SYSTEMnews CEO’s corner Ralph W. Muller
CEO, University of Pennsylvania Health System
The past few years have seen extraordinary additions to the physical make-up of Penn Medicine. The Ruth and Raymond Perelman Center for Advanced Medicine, the Roberts Proton Therapy Center, and the Smilow Center for Translational Research all represent the latest thinking in the design and operation of world-class health buildings. The commitment to excellence that saw these structures advance from concept to construction didn’t end, however, when the last plate of glass was installed and final coat of paint applied. It carries on in the form of several new, system-wide projects that will continue to transform the way we look and how we serve patients. A dynamic feature of the unified Perelman/Roberts/ Smilow complex is its adaptability. Built in stages, the suite of structures holds still more scope for development. So that’s precisely what we’re doing. Construction is underway on the South Pavilion Extension, a five-floor addition that will sit directly over the dock of the Perelman Center. Its 200,000 square feet will comfortably house almost all remaining HUP outpatient services. Freeing up space at HUP will allow us to shift the departments and services now at Penn Tower into the hospital (or other locations) in preparation for razing the Tower and its garage. But while the nearly 40-year old garage may soon be gone, the parking spaces will live on — and then some. Construction of a 1,000-car garage adjacent to Lot 51 is well underway. The new structure will, when the time is right, also support several floors above it, providing added administrative, research, or education space in the future. Moving to PPMC, work is in progress on two major initiatives that will greatly affect how care is delivered in both West Philadelphia and our region in general. The new 11-story Penn Center for Specialty Care will help revitalize the 38th Street area while bringing more health care services directly to the community. The facility, which is scheduled for completion in 2014, will add more than 150,000 square feet of outpatient and surgical care space, including the multidisciplinary Penn Musculoskeletal Institute — as well as offer ample office space for growing technology and science companies. Good Shepherd Penn Partners will also occupy significant space in the building. (continued on page 2)
Inside Making Connections................ 2 Rubenstein to Step Penn Down.................................2 Medicine@Work..............3 From Pastels to PDA’s...............2 Newsmakers..............................4 RoundtableFree Skinfor A Permanent Home Cancer Screening......................3 Those Without...........................5 Shortakes...................................4 Awards and Accolades.............6 Another Title..............................5 New Center for Blood Disorders to Unify SOM Ranked #2.........................6 Patient Care, Research and Public Education....................... 6
`` Edward Cantu, MD, (r) works with procurement surgeon Yoshikazu Suzuki on a donor lung.
Giving Lungs A
`` The excess fluid in the donor lung (top) decreases significantly after two hours of ex vivo lung perfusion (bottom).
Lungs are the most vulnerable of all organs. Indeed, when it comes to viable transplants, the lungs fall far behind other solid organs. This country transplants 10 times more kidneys than lungs, four times as many livers, and 40 to 50 percent more hearts. “Lungs are incredibly delicate. They are the least recoverable and the first organ to go bad,” said Edward Cantu, MD, of Cardiovascular Surgery. “In the U.S., only 15-20 percent of potential donors have viable lungs for transplantation.”
Now, a new technique at Penn repairs damaged donated lungs that would have otherwise been unusable, allowing for the successful transplantation of the reconditioned lung. Called ex vivo lung perfusion (EVLP), the process could potentially double the number of usable lungs for patients awaiting transplantation.
How Does EVLP Work? As a person breathes, air travels down into the lungs, passing through the bronchial tubes and into the alveoli (air sacs). Oxygen goes through a thin membrane into blood vessels as carbon dioxide is removed from the bloodstream. When death occurs, tiny holes develop between the lung and the membrane; water seeps into the lungs from the blood vessels. “All the alveoli that contribute to the breathing process fill with water,” Cantu explained. “The lungs are basically drowning.” As a result of this post-death occurrence, the faster the lungs can be removed from the donor, the less damage they will suffer. Unfortunately, the procurement process — when transplant teams remove organs from a donor — can also adversely affect donor lungs. “My team wants the lungs as dry as possible, to protect them,” he said. “But the other procurement teams want more fluids given to keep their respective organs working well. We have competing interests.” EVLP removes this extra fluid from the lungs, helping to reverse lung injury. During the three- to fourhour process, donor lungs are placed inside a sterile plastic dome attached to a ventilator, pump, and filters. The lungs are maintained at normal body temperature and perfused with a bloodless solution that contains nutrients, proteins, and oxygen. “The solution was developed specifically to protect the lung. It contains recombinant albumin, which acts like a sponge, pulling water out of the organ.” EVLP not only potentially repairs the lung, but also provides an extended period of evaluation to measure the quality of the donor lung. “Getting the lung into this controlled environment allows us to monitor specific parameters,” he said, including how well the lung oxygenates, the peak airway pressure (ie, how much pressure is needed to inflate and ventilate the lung), and lung compliance, which is a measure of how stiff the lung is. “Lungs are like two big balloons. The more elastic they are, the more capable of doing their job,” said Jaya Tiwari, CCRP, who works with Cantu as project manger for the Novel Lung Trial. This multicenter clinical research trial is designed to compare outcomes from lung transplants using the ex vivo technique with those using the traditional method. “If the lung stays stable during EVLP and oxygenates well, we’ll use it,” he said “But if the lung starts to deteriorate during perfusion, we can tell it’s not good for transplant.” (continued on page 5)
`` Customer Service Reps can see the number of consumer calls in queue by looking at display board. With the new system coming later this year, this information will be on the computer screen.
