SYSTEMnews november 2013

Volume 13

Issue 2

November 2013

SYSTEMnews CEO’s corner

At the CENTER of (and for)

I nnovation

Ralph W. Muller

CEO, University of Pennsylvania Health System

Medicine isn’t static. It’s dynamic, continuously changing.

New developments — typically high-tech in orientation — frequently surface, offering brighter, more realistic prospects of slowing down, even eradicating diseases and conditions which in the past were commonly terminal.

Yet a price is often paid in the form of a more depersonalized patient experience. Amidst jam-packed data dashboards and exhaustive DNA-sequencing printouts, we risk forgetting about the human being in the bed or outpatient waiting area.

Health care shouldn’t be a choice between technical sophistication and a warm, empathetic healing environment.

That’s a false dichotomy; patients deserve both. So at Penn Medicine, we’re continuing our focus in keeping our care patient- and family-centered. And not in a small way. Instead, we’re going system-wide, across the full scale of our programs.

Here are two ways we’re doing it.

Over 2,000 managers and staff members from CPUP (the Clinical Practices of the University of Pennsylvania) and CCA (our Clinical Care Associates) have participated in the Penn Medicine Experience, a special training project aimed at improving the patient experience and offered through the Penn Medicine Academy. (The Academy supports training throughout Penn Medicine in many forms, from new-hire orientation, on-site degree completion programs and leadership development to our high school pipeline program.)

In the Penn Medicine Experience offering, front-line staff including nurses, patient service representatives, and medical assistants participate in four-hour classes focused on skillbuilding through video, simulation, role-playing, and coaching.

The emphasis is on such behaviors as acknowledging the patient, ensuring staff always introduce themselves, explaining what will happen, and thanking the patient for coming to Penn Medicine. The program also helps managers and supervisors learn to develop the kinds of behaviors and processes that will enhance the patient experience. We’ve seen gains in our patient satisfaction scores following the introduction of the program and are working hard to build upon our successes. We’ll be expanding the program to the hospitals over the next 15 months – the work in in-patient pilot units has already begun!

Second, our new Academy of Master Clinicians will recognize and reward outstanding Penn Medicine clinicians. Invitation to the Academy will be a significant honor available for Penn physicians. A master clinician will be distinguished by superior scope of knowledge and clear enthusiasm for pursuing new knowledge. Equally important will be excellent judgment, integrity, and exemplary interpersonal and communication skills with patients and colleagues at all levels. Once announced, our new master (continued on page 6)

Inside Inside Chester County Hospital & Health System Join UPHS........2 Penn Medicine Rubenstein to Washington Square Major Hub for PAH Step Down.................................2 Outpatient Care.........................2 From Pastels to PDA’s...............2 A New App Simplifies Penn Radiology.........................

2 RoundtableFree Skin

`` (L. to r.) Roy Rosin, David Asch, and Kevin Volpp want to hear your best ideas to improve health care.

Releasing the footbrake on the imagination could be the guiding theme of the Penn Medicine Center for Health Care Innovation. Consider some of the ideas its leaders are working on: • Is paying smokers to quit their habit effective?

• Can “automated hovering” help patients remember to take their heart medication?

• Can a magic scale help get the weight off?

Questions such as these are prompting some of the most mold-breaking thinking in American health-care circles —­and it’s happening at Penn. The Center is the brainchild of Kevin Mahoney, Penn Medicine’s chief administrative officer, who believes that the best way to keep the organization advancing is by promoting the creative capacities of personnel within the Health System and the University.

At the Center, staff members and associates with backgrounds in medicine, behavioral economics, business, engineering, design, software development, and hospitality develop and test fresh ideas for improving health care delivery. Additionally, the Center’s grant program funds Penn Medicine staff members with imaginative ideas for preventing hospital readmissions, improving the patient experience, and delivering evidence-based care.

David Asch, MD, MBA, executive director of the Center, says:

We’re called the Penn Medicine Center for Health Care Innovation — not the Penn Medicine Center of Health Care Innovation. ‘For’ means we’re there for those with great ideas. ‘Of’ implies that all of the

Cancer Screening......................3 Penn Medicine@Work..............3

innovation takes place within our walls. And that’s

Newsmakers..............................4 Shortakes...................................4 A New Era Another Title..............................5 of Medical Education................5

not something we want.

Credentials for#2.GSPP SOM Ranked ........................6 Outpatient Residencies.............5

Innovation is hard work, says Asch. “We’re not just creating trendy smart phone apps. We’re keeping the patient in our sights, and we want to provide enduring value.” Asch notes that most health-care financing in the US addresses hospitalizations and outpatient visits. But the Center emphasizes the 5,000 annual waking hours patients spend out of the doctor’s office or hospital. “These hours directly influence whether patients remain healthy,” says co-director Kevin Volpp, MD, PhD. “Deciding whether to take their medication regularly and not just when they feel ill, choosing what to eat and drink and whether to smoke, all greatly affect patients’ health. Most patients know what those choices should be; we just give them a little outside help.”

