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HealthLines is a publication of Penn Highlands Healthcare which includes the hospitals of Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois, Penn Highlands Elk and Penn Highlands Huntingdon. It is produced by the system’s Marketing Team and is always available on our website at www.phhealthcare.org/ magazine.
For more information, please contact the Marketing Team at HealthLines@ phhealthcare.org or call on weekdays from 8:00 AM to 4:00 PM.
The Marketing & Communications HealthLines Team
Kristine Gasbarre, MA, Marketing Coordinator/Creative Writer Mary Jo Herzing, Graphic Design Coordinator/Webmaster
Joy Weidel, Sales & Marketing Coordinator
The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 9-1-1 for any emergency.
Put a smile on your face and help Penn Highlands Healthcare when you shop on AmazonSmile this holiday season!
AmazonSmile is a website operated by Amazon that lets you enjoy the same shopping experience as on Amazon, but with a benefit to Penn Highlands Healthcare. When you shop on AmazonSmile (smile. amazon.com), the AmazonSmile Foundation will donate 0.5% of your eligible Amazon purchase.
Sign-up at smile.amazon.com today.
Join the movement on #GivingTuesday - December 1, 2020. As a not-for-profit organization, Penn Highlands Healthcare is grateful for the support from all of our communities on this special day of giving. For more information, call our Fund Development Office at 814375-3901.
Donations can be made to our Annual Giving Campaign by check or online at phhealthcare.org/ donate.
A message from Dr. Istikram Qaderi, Penn Highlands Healthcare Chief Quality & Transformation Officer
In recent issues of HealthLines, we’ve explained how seriously we take our patients’ comments when you complete the surveys you receive following your experience at Penn Highlands Healthcare. As we continue to move forward with our systemwide transformation journey and the "Creating Excellence" vision that we launched in 2019, I recently applauded our team across the Penn Highlands system for doing an amazing job to deliver highly reliable care to our patients over this past year.
There's no question that because of COVID-19, we faced some especially burdensome challenges toward the end of our fiscal year in spring— but thanks to our staff, we're still seeing remarkable transformation results. Here are just a few examples to demonstrate the successes our team has achieved in providing highquality, safe, and patient-centric care to Penn Highlands patients.
Based on feedback we heard from our patients in patient surveys and a third-party vendor that conducts analyses for healthcare organizations throughout the country, here are a few areas where we improved across all of Penn Highlands between 2019 and 2020:
We improved patient flow across the system:
• For patients who needed to be admitted after entering our Emergency Departments, we reduced their arrival to our inpatient units by 19 minutes, or 7.8%, which exceeded our internal goal.
• We reduced Emergency Department arrival to discharge by 6.8%, addressing our patients’ care and allowing them to return home faster.
• For patients:
• We reduced hospitalacquired C-diff rates by 42.5%.
• For staff:
• We reduced employee infectious exposures by 20%.
• We reduced employee needlestick injuries by 33%.
• We improved overall patient experience in our Emergency Departments by 12%.
• We improved overall patient experience in the outpatient setting by 9%.
• We improved overall patient experience in ambulatory surgery areas by 7%.
• We reduced the number of patient grievances by 31%.
All this shows the great work we have started together on our journey to high reliability in these past two years. As I have shared with our team, when we hold ourselves to the highest standard, it's clear we are truly capable of delivering the highest-quality care that is unmatched by any other healthcare organization.
At Penn Highlands, we are committed to providing the best experience for our patients, as well as our staff. We are thankful to you, our communities, for your support, especially during the COVID-19 pandemic. With your confidence in what we do at Penn Highlands, we continue striving to create an excellent experience for our patients.
Do you fill out your surveys? Patient surveys are sent after a stay at one of our hospitals. If you receive one, please fill it out. We want to know how we are doing.
Some come via U.S. Mail (especially if you are a Medicare patient) and others may come via emails and text message.
In 2018, Penn Highlands Healthcare announced our Master Facilities Plan, a $111 million investment to enhance access to critical services and advanced care for the residents of Northwestern/Central Pennsylvania. The Master Facilities Plan triggered eight major expansion and renovation projects to modernize, improve, and expand upon the services we offer patients at our hospital campuses and outpatient facilities throughout the 34-county region we serve.
