May/June 2022 Arkansas Medical News

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Pharmacogenomics Revolutionizing Disease Management, Prevention in Arkansas


Precision medicine advances mean more options for more diagnoses By MELANIE KILGORE-HILL

Cancer Nanomedicine: Potential for Improved Outcomes, Reduced Side Effects and Increased Efficacy UAMS researcher Robert J. Griffin on the biology of experimental therapeutics and targeted radiation strategies for solid tumors.

Pharmacogenomics is a game changer in the field of precision medicine, and now patients and providers in Arkansas are reaping the life-changing benefits of the study between DNA and drug response.

More precision

“Precision medicine’s aim to deliver precise healthcare, and pharmacogenomics, which is really a study of both pharmacology and genomics, Feliciano “Pele” Yu, MD Bradley Schaefer, MD Sam Makhoul, MD deals with the understanding of how drugs and genes are interrelated - so we can treat patients better,” explained clinical informatics specialist Feof Arkansas Children’s pharmacogenomics program with his inforliciano “Pele” Yu, MD, a pediatrician and Chief Medical Information matics expertise. In 2018, the Pediatric Precision Medicine program Officer at Arkansas Children’s Hospital and professor of Pediatrics, was founded by Bradley Schaefer, MD, Professor of Genetics and Biomedical Informatics and Public Health at the University of ArkanPediatrics at UAMS. The program was born from a generous philsas for Medical Sciences (UAMS). Yu was instrumental in the launch anthropic grant supporting precision medicine through the Arkansas (CONTINUED ON PAGE 4)

Robert J. Griffin, PhD, a professor of radiation and cancer biology in the University of Arkansas for Medical Sciences (UAMS) Department of Radiation Oncology, finds this an exciting time to be involved in nanomedicine, the use of extremely small particles to deliver nanoliposomes and different types of nanomedicines directly to tumor cells and tumor tissue to avoid damage from radiation, chemotherapy or thermal treatment in healthy cells and tissues.

New Clinical Guidance in Neuropalliative Care Training is needed for serious illness communication By LYNNE JETER The task: to support neurological patients by focusing on improving their quality of life through symptom control, both physical and psychological, instead of the diagnosis and treatment of their underlying diseases. Updated guidance may be found in a new position paper, “Clinical Guidance in Palliative Care,” developed by a joint

Article on page 3

Please find more local Arkansas healthcare news beginning on page 7. ARKANSAS




committee of the American Academy of Neurology (AAN), American Neurological Association and Child Neurology Society, published March 8 in Neurology. It’s a longawaited revision to the AAN 1996 position statement. The revised position statement is “welltimed,” said Kate T. Brizzi, MD, a neurologist at Massachusetts General Hospital with hospice and palliative care expertise. (CONTINUED ON PAGE 5)

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Cancer Nanomedicine: Potential for Improved Outcomes, Reduced Side Effects and Increased Efficacy

UAMS researcher Robert J. Griffin on the biology of experimental therapeutics and targeted radiation strategies for solid tumors By BECKY GILLETTE

Robert J. Griffin, PhD, a professor of radiation and cancer biology in the University of Arkansas for Medical Sciences (UAMS) Department of Radiation Oncology, finds this an exciting time to be involved in nanomedicine, the use of extremely small particles to deliver nanoliposomes and different types of nanomedicines directly to tumor cells and tumor tissue to avoid damage from radiation, chemotherapy or thermal treatment in healthy cells and tissues. Griffin has authored nearly 150 peer-reviewed articles on the biology of experimental therapeutics and targeted radiation strategies for solid tumors. Griffin is currently teaming up with a small startup company, Rejuvenix Technologies, LLC, at the UAMS business incubator in Little Rock to help develop patents for radiation-triggered drug release from lipid-based carriers for cancer. A $383,213 National Cancer Institute (NCI) Small Business Innovation Research Phase I contract was awarded to develop encapsulated radiation-triggered liposomes intended to achieve safer, controlled delivery of chemotherapy. The technology has the potential to improve clinical outcomes for cancer patients by reducing side effects while increasing effectiveness of certain drugs that would be part of a normal mixture of various chemotherapy agents, depending on the cancer type and stage. “It is exciting to be involved with radiation drug-release nanoparticle therapy,” Griffin said. “Messenger RNA Covid vaccines are lipid-based nanoparticles. We have really got acceptance with our lipid-based drug-delivery nanoparticles.” As part of his research effort and a business development program offered by the NCI, Griffin talked to over 100 experts in the oncology arena and found they are desperate to deliver chemotherapies that are already FDA approved more selectively and effectively in a variety of contexts.” “When patients are flooded with chemotherapy, they are indiscriminately being exposed to high drug levels all over the body and can have a rough go of it,” Griffin said. “The chemotherapy works to kill cancer cells in the primary tumor or those that might be spread arkansasmedicalnews