The Center has brought in entrepreneurial expertise to help it achieve its mission. Roy Rosin, the Center’s chief innovation officer and a college classmate of Volpp’s, came to Penn after serving as first vice president of innovation for Intuit, a global software company known for Quicken, QuickBooks, and TurboTax. But the leap from online mortgages and DIY income tax returns is not as improbable as it may seem.

Rosin, who oversaw Intuit’s innovation program, says, “My role was helping internal teams test new ideas. We’re following the same model here at Penn. Innovation — and most science today — isn’t about a lone genius having a ‘eureka’ moment. Instead it’s based on teamwork and learning early on and at low cost if you’re going in a viable direction.” Asch says this about Rosin: “After three minutes with Roy you know he can help you better understand what your real goals are, and get you on the path to achieving them.” (continued on page 5)

Awards and Accolades.............6

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PENN MEDICINE Washington Square Major Hub for PAH Outpatient Care Penn Medicine Washington Square, which officially opened last month, will serve as the major hub of outpatient care for Pennsylvania Hospital, much as the Perelman Center for Advanced Medicine does for HUP. The 153,000 square foot modern facility features leading-edge telecommunication and clinical information systems, providing patients with the most advanced level of collaborative and interdisciplinary care.

“Penn Medicine Washington Square is part of the hospital’s $61 million facilities master plan which includes the expansion of private rooms for our patients,” said R. Michael Buckley, MD, executive director of Pennsylvania Hospital. “It’s imperative that we stay at the forefront of medical technology to best meet the current and future health-care needs of our patients, and to give our providers the environment and tools they need to deliver that care.”

Chester County Hospital

Chester County Hospital & Health System Join UPHS As of September 1, The Chester County Hospital and Health System (TCCHHS) became the newest addition to the Health System. TCCHHS includes a 245-bed hospital complex in West Chester and satellite locations in Exton, West Goshen, New Garden, Jennersville and Kennett Square.

More than 100 providers from across a wide range of services — including cardiology, concierge medicine, otorhinolaryngology, primary care, surgery and women’s health — are now available in one location along with patient pre-admission testing and phlebotomy services. The 12-floor facility is also built atop an existing parking garage, offering added convenience for patients.

“Services are coordinated and coherent and co-located so that when patients come in and need a referral to another doctor, they can walk down the hall or take a short elevator ride,” said UPHS CEO Ralph Muller.

With this partnership, “we hope to further expand the depth and breadth of quality health-care services that Penn Medicine provides to the greater Southeastern Pennsylvania region,” said CEO Ralph W. Muller of the Penn Health System. “As one of the world’s leading academic medical centers, dedicated to the missions of medical education, biomedical research, and excellence in patient care, we plan to provide unparalleled access and support to both patients and staff at TCCHHS.”

The building was designed around creating a better patient experience. For example, all of the waiting rooms are on the north side of the building, with a glass exterior that allows for sunlight. The exam rooms are placed toward the center of the building and there are now more consultation rooms available for physicians to talk to patients and their families.

TCCHHS currently offers a variety of inpatient and outpatient medical/surgical services, including interventional cardiovascular services, open heart surgery, oncology, radiation oncology and comprehensive maternal/infant health services.

The health system also offers home health and hospice care; skilled nursing care; occupational and employee health care; professional and technical education; outpatient laboratory; radiology and physical therapy services; prenatal care and gynecological care centers for the underserved; and cardiopulmonary rehabilitation.

“It’s a very patient-friendly, environmentally friendly and tech-friendly environment, and a great space for providers and patients and families,” said Daniel Feinberg, MD, the hospital’s chief medical officer. “So far, the feedback has been very positive across the board.”

“This is an exciting time for our organization,” commented Michael J. Duncan, president and CEO of The Chester County Hospital and Health System. “We will now blend the best of Chester County Hospital with the remarkable achievements of Penn Medicine to create one of the leading hospitals in the Philadelphia suburbs.”

The new outpatient building is also a green urban redevelopment site. It features energy efficient heating and cooling systems; optimized day lighting; increased wireless access; paper, metal and plastics recycling; maximized water efficiency systems in restrooms; and storm water retention through a “green roof ” terrace.

The new affiliation will expand current strategic programs between Penn Medicine and TCCHHS, such as membership in the Penn Cancer Network, and foster additional collaboration to identify new programs and technology that can be brought to the community.

A New App Simplifies Penn Radiology A new smart phone application developed by three members of Penn Radiology aims to eliminate the sometimes frustrating process clinical providers encounter in tracking down the right radiologist to get specific study results. The Radphone Smartphone App provides a list of “real-time” Radiology phone numbers (which change depending on the time of day) for each Health System hospital and the VA. Working with Radiology residents Allison Lawyer, MD and Ruchika Dua, MD, Joel Stein, MD, PhD, a neuroradiology euroradiology fellow, developed the app which easily and quickly provides a list of phone numbers for the numerous radiology studies available. “The app displays the right number to call for a given study at any given time of day or night,” he explained, “and then allows you to dial that reading room.”