CSR then puts the information into Sunrise, where it becomes part of the patient’s discharge papers. “Instead of sending a patient home with instructions to ‘Call for a doctor’s appointment in two weeks,’ everything is set.”
Linking Referring Doctors
`` CSR Cheryl Broadus helps a patient find the right doctor to meet her needs.
Making Connections Contact Center makes sure patients get what they need
Matching a patient with the right type of doctor is not always easy. Take, for example, someone with back pain. Depending on the symptoms, that person might need to see a rehab specialist, an orthopedic surgeon, a neurosurgeon or a pain anesthesiologist. In this scenario, seeing the wrong specialist is not only a waste of time; it also prolongs the pain. If that person called Penn Medicine’s Contact Center, a nurse from Physician Referral Services would recommend a specialist based specifically on the caller’s symptoms and back pain history. “It’s going that one step further to make sure we meet all of the customers’ needs,” said Amy Zylstra, director of the Contact Center.
A Customized Approach A staff of 32 customer service reps (CSRs) and nurses in Physician Referral Services handles, on average, over 350,000 calls a year and over 30,000 web inquiries and appointment requests, as well as a variety of other patient-centered services. It’s a fastpaced environment but the person on the other end of the line wouldn’t sense that. In addition to the customized approach to referrals, the Contact Center also provides a ‘transitions in care’ service to inpatients at HUP with complex medical needs, “as a way to help lower readmissions,” Zylstra said. A CSR directly contacts the patient prior to discharge to help set up post-discharge, follow-up appointments, based on e-mailed instructions from the patient’s attending or resident. Once scheduled, the
The Contact Center also goes the extra mile to connect referring physicians with Penn doctors through Penn PhysicianLink®. The special line (1-877-937-PENN) is available 24/7 and never goes into queue. “A dedicated nurse tracks every call to completion. Until she knows that the two doctors have physically talked, she will continue to contact the Penn physician via email, calling, or paging,” said Barbara Manger, Physician Referral coordinator. Last year alone, 17,000 calls came through the physician line. Zylstra noted that this line is also a direct link to PennSTAR, for neurotrauma and other traumatic emergencies. The Center’s Corporate Operator Services answer and triage all after-hours physician referral calls, but its main responsibility is answering the more than 2,000,000 calls that come in every year through the main numbers of all the hospitals, as well as ambulatory locations throughout the Health System.
Coming Soon: New Call Management System A new call management system will come on board shortly, replacing technology that’s been in use since the 1990s. Avaya, the new system, will provide real-time statistics for both the divisions and individual agents. This capability will allow supervisors to better staff based on call volume and help improve operator efficiency. It will also allow skills-based routing, which will send calls requiring a specialized skill set to the appropriate agents. Avaya will display information about incoming calls and those in queue across the bottom of each agent’s computer screen, like a ticker tape. Currently, operators need to look up — or sometimes even stand up — to see a wallboard that displays this information. “If the information is right in front of you, it’s more easily managed,” said Sophie Douglas, manager of Corporate Operator Services. The Center’s web-based presence will expand as well, eventually. “We could eventually set up a webchat with patients, which could convert to a call and possibly an appointment,” Zylstra said.
`` Penn Medicine Washington Square
`` Advanced Care Hospital Pavilion at PPMC
CEO’s corner (continued from cover) Equally transformationally, with the opening of the new Advanced Care Hospital Pavilion in early 2015, the trauma center at Penn Medicine will relocate from HUP to PPMC. The 178,000 squarefoot facility will feature extensive renovations and expansion of the existing emergency and radiology departments, including additional emergency bay and operating room capacity and a new state-of-the art trauma resuscitation area. The project will also incorporate a new concourse to enhance patient flow. Additionally, the exterior of the PPMC campus will be developed to feature a landscaped green space in the 38th Street courtyard.