to other organs--but comes at a termal tissue at a minimum. The ultimate rible cost. Everything seems advanced goal would be to develop a new stanthese days, but we are still using many dard of care for surgery and radiation chemotherapy treatments that are detherapy based on that approach which, cades old. UAMS after being tested and and Rejuvenix have validated in clinical interesting potential trials, would replace to help oncologists do what is being done a better job helping now. Everyone would patients. After talkbenefit from this new ing to the physicians approved standard.” administering these It can take a dedrugs, we learned a cade or longer to lot. A new approach develop a new drug administering one or therapy and put it on more of the drugs that the market. Griffin are part of the thersaid Rejuvenix may apy cocktail could be be able to get approval very promising. You faster since they are are basically finding using FDA-approved Robert J. Griffin, PhD out the market for the drugs already being concept and figuring used in cancer patients out what questions about which drugs and lipids that are also widely accepted. need to be answered.” “There may be a way to fast track They had good results from phase Rejuvenix,” Griffin said. “The timeline one of the NCI study, and have been inrelated to this company effort might not vited to submit a phase two application. be far away. It is nothing that extreme. The next step after that is clinical trials. We are hoping this could be approved “You can only get so far with basic for phase one safety trials in three to research, but then it needs a massive fifive years. When all hands are on deck nancial boost to get into clinical trials and financing is in place, it can happen with patients,” Griffin said. “The hope quickly.” is that then a larger pharmaceutical His entire radiation oncology decompany would join the effort because partment is moving to a new facility that they have the major resources to put includes a proton therapy center where together the larger, randomized clinical charged particle beams can be delivtrials needed to validate these things.” ered precisely to tumor volumes. This Griffin has more than 25 years of is a cooperative effort between UAMS, experience as a radiation biologist, and Baptist Health, Arkansas Children’s his published research articles include Hospital and Proton International. those on experimental therapeutics and We generally think of radiation as targeted radiation strategies for solid being bad but, being trained in radiatumors, focusing on targeted delivery tion biology, Griffin is mostly interested to the tumor vasculature and improvein using novel features of different types ment of responses to radiation, thermal of radiant energy to our advantage to treatment, or chemotherapy. Some of deliver other drugs to cancer cells, and his most notable recent publications are exploit what happens when tumors are on using gold-cytokine nanoparticles to also treated with other energy modalitarget the tumor microenvironment ties such as ultrasound and lasers to which can be used as a light-activated heat and destroy the tumor. nanodrug. “A lot of our treatment modalities “A lot of what we are doing inwhen applied to a tumor change the tuvolves not only nanoparticles, but also mor’s gene expression,” he said. “That antibodies and peptides that preferencreates new proteins to be expressed tially bind to tumor cells or tumor blood and those can be targeted by antibodies vessels,” Griffin said. “We selectively or peptides (small proteins).” deliver toxic drugs, so we have a differGriffin has also done considerable ential between the tumor and normal work in the area of anti-angiogenic/ tissues you don’t want targeted. There vascular biology of myeloma and breast is a synergistic action to get maximum cancer metastasis models and the develtumor kill while keeping effects to noropment of PET imaging or photoacous-

tic detection of targeted drug delivery to these cancers. Griffin graduated from St. Olaf college with a B.A. in biology and music in 1991, and then continued on to receive his PhD in Biophysical Sciences from the University of Minnesota in 1998. He has served as president and program chair for the Society for Thermal Medicine, which has an emphasis on nanotechnology for thermal treatments in a variety of modalities. He is also an associate senior editor for Technology in Cancer Research and Treatment and as associate editor for the International Journal of Radiation Oncology, Biology and Physics, as well as the journal Radiation Research. Griffin’s first job out of college was in a radiation biology lab. He was attracted to radiation oncology because it is multidisciplinary and applied. It takes knowledge of all three: biology, physics and medicine. Currently UAMS is working to get National Cancer Center designation, which would help attract more research dollars and enhance the reputation of UAMS. “We hope this startup technology to deliver drugs more effectively will be a part of that story as a nationallyknown NCI designated, comprehensive Cancer Center,” Griffin said. Griffin says their 16 years in Arkansas have been great for him and his family. He grew up in Wisconsin where he enjoyed fishing and hunting, and has found fertile territory to pursue those hobbies in Arkansas. He and his wife, Amy Griffin, a teacher at Little Rock Christian Academy, have four children, one in junior high, one in high school, one in college and one college graduate. “We spend as much time as we can on Greers Ferry fishing, camping and everything else,” Griffin said. “That has been our playground so far.”

For more information, visit: Rejuvenix Technologies Wins NIH SBIR Award to Improve Chemotherapy Treatment UAMS, Arkansas Children’s, Baptist Health and Proton International Sign Letter of Intent to Build State’s First Proton Treatment Center




Pharmacogenomics Revolutionizing Disease Management, Prevention in Arkansas Children’s Research Institute. Schaefer also runs a precision medicine consultation service at his Arkansas Children’s Northwest clinic.

Hospital is able to link those things in a meaningful way so physicians can get the best information possible.”

Leveraging data

Sam Makhoul, MD, medical director of clinical research at Little Rockbased CARTI, said EHR connectivity is key for continued growth of pharmacogenomics. An independent, not-forprofit cancer care provider, CARTI treats more than 35,000 patients each year from every county in Arkansas, and across the country. “This science will take us a long distance if handled well,” Makhoul said of pharmacogenomics. “We must implement and maintain well connected EHRs and genomics platforms, both locally and nationally. As we learn more about the profile of disease and which patients are at high risk, that will guide us dramatically as we collect more data in the same platform.” Makhoul also stressed importance of patients being allowed full participation in the process including access to their EHR, with the opportunity to provide feedback and patient reported outcomes. “There’s a huge opportunity to remove the ceiling here and take this to the next level,” he said. “The best technology needs the best structure for each patient, because the patient is ultimately at the center of this.” Makhoul said precision medicine has become standard of care for most metastatic cancer patients at CARTI, and is proving essential for patients with Lynch syndrome or to women with BRCA mutations as well. “It’s important to know every breast cancer patient’s genetic profile,” Makhoul said.

While oncology and hematology were among the earliest adaptors of precision medicine, Yu said the science is impacting every facet of healthcare including cardiology, gastroenterology, psychology and addiction medicine, among others. “Caring for patients in pharmacogenomics requires a lot of information, and we’re challenged to combine these healthcare data points and crunch numbers to provide that information in a meaningful way to providers and their patients,” Yu said. “Biomedical informatics is concerned with using information technology and healthcare in improving patient care, and in Arkansas we’re really leveraging digitized genomic and clinical data for the future of medicine.” In pharmacogenomics, a patient sample is run through a machine capable of detecting specific genetic abnormalities, or mutations that are associated with a drug’s metabolism. “Research has known for years that a particular drug, when given to particular patient, could also have adverse effects or conditions that would make the drug ineffective,” Yu said. “Pharmacogenomics can be used to describe the potential serious side effects or provide additional information about the appropriate drug dosing that may be effective for patients. We’re very fortunate here in Arkansas to have this technology and want to make it available to all.” Arkansas Children’s laboratory testing instrument currently detects 175 mutations that cover more than 50 genes and the technology to program a number of drug-gene interactions directly into the hospital’s clinical information systems. “One of the fortunate things we have is a very robust electronic health record (EHR) capable of capturing information in a way that we can provide it back to prescribing physicians in a timely manner,” Yu said. “Arkansas Children’s

Staying connected

Options in oncology

In Northwest Arkansas, Highlands Oncology Group has been among the region’s earliest adapters of precision medicine, with oncologists now working to promote the science in the broader healthcare community. “We keep trying to educate non-oncologists that there are a lot of newer and more targeted approaches in how cancer is treated