Although this spring we dealt with some financial challenges due to COVID-19, we have carried on with our Master Facilities Plan projects. We were obligated to use those funds for the projects for which they had been borrowed and intended— and even in the face of tough times, we remain committed to providing our patients with the services they need, and doing so inside premier facilities.
In recent months, ground has broken on several of these projects. To review the progress to date:
Ground broke for the Center of Excellence on the Penn Highlands DuBois-West campus to serve Penn Highlands patients with world-class care and sophisticated services in such areas as Neurosurgery, Orthopedics, and Women’s Health.
Demolition began in July to the rear wing of Penn Highlands DuBoisWest to accommodate the creation of a trauma center with Emergency Department bays, an Observation and Clinical Decision Unit, and a four-bay “Vertical Care” area.
underway for updates to the Behavioral Health Hospital at Penn Highlands DuBois-East to expand the facility to hold a greater number of patients inside a tranquil atmosphere, with a green space and other updates.
This fall, a “wall-breaking” ceremony will be held at Penn Highlands Clearfield with PHH leaders, including PH Clearfield president Rhonda Halstead, to commemorate the start of the sizable Emergency Department renovation.
We work closely with our contacts in the media to keep our community apprised of changes to traffic and parking. As we remain steadfast in our mission to provide the highestquality care to our communities, please continue to watch for news on our construction progress.
Construction began in spring for the Clarion Medical Office Building, which will offer QCare along with specialties such as Orthopedics, Pulmonology, Endocrinology, Obstetrics & Gynecology, Optometry, and more.
At Penn Highlands Elk Pinecrest Manor, renovations re-started in mid-August to provide fresh structural and aesthetic updates to resident living quarters and shared spaces.
In August, construction got
This year was set to be an exciting time for our communities, as we planned the first ribbon-cuttings and unveilings of our renovation and construction projects. However, COVID-19 required us to adapt. For example, in March we were forced to cancel the community open house we had planned to celebrate the completion of the Founders’ Café & Grill, which is the name of the new cafeteria at Penn Highlands DuBois-West. However, since the COVID-19 pandemic reached our country, our most important priority has been to keep our patients, our staff, and you—our community— safe.
Thank you to our patients and your loved ones for understanding that the restrictions we put in place have been for your protection, per guidelines from the Pennsylvania Department of Health and the Centers for Disease Control and Prevention. Please continue to do your part to stay safe. See our back page for information on how getting a flu shot in 2020 could also help you and your family stay safe from COVID-19.
You can help us grow. Your donation will help bring even more advanced care right here. Go to www.phhealthcare. org/footprint.
In July, the new Medical Office Building opened on the Penn Highlands Brookville hospital campus to offer services such as family medicine, QCare, pulmonology, general surgery, oncology and urology. "We are already hearing from patients who are excited that the new Medical Office Building makes their access to our esteemed providers more convenient than ever," said PH Brookville president Julie Peer. "Everything is right here in one spot for them."
In March, the West Wing Annex at Penn Highlands DuBois-West opened with new space to house patients, along with updated break and gathering spaces for employees, and a new cafeteria that is equipped with a viewing monitor so the loved ones of patients who are undergoing medical procedures can follow the patient’s progress.
When you visit Penn Highlands facilities, we appreciate your patience and understanding as we work hard to grow our services to bring you the highest quality life-saving care that’s close to home.
At Penn Highlands Healthcare, we’re proud to be the first organization in Northwestern/Central Pennsylvania to offer joint replacement procedures assisted by Stryker’s robotic arm, Mako SmartRobotics. For our patients in need of knee or hip replacements, this latest advancement in joint replacement surgery is transforming the way these procedures are performed.
What Is Robotic Arm-Assisted Surgery? Robotic arm-assisted surgery is a new approach to joint replacement that offers the potential for a higher level of patient-specific implant alignment and positioning. The technology enables surgeons to create a patient-specific 3D plan to perform joint replacement surgery using a surgeoncontrolled robotic arm that helps your Penn Highlands Orthopedics surgeon execute the procedure with a high degree of accuracy. For our patients, this results in smaller incisions, less soft tissue injury around the hip and knee, less blood loss, greater preservation of healthy bone, less pain after surgery and ultimately faster recovery so you can return to your desired activities.