`` Penn Center for Specialty Care at PPMC
`` The South Pavilion Extension at the Perelman Center for Advanced Medicine
Pennsylvania Hospital, the nation’s first and oldest hospital, is still making history. Penn Medicine at Washington Square, a 12-story, $22 million facility, consolidates PAH’s ambulatory and support functions in a highly modern, eco-friendly space. Medical practices and nearly a dozen hospital departments now in various locations in and near the hospital will come together in one place. As a bonus, the new facility is being built on top of an existing parking garage, providing added convenience for patients and visitors. This structure will allow Pennsylvania Hospital to achieve its goal of an all-private-room, acute-care hospital at its main campus. Finally, Penn Medicine Valley Forge recently marked the opening of the on-site Abramson Cancer Center. The new service offers radiation oncology treatments with a new state-of-the-art linear accelerator, chemotherapy infusion delivered in its 12 chemotherapy bays, and cancer related consultations and follow up visits delivered by a multidisciplinary physician team. All of these changes are strong proof that our commitment to excellence remains on a clear and steady path — regardless of ongoing national economic uncertainties. While building and construction in general have slowed down, we continue to move ahead with visionary projects to meet future needs. The result of all these efforts will be even more high-quality care options for patients throughout our region. And that’s something we can all be proud of.
`` Abramson Cancer Center at Penn Medicine Valley Forge
`` Allen Torrance, PSR Academy participant, answers a question during classroom training.
`` Latoya Prioleau, PSR Academy participant practices using EPIC in the Orthopedics practice at PPMC as Fabian Marechal, Practice Manager, observes.
The PSR Academy has been an amazing experience and certainly a journey. I never would have imagined being part of a team who is rooting for your success. This academy has taught me it’s
The Patient Service A
Exc elle nce Academy
par t nersh i p
ok to be who you are.
— Valerie Fordham, PSR Academy participant
ac t i on
The CPUP Patient Service Excellence Academy, a new six-week apprenticeship training program, is dedicated to developing the most understanding and compassionate individuals to work as Patient Service Representatives at Penn Medicine’s clinical practices. The Patient Service Representative (PSR) is a challenging and highly important component in the patient experience. PSRs are often the first point of face-to-face contact for our patients. They not only greet patients upon arrival, but also collect/verify insurance and referral information, and manage the “patient flow” of the waiting area. PSRs are also responsible for maintaining medical records in EPIC and communicating waits and delays. In addition, when a patient arrives for an appointment, he or she may be feeling disheartened, confused or overwhelmed. The PSR needs to offer an experience tailored to each person’s needs when guiding patients through the registration and case process.
Recruitment Process The Patient Service Excellence Academy took a new approach to PSR recruitment and onboarding. Candidates were evaluated based on key attributes, such as orientation to service, problem-solving aptitude, communication skills and multi-tasking ability. Additionally, new tools helped recruiters identify the “best fit” individuals for the job. Montage, a virtual interview tool, allowed candidates to record answers to pre-determined questions so recruiters and practice managers could review virtually, prior to in-person interviews. Additionally, CPUP recruiters used the Healthcare Selection Assessment tool to gauge a candidate’s focus on service excellence and teamwork. Over a short period of time, these approaches and others narrowed a pool of 1,000 applicants to the inaugural Patient Service Excellence Academy class of 19 candidates.
Learning by Doing The Patient Service Excellence Academy program bridges the technical components of the position (EPIC, insurance, check in, and check out) with the service-centered elements (courtesy, friendliness, problem solving, clear communication) in a highly-interactive, handson program.
As part of the training process, participants worked with Standardized Patients — ie, actors trained to play the role of a patient — for the instruction, practice, and assessment of interpersonal skills. In this environment, each individual had the opportunity to work with a distracted patient, an angry patient and one who had just received bad news. “In each of these scenarios, the Academy participant was given one-on-one, personalized feedback by the actor, the facilitator and the some of the other academy participants,” said Frances Graham, Associate Director Workforce Development. Participants also took part in a “service scavenger hunt. ” Divided into groups, they went out into the community to find specific examples of good, bad or great customer service. When visiting donut shops, drug stores, or convenience stores, each group was instructed to ask specific product questions or non-store related questions, such as directions to a nearby building. Academy participants were encouraged to carefully notice the answers provided, as well as the body language, eye contact, tone of voice and overall helpfulness of store clerks. During a post-exercise debrief, the group concluded, that although varying levels of service exist in the marketplace, good service can exist anywhere and is not always complicated to deliver. The class agreed that we could learn from non-health-care organizations and apply those findings to Penn Medicine. The final component of the Patient Service Excellence Academy was a three-week rotation through multiple CPUP practices. This experience provided a great “on the job” opportunity for Academy participants to observe EPIC in use and understand how practice operations work. Additionally, Academy participants found it valuable to see practices that vary in size, volume, location, specialization and patient demographics. These three weeks also allowed Academy participants to practice their skills in a real-life environment and learn tips/ techniques from our “star” PSR preceptors. Most exciting was the leadership and participation of so many internal Penn Medicine experts, said Beth Johnston, CPUP executive director. “This is a key component of the program,” she said. “Working side by side with our top performing managers and staff is a great way to recognize our “stars” while ensuring our newest PSRs see first hand the values we espouse made real in every day operations.”