Additional Resources: • ACH link to Pharmacogenomics Service • Paper for Arkansas Childrens Pharmacogenomics experience Gill PS, Yu FB, Porter-Gill PA, Boyanton BL, Allen JC, Farrar JE, Veerapandiyan A, Prodhan P, Bielamowicz KJ, Sellars E, Burrow A, Kennedy JL, Clothier JL, Becton DL, Rule D, Schaefer GB. Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children’s Hospital. J Pers Med. 2021 May 11;11(5):394. • Local Healthcare Journal of Arkansas article Porter-Gill PA, Gill PS, Yu FB, Schaefer GB. Precision Medicine in Arkansas. Healthcare Journal of Arkansas. 2021, July/August:32-33. • Local The Journal of the Arkansas Medical Society Porter-Gill PA, Gill PS, Schaefer GB, Allen JC, Boyanton BL, Yu FB. Arkansas Physicians’ Interests and Learning Opportunities with Pharmacogenomics. The Journal of the Arkansas Medical Society. 2021, August; 118 (2): 30-32.




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Pharmacogenomics can be used to describe the potential serious side effects or provide additional information about the appropriate drug dosing that may be effective for patients. We’re very fortunate here in Arkansas to have this technology and want to make it available to all. — Feliciano “Pele” Yu, UAMS, Arkansas Childrens, Arkansas Childrens Northwest

compared to our older classic chemotherapies,” said Eric Schaefer, MD. Highlands Oncology has been heavily involved with clinical trials involving precision medicine since the 1990s, and their clinical trial program is nationally recognized and has been instrumental in Highlands’ continued growth. Schaefer said alternative therapies are particularly well received among older patients. “The biggest benefit is that the newer therapies, such as immunotherapies, are much better tolerated and more effective than classic chemo,” he said of the older population. “Probably half of patients have seen immunotherapies advertised but don’t fully understand what they are, and many are relieved to be treated with a non-chemotherapy regimen.” He encourages PCPs to refer even older, non-fit patients to medical oncologist to discuss available options. While not everyone is eligible for targeted therapies, oncologists often have options outside of traditional treatment. Schaefer is particularly optimistic about a new therapy called Theranostics, which is currently being used by Highlands Oncology for the treatment of prostate cancer. “Prostate cancer cells have specific antigen on their surface which diagnostic radiotracers can bind to, allowing a special diagnostic PET scan to detect a minute focus of cancer,” Schaefer said. “We can either treat this focus with external beam radiation (if it is a solitary focus) or through an IV infusion - where the diagnostic radioisotope is replaced with LU-177, a radioligand that selectively targets and kills the cancer cells. It’s better tolerated and more effective than some older treatment methods.” While outcomes depend on mutation and disease type, Schaefer said immunotherapies are now available for 37 cancer types. He’s especially hopeful for the future of lung cancer treatment, since Northwest Arkansas is home to the largest lung cancer screening program in the nation

thanks to Highlands’ free low dose CT scans. Between 60 to 100 eligible patients are screened through the program each week, resulting in findings of stage I lung cancer in 1 in 63 patients. “This has become a hugely successful program in Arkansas, and we’re proud to be able to offer it at no cost,” Schaefer said.

Looking forward

Yu continues to work with providers to help them understand constraints and abilities of pharmacogenomics. Common concerns include patient costs, the consent process, training, turnaround time and sharing test results with patients. Funding of lab equipment and specialty pharmacists also pose constraints for smaller hospitals. To that end, Yu has helped establish a pharmacogenomics consultation service at Arkansas Children’s, continues to write papers and book chapters for regional and national publications, and takes on speaking engagements. “We want providers to know it’s available, and which gene-medication pairing offers the best evidence,” he said. He’s also spreading awareness about the nuances of pharmacogenomics between pediatric and adult populations. “Most genes express early, but some express later as a child develops, depending on the child’s physiology,” he explained. “Sometimes gene expression is associated with patient level of development, so we have to make sure we’re testing at the appropriate age and growth stage. When you’re able to detect things early you have an advantage, not only for treatment but also prevention. Our goal and the most exciting part of this is the ability to predict what could happen and make necessary adjustments in care. The future of medicine here in Arkansas is precision health, and that includes preventative and predictive opportunities. Pharmacogenomics sits in the middle and gives us a more extensive and personalized approach to health care.” arkansasmedicalnews


New Clinical Guidance in Neuropalliative Care

Kate T. Brizzi, MD

Lynne P. Taylor, MD

“In the last several years, I’ve witnessed a significant increase in trainee interest in the field, and there’s growing recognition of how a palliative care approach can improve patient care,” said Brizzi. The position paper states that given the high prevalence of life-altering neurologic conditions, neurologists need training in serious illness communication. This dire need is reflected in the 42 percent of respondents in 49 neurology residency programs admitting their dissatisfaction with palliative care education. “Necessary communication skills include delivering bad news, assessment, explaining prognosis, assisting patients and families in the process of decision-making, and setting limits when certain types of care are objectively futile,” according to the report. “The familiarity that neurologists have with these tough conversations supports the argument that all neurologists should attend to their patients’ palliative needs and be able to recognize when the demands of the situation require assistance from palliative care specialists.” Lynne P. Taylor, MD, a professor at the University of Washington School of Medicine in Seattle and an AAN fellow, pointed out “neurologists provide palliative care to people living with life-altering neurologic illnesses not just at the end of life but throughout the course of a disease, improving their lives with symptom control.” Many neurologic illnesses such as stroke, postanoxic coma, traumatic brain injury, encephalitis, and demyelinating disease inherently involve unknown degrees of acute survival, functional recovery, or chance of recurrence, according to the paper.