“We’re thrilled to bring the Mako robot to Penn Highlands patients,” said Dr. Matt Varacallo, Director of Orthopedic Robotic Surgery at Penn Highlands. “This is truly the leading edge of orthopedic surgery. Roboticassisted total joint replacement is only available in larger cities like Philadelphia and Pittsburgh, so there has been a void in this market for quite some time. I have been utilizing this type of technology since 2016 and I am thankful that we are now bringing this innovation to our area.”
On what this means to patients, Varacallo continued. “The Mako surgeon-controlled robot is positively impacting patient outcomes as it enhances our level of precision using a virtual model of the patient’s unique joint anatomy. This sophisticated process enables us to target our maneuvers before we even make the first cut. It delivers highly precise, smaller incisions, and ultimately less pain and more efficient recovery for the patient.”
The Mako application is a treatment option for adults who suffer from degenerative joint disease of the hip and knee. Using a virtual 3D model, the Mako system allows your Penn Highlands Orthopedics surgeon to customize your surgical plan preoperatively, so there is a clear plan for how the surgeon will position the implant before even entering the operating room. During surgery, the
surgeon can validate that plan and make any technical adjustments, while the robotic arm then allows the surgeon to execute that plan with a high level of accuracy and predictability. The combination of these three features of the system has the potential to lead to better outcomes and higher patient satisfaction.
In the OR, the surgeon guides the robotic arm during bone preparation to prepare the knee or hip socket and position the implant according to the pre-determined surgical plan. In cadaveric studies, Mako has been shown to be four times more accurate and reproducible than manual joint replacement procedures.
”We are thrilled to be among the first to use this innovative technology in Pennsylvania,” said Dr. Keith Zeliger, orthopedic surgeon at Penn Highlands Elk. “It is one part of the Penn Highlands Healthcare commitment to provide our community with safe, highly reliable healthcare and exceptional outcomes.” Varacallo adds that the orthopedic joint replacement program will continue to build on the accelerated recovery programs following joint replacement which are now some of the quickest in the country, including combining robotic-assisted joint replacement surgery with the currently implemented preoperative IOVERA treatments. Dr. Varacallo concluded, “This type of multi-faceted and comprehensive approach to pain control and accelerated total joint recovery is not offered anywhere else in the country!”
At this time, orthopedic surgeons will perform surgeries assisted by the robot at Penn Highlands DuBois and Penn Highlands Clearfield.
Is the Mako robotic arm-assisted surgery an
my hip or knee replacement?
Your orthopedic specialist at Penn Highlands Healthcare can help you determine whether Mako is right for your joint replacement procedure.
The result of a procedure performed with Mako can differ from traditional joint replacement surgery with fewer soft tissue releases and smaller incisions, less blood loss, protection of healthy bone, and ultimately optimal joint alignment and faster recovery.
The Mako SmartRobotics technological process is unique from other joint replacement procedures because it begins with your CT scan to allow your surgeon to create a personalized plan based on your unique anatomy as displayed in a virtual model of your joint. Your Penn Highlands Orthopedics surgeon can then target his or her maneuvers before even making the first incision.
The robotic arm assists your surgeon as it is guided by haptic technology that limits the arm within the virtual boundaries. All this provides you with permanent relief from your joint pain so you can get back to doing what you love.
Currently, Mako robotic arm-assisted surgery is available from the Orthopedics teams at Penn Highlands DuBois and Penn Highlands Clearfield.
One of the greatest benefits of the Mako SmartRobotics arm for your joint replacement is the faster recovery time that’s been demonstrated for a significant number of patients who have undergone procedures with Mako. While traditional joint replacements can require four to six weeks of recovery before a patient can return to some normal routine activities, in some cases, Mako is shown to decrease recovery time by as much as half. Mako may also lead to less blood loss, swelling, and pain than traditional knee replacement surgery.
