolving or improving the important chronic conditions of diabetes and hypertension in the majority of cases,” Mainous said. “Bariatric surgery can improve quality of life, decrease the risk of premature death,

and lower disability and health care costs. Consequently, this health disparity in treatment has implications for health care costs and morbidity due to common diseases like diabetes and hypertension, conditions that are highly prevalent in the AfricanAmerican community.”

Given these estimates and study results, Mainous and his colleagues suggested the following summary of potential causes of this disparity, including: access-tocare issues due to differences in insurance coverage; persistent lack of trust by blacks of physicians; differences in how blacks and whites assess surgical risks; and some cultural evidence of acceptance of obesity in black populations.

Continued from Page Three

The CATAlysT, August 9, 2013 9

Labor & Delivery Unit eagerly expecting Epic By meGAn Fink Epic Program A day in the life of a labor and delivery nurse currently consists of documenting in a mix of electronic and paper charts in four different systems. This data entry into fragmented systems that don’t talk to each other is “painful,” according to labor and delivery/ antepartum nurse manager Karen Stephenson, R.N. Stephenson looks forward to the seamless integration of all her systems into Epic, ultimately having one chart for each patient.

A staff nurse for more than 20 years before entering management, Stephenson has seen the evolution of technology firsthand.

She recalls hand delivered and telephoned orders.

There also once was only one computer per nursing station, which was not conducive to bedside charting.

Several systems have followed, but the current charting process is still complex and confusing.

“The current system just doesn’t work for us,” said Stephenson. “There are so many logins and software systems to document in that we feel sabotaged by the current process. We can’t possibly touch all the systems in one day as there is always something else to do. Epic has the capability to tighten up the process. We have lots of staff buy in now.”

Benefits of Epic for Women’s Care Services include real-time charting, documentation at the bedside, simplified recording, and better reporting elements translating into improved patient care and safety.

Currently, it takes hours for a Labor and Delivery Unit nurse to extract discrete patient data by hand to show metrics such as their decision to incision times, elective delivery rates before 39 weeks, thresholds to pain, and breastfeeding measures.

Seeing the benefits of having an integrated electronic health record, Stephenson and her staff are on the front line gearing up for Epic Enterprise go-live July 1, 2014.

“It’s the ultimate package if populated well, so we have to help build it,” she said. “If you don’t get involved, you can’t complain after the fact. This is the time to make changes, and have the analysts customize the system so things are logical to your area.”

Assisting the Epic analysts who are putting the

Go-live for integrated electronic health record planned for 2014

Labor and Delivery/Antepartum nurse manager Karen Stephenson and Women’s Care Services nurse Taiwana Richardson spend some time reviewing their current workflow. finishing touches on the Labor and Delivery Unit application for Enterprise go-live, Stephenson’s team is working hard on the front end so it pays off for them on the backend. They are sharing their input on workflows affecting their areas to make sure each line item flows into Epic as it should, they are participating in clinical preparedness committees and becoming “SuperUsers” or advanced users of Epic.

In addition to participation, Stephenson is regularly communicating to ensure a successful project implementation for her units. She encourages communication in every direction, on every level. Some tactics Stephenson uses to keep her staff informed on Epic news include regular staff meetings, emails and a newsletter-like document pushed out to staff on a consistent basis.

“We need to see messages multiple times

epiC appliCations for WoMen’s serviCes • “Stork” (Labor and Delivery application) • “Ambulatory” – (Outpatient care application — already live with Epic) • “Willow” (Pharmacy application used for antepartum medications) • “OpTime/Anesthesia” (Operating room application used for C-sections) • “Cadence” (Scheduling application) • “Orders” (CPOE application used for physician orders) • “ClinDoc” (Clinical documentation application)

for it to be effective,” Stephenson said. “We need to touch it several times before it’s absorbed.”

There is still time for all departments, divisions and units to get involved and ready for Epic.

The Epic Enterprise Program encourages all employees and future system users to become engaged, go to supervisors with questions and join a SuperUser program.

For information, visit the Epic intranet site at mcintranet.musc.edu/epic/index.htm. Click on Training Resources on the left menu bar and select SuperUser Program from the same menu area.