“Neurologists often cite prognostic uncertainty as the reason they feel uncomfortable discussing decision-making with patients and families, but the literature supports that patients desire prognostic information even when prognosis is uncertain and appreciate when their physicians disclose the presence of that uncertainty. Discussions of prognosis are critical to facilitating disease understanding and empowering patients and surrogates in the decision-making process to achieve care consistent with established goals of care,” the report continues. When they have a longstanding relationship with a patient, or when withdrawal bias is present, clinicians run the risk of overestimating or underestimating prognoses and “must remember to use evidence-based estimates and explore personal biases when offering prognostic assessments,” according to the paper. “The statistical language clinicians use is easily misinterpreted by patients and their families,” particularly among lower-educated patient families. Established strategies for decision-making in the setting of prognostic uncertainty include the best/worst case scenarios and most likely functional outcomes for a particular illness. To improve accuracy and flexibility, the paper suggests framing predictions of longevity in vague time intervals rather than specific time frames, adding that routinely addressing goals of care “may destigmatize conversations around the potential for worsening illness and help patients and families be more prepared to make decisions when clinical deterioration occurs.” Challenges surface when the prognosis is uncertain. In that case, time-limited trials may be suggested to allow maximum recov-

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ery before further decisions are made. “A prolonged period of aggressive life-prolonging care should not be pursued if the surrogate is confident that this type of care would not be in line with the patient’s preferences, even if a degree of recovery is believed to be possible. “When treatments are physiologically futile, it’s the clinician’s responsibility to remove the burden of decision-making entirely by explaining that such interventions will not be offered,” noted the authors, who concurred “it’s counter to the principle of nonmaleficence to offer such treatments, as they may cause harm in the absence of potential benefit. Futility exists in the context of all medical specialties; a specific example in the setting of neurologic disease includes cardiopulmonary resuscitation in the setting of cardiac arrest due to irreversible herniation.”

The paper glosses over the role of the neurologist in “lawful physician-hastened death (LPHD).” Some states –and Washington, DC – now allow neurologists to approve requests for LPHD for adult patients with serious neurologic illnesses. They include California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont and Washington. Montana allows LPHD via court ruling. The authors noted an in-depth discussion of LPHD is beyond the scope of the position paper, referring readers to a 2017 AAN position statement on the topic. “I anticipate this will be an area of further discussion in the neurology and palliative care community,” Brizzi said, “as requests for hastened death are frequently encountered from patients with serious neurologic illness.”

Neurologists provide palliative care to people living with life-altering neurologic illnesses not just at the end of life but throughout the course of a disease, improving their lives with symptom control…. — Lynne P. Taylor, MD, University of Washington School of Medicine, and a fellow of the American Academy of Neurology

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Lymphoma Survivor: Bob Baine Treatment: CAR T-cell therapy only at UAMS


HELPING YOUR PATIENTS BEAT CANCER To make a referral or learn more, call 501-296-1200 or visit UAMS.Health/CarTCell.

At the UAMS Winthrop P. Rockefeller Cancer Institute, we offer more of what your patients need, including the world-renowned Myeloma Center. Our surgical oncologists perform many of the state’s most complex cases. Plus, our physician scientists are backed by cancer researchers working on the latest treatments and clinical trials. Bringing benchmark research to the bedside to ensure your patients have a better chance of beating cancer.






GrandRounds Angie Longing Appointed as New CHI St. Vincent Chief Nurse Executive LITTLE ROCK – CHI St. Vincent has appointed Angie Longing, MHSM, BSN, RN, NE-BC as the non-profit health system’s new Chief Nurse Executive. Longing has served CHI St. Vincent’s healing ministry since 1994, beginning her career as a Labor and Delivery nurse at CHI St. Vincent MorrilAngie Longing ton. She most recently served as Chief Nursing Officer and Vice President of Patient Care Services through a partnership with Conway Regional Health System. She will now provide leadership and coordination of excellence in nursing practice across the CHI St. Vincent system. “Angie is a champion for nursing and we’re incredibly proud to have her leadership in such a vital role,” said CHI St. Vincent CEO Chad Aduddell. “She has led the way in nursing excellence throughout her career and we know that our inspiring nurses and healthcare heroes will find themselves fortunate to have her at the helm.” Longing’s 28 years of healthcare experience also includes serving as Executive Director for Hospital Based Physician Practices at CHI St. Vincent. She has also served as Executive Director of Nursing for CHI St. Vincent Infirmary, CHI St. Vincent North and CHI St. Vincent Morrilton, as well as Chief Nursing Officer at CHI St. Vincent Morrilton. In addition to her other accomplishments, Longing has also achieved her Board Certificate as a Nurse Executive. “I have always been an advocate for nurses and knew this was my path from a very early age,” said Longing. “I feel it’s my duty to ensure our coworkers providing direct patient care have the resources and support they need to provide the exceptional, compassionate care our patients deserve. Being able to serve my home state in this role is an incredible honor.” Longing earned her Bachelor of Science in Nursing from the University of Central Arkansas and completed her Masters in Health Services Management at Webster University in Little Rock.

Arkansas Health Network Promotes Camille Wilson to Vice President of Population Health Management LITTLE ROCK – Arkansas Health Network (AHN), a physician-led, Clinically Integrated Network (CIN) serving Arkansas patients, providers and employers through a value-based approach to healthcare, has promoted Camille Wilson as Vice President of Population Health Management. Wilson, who played a key leadership role in the development of AHN’s advanced care management and associated capabilities since joining AHN as director of



population health in 2017, will continue to transform value-based care and associated healthcare reimbursement models in this expanded role. “Camille’s dedication to our mission of championing value-based healthcare has helped propel AHN to a nationally recognized best practice,” said AHN President Bob Sarkar. “Her work has been vital as AHN repeatedly exceeded quality improvement and financial goals year-over-year. We look forward to Camille’s ongoing leadership as we continue to prove that organizations can realize healthcare savings by focusing on value, quality, consumer experience and compassionate care.” AHN is the largest and most successful CIN in the state of Arkansas working with Medicare and private employers to help deliver improved healthcare at lower costs. The organization currently manages Camille Wilson over 130,000 patients across the state and partners with a growing network of more than 3,400 providers, 25 Skilled Nursing Facilities and 18 hospitals. With the rising cost of healthcare growing as a concern for employers across Arkansas, AHN has partnered with Arkansas Children’s Care Network and Next Health CIN to provide a unique health care delivery model designed specifically for employers. The model leverages technology and big data to pre-emptively identify highrisk and rising risk patients and then connects them with a multidisciplinary care team of registered nurse health coaches, social workers, pharmacists and others to proactively manage their care with an emphasis on preventive, rather than reactive services. The patients’ own physicians are also engaged in this endeavor. This holistic approach drives positive outcomes for employees and their dependents and generates cost savings for employers. AHN is a wholly owned subsidiary of CHI St. Vincent. Previously, Wilson served as Manager of Care Coordination for CHI St. Joseph Health in Bryan, Texas. Wilson is a registered nurse and holds a master’s degree in Nursing from Angelo State University in Texas.