Considering hip or knee replacement
Here, our experts answer your questions about Mako:
option for
The Rehabilitation Center has doctorate-trained Physical Therapists and consistently scores well above the national averages in Outcome Surveys for returning our patients to proper function, reducing their pain, and providing excellent customer service.
When recovering from joint replacement surgery, The Rehabilitation Services at Penn Highlands Healthcare will help you improve mobility and get you back to the quality of life you’re used to.
“Seeing our patients return to the life they love is what gives our therapists purpose every day,” says Mark Hoffman, Penn Highlands service line director of rehabilitation services and occupational health. “It’s especially great to be part of their progress following their robotic arm-assisted joint replacement procedures. Our team has worked closely with our Penn Highlands Orthopedics surgeons to prepare patients to reach their goals in the most efficient timeframe, while honoring each patient’s own journey to healing. Having the Mako robots here is a win for our patients—and that makes it a win for us, too.” Visit www.phhealthcare. org/rehab to learn more about our rehabilitation services.
Beginning in 2022, the orthopedics program will be headquartered in the Penn Highlands DuBois Center of Excellence, for which construction got underway this summer as part of the Master Facilities Plan that the health system announced in 2018.
However, patients looking for stateof-the-art services and high-reliability joint replacements don’t have to wait.
On Saturday, August 15, Stryker was onsite at PH Clearfield to present a certification training for five Penn Highlands Orthopedics surgeons: Dr. Mark Nartatez, Dr. Ashish Kumar Patel, Dr. Mitchell Rothenberg, Dr. Matt Varacallo, and Dr. Keith Zeliger. Several patients have already undergone hip and knee replacement procedures that have been assisted by Mako at Penn Highlands DuBois and Penn Highlands Clearfield. “So far, our patients have been thrilled to experience joint replacement with Mako,” Varacallo says. “Our goal is to see them getting back to what they love, as soon as possible.”
Mark A. Nartatez, DO
Orthopedic Surgery and Sports Medicine Offices in Clearfield and Philipsburg
Ashish Kumar Patel, MD
Orthopedic Surgery and Sports Medicine Offices in Brookville, Clearfield and DuBois
Orthopedic Surgery and Sports Medicine Office in DuBois
Matthew A. Varacallo, MD
Orthopedic Surgery and Sports Medicine Office in DuBois
Keith L. Zeliger, DO
Orthopedic Surgery and Sports Medicine Office in St. Marys
Penn Highlands has six Orthopedic and Sports Medicine clinics throughout the region. Find one near you by clicking here.
With October and Breast Cancer Awareness Month upon us, many Penn Highlands Healthcare patients are growing more aware not only of the importance of breast cancer screenings, but also of an important service that we at Penn Highlands offer to help patients learn whether their personal biology puts them at risk for breast cancer and other types of cancers.
Penn Highlands General Surgery physician assistant Melissa Hilliard first observed the need for genetic testing in our region while working in women’s health. Five years ago when she joined the practice of Dr. Kelley Smith, Penn Highlands general surgeon and women’s breast specialist, the high incidence of
breast cancer patients who came through the practice reinforced that need. “With our practice having such a high predominance of breast cancer,” Hilliard says, “so many of those patients had a strong family history”—which “has such an important impact on what decision to make.”
Knowing this, Hilliard led the accreditation and approval process for extensive genetic testing to become available at Penn Highlands Healthcare. Previously, BRCA 1 and BRCA 2 were the most common genes to be tested for, but those only reveal a limited finding for most patients. Since Hilliard introduced the program in 2016, the panel tests for a wide range of cancer genes such as those affecting the breasts (including for males), the colon, pancreas, uterus, ovaries, kidneys and thyroid, as well as melanoma and leukemias.
Today, the Penn Highlands genetic testing program has gained such momentum that Hilliard, who studied at Bucknell and obtained her board certification from the National Commission of Certification of Physician Assistants, recently earned a certificate of achievement from Harvard University’s medical school in cancer genomics and precision
oncology. Now she is actively working toward a certification in Cancer Genetics and High Risk Breast Assessment through the National Consortium of Breast Centers.