Previously, Dua said, “clinicians had to call many people to get results of their radiology tests.”

The app also provides answers to commonly asked questions, such as “Can a patient with a pacemaker get an MRI?” and “How do you manage patients with contrast allergies?’

The app is easily downloaded to a smart phone. While on the Health System Wi-Fi network, type http://uphs-ctii.uphs.upenn.edu/radphone or simply type “radphone” into the browser address bar.” The app will load and then you can just add it to your home screen,” Lawyer said. “Once it’s downloaded, you can access the information from anywhere.”

Lawyer, Dua and Stein received Penn’s Patient Safety Innovation Award for developing the Radphone Smartphone App. The HUP/CPUP Patient Safety Steering Committee created this award to recognize employees for their contribution to patient safety.

`` (L. to r.): Ruchika Dua, Joel Stein and Allison Lawyer worked together to create the Rad App, which easily and quickly provides a list of phone numbers for radiology studies done at all three UPHS hospitals and the VA.

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Creating mobile web applications and smart phone applications is not new for Stein. He has also created an app for the iPhone and iPad. Rad Signs, he explained, “is an educational application to help medical students and radiology residents learn the classic imaging appearances of different diseases.” It’s available on the App Store.

and team-based relationships that define medicine today. High-tech recording and simulcast technology will allow faculty members to more easily create online courses and lectures available to millions across the globe. Students will be able to quickly call up EKG results, tissue samples, 3D videos of organs, and the latest journal articles while they discuss classroom work or clinical rotations. Telemedicine meetings or consultations will facilitate constant collaboration among Penn Medicine laboratories and other schools, centers, foundations, and institutes.

The Center was named to honor the late Henry A. Jordan, MD, thanks to a major gift from his wife, Barrie. “Henry loved this institution, the vision that it embraced and, in particular, its extraordinary medical students,” she said. “Our family is honored to have his name associated with this stunning new educational facility.” `` (L. to r.) CEO Ralph Muller, Gail Morrison, senior vice dean for Education; University president Amy Gutmann; and J. Larry Jameson all participated in the beam signing for the Henry A. Jordan, M ’62, Medical Education Center.

A New Era of Medical Education Construction is under way on the Henry A. Jordan, M ’62, Medical Education Center, creating a new era of medical education for students at the Perelman School of Medicine.

With its location atop the Perelman Center for Advanced Medicine and connected to the Smilow Center for Translational Research and the Roberts Proton Therapy Center, the Henry Jordan Center is one of the few medical educational facilities in the nation to be fully integrated with research and clinical practice facilities.

“More than a collection of classrooms and study areas, the new Henry Jordan Center will play a prominent role in advancing innovation in every aspect of medicine,” said J. Larry Jameson, MD, PhD, executive VP of the University of Pennsylvania for the Health System and dean of the Perelman School of Medicine.

The Center will have a flexible, adaptable and state-of-the-art environment to support the School of Medicine’s small-group learning model. It will also strengthen the collaborative

`` Fearless of the height, members of the construction team working on the Henry A. Jordan, M ’62, Medical Education Center recreate Lunch Atop a Skyscraper, a famous black-and-white photo taken in 1932 during construction of the RCA Building in NY.

Credentials for GSPP Outpatient Residencies The Penn Therapy & Fitness orthopedics residency and women’s health residency programs at Good Shepherd Penn Partners were recently credentialed by the American Physical Therapy Association (APTA). The PT orthopaedics residency program is only the second program in the Philadelphia area to be credentialed by the APTA. The women’s health program for physical therapists, meanwhile, is only the seventh such program in the entire nation to meet the high standards of the APTA. APTA credentialing highlights the quality of education provided by these programs. Both residencies last 50 weeks, with 35 hours of work training plus 10 hours of mentorship per week.

Receiving this recognition from the APTA is the culmination of more than five years of program development efforts. The therapy team members who over the years helped bring this status to fruition include Jeffrey O’Neill, PT, DPT, OCS, who leads the orthopaedic program, and Bryan Spinelli, PT, MS, OCS, CLT, who leads the women’s health residency. Credit also goes to Brian Eckenrode, PT, DPT, MS, OCS, who resurrected the orthopaedic residency in 2009 and helped build momentum for credentialing. `` Physical therapists in GSPP’s recently credentialed Women’s Health and Orthopaedic PT residencies.

These are just a few of the numerous individuals who helped make this accomplishment possible. In total, more than 35 therapists across multiple Penn Therapy & Fitness outpatient sites support these two residency programs.