Whole Health Institute Names Walt Cooper CEO BENTONVILLE - Last month, Whole Health Institute announced Walt Cooper, PhD as chief executive officer. Prior to this role, Cooper served as managing director for healthcare initiatives, overseeing strategic planning, budget, and operations at Whole Health Institute, and before that, he served as head of Walmart Health innovation and optimization. Cooper co-founded Cortica Healthcare, treating children with neurodevelopmental conditions. He has had a highly-decorated career in the military, holds a Doctor of Philosophy

Conway Regional Opens New $21 Million Intensive Care Unit Conway Regional is taking the ordinary to extraordinary with the grand opening celebration of a new intensive care unit. The 65,000-square-foot, $21 million facility is part of the health system’s $60 million Growing Together capital investment campaign. The new unit expands access to intensive care services for Faulkner County and the surrounding areas, increasing capacity from 17 to 24 critical care beds with room for future growth and expansion. “Conway Regional has been the community’s hospital for more than 100 years. As we focus on meeting the needs of the communities we serve, our priority is our patients,” said Matt Troup, President and CEO of Conway Regional Health System. “The new intensive care unit will enrich the experience of our patients and their families as we provide additional capacity, convenience, and comfort.” The new facility features an impressive 4,600-square-foot atrium,

from Harvard, and a Master of Science from Oxford, where he was a Rhodes Scholar. Cooper follows Tracy Gaudet, who recently resigned from the institute in this leadership role. Walt Cooper, PhD, Chief Executive Officer for Whole Health Institute. Cooper previously served as Managing Director for Healthcare Initiatives, Walt Cooper overseeing strategic planning, budget, and operations at Whole Health Institute. Prior to that role, he was Head of Walmart Health Innovation and Optimization. Cooper co-founded and served as president of San Diego-based Cortica Healthcare, treating children with autism and other neurodevelopmental conditions. At Cortica, Cooper developed an operational infrastructure that enabled this novel clinical model to grow and expand.

featuring a variety of plants, trees, and shrubs, along with benches, tables, and ambient lighting. This serene space provides visitors and family members with an additional waiting area when visiting patients in the unit. The new 330-square-foot patient rooms provide ample space and feature cutting-edge equipment, ensuring patients receive the highest-quality care. During the planning and design of the new unit, physicians and staff members utilized a mock-up space to provide insight and guidance, helping ensure appropriate placement of all equipment. “Our state-of-the-art facility allows us to continue meeting the needs of our patients, while also growing and adapting to serve our growing communities. We’re not just growing—we’re growing together,” said Troup. Cromwell Architects Engineers designed the unit, and Conwaybased Nabholz Construction is the general contractor. The unit will open for patient care by the end of May.

Cooper has also worked with the U.S. Department of Veterans Affairs following a highly decorated career in the military. Cooper served as a Special Forces Officer in the US Army and was recently appointed to the Green Beret Foundation’s Board of Directors. During his 14 years on active duty, he led troops during multiple combat deployments, taught as an Assistant Professor of Social Sciences at West Point, and worked as a speechwriter for General David Petraeus. He continues to serve as a lieutenant colonel in the Army Reserves. Cooper graduated as valedictorian from West Point, holds a Master of Science degree from Oxford, where he was a Rhodes Scholar, and a Doctor of Philosophy degree from Harvard.

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GrandRounds Two New Baptist Health Urgent Care Locations Opening in Fort Smith, Van Buren FORT SMITH – Baptist Health Urgent Care has announced it will open two new locations later this summer in Fort Smith and Van Buren. The location in Fort Smith is scheduled to open in late July and will be located in the Northside area on Rogers Avenue, across from Walgreens. In August, a center in Van Buren will open on Fayetteville Road, across from McDonald’s. The centers are open seven days a week and offer evening hours during the work week. For added convenience, walk-ins are welcome or can plan a same or next day visit online with Hold My Spot® or reserve a telemedicine visit. All of the current 11 Baptist Health Urgent Care centers assist with a variety of non-life-threatening health conditions and injuries.

The centers are open Monday through Friday, 8 a.m. to 8 p.m.; Saturday 8 a.m. to 4 p.m. and Sunday 1 p.m. to 6 p.m. Most insurance plans, including TRICARE and VA, Medicare and Medicaid, as well as cash and credit card are accepted. ARKids requires a physician referral in advance of the visit.

UAMS Community Health & Research Moves to New Facility in Springdale SPRINGDALE — The University of Arkansas for Medical Sciences (UAMS) Office of Community Health & Research is relocating to Springdale, strengthening collaboration, involvement and relationships between the office and the wider Northwest Arkansas community. The Office of Community Health & Research is moving from its previous location on the UAMS Northwest Regional Campus in Fayetteville to a 28,000-square-foot building at 2708 S. 48th St. in Springdale. The move will allow Community Health & Research staff

to strengthen collaborations with community partners in the region and support the growing team of over 150 team members. The Office of Community Health & Research was founded in 2012 to reduce health disparities and increase access to chronic disease prevention and management services in Northwest Arkansas. In 2015, Community Health & Research launched the Center for Pacific Islander Health, the first center in the United States to focus solely on Pacific Islander health issues through research, community programs, training and policy. Community Health & Research is a successful and productive research office with a team of more than 150 fulltime staff and faculty implementing more than 75 community-engaged projects to reduce health disparities in Northwest Arkansas, across the state and nationally. In Northwest Arkansas, Community Heath & Research staff have worked with community members and partner organizations to provide healthier foods in