• To undergo testing, patients need a referral and then can build their pedigree online using a secure portal with a username and password that Hilliard provides.
• The test is usually done via a simple saliva sample. In most cases, patients can expect to receive their results in three to four weeks (except when the family risk factors dictate a faster turnaround).
• When the results return, Hilliard meets with the patient to develop a strategy based on the test’s findings, whether that’s an important interventional procedure or increasing the frequency with which the patient undergoes certain screenings.
PENN HIGHLANDS HEALTHCARETo schedule your appointment visit us at www.phhealthcare.org/pink
Click here to learn more about Genetic Testing.
Kevin Huang, MD General Surgeon
John Mawn, MD Radiologist
Penn Highlands DuBois Radiology
100 Hospital Avenue DuBois, PA 814-375-3261
James Pacelli, MD Neurology Hospitalist
Penn Highlands Neurology
145 Hospital Avenue, Suite 210 DuBois, PA 814-375-2070
Penn Highlands General Surgery
820 Bryan Street, Suite 3 Huntingdon, PA 814-643-4876
Lucas Irwin, DO Family Practitioner
Penn Highlands Family Medicine 502 Park Avenue Clearfield, PA 814-765-2950
Sara Lange, DO Obstetrician / Gynecologist
Penn Highlands Life’s Journey
190 West Park Avenue, Suite 9 DuBois, PA 814-371-1900
Ashish Kumar Patel, MD Orthopedic Surgeon
Penn Highlands Orthopedics & Sports Medicine
145 Hospital Avenue, Suite 311 DuBois, PA 814-375-6200
Charles H. Schafer, MD General Surgeon
Brad Solomon, DO Gastroenterologist
Penn Highlands Gastroenterology
621 South Main Street DuBois, PA 814-371-0600
Ayub Suleiman, MD Interventional Radiologist
Penn Highlands DuBois Radiology
100 Hospital Avenue DuBois, PA 814-375-3261
Samantha Anders, PA-C Board Certified Physician Assistant
Penn Highlands Gastroenterology
900 Bryan Street, Suite 7 Huntingdon, PA 814-643-8600
Penn Highlands General Surgery
820 Bryan Street, Suite 3 Huntingdon, PA 814-643-4876
Tyler Beers, PA-C
Board Certified Physician Assistant
Penn Highlands Orthopedics & Sports Medicine
145 Hospital Avenue, Suite 311 DuBois, PA 814-375-6200
Shelby Fleck, PA-C
Board Certified Physician Assistant
Penn Highlands Oncology/Hematology
100 Hospital Avenue DuBois, PA 814-375-3800
Tammy Ganoe, CRNP Certified Registered Nurse Practitioner
New Bethlehem Rural Health Center 1323 Brookville Street Fairmount City, PA 814-275-3320
Madalyn Hoke, PA-C
Board Certified Physician Assistant
Penn Highlands Neurosurgery
145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433
Crescent Miller, PA-C Board Certified Physician Assistant
Penn Highlands Gastroenterology
900 Bryan Street, Suite 7 Huntingdon, PA 814-643-8600
Elizabeth Schell, PA-C Board Certified Physician Assistant
QCare Clearfield
1900 River Road Clearfield, PA 814-205-1250
The Graduate Medical Education (GME) program at Penn Highlands Healthcare recently welcomed its third class of family medicine residents. These physicians in training hail from around the country, drawn to our area by the unique opportunity to care for the patients in our community as our health system addresses a wide variety of patient needs. Recent graduates of the program noted this as an appeal since it offers them training in more diverse patient needs than they receive in more metropolitan areas.