(continued from cover)

At the CENTER of (and for) Way to Health

I nnovation

Much of the Center’s work is tied to Way to Health, a web-based IT platform developed at Penn and supported by an economic stimulus grant from the National Institutes of Health. (The name may ring a bell. It intentionally evokes Benjamin Franklin’s The Way to Wealth, a short guide to prosperity.) Asch calls it “a new pathway for care delivery.”

Way to Health supports what Asch, Volpp, and UPHS CEO Ralph Muller christened in a joint article in The New England Journal of Medicine as automated hovering: mixing behavioral economics — such as paying people to perform healthy behaviors — with biometric devices such as “smart” pill-bottle tops. The goal is to motivate patients to improve their health while keeping track of their progress and letting them know if they’re slipping behind. Way to Health helps researchers allocate participants in studies, send surveys and voice and text messages, and pay participants by transferring money into their bank accounts.

For example, at the Children’s Hospital of Philadelphia, employees hoping to lose weight were randomized to take part in monthly weigh-ins through The Way to Wealth. They were given the goal of losing a pound a week for 24 weeks with 1) no financial reward, 2) $100 monthly for reaching their target weight, or 3) $500 monthly for groups of five employees who reached their target. Which would work best?

Participants weighed themselves on a Way to Health “magic” workplace scale. The machine sends weight information to a server, which calculates the applicable incentive. Payments are then transferred electronically to the participants’ banks. The results showed that the groupbased incentive — perhaps reflecting a positive form of peer pressure — produced three times the weight loss as individual rewards. As a result of these findings, Asch and Volpp expect that employers will offer similar incentives to their own employees.

Another focus is on encouraging patients to take their medication regularly. One technique involves “smart” pill caps. A chip inside the cap sends information electronically to the Way to Health platform, indicating whether the heart-medicine bottle has been opened that day.

Patients volunteer to have family members notified if they forget to take their medicine.

“Imagine you’re a 50-year-old male whose 19-year-old daughter will be told if you skip your pills,” says Volpp. “You certainly don’t want to get a call from her asking why you missed your medication.”

Smoking Through Center-based research, Volpp and colleagues found that smokers given financial incentives quit smoking at three times the rate of those not similarly rewarded.

A program based on this approach was implemented for all 152,000 General Electric employees in the U.S. Volpp continues to assess how the model can be improved, noting that the incentivized quit-rate, while significantly better than the five percent of workers who weren’t given financial incentives, was still only 15 percent. That means 85 percent of smokers who want to quit still have a hard time doing so — even with $750 in financial incentives.

DreamIt: IBX Partnership Rosin leads Penn Medicine’s role in DreamIt Ventures, a partnership with Independence Blue Cross aimed at finding new ways to improve care and use resources effeciently.

An early result of the teaming-up is the first Philadelphia-based health care “accelerator,” which supports promising health-care start-up companies. The accelerator provides cash, guidance from experienced health-care executives (including members of the Center’s staff), and office space. Its four-month boot camp recently helped support 10 new local health-care startups, tackling such problems as hospital readmissions, patient communications, and cost transparency. The program culminated in a “demo day” with the 10 companies presenting their businesses to investors and potential customers, including major health-care organizations.

Patient Experience Penn is renowned for the kind of care that only a few places around the country can deliver.

But it still has to make patients feel welcome and supported. Along with Emilie Bartolucci, who came to the Center from the Ritz Carlton Hotel, and Meera Gupta MD, a general surgery resident, Rosin developed a program for assessing patient feedback so hospital staff members can get a sense of what patients think of their care. It features a combination of new software (think private Yelp or Twitter for hospitals) and rigorous analysis.

And these are only some examples of what’s taking place at the Center. Results are already showing how patients can improve their health. While not every reader of Dr. Franklin’s The Way to Wealth, became a well-heeled tycoon, those who hold fast to the findings of the Penn Medicine Center for Health Care Innovation can remain in the pink for a good long while.

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penn medicine

work

Learning by Doing The Coding Academy, coordinated through the Penn Medicine Academy, is being taught in partnership with Temple University faculty and Jennifer Ritter, Coding Academy Manager. It is a challenging one-year commitment for the candidates that were selected. The first group of 13 coders have started their training with six months of intensive classroom learning, meeting for full workdays, five days a week at the Penn Medicine Center for Innovation and Learning. The challenging course of study has been likened to achieving fluency in a foreign language in just six months.

“I think it will increase the quality and production of Penn’s medical records,” says Marisa Peirandoczi, a recent graduate of Temple University’s Health Information Management program. She believes that the Academy’s intensive learning schedule will ultimately lead to better outcomes for Penn Medicine. “The program is brand new, so none of us knew what to expect. It’s so professional and the structure is very unique compared to other programs.” `` Coding Academy manager Jennifer Ritter with the first group of students on their way to becoming qualified, medical coders.

Penn Medicine Coding Academy Earlier this year, Penn Medicine launched the Penn Medicine Coding Academy.