A Healthier You This Year The start of a new year is a great time to focus on becoming healthier. At UPHS, the health and well-being of our employees matter. As a health system, we provide the best care to our patients but we can only do that if we provide the best care to ourselves as well. Therefore we want to remind you of the current resources, tools, and programs available to you to assist you in becoming healthier this year. Know Your Numbers: Knowing your blood sugar, cholesterol, BMI, and blood pressure is very important for preventing and managing chronic disease. If you have not recently had your numbers checked, make an appointment with a primary care physician to do so. Visit the My Health Journey section of the Wellfocused website for more information — www.uphshrandyou.com. It will pay to Know Your Numbers during Open Enrollment this year!
Get Moving: You can get reimbursed $150 for working out at the gym 120 times per year if you are enrolled in either the Penn Care PPO or KPOS benefit plan through Independence Blue Cross (IBC) Healthy Lifestyles Program. Aetna members can receive discounts for home exercise equipment and for joining a gym.Visit the Discounts and Bargains page on the Wellfocused website to find out more information and more ways to save — www.uphshrandyou.com.
Quit Tobacco Use: UPHS offers all employees and dependents covered under a medical plan a FREE Tobacco Cessation Program through Health Advocate. This program provides you with 13 weeks of coaching and nicotine replacement therapy (gum, patch, or lozenge) that will be mailed directly to your home at no cost to you. All tobacco cessation prescription co-pays are waived as well. Be tobacco free this year! Call 1-866-695-8622 to get started today.
Address the Stress: Our Employee Assistance Program offers you eight free, confidential counseling sessions each year to help your manage your work-life balance. Call 1-888-321-4433 to speak with someone to assist you today.
Manage Your Weight: Many options are available tohelp you manage your weight! Through Independence Blue Cross you can see a registered dietitian six times per year for FREE! You can also be reimbursed up to $200 per year for enrolling in and completing a weight-management program through IBC Healthy Lifestyles Program. Aetna members can get discounts for enrolling in a variety of different weight-loss programs. UPHS employees also have access to online nutrition programs through Carewise Health. Visit the My Health section of the Wellfocused website for more information — www.uphshrandyou.com.
Another benefit, offered through Heath Advocate, is designed to help handle health-care and insurance-related issues by cutting through the red tape and barriers that so often create frustration and problems. Health Advocate will help you: • Sort out insurance claims and billing issues. • Explain conditions and treatments when faced with serious illness or injury. • Obtain doctor services for your elderly parents and parents-in-law. • Obtain cost estimates for procedures, secure second opinions. • Schedule doctor appointments. • Find the right providers.
NEWSmakers / / / Altered Immune Cells Beat Leukemia A front-page story in The New York Times detailed the progress of a Perelman School of Medicine team in using genetically engineered versions of leukemia patients’ own T cells to fight their cancer. This approach has now been used in 12 patients, 9 of whom responded to the therapy — including two children treated at the Children’s Hospital of Philadelphia (CHOP). “Our goal is to have a cure, but we can’t say that word,” said the study’s leader, Carl June, MD, the Richard W. Vague Professor in Immunotherapy in Pathology and Laboratory Medicine and director of Translational Research in Penn’s Abramson Cancer Center. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases. David Porter, MD, director of Blood and Marrow Transplantation in the Abramson Cancer Center, Michael Kalos, PhD, director of the Translational and Correlative Studies Laboratory, Bruce Levine, PhD, director of the Clinical Cell and Vaccine Production Facility, and Stephan Grupp, MD, PhD, director of Translational Research in the Center for Childhood Cancer Research at CHOP, are also quoted in the news coverage of the trial results. The Philadelphia Inquirer, CNN, Bloomberg News, Fox News, Anderson Cooper 360, ABC World News Tonight, and the Huffington Post were among several media outlets that ran stories. The team’s research was also the subject of a short documentary, “Fire With Fire,” that premiered at the Dubai International Film Festival.