Alice L. Walton Foundation and Washington Regional Medical System Form Partnership In Northwest Arkansas BENTONVILLE AND FAYETTEVILLE – The Alice L. Walton Foundation and Washington Regional Medical System have announced their intention to create a regional health system to improve health outcomes across Northwest Arkansas and beyond. The announcement follows the news last year of a joint initiative through the Alice L. Walton Foundation and Cleveland Clinic to identify ways to provide access to Cleveland Clinic’s renowned specialty care services in Northwest Arkansas. The initiative was formed after a study highlighted that area residents frequently leave the region in order to receive specialty care. Through these two initiatives, the Alice L. Walton Foundation and Washington Regional Medical System intend to work with Cleveland Clinic to support the growth of health care services in the region. “This partnership is all about access, ensuring that residents of our thriving region have ready access to world-class health care services, including specialty care,” says philanthropist Alice Walton. “We’re bringing together three organizations with unique strengths—including Washington Regional’s excellence in serving this community, Cleveland Clinic’s innovative care, and my foundation’s focus on enhancing access—to offer a broader scope and scale of services to our region and beyond.” “The creation of the regional health system will advance our mission and vision, including expanding our clinical, academic, and operational capabilities, and continuing to invest in our facilities,” says Larry Shackelford, President and CEO for Washington Regional Medical System. “Our mission is to improve the health of area residents through compassionate, high-quality care and wellness education, and to act as the central hub for clinical, educational and research activities in Northwest Arkansas. This partnership provides the resources to take our health care services to the next level to best serve our growing community.” The Alice L. Walton Foundation and Washington Regional Medical System will now begin to develop operational plans for this new partnership, with an intent to finalize next steps during the remainder of this year. Founded in 2017, the Alice L. Walton Foundation works to enhance quality of life for individuals and communities through providing access to offerings that enhance well-being. In 2020, Walton announced the formation of Whole Health Institute, and in 2021 she announced the formation of the Whole Health School of Medicine and Health Sciences. Both of these organizations, based in Bentonville, Ark., focus on redesigning the systems that impact health and well-being with the goal of making whole health accessible and affordable to all. In partnership with Washington Regional Medical System and Cleveland Clinic, the foundation will focus on infusing whole health principles into the clinical, educational, and operational practices of this new health care system with the goal of improving health outcomes in the region and enhancing value-based care. The system will work with Whole Health School of Medicine to support academic and teaching opportunities as well.




schools and community meal programs; increase positive birth outcomes and support through family wellness programs; lower COVID-19 infection rates among Marshallese and Hispanic populations; improve care and outcomes for individuals adversely impacted by Type 2 diabetes; and more. The pioneering work of the office has established a nationally recognized presence in Northwest Arkansas, engaging in innovative collaborations with regional, statewide and national organizations dedicated to eliminating health disparities and improving health outcomes for all. Last year, the office’s work in Marshallese, Hispanic and rural communities helped earn UAMS the Spencer Foreman Award for Outstanding Community Engagement from the Association of American Medical Colleges (AAMC). For more information about the UAMS Office of Community Health & Research, visit

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Higher Level of Urgent Care Coming to Jonesboro JONESBORO - In partnership with Haag Brown Medical Holdings, NEA Baptist announces a major upgrade in services to the corner of Red Wolf Blvd. and Apache Dr. with the addition of Urgent Care PLUS, an 18,000 square foot ultra-modern facility. The new development will feature Red Wolf Clinic Primary Care (currently known as Stadium Clinic), Outpatient Imaging services, and an Urgent Care PLUS all in one central location. The service upgrade will provide patients with easier access to a higher level of care without the need for an expensive Emergency Department visit. As a leader in innovation and care integration, NEA Baptist will be the first in the region to offer X-Ray, CT, and Ultrasound services in an Urgent Care setting. Studies show that radiology exams are ordered in over 10 percent of urgent care visits. By providing these imaging services in one location, patients can receive a more convenient experience through integrated care. The new layout will also allow a more efficient process and workflow in family medicine by using an on-stage, off-stage concept creating an overall better patient experience. The Urgent Care PLUS facility will house state-of-the-art medical technology offering more robust on-site lab services needed to quickly diagnose and treat patients. The new construction will serve as the largest project NEA Baptist has completed in the area since the development of the main medical campus on East Johnson in 2014. This signalized corner sits at the base of the I-555 exit onto Red Wolf Blvd. earning the attention of over 33,000 cars per day. The property is connected to multiple continued care medical businesses along Apache Drive including Southern Pharmacy, ArKids Pediatric Day Center, Arkansas Continued Care Hospital, Apache Drive Children’s Clinic, NEA Baptist Dialysis Clinic, and St. Elizabeth’s Place. Haag Brown Medical Holdings is also developing a free-standing Southern Pharmacy just south of its current residence within the NEA Baptist Clinic Stadium Urgent Care facility, creating individualized care facilities for both businesses. Stone Bridge Construction will work as the general contractor for both projects.



Stacy Zimmerman, MD, Joins UAMS to Oversee Physician Residency, Fellowship Programs LITTLE ROCK — Stacy Zimmerman, MD, will join the University of Arkansas for Medical Sciences (UAMS) as the Regional Centers Designated Institutional Official (DIO) overseeing physician residency and fellowship programs, effective Aug. 1. Zimmerman will have responsibility for the accreditation of existing regional residency programs and will be responsible for oversight and growth of statewide graduate medical education (GME) efforts particularly focused in Northwest Arkansas, which are key to UAMS’ efforts to train addiStacy tional, much-needed Zimmerman physicians for Arkansas. Zimmerman will be key to the UAMS partnership with Washington Regional Medical Center to add a significant number of residency positions in Northwest Arkansas. Additionally, Zimmerman will play an important role in the launch of new rural training track programs in partnership with hospitals, including one planned with the Berryville and Eureka Springs communities in Northwest Arkansas. Her leadership will be critical to expanding graduate medical education in the region. Designated Institutional Officials serve as the chief administrative overseer for sponsoring institutions of physician training programs accredited by the national Accreditation Council for Graduate Medical Education (ACGME). Zimmerman will succeed Patricia Edstrom, who is retiring this summer. Zimmerman also will serve as an associate professor in the UAMS College of Medicine Department of Internal Medicine. “Dr. Zimmerman’s leadership experience in developing community-based residency programs will prove instrumental in building residency training opportunities in Northwest Arkansas,” said Amy Wenger, vice chancellor of the UAMS Northwest Regional Campus. “I am delighted she is joining our team.” Zimmerman currently serves as the founding program director for the Internal Medicine Residency Program and the Transition Year Residency Program at Unity Health in Searcy, where

she has practiced since 2016. She previously was in private practice for 14 years as an internist and pediatrician in Clinton, where she also served as a staff hospitalist and emergency physician for Ozark Health Medical Center. She has held adjunct faculty and preceptor positions with UAMS, the Arkansas College of Osteopathic Medicine in Fort Smith, Kansas City University of Medicine and Biosciences, and the New York Institute of Technology College of Osteopathic Medicine in Jonesboro. A 1999 UAMS College of Medicine graduate, Zimmerman completed a combined residency in internal medicine and pediatrics at UAMS and Arkansas Children’s. She is a Fellow of the American College of Physicians and the American Academy of Pediatrics.