The Academy is designed to help fill a gap in qualified, medical coders that is being anticipated throughout the health-care industry. This shortage is due in part to changes in the code sets based on the International Classification of Diseases (ICD), used to report medical diagnoses and inpatient procedures. The previous code-set, ICD-09, was adopted in 1975 and has become outdated as medicine has evolved and advanced over time. The newest revision, ICD-10, has been designed to be more flexible, allowing for greater reporting detail within the codes and the ability to expand to include new diagnoses and procedures. The Health Insurance Portability Accountability Act (HIPAA) dictates that any organization covered under it be fully transitioned to using ICD-10 code sets by October 2014.

Healthy Rewards

Challenge Spotlight

The students have completed phase 1 of their learning, and are now onto phase II — gaining experience and honing their skills through exposure to real patient records.

Students are given a blank slate to work from and then get to compare their results to the original coded chart. Peirandoczi notes, “After all the classroom time, the chart comparison allows us to really see how much we’ve learned.” As students continue to develop their skills, the cases they are reviewing will become increasing more complex.

Why Start a Coding Academy?

In the past, due to the complexity of medical cases and the time it takes to move from a novice to being fully competent in coding, Penn Medicine was not able to recruit entry-level coders. With the creation of the Coding Academy, Penn Medicine is able to leverage the learning infrastructure already in place to support the training and professional development of coding specialists, while making sure the Health System is fully prepared to meet the challenges that lie ahead.

JOIN THE HEALTHY CAFÉ FOR UPHS EMPLOYEES Earn 10 Healthy Reward points each week (120 total points) for choosing the Wellfocused item of the week

These Healthy Rewards Challenges — including those below — are waiting for you.

Visit www.uphshrandyou.com and click the “Wellfocused” tab to learn more.

Fall Into Fitness FAT TAL TO

To meet the challenge, simply exercise at least 15,000 steps each week. That works out to just over 2,000 steps, or about a mile, per day. If you already spend some time walking and exercising this will be a breeze. If your weekly rhythm is a bit more sedentary, this is great time to start moving. You will be amazed at how many steps you can take as you go about your work each day. If you have a fitbit, or use the Nike+ or Runkeeper apps, you can sync them to track this challenge. Meet this challenge and you will earn 25 Wellfocused points.

November Great American Smoke out Challenge Earn 25 points for your committment that you will quit smoking — or that you’ll support a friend or loved one who quits — for the Great American Smoke Out on November 15.  Did you know?

All UPHS employees and dependents covered under a medical plan are eligible to enroll in the free UPHS Tobacco Cessation program administered through Health Advocate. The program consists of 13 weeks of telephonic coaching with a quit coach, free nicotine replacement therapy (patch, gum, or lozenge) mailed straight to your home, and a $0 co-pay for prescription quit smoking medications. Call Health Advocate today to enroll at 1.866.695.8622.  Lend your support: Have a conversation with your friends or loved ones about the Great American Smokeout. Make sure they are committed to quitting for the day. Pledge to support them that day and beyond, if they choose to do so. Report back to your home page and click “I did this” after November 21st to earn your points!  Resources: For more information on kicking the habit, visit the Tobacco Cessation Page on the HR and You website under the Wellfocused tab.

≤600mg

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1. Join the Healthy Café challenge by logging into the Healthy Rewards site from www.uphshrandyou.com 2. Choose the item labeled with a Wellfocused logo in the cafe 3. Track that you chose the Wellfocused item once that week to earn 10 points/week!

Healthy Café Challenge Each week, simply eat cafeteria savvy on at least one day by choosing the featured Wellfocused item at your hospital cafe. You’ll earn 10 Wellfocused points for each week that you complete the challenge. Visit your local café to learn more about which day(s) of the week the Wellfocused item will be served.

More new challenges are available to you on the Healthy Rewards site! Visit www.uphshrandyou.com and click Healthy Rewards to sign in today. Improve your health and well-being, earn points — and maybe even win prizes — along the way.

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Penn Medicine

NEWSmakers / / / Radiation Therapy Overused in Advanced Prostate Cancer, Study Says

/ / / Researchers Take Step Toward Predicting Parkinson’s

A study published in JAMA, led by Justin Bekelman, MD, an assistant professor of Radiation Oncology in the Abramson Cancer Center, found that, despite evidence indicating that a single radiation treatment provides just as much relief of pain and other symptoms to patients with prostate cancer that has spread to their bones as multiple treatments, more than 95 percent of these patients undergo more than one session of the therapy.

The findings indicate that health-care costs are driven up for these terminally ill patients without providing any additional benefits to them. “We know that it takes time for clinical trial evidence to get into routine practice. But these findings are nonetheless surprising,” Bekelman told HealthDay News. “The fact is, this is a good treatment that’s better for patients. It’s effective, it’s more convenient, and better for their quality of life. Singlefraction treatment should be the standard of care.” The study was also covered by The Philadelphia Inquirer, KYW NewsRadio and the Daily RX.