/ / / Hospitals Urge Precautions as Flu Spreads As influenza continues to spread across the United States, NBC Nightly News highlighted the precautions HUP staff are taking to protect patients. Jill Baren, MD, MBE, chair of Emergency Medicine, discussed the recent rise in the number of patients seeking help in HUP’s emergency department for the flu. Annette Davis, RN, BSN, outlined the steps patients with flu-like symptoms are asked to take as soon as they arrive in the ED’s waiting room to help avoid spreading the infection to others — putting on a mask, using alcohol-based hand sanitizer on their hands, and practicing proper coughing and sneezing hygiene. Victoria Frondorf, CRNP, was also featured in the piece caring for a flu patient who was interviewed for the story.
/ / / Penn-Led Team Studies Sleep in Mars Mission Simulation Coverage in USA Today and a front page article in The Philadelphia Inquirer detail a new study led by Penn Medicine researchers that analyzed sleep and activity levels in astronauts in a simulated 520-day mission to Mars. The cooperative effort by the Russian Institute for Biomedical Problems and the European Space Agency “sent” six young men on a simulated round-trip to Mars conducted within trailer-size isolation chambers. The Penn study, led by David F. Dinges, PhD, professor and chief of Sleep and Chronobiology, and Mathias Basner, MD, PhD, MSc, assistant professor of Sleep and Chronobiology, measured whether the crew members were awake, resting, or asleep by means of special electronic wristwatches that detected movement. With no exposure to natural light, four of the six experienced some form of sleep disruption — including one man who went to bed later and later until he started to turn night into day. In general the six became more sedentary by the end of the mission — a problem if it had been an actual long-term space trip, where exercise is essential to maintain bone and muscle strength. The findings serve as a reminder of the need to maintain a regular day schedule not just for astronauts but for people on Earth, Dinges told the Inquirer. A night-owl regimen can wreak havoc with sleep, digestion, cognitive performance, and mood. The research was also covered by numerous national and international media outlets.
/ / / Chester Co. Hospital in Talks to Join Penn Medicine In a proposed deal, The Chester County Hospital and Health System will join the University of Pennsylvania Health System, The Philadelphia Inquirer reported. Both organizations signed a nonbinding letter of intent and completion of the deal is expected in the spring.
/ / / Lindsay Ess’s Story: Getting New Hands Nightline featured the inspiring story of Lindsay Ess, Penn Medicine’s first bilateral hand transplant recipient. A quadruple amputee, Lindsay lost her hands and feet to a sepsis infection five years ago. The 29-year-old’s arms had been amputated just below the elbow, so simple tasks, such as feeding herself and putting on her prosthetic legs, became impossible without help. In September 2011, led by L. Scott Levin, MD, FACS, chair of Orthopaedic Surgery, two teams of surgeons at Penn Medicine worked for nearly 12 hours to perform a cutting-edge operation to give her new hands. In the few months after having surgery, Lindsay made remarkable progress. She could extend and move her wrists and fingers, begin to sense hot and cold, and even pick up lightweight objects ahead of schedule. Lindsay has at least two more years of daily therapy ahead of her, but today her recovery is ahead of schedule and she is regaining function every day.
/ / / Don’t Blame Parkinson’s Disease for Addiction: Study Even though some Parkinson’s disease patients undergo psychological changes where they may suddenly take up gambling or compulsive eating or shopping, the cause is likely the medications they are taking and not the disease itself, a new study shows, HealthDay reported. MedPage Today also reported that patients with newly diagnosed Parkinson’s disease did not have more symptoms of impulse control disorders or related behavioral issues than those in a control group. “Parkinson’s disease itself does not seem to confer an increased risk for development of impulse control or related behavior symptoms, which further reinforces the reported association between Parkinson’s disease medications and impulse control disorders in Parkinson’s disease,” said lead study author Daniel Weintraub, MD, associate professor of Psychiatry and Neurology. “Given that approximately 20 percent of patients with newly diagnosed Parkinson’s disease report some impulse control or related behavior symptoms, long-term followup is needed to determine whether such patients are at increased risk for impulse control disorder development once Parkinson’s disease medications are initiated,” researchers noted.
/ / / Coated Aspirin’s Drawbacks Pharmacological resistance to low-dose aspirin is extremely rare, according to a new Penn study. Among 400 healthy volunteers given a single oral dose of 325 mg regular “immediate release” or enteric coated aspirin, they couldn’t find a single case of true aspirin resistance. They did find “pseudoresistance” due to delayed and reduced absorption caused by the enteric coating found on most brands of aspirin, however. “The message to clinicians is that true resistance is vanishingly rare, so don’t waste time and money on screening patients prior to putting them on aspirin, either using point of care platelet tests or urine tests for thromboxane metabolites,” said Garret A. FitzGerald, MD, FRS, director of the Institute of Translational Medicine and Therapeutics. News of the study appeared in The New York Times, Wall Street Journal, and The Philadelphia Inquirer. The study was led by FitzGerald, Tilo Grosser MD, research assistant professor of Pharmacology, and Susanne Fries, MD, research assistant professor of Pharmacology. FitzGerald and Joel S. Bennett, MD, professor of Medicine, also appeared in a Reuters Health article. Additional coverage ran in Bloomberg Businessweek, MedPage Today, Forbes, CNN, and ABC World News Tonight.