Kutty Presents at National Meeting BATESVILLE – White River Health System (WRHS) was proud to have Dr. Raman Kutty, Class of 2023 Internal Medicine Resident, represent the WRHS residency program at the American College of Physicians National Meeting in Chicago, Illinois. Out of 4,000 applicants from across the world, our resident’s project was one of only 10 to be selected. The project focused on expired prescription drug potency. With prescription drug prices rising, Kutty hopes that his team’s work will help reduce the cost to patients across the country. “We have a really unique opportunity here to get to the root of the issue,” said Kutty. “Everyone has old medications in their medicine cabinet and we all wonder if they’re still good or not. If medicines stay good for longer than we thought that’s a huge savings for everyone” he added. Raman Kutty Kutty was grateful for the opportunity. Publicly, he thanked his project team, his fellow residents and program director at WRHS, the presentation review “committee,” and his friends and family. The Internal Medicine Residency Program has welcomed five classes of 10 residents to the program. The first class of residents graduated from the program in 2021, with the second class expected to graduate this month. Out of these two classes, WRHS is proud to have three physicians join the staff at WRHS and three others sign letters of intent. Physicians include Drs. Michael Andryka, Doreen Kamoga, Wyatt Lydolph, Mitchell Keel, Shoaib Khan, and Edwin Suarez.

MRMC Names Brett Kinman CEO MAGNOLIA – The Magnolia Regional Medical Center Board of Directors announces the appointment of Brett Kinman as Chief Executive Officer. Kinman

brings more than 25 years of healthcare management experience to Magnolia. He will succeed Rex Jones as CEO. Jones served over five years at MRMC before announcing his resignation earlier this year. Kinman most recently served as Administrator of CHRISTUS Good Shepherd Medical Center in Marshall, Texas, and CHRISTUS St. Michael Hospital Brett Kinman in Atlanta, Texas. His past experience also includes leadership positions at Forrest City Medical Center in Forrest City, and Harris Hospital in Newport. Kinman was born and raised in San Antonio, Texas. He is a Biomedical Science graduate of Texas A&M University. He obtained his master’s degree in healthcare administration from Trinity University in San Antonio. Mr. Kinman and his wife, Leslie, are the parents of one daughter, Mackenzie, who attends Sam Houston State University.

UAMS Begins Final Study of First Rapid Test for Acetaminophen Toxicity with $3.2 Million Grant LITTLE ROCK — The first rapid diagnostic test for acetaminophen toxicity has cleared a major hurdle on its long road to the marketplace from the University of Arkansas for Medical Sciences (UAMS). The test’s inventors, UAMS’ Laura James, M.D., Jack Hinson, Ph.D., and Dean Roberts, Ph.D., received a threeyear, $3.2 million National Institutes of Health (NIH) Small Business Technology Transfer (STTR) grant to conduct the final phase of study before seeking Food and Drug Administration (FDA) approval of the blood test. The grant will include the final development of the new laboratory test AcetaSTAT, a rapid assay to diagnose acetaminophen liver injury, and a clinical trial involving multiple centers to evaluate the test’s performance. The new blood test can detect blood markers for liver injury from acetaminophen overdose in about 20 minutes. Acetaminophen is the most common drug for pain and fever, and it is the most common cause of liver failure in the United States. “It has been a long journey, but it has been fun and exciting because we’re moving toward a big contribution in health care,” said James, who founded her company, Acetaminophen Toxicity Diagnostics (ATD) LLC, in 2006 with Roberts and Hinson. James also serves as the director of the UAMS Translational Research Institute. ATD developed the test in conjunction with UAMS and Arkansas Children’s. continued on page 10




GrandRounds Physicians have no FDA-approved test to confirm the diagnosis of acetaminophen liver injury. They must rely on patient history and nonspecific tests of liver injury when evaluating patients with liver injury due to acetaminophen overdose. William M. Lee, M.D., a liver disease specialist at the University of Texas Southwestern Medical Center at Dallas, is a co-investigator on the clinical trial and has been involved in prior testing of the assay. James also credits him for giving her the idea to pursue a rapid, pointof-care test. “I have been impressed that the assay provides a reliable yes/no answer as to whether acetaminophen is responsible for the liver injury,” Lee said. “I look forward to seeing AcetaSTAT being available in any Emergency Department worldwide. Having the test will ensure that more patients receive the right diagnosis and appropriate treatment.” James is optimistic about the assay’s prospects for FDA approval, given its past performance. She has assembled a strong, interdisciplinary team to conduct the multisite clinical trial.

Three Washington Regional Hospitalists Advance to New Roles FAYETTEVILLE — Three physicians in Washington Regional’s hospital medicine group were recently appointed to new roles within the medical center. Anthony Williams, MD, assumed the role of vice president and chief quality officer at Washington Regional Medical Center. Dr. Williams first joined Washington Regional as a Anthony hospitalist in 2007. He Williams then served as the chief quality officer at Jackson Memorial Hospital in Jackson, TN before returning to Washington Regional in 2014 as the director of hospital medicine. Dr. Williams attended medical school at the University of Arkansas for Medical Sciences and completed a residency in internal medicine at Vanderbilt University Medical Center. Michael Bolding, DO, succeeds Dr. Williams as the new director of hospital medicine. Dr. Bolding has been a part of Washington Regional’s hospital medicine group Michael for more than 12 years. Bolding Dr. Bolding received his medical degree from Oklahoma State University of Osteopathic Medicine and completed his residency in internal medicine at West Virginia University. Jonna Dyer, MD, has taken on the role of assistant medical director for hospital medicine. Dr. Dyer has been with Washington Regional for more than eight years. She has served in many lead-




ership roles within the medical staff and is the chair of the department of medicine. Dr. Dyer received her medical degree from St. Louis University School of Medicine and completJonna Dyer ed her family medicine training at Research Family Medicine in Kansas City.