A published study takes the first major steps toward predicting who will get Parkinson’s disease and what the course of their progression will be, USA Today reported. The study is the first significant finding from the Parkinson’s Progression Markers Initiative, a major multiyear trial tracking the biology of Parkinson’s over time. The study will eventually examine 400 patients and 200 healthy people as a control group. “By following people systematically you hope to gain the greatest insight into the many nooks and crannies of what is a complex disease process,” said Leslie Shaw, PhD, a study leader and professor of Pathology and Laboratory Medicine. “The hope that everyone has is that we’d be able to intervene earlier,” Shaw said, which would be “better for helping those people have a better lifestyle.”

Additional coverage appeared in Medpage Today, Healthline and more than 40 NBC and Fox affiliates from Jackson, Mississippi, to Juneau, Alaska.

/ / / National Cancer Campaign Hits Home Articles in the Jewish Exponent and Boston Globe detail efforts of the Basser Research Center for BRCA’s Jewish outreach campaign, which seeks to raise awareness of inherited forms of breast, ovarian and other cancers that are prevalent among individuals of Ashkenazi Jewish heritage. Susan Domchek, MD, executive director of the Basser Center, said one objective of the campaign, which has distributed posters and educational materials to more than 1,500 synagogues across the United States and will be amplified by educational events in synagogues from coast to coast, is to provide information that will help dispel some of the misconceptions surrounding the presence and impact of BRCA gene mutations. “There are a lot of different issues that are relevant, and we are sensitive to these in this outreach campaign.” As an example, she referred to “Jewish individuals and families out there who don’t have access to their family history, as whole generations of families were wiped out in the Holocaust. Even when one or a few people survived, there is no real way to find out the family history.”

Domchek was also quoted in an NBCNews.com article focusing on patterns in inheritance of breast cancer risk genes passed down through the father’s side of a family.

“Men with these mutations have a 5 to 10 percent risk of developing breast cancer,” she said. “In the general population, the risk of breast cancer in men is 0.1 percent.

If there is breast cancer in a male relative, “that should be a big red flag” for families to consider genetic testing, Domchek said.

/ / / Many Looking for a Good Night’s Rest Turn to Sleeping Pills NBC Nightly News reports that millions of Americans rely on sleep aids to help them for slumber, but the pills may not be the best course to ease sleep disorders. At least 8.6 million Americans take prescription sleeping pills to catch some Zzzs, according to a new report from the CDC. And women are more likely than men to take these medications. While the pills can provide a short term solution for sleep problems, experts say that sleep medications are not meant to be a long-term fix.

Philip Gehrman, PhD, CBSM, assistant professor of Clinical Psychology in Psychiatry, said, “Generally most sleeping medications are recommended for one month or less.” For Penn Medicine patient Patricia Haggarty, cognitive behavioral therapy for insomnia (CBT-I) has helped her regain precious hours of sleep. Having previously tried sleep medication, through CBT-I she was able to work through the fear and anxiety she had around falling asleep.

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/ / / For Nearly 1 in 5 Americans, BMI May Tell the Wrong Story Obese is bad and lean is good. End of story, right? Wrong, said a pair of Penn physicians and obesity researchers who are calling for better ways to assess individual health prospects than the body mass index, or BMI, The Los Angeles Times reported. Rexford Ahima, MD, PhD, professor of Medicine and director of the Obesity Unit in the Institute for Diabetes, Obesity and Metabolism, and Mitchell Lazar, MD, PhD, professor of Medicine and Genetics and director of the Institute of Diabetes, Obesity, and Metabolism, wrote a Perspective piece in Science saying that “there is an urgent need for accurate, practical, and affordable tools for assessing body composition, adipose hormones, myokines, cytokines and other biomarkers as predictive tools” that would let physicians separate the fat-but-fit from those in danger, and to identify the trim ones who look healthy but are actually at risk of illness and early death. “The BMI doesn’t tell you anything about how fat is distributed in the body or about the fat-muscle ratio, and doesn’t take into account racial differences or differences between male and female,” Ahima told The Telegraph (of India). Coverage also appeared in Scientific American, Huffington Post, The Telegraph, LiveScience, Fast Company’s CoExist, and Health Central.

/ / / Should Severe Premenstrual Symptoms Be A Mental Disorder?

NPR reported on premenstrual dysphoric disorder, or PMDD, a syndrome in less than one percent of menstruating women that causes disabling emotional and sometimes physical reactions to hormonal changes during a woman’s period. In PMDD, said C. Neill Epperson, MD, director of the Penn Center for Women’s Behavioral Wellness, a woman clearly has “symptoms under a certain hormonal state that are not there under another hormonal state.” Epperson served on the work group dedicated to updating the new Diagnostic and Statistical Manual, the DSM-5, which lists PMDD as a distinct mental disorder.