Alexis Braid, DO Family Medicine, Lake Erie College of Osteopathic Medicine
Kaylin Darling, MD Family Medicine, University of Wisconsin School of Medicine and Public Health
Isabela Tetino, PA-C Board Certified Physician Assistant
Penn Highlands Neurosurgery
145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433
Sarah Whiteman, CRNP Certified Registered Nurse Practitioner
Penn Highlands Urology
145 Hospital Avenue, Suite 200 DuBois, PA 814-375-9200
The GME program started in July 2017 after PHH earned approval from the American Osteopathic Association. Now the program is accredited through the Accreditation Council for Graduate Medical Education. When the first class of residents graduated this past June from the Graduate Medical Education program, Penn Highlands Healthcare Chief Executive Officer Steve Fontaine acknowledged the current state of the program as the culmination of more than six years of working with the idea to establish Penn Highlands as a teaching hospital. “When our GME program was first initiated, our goal was to elevate Penn Highlands within the medical community, while offering professional development to future physicians and providing our communities with greater access to leading-edge care,” said Fontaine.
Welcome to our new class of family medicine residents, who are seeing patients of all ages at the Family Medicine Residency Clinic inside the Medical Arts Building (145 Hospital Avenue) at Penn Highlands DuBois West.
Medical Arts Building
145 Hospital Avenue, Suite 315 DuBois, PA 15801 814-503-4305
Jordan Margolis, DO Family Medicine, Lake Erie College of Osteopathic Medicine
Kaylin StrauserCurtis, DO Family Medicine, Lake Erie College of Osteopathic Medicine
Jonathan Soekamto, DO Family Medicine, Lake Erie College of Osteopathic Medicine
Alexander Westcott, DO Family Medicine, Touro College of Osteopathic MedicineMiddletown
To start, Penn Highlands infectious disease specialist Dr. Deepak Garg says, “I want to make people understand an important point: both the flu and COVID-19 affect the respiratory system, and you don’t want to get both. That is a concern for complication and even death.” Not to instill fear but instead to impart wisdom, here’s why the flu shot will be so beneficial this year.
National reports suggest getting the flu shot this year is more important than ever. Is that true? Yes, that’s true. During the last flu season when COVID-19 came, healthcare professionals saw many patients who had both flu and COVID-19. Both can compromise your breathing or give a patient shortness of breath—so you don’t want to get both. If you can prevent the flu, that would be best.
Do we need to get our flu shots earlier this year? Yes, I would say get them as soon as they are available. Historically, the flu shot has offered protection for four to five months. Many patients would receive the shot toward the end of September or in October to stay protected for all of flu season.
In that case, will we need to get a second flu shot? It
depends on the condition and the recommendation at that time. The CDC will establish guidelines. However, I would still advocate for getting an early flu shot. If you don’t get the flu, then you won’t transmit flu—so you help keep other people safe. COVID-19 is the same: if you have it, you will transmit it.
Penn Highlands Infectious Disease 814-371-4320
What else is important for the public to know about the flu this year? We’re already in a pandemic, and we don’t want to have another epidemic. The flu vaccine will help individuals do our part to control the spread and avoid creating a flu epidemic in our area.
How does COVID-19 affect my chances of the flu? Any infection will weaken your immune system and make you more prone to get more infection.
Will a flu vaccine protect me against COVID-19? No.
Could the vaccines for the flu and COVID-19 interact? On that, I cannot comment yet. Ultimately it will depend on the guidelines, but I don’t see a reason why they would interact.
Will the elderly be most vulnerable? The elderly are always more vulnerable for these infections, but that doesn’t mean a young person doesn’t need a flu vaccine. It’s not only for your protection—it’s for the protection of your loved ones and others, also.
(In addition, the CDC suggests that some people are at high risk of developing serious flu-related complications. This includes individuals aged 65 and older, people of any age with certain chronic medical conditions such as diabetes, asthma, and heart disease, pregnant women, and children age five and under, but especially those under age two.)
Will you remind us of the difference between a pandemic and an epidemic? A pandemic affects multiple continents. An epidemic occurs in a specific area.
Penn Highlands is offering flu shots at:
• 40+ Penn Highlands Primary Care locations
• Eight QCare locations
• Penn Highlands Huntingdon Urgent Care Center
• Two Retail Pharmacy locations - Penn Highlands Community Pharmacy in DuBois and McCabe Drug Store in Reynoldsville.
To find a provider who’s right for you, call the Penn Highlands Healthcare Referral Line at 814-375-6644 or visit us at www.phhealthcare.org/ findadoc.