/ / / Penn Team Unravels a Parkinson’s Mystery Penn researchers found that, in healthy mice, a single injection of synthetic, misfolded a-Syn fibrils led to a cell-to-cell transmission of pathologic a-Syn proteins and the formation of Parkinson’s a-Syn clumps known as Lewy bodies in interconnected regions of the brain. Their findings appear in this week’s issue of Science. The team was led by senior author Virginia Lee, PhD, director of the Center for Neurodegenerative Disease Research and professor of Pathology and Laboratory Medicine, and first author Kelvin C. Luk, PhD, research assistant professor, CNDR. The major significance of the paper is that it resolves the long-standing controversy about the role of a-Syn Lewy bodies in the degeneration of dopamine-producing neurons, thereby sharpening the focus on Lewy bodies as targets for discovery of disease-modifying therapy for Parkinson patients. News outlets covering the Science paper include The Philadelphia Inquirer, The Scientist, Nature, Scientific American, Discover, and Bloomberg, as well as the Michael J. Fox Foundation’s Fox Feed blog.
/ / / Perspective on the Sandy Hook Elementary School Tragedy Steve Berkowtiz, MD, director of the Penn Center for Youth and Family Trauma Response and Recovery, spoke with WHYY’s Radio Times and FOX 29 about the psychological ramifications of the Sandy Hook Elementary school shooting. “We are all struggling to make sense of the senseless. This event is completely incomprehensible,” Berkowitz said. Regarding next steps for those involved and for the general public, “One of the most important things that you can do is to get back to your routines and get on with your life. If you let it interfere and stop your life, you are much more likely to develop symptoms of PTSD and related disorders.” Berkowitz was also featured in a Huffington Post article and 6ABC segment. In addition, Anthony Rostain, MD, professor of Psychiatry and Pediatrics, was a featured guest on 6ABC’s “Inside Story” program that focused on societal issues, including treatment resources available for people with mental illnesses in the U.S., in the aftermath of the Newtown, CT school shooting.
/ / / Brain Scan Can Sort Dementia by Type The BBC reported that US experts can accurately identify Alzheimer’s disease and another type of dementia from structural brain patterns on medical scans, Neurology reported. Despite being two distinct diseases, Alzheimer’s and frontotemporal dementia share similar clinical features and symptoms and can be hard to tell apart without medical tests. A Penn team set out to see if it could ultimately reduce the need for a lumbar puncture test and instead predict brain protein levels using MRI brain scans alone. They found the density of gray matter on the MRI scans correlated with levels of two key proteins. The MRI prediction method was 75 percent accurate at identifying the correct diagnosis. Lead researcher Corey McMillan, PhD, of Penn’s Frontotemporal Degeneration Center, said: “This could be used as a screening method and any borderline cases could follow up with the lumbar puncture or PET scan” to determine which disease was present. The research was also covered by Medscape and MedPage Today.
To reach the Penn Medicine news website, go to www.PennMedicine.org/news
`` Tom Volkert worked with Mary Ellen Graham to establish My Place Germantown.
started. MPG takes this model and “flips it on its head,” Volkert explained, by providing permanent housing for residents as well as 24-hour staff and case management presence to help ensure each individual develops goals and receives the resources they need. Each resident, all around 40-60 years old, must prove a disability among other requirements to be admitted. MPG provides “safe housing and strong support,” said Graham, who explained that none of their previous residents are now homeless. “It’s very challenging but it’s working.” Some residents are working, some are looking for work, and others perform jobs in the neighborhood. In a typical day at MPG, the independent living coordinators assist residents in obtaining benefits and provide various recreational activities (including art and music therapy). A wellness group explores mental and emotional health issues.