/ / / The (Non) Burning Question The Philadelphia Inquirer focused again on the debate over the efficacy and safety of e-cigarettes and the pending US Food and Drug and Administration’s proposal to regulate the industry more closely. Andrew Strasser, PhD, director of the Biobehavioral Smoking Laboratory, said more research is needed to help answer the myriad of questions surrounding e-cigarettes. He is currently enrolling patients in a study to see how they respond to them. “More evaluation needs to be done before you make a decision either way,” he told The Inquirer.

/ / / Why Are Some People Resistant to Dementia?: Analysis of Alzheimer’s Pathological Lesions Offers Clues A team of researchers recently reported that factors other than plaques and tangles may be more directly related to cognitive impairment and to neuronal and synaptic damage in Alzheimer’s disease. The findings support the idea that some individuals may resist the insult of classical Alzheimer’s lesions in their brains. There is a great deal of interest and a number of studies on why some individuals with significant AD pathology do not develop dementia symptoms, said David A. Wolk, MD, assistant professor of Neurology and assistant director of the Penn Memory Center.“I think this paper is interesting and adds to our knowledge of what mechanisms might be involved, and provides investigators with a direction to better explore these differences,” he told Neurology Today in a telephone interview. There is a possibility that the patients without dementia may not have been as far along as the others in disease progression, he noted.

/ / / Bridging the Doctor Distribution Gap with ‘Teledermatology’ On any given day, Carrie Kovarik, MD’s dermatology patients range from an HIV-infected girl in Malawi with a growth on her shoulder to a complex leprosy case in Brazil to a worrisome-looking mole on the neck of a woman from West Philadelphia, reported Al Jazeera America. Her practice is here, where she is an associate professor of Dermatology, but she sees many of her patients not in a clinic but on her iPad. Health workers from around the world, from rural clinics to thinly-staffed urban hospitals, send her images shot with their smart phones or digital cameras, that Kovarik uses to help diagnose complicated skin conditions.

/ / / Hair Loss Cure? Scientists Find Way To Regrow Hair With Person’s Own Cells Scientists have successfully grown new hair follicles from the skin cells of balding men. While the research team hasn’t yet shown whether the structures, which produce strands of hair on our bodies, are fully functional and usable for transplants onto a scalp, experts say the discovery is a significant step toward finding new treatments for hair loss. The success of the approach is exciting, but the real breakthrough for other researchers in the field is the new data on gene expression in dermal papilla cells, said George Cotsarelis, MD, chair and professor of Dermatology, who was not involved in the study. The full readout of what genes are on and off in dermal papilla cells has never been collected before, so researchers now have a new list of thousands of genes to study further that may play key roles in hair follicle development. “It could have implications for not just hair, but treating wounds and scarring,” he told Science. This also appeared in The Huffington Post, Smithsonian.com, LiveScience, and LAist.

To reach the Penn Medicine news website, go to www.PennMedicine.org/news

AWARDS AND ACCOLADES Gilliland Named Vice Dean & VP for Precision Medicine D. Gary Gilliland, MD, PhD, has joined Penn Medicine as the inaugural vice dean and vice president for Precision Medicine, a newly created position that supports one of the pillars of our strategic plan, “lead in delivering individualized medicine.” Gilliland will work with key partners in cancer, heart and vascular medicine, neurosciences, genetics, and pathology, and leaders in other disease specialties throughout Penn Medicine. Our strong base in this new field and Gilliland’s background and accomplishments will provide experienced leadership to take us to the next level of excellence.

Gilliland was formerly senior VP of Merck Research Laboratories and Oncology Franchise Head. Prior to joining Merck, Gilliland was a member of the faculty at Harvard Medical School for nearly 20 years. He was also an Investigator of the Howard Hughes Medical Institute, director of the Leukemia Program at the Dana-Farber/Harvard Cancer Center, and director of the Cancer Stem Cell Program of the Harvard Stem Cell Institute.

Gilliland’s discoveries as an investigator studying hematologic malignancies have contributed to our understanding of the genetic basis of leukemias and other cancers that affect the blood and bone marrow. His work has earned him numerous honors including the William Dameshek Prize from the American Society of Hematology.

Changes in Medicine Leadership Michael Parmecek, MD, will serve as interim chair of Medicine, replacing Richard Shannon, MD, who will leave Penn to become executive VP for Health Affairs at the University of Virginia.

Parmecek, who was founding director of Penn’s Cardiovascular Institute, will remain chief of Cardiovascular Medicine. A national search for the next chair of Medicine will begin shortly.

Effective November 1, Gregory Tino, MD, as been appointed as Penn Presbyterian’s next chief of Medicine. Jack Ende, MD, who has `` Michael Parmaceck, MD `` Gregory Tino, MD served as PPMC’s chief of Medicine for the last 16 years, will step down from his position and assume a new role as assistant vice president of the Health System and assistant dean in the Perelman School of Medicine.