There you’ll find what’s expected and a tool box for SuperUsers.

10 The CATAlysT, August 9, 2013

ChAllenGed

Continued from Page One

“The final projects were easy for us to advise as they were all related to consumers and health care,” said Patel.

“We pretty much said to them, ‘Here’s a concept, now figure it out.’ Each of the teams worked together in finalizing their project ideas. We assisted by helping them identify their customer base and find out what they would want a phone app to do to meet their health needs as guided by practice guidelines and build a business plan around that. Once again the students came through with their own successes.”

Voorhees College computer science junior Jennifer P. Jackson first heard about the program through Voorhees’ Center of Excellence. She learned the summer internship provided a stipend and an opportunity to learn programming and product development using medical apps. The internship’s entrepreneurial curriculum was a bonus as Jackson is already a small business owner of a music DJ company.

“After completing this program, I have a better idea of what I want to do with my career. Computer science is a broad field and with this hands-on experience, I feel I now know what I need to do,” Jackson said.

Creating new friendships and collaborating with others also attracted Orangeburg native Michelle Frazier. A 2013 GSSM graduate, Frazier is headed to Clemson University in the fall.

For her team’s project, Frazier worked with Markea Sheppard and Dominic Bett, both Claflin University students majoring in computer science. The team developed a smartphone fitness tracking app.

“I like hanging out with smarter people than myself. You learn more.

Everyone was nice and respectful. We treated each other as equals in every way,” said Frazier. “Being here with this program has made me upgrade my life game plan. If I really tried, I can work toward being an entrepreneur. I want to do more things in life. In this program we listened to successful entrepreneurs tell their story, and it helped me realize what anyone can do with a good idea.

As for this experience, I definitely would recommend it to anyone.”

Discussions for this project began

as early as 2010 under the guidance of MUSC President Ray Greenberg, M.D., Ph.D., as a way to inspire and attract minorities, especially African-Americans, to consider careers in technology that support or contribute to the Tri-county’s growth in the areas of research, science and innovation.

South Carolina’s African-American unemployment rate was 1.5 times higher than the overall state rate during the third quarter of 2011, according to an Economic Policy Institute study.

Greenberg and local leaders are supportive to training and preparing minority programmers, developers and entrepreneurs to use new technologies and discoveries that can positively impact health care for this population in the future.

With good overall results, both Finnegan and Patel are pleased to have developed an internship that now can be offered to a variety of other students including medical and graduate students.

They both agree that the rewards as coleaders of the program have far exceeded their expectations.

“This was truly a rewarding experience.

It was fun to see how each developed through this process. It shows that with young people, one can never foresee their potential until it happens,” Patel said.

Finnegan summed up the risk and

rewards best.

“There was an element of some risk in this project as this was an entirely new experience for the internship students, our team and support people at MUSC,” he said. “This is the type of thinking and mindset that MUSC’s Center for Innovation and Entrepreneurship is trying to introduce and support – the need to convert ideas to into tangible projects.”

Summer Entrepreneurship and Medical Apps Program Interns

Dominic Bett, Claflin University; Michelle Frazier, GSSM; Joshua Goodwin, Claflin; Kaynisha Harris, Claflin; Jennifer Jackson, Voorhees College, Markea Sheppard, GSSM; Adaya Sturkey, GSSM, and Christian White, GSSM

Voorhees College’s Jennifer P. Jackson studies computer science and was among eight students involved in the programming, product development and commercialization of a medical app idea.

MUSC President Dr. Ray Greenberg joins sponsors from AT&T, internship instructors Sachin Patel and Tom Finnegan and graduates of the first MUSC Summer Entrepreneurial and Medical Apps Internship Program.

The CATAlysT, August 9, 2013 11

Furniture

Volunteers needed Medical volunteers

NEW MATTRESS SET Queen are needed to help with P-Top Matt set $150 new/war- SC Mission 2013. This ranty, can deliver! call 900two-day event, Aug. 23 0233

and 24, will provide free health care services including medical and eye care to adults in the community who are uninsured or underserved. Sign up at scha.org/sc–mission.

12 The CATAlysT, August 9, 2013