Mercy Names Ryan Gehrig President of Both Northwest Arkansas and Fort Smith Hospitals ARKANSAS – Ryan Gehrig will guide the future of Mercy hospitals across Arkansas, including the two largest facilities in Rogers and Fort Smith, with a newly expanded role as president of Mercy Hospitals Arkansas. “Mercy has deep roots in both communities, and as Arkansas continues to grow at a rapid rate, it’s important our teams take a one-Mercy approach so Ryan Gehrig we can continue to provide the highest quality, compassionate, faith-based care to the people we serve,” said Dr. John Mohart, president of Mercy communities, who leads operations for all Mercy hospitals. “Ryan is uniquely suited to unify our efforts in Arkansas and provide a seamless approach to care and service that best meets the needs of people in Northwest Arkansas and the River Valley.” In Gehrig’s 10-year career as president of Mercy Hospital Fort Smith, he has led a team deeply committed to providing nationally recognized care, with 12 consecutive A grades for quality of care from Leapfrog, an independent watchdog organization. He has also taken a lead role in efforts to introduce new and expanded services, including a new emergency room/intensive care buildout set to open in Fort Smith in 2024, a rehabilitation hospital and Ronald McDonald House that opened in 2021 and expanded neurological services that were much needed in the Fort Smith area. Gehrig came to Mercy from Norman Regional Health System, where he served as vice president of enterprise systems and chief administrative officer for Moore Medical Center, one of the system’s hospitals in Norman, Oklahoma. He previously served as chief operating officer of Wesley Medical Center in Hattiesburg, Mississippi, as CEO and chief operating officer of Bristow Medical Center in Bristow, Oklahoma, and as chief operating officer of Cushing Regional Hospital in Cushing, Oklahoma. Gehrig graduated from Texas A&M University with a bachelor’s degree in biomedical science. He received a master’s in health care administration from Trinity University in San Antonio, Texas. In addition, he completed an adminis-

trative residency at Hillcrest Healthcare System in Tulsa, Oklahoma. As part of the transition, Eric Pianalto, current president of Mercy Hospital Northwest Arkansas, will assume a new role as chief strategic growth officer for Mercy Arkansas. Pianalto will partner closely with the Mercy Clinic team, including Dr. Scott Cooper, president of Mercy Clinic, and Amy Fore, recently named chief operating officer for Mercy Clinics Arkansas. These experienced teams are charged with expanding hospital services, clinic locations and recruiting needed primary care and specialty physicians to meet growing demand across Mercy’s Arkansas communities. “Eric has an affinity for this work, and we know his experience and great ability to collaborate with physicians is just what’s needed to support the future success of Mercy Clinics across Arkansas as we chart our future development in the region,” said Dr. Jeff Ciaramita, Mercy’s chief physician executive. “We are deeply thankful for Eric’s leadership in building our hospital in Rogers into an amazing place and grateful that he is excited to take on this new role for Mercy as we expand in the region.”

Dr. Dustin Tubre Joins CHI St. Vincent Surgery Clinic in Hot Springs HOT SPRINGS – CHI St. Vincent announced that Dr. Dustin Tubre has joined the team of leading surgeons at the CHI St. Vincent Surgery Clinic in Hot Springs. Dustin Tubre Dr. Tubre began seeing patients in May at the clinic, located at 1 Mercy Lane, Suite 201.

After attending medical school at American University of the Caribbean School of Medicine in St. Maarten, Netherlands, Dr. Tubre completed his residency in general surgery at Creighton University. He is certified in general surgery by the American Board of Surgery and previously served as general and acute care surgeon at Kent Hospital in Warwick, Rhode Island. The team of specialists at the CHI St. Vincent Surgery Clinic offer the latest surgical procedures, including minimally invasive and laparoscopic techniques. To schedule an appointment with Dr. Tubre, call: 501.609.2229.

Dr. Lauren August Clark Joins Baptist Health Gastroenterology Clinic LITTLE ROCK – Baptist Health Gastroenterology Clinic in Little Rock recently welcomed Dr. Lauren August Clark. Dr. Clark, a native of Texarkana, Texas, received her medical education from the University of Arkansas for Medical Sciences College of Medicine. She received residency training in Internal Medicine at Baylor University Medical Center. “My goal is to pro- Lauren August Clark vide excellent, personalized care based on the latest research available,” Dr. Clark says. “I strive for every interaction to be pleasant and beneficial to the patient.” For more information about Dr. Clark and the services she provides at Baptist Health Gastroenterology Clinic in Little Rock, visit or call 1-888-BAPTIST.

Vold Vision Successfully Performs First EVO Visian ICL Procedure in Arkansas FAYETTEVILLE – For decades, LASIK surgery has been the most prominent corrective eye surgery in the world. However, conditions have to be just right for patients to qualify, leaving a massive gap for millions with impaired vision. Recently approved by the U.S. Food and Drug Administration (FDA), the EVO/EVO+ Visian® Implantable Collamer® Lens (EVO) is used for the correction of myopia and myopia with astigmatism. Myopia, which is also known as nearsightedness or the need for distance vision correction, is the most common vision disorder globally and its prevalence is rapidly growing. An estimated 100 million U.S. adults ages 21 to 45 who have myopia are potential candidates for EVO, a biocompatible implantable lens that corrects distance related vision issues. Unlike other surgeries, EVO works in conjunction with the eye instead of altering the eye’s shape. It is also removable if the patient desires. This surgery applies to patients: • whose eyes are not candidates for LASIK, • who have been told there is no option for vision correction • their only vision correction options are procedures with multiple steps or long down time • who are candidates for LASIK but prefer an alternative reversible option In contrast to the previously offered ICL involving multiple procedures, this new EVO lens allows patients the same noninvasive procedure with a fast recovery as LASIK. While it is new to the US market, over 1,000,000 EVO ICL lenses have been implanted worldwide, with 99.4 percent saying they would have the procedure again.