A Permanent Home for Those Without While volunteering his time at a personal care home, assisting its mentally challenged and/or considerably low income residents, Tom Volkert, social worker for Penn Home Care and Hospice Services, agreed to be in on the ground floor of My Place Germantown (MPG), a new permanent housing project for people facing similar issues. Working with MPG executive director and president Mary Ellen Graham and others, they founded community-based permanent housing for 12 homeless, disabled men in Germantown in 2007 and opened its doors three years later. “We worked very hard to get neighborhood support,” said Volkert, who is now chairman of the MPG board. “Through hard work and the grace of God, we received a grant to start the home.” Today, financial support comes primarily through federal Housing and Urban Development grants, a federal Home Loan Bank grant, and support from the Department of Housing and Community Development in Philadelphia. “It was tough going for a while but many neighbors have come to see that the residents want a safe and peaceful neighborhood as much as they do,” he continued. MPG emphasizes neighborhood involvement in many ways. Zoning approval for the building included the stipulation that MPG leadership would hold regular meetings with the community. The Neighborhood Advisory Committee meets regularly at nearby St. Vincent’s Parish for anyone to express any ideas, concerns, or praise. The group also hosts potlucks at the home for the entire community. Transitioning people from the street to temporary shelter or halfway house all too often provides onlyshort-term support, in which they end up back where they
Thanks to a Penn Medicine CAREs Foundation grant, MPG will host CPR training for its staff and residents, which is particularly important in supporting residents’ care. The funds will also purchase a blood pressure cuff to monitor their blood pressure. One of the residents is currently serving as a nursing aide and, because of the grant, will now be able to train others in CPR.
MAKE IT COUNT
C o n gratulatio n s to the New CAREs Grant Recipients! The most recent recipients of a Penn Medicine CAREs Foundation grant are: Penn Presbyterian ...........................................Camp Kesum
Peter Cronholm Perelman School of Medicine.........UCHS Health Collaborative
John Flamma, Jr, MD
Carmen Guerra HUP......................................................Patient Navigation Program
Penn Presbyterian...............ED Patient Medication Assistance
Penn Presbyterian................................East Parkside Bike Rodeo
Phanerrica Muhammad HUP............................................... Esophagectomy Support Group
Alyssa Vaysman PAH.............................................. Pharmacy Community Outreach
Carrie Kovarik HUP.......................................................................... Teledermatology
Joel Fein, MD, MPH
Perelman School of Medicine.......CHOP Violence Intervention
Margie Delaney Corporate..........................................................The Veterans Group
Antiques Show Benefits EVLP Thanks to the tireless efforts of more than 200 volunteers, the 2012 Philadelphia Antiques Show was a resounding success, raising $660,000 to help establish the Penn Lung Transplant Ex Vivo
(continued from cover)
Giving Lungs A
Lung Perfusion Program. This addition to Penn Medicine’s Lung Transplant Program is a major initiative to promote innovative donor recovery practices, as well as extend treatment to more
This is truly the beginning of a new tomorrow, opening a door to many, many possibilities. If we can make more organs available, fewer transplant patients will die waiting.
patients suffering from chronic lung disease. (see article on page 1) Proceeds from the 2013 Philadelphia Antiques Show will benefit the Department of Emergency Medicine and the Center for Resuscitation Science at Penn Medicine. This funding will help create state-of-the-art medical resuscitation rooms where patients suffering from cardiac arrest and other life-threatening critical illnesses can receive the most modern and advanced resuscitation care. Over the past five decades, the Antiques Show has raised roughly $19 million for the advancement of patient care at Penn Medicine. The 2013 Show will be held at the Pennsylvania Convention Center on Saturday, April 13, 2013 —
Same — or Better — Results As part of the Novel trial, Cantu performed the EVLP procedure on the first patient in the region last month, using lungs that had been turned down by another transplant center outside of the area. “The lungs were procured by another team and brought to us by courier,” he said. “We were able to put them on the perfusion machine and evaluate them. The patient had fantastic results. Ordinarily we’d never have had that opportunity. This is good for both the donor and recipient families.” EVLP has been used in Europe and Canada for many years. Cantu said that results from a 2010 clinical study in Toronto — the largest so far in the world — showed that patients who received perfused lungs had the same survival rate and length of time on a ventilator, in the ICU and in the hospital as those with organs that were transplanted normally. In fact, “the numbers in the perfused organs are trending to shorter times and less injury, so this process may potentially be better,” he said. “This raises the question: should we do all donor lungs? Would this decrease the length of recovery time in all lung transplant patients?” Not every lung reconditioned through EVLP will meet the transplant criteria, Cantu noted, but even if not suitable for transplant, “we can use them for study, for example, to better define pneumonia or better understand ventilator injury. All these things we can do because we can keep the lung alive for an extended period. “This is truly the beginning of a new tomorrow, opening a door to many, many possibilities,” Cantu said. “If we can make more organs available, fewer transplant patients will die waiting.”
Monday, April 15. For more information, please visit www.thephiladelphiaantiquesshow.org.
AWARDS AND ACCOLADES Sataloff New Chair of Surgery at PAH Dahlia Sataloff, MD, has been appointed chair of Surgery at Pennsylvania Hospital. On the surgical staff since 1985, Sataloff has dedicated her practice exclusively to breast surgery and the treatment of benign and malignant breast diseases. She has lectured extensively and is the author of over 30 scientific papers and books. The recipient of multiple awards, Sataloff has been consistently recognized as one of Philadelphia Magazine’s “Top Docs” for the treatment of breast disease and Castle Connolly’s America’s Top Doctors for Cancer.