Since coming to Penn in 1986, Tino has held various clinical and administrative positions in the Pulmonary, Allergy & Critical Care Division at HUP. He became an attending physician at Penn Presbyterian in 1997. Tino is a nationally recognized expert in pulmonary diseases and critical care medicine and has won a number of awards. He is the Chairelect of the Assembly on Clinical Programs of the American Thoracic Society and a Fellow of the American College of Chest Physicians and the American College of Physicians. He has published extensively.

Alex Brucker, MD, of Ophthalmology, received the Gian Battista Bietti SOI Medal Lecturer from the Italian Ophthalmology Society (SOI) at the Oftalmologica Italiana International Congress in Milan, Italy.

Garret Fitzgerald, MD, chair of Pharmacology and director of the Institute for Translational Medicine and Therapeutics, is the 2013 recipient of the Jay and Jeanine Schottenstein Prize in Cardiovascular Sciences from the Wexner Medical Center at Ohio State University. The prize is given to an international leader in the clinical sciences of cardiovascular medicine, cardiothoracic surgery, or the basic sciences of molecular or cellular cardiology.

Stephen M. Hahn, MD, chair of Radiation Oncology, has been named among the ten 2013 Fellows of the American Society for Radiation Oncology. ASTRO’s Fellows Program honors radiation oncology leaders who have made substantial contributions to the field in the areas of research, education, patient care or service, and leadership.

Henry Kranzler, MD, of Psychiatry, has been named director of the Center for Studies of Addiction.

Kranzler’s work has contributed to the identification of genetic risk factors and pharmacological treatments for drug and alcohol dependence.

Catherine Hanly Mikelson, senior physician liaison at Penn Medicine, was elected to serve on the 20132014 Board of Directors of the American Association of Physician Liaisons. As a Board member, she will provide vision and guidance to various AAPL committees and their volunteer leaders.

Charles O’Brien, MD, PhD, of Psychiatry, has received the Medal of Chevalier (Knight) of the French National Order of the Legion of Honor, one of the country’s highest honors, for his commitment to FrenchAmerican relations in science and public health. O’Brien’s discoveries over the past 30 years have become the standard of care in addiction treatment throughout the world.

5K for IOA a Success!

A beautiful fall-like morning greeted the participants — ranging in age from seven months (in a stroller!) to 90 — for the second annual 5K for the IOA and Memory Mile Walk. Proceeds of nearly $38,000 will help further research by the Institute on Aging for the treatment and care of patients with Alzheimer’s, and other neurodegenerative, age-related diseases. “These funds really have an impact,” said John Trojanowski, MD, PhD, IOA director. “They seed new science, an important contribution to what our researchers are doing.”

`` John Trojanowski (left) and PJ Brennan with former Penn neurotrauma patient Candace Gantt, who continues to support research efforts at Penn.

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“Despite cuts in federal research support, we have a responsibility to continue agerelated research as baby boomers head towards retirement and seniors are living well into their 90s and 100s,” said race organizer PJ Brennan, MD, the Health System’s chief medical officer and senior VP. Last year’s race proceeds supported pilot projects for young investigators “in novel areas which might not otherwise be funded, to potentially identify new opportunities for understanding the diseases and indentifying new therapies.”

CEO’s corner (continued from cover)

clinicians will lead faculty workshops and serve as role models and mentors who exemplify the highest levels of professionalism. They will be change agents for positively influencing the culture of Penn Medicine. Physicians, nurses, and staff members have nominated Penn physicians from throughout the Health System for selection to the Academy. A selection committee is currently reviewing all nominations.

Focusing on the patient experience throughout the Health System is important for several reasons. First, better patient experiences often mean better clinical results. Research shows that when patients are more comfortable in the care environment, they can respond more favorably to the care that’s offered. They are also more likely to keep appointments, take their medication as directed, and come back for return visits. Second, patient satisfaction has appropriately become a key ingredient for market success in today’s highly competitive health-care environment.

Third, government and private sector payers are increasingly opting for pay-for-performance reimbursement models. This includes both the clinical outcomes of patients as well as patient experience scores.

Finally, and most important, delivering a positive patient experience is the right thing to do. Patients and their families are concerned about their plan of care, no matter how “minor” the problem or brief the stay. Those of you who have been patients yourselves have experienced the same concerns. Each of us has a professional responsibility to treat others as we would want to be treated ourselves.

Penn Medicine already enjoys a national reputation for clinical expertise, research excellence, and outstanding clinical education programs. We’re continuing our focus on excellence by providing a first-rate patient experience as well. With the exceptional team that we have in place — including you — I’m confident that we will position Penn Medicine as a continued leader in patient care.

Systemnews Editorial Staff: Sally Sapega, M.A. Editor Trissy Harding Graphic Design

Administration:

Susan E. Phillips Senior Vice President, Public Affairs

Let Us Hear From You: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 Please feel free to share your thoughts and ideas for improving System News! E-mail the editor at sally.sapega@uphs.upenn.edu.