Four Elected to Institute of Medicine Four faculty from the Perelman School of Medicine have been elected members of the Institute of Medicine, one of the nation’s highest honors in biomedicine. The new members bring Penn Medicine’s total to 61. Established in 1970 by the National Academy of Sciences, the IOM is a national resource for independent, scientifically informed analysis and recommendations on health issues. The new Penn Medicine members are: • Shelley Burger, PhD, director of the Penn Epigenetics Program. • Carl June, MD, director of Translational Research in Penn’s Abramson Cancer Center. • Mitchell Schnall, MD, PhD, chair of Radiology. •K evin Volpp, PhD, founding director of the Center for Health Incentives and Behavioral Economics and co-director of the Penn Medicine Center for Innovation.
Janice K. Hillman , MD, was selected by the Pennsylvania chapter of the American College of Physicians for its Clinical Practice Award, which recognizes Fellows and Masters of the ACP who exhibit dedication to excellence in patient care, education, research, community service, and their ACP chapter.
New Center for Blood Disorders to Unify Patient Care, Research and Public Education Penn Medicine has established the region’s first dedicated center for the treatment and research of blood diseases by combining the expertise of physicians who specialize in the care of blood disorder patients of all ages along with basic science and clinical researchers who are working to advance treatments for these illnesses. The Penn-CHOP Blood Center for Patient Care and Discovery will bring together a multidisciplinary team of experts to provide cutting-edge patient care and research for diseases, including sickle cell disease, thalassemia, bone marrow failure, and bleeding and clotting disorders. Smoothing the transition between pediatric and adult care will also be a top priority for the new center. The Blood Center will help foster and integrate collaboration among faculty members across disciplines, schools, departments and institutes at Penn and CHOP. Participating departments will include Medicine, Pathology and Laboratory Medicine, Pharmacology, and parallel programs at CHOP. Basic scientists, translational researchers, and clinical investigators participating in the clinical hematology and transfusion medicine programs of the Health System and CHOP are welcome to become members of the Blood Center and are encouraged to participate in the Center’s sponsored research and educational programs. To learn more, go to www.PennMedicine.org/ blood-disorders-center.
Carl H. June, MD, director of Translational Research in Penn’s Abramson Cancer Center, will receive the 2012 Ernest Beutler Lecture and Prize from the American Society of Hematology. June will receive the prize along with Bruce Blazar, MD, of the University of Minnesota for their significant advances in the field of bone marrow transplantation and adoptive immunotherapy. L. Scott Levin, MD, chair of Orthopaedic Surgery and director of the Penn Hand Transplant Program, was elected to the Board of Regents of the American College of Surgeons. As an ACS regent, Levin will work closely with other members of the Board of Regents to assist in formulating policy of research, health-care delivery, and continued education for surgeons. Regents are members of the College who have demonstrated outstanding integrity and medical statesmanship along with a devotion to the highest principles of surgical practice. Daniel J. Rader, MD, chief of Translational Medicine and Human Genetics, has received the American Heart Association’s Clinical Research Prize for developing new methods to identify factors regulating the metabolism of fat particles in the bloodstream and testing their impact on the development of atherosclerosis. Rader has spent the last two decades working in the field of lipoprotein biology and atherosclerosis and is a widely recognized international leader in this field. Parvati Ramchandani, MD, section chief, Genitourinary Radiology, was selected by the American Association for Women Radiologists as the 2012 recipient of the Marie Sklodowska-Curie Award for outstanding contributions to the field of radiology. Ramchandani was chosen for her service in numerous leadership and mentorship roles in the specialty.
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Administration: Brian Strom, MD, MPH, executive vice dean for Institutional Affairs, has been selected to chair the Institute of Medicine’s Committee on the Consequences of Sodium Reduction in Populations. The Committee will evaluate the results and study design and methodologies used to assess the relationship between sodium and health outcomes in literature.
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H. Lee Sweeney, PhD, chair of Physiology, has been named the inaugural director of Penn’s Center of Orphan Disease Research and Therapy. The Center’s primary mission is to expedite the translational science and development of novel therapies for rare and orphan diseases, ie, those affected by fewer than 200,000 people. For much of his career, Sweeney has studied the mechanisms that help control muscle function to gain a better understanding of ways to thwart muscle deterioration caused by age and degenerative diseases and to promote muscle growth.
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Alan J. Wein, MD, chief of Urology, was elected vice president of the Clinical Society of Genitourinary Surgeons for FY13 and will serve as the organization’s president in 2013-2014.
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