Healthcare Heroes award winners Dean Thomas Lawley and Dr. Ursula Kelly
This weekâ€™s issue of the Atlanta Business Chronicle spotlights the winners of its annual Healthcare Heroes Awards, recognizing the contributions of top medical professionals in the Atlanta health care community. Emory was well represented again this year among the impressive list of winners and finalists. Winners included:
Linda Cendales, MD, assistant professor of Surgery at Emory University School of Medicine, nominated in the Healthcare Innovations category for successfully performing the stateâ€™s â€“ and one of the nationâ€™s â€“ first hand transplants on a college student from Orlando, Fla. (see Emory article)
Katherine L. Heilpern, MD, professor and chair of the department of emergency medicine, nominated in the Physician category for her contributions to emergency and trauma care and for her leadership among 5 hospitals in Metro Atlanta which receive 250,000 patient visits per year.
Curtis Lewis, MD, assistant professor of radiology, Emory University School of Medicine, nominated in the Physician category for his management and training of physicians and residents in his role as chief of staff and senior vice president of medical affairs at Grady.
Approximately 250,000 people each year suffer from a particularly deadly form of heart attack known as a STEMI (ST-Elevation Myocardial Infarction), in which blood flow is completely blocked to the heart. Restoring blood flow quickly is crucial in order to save the patientâ€™s life, yet more than 30 percent of these patients receive no life-saving intervention at all.
Michael Ross, MD
Led by Emory emergency medicine physician Michael Ross, the Society of Chest Pain Centers (SCPC) and the American Heart Association (AHA) recently announced they will be joining efforts to save even more lives. The joint agreement seeks to improve cardiac care, specifically the care of patients suffering from STEMI.
The new collaborative framework for hospital accreditation meets criteria of the AHA initiative â€œMission: Lifeline,” established in 2007 to improve the processes surrounding care of the STEMI patient by eliminating the obstacles that keep patients from accessing and receiving appropriate treatments.
Mission: Lifeline systems start with the 9-1-1 call or at the point of entry in the emergency system, continue through the catheterization laboratory and through hospital discharge by promoting best practices that use the latest scientific evidence-based treatment for STEMI.
Mission: Lifeline systems currently cover more than 56 percent of the United States. Mortality rates from STEMI have decreased from 5.8 percent in 2008 to 4.8 percent in 2010.
â€œSCPC, through their Chest Pain Center accreditation, has already improved cardiac processes in close to 14 percent of hospitals within the U.S. and has moved this accreditation to the international setting,â€ says Ross, who is immediate-past SCPC president and an associate professor of emergency medicine and medical director for observation medicine at Emory.
â€œCollaboration between these two non-profit organizations, who share similar missions, will help bring consistency to health care delivery by providing a standard approach to the treatment of STEMI. Providing cardiac accreditation programs is in the best interest of patients, meets the needs of the health care community, and will help to significantly reduce cardiac deaths.â€
Most commonly known as coronary angioplasty, PCI is a therapeutic procedure to treat the narrowed coronary arteries of the heart found in coronary heart disease. The designation is a distinguishing attribute since PCI is now the preferred treatment for heart attack patients.
For more information about heart disease and cardiac care option – from heart transplants and ventricular assist devices to imaging services and minimally-invasive interventional treatments, please visit Emory Healthcare at: http://www.emoryhealthcare.org/heart-center-atlanta/.
When Jon Pomenville of Anderson, SC, decided to donate a kidney altruistically to someone â€“ anyonein need, anywhere in the country â€“ little did he know his selfless sacrifice would in turn change the lives of not one, but numerous individuals and their families, including one little boy from Atlanta.
And little did he know that the selfless, anonymous act would quickly become not so anonymous. During a recent post-surgical clinic visit to Emory University Hospital, Pomenville met by accident â€“ right in the transplant clinic waiting room â€“ many of the individuals whose lives were changed. Soon the patients â€“ recipients and donors â€“ two father and son combinations and Pomenville, the man who would give to anyone â€“ were hugging, shaking hands, and recounting their backgrounds and experiences.
Pomenville and the others, who were all part of what is called a paired kidney exchange, were unwittingly scheduled for appointments within a short period of one another. As one person began recounting the experience, eyes and ears began to focus on the tale being told from across a crowded room.
A chance meeting in a doctors’ waiting room led to a meeting between most of the people involved in the paired kidney exchange.
The Emory Transplant Center created and opened its innovative Paired Donor Kidney Exchange Program in 2009, providing greater hope for patients in need of kidney transplants. According to Kenneth Newell, MD, director of Emory’s living donor program, a paired exchange donation allows healthy individuals to donate a kidney to either a friend, loved one, or even altruistically to a stranger, despite incompatible blood matches. In paired donation, a donor and recipient are matched with another incompatible donor and recipient and the kidneys are exchanged between the pairs.
The procedure is another form of living donor transplantation. Donated kidneys also come from recently deceased donors. While most kidneys from deceased donors function well, studies have shown that a kidney from a living donor, either a blood relative or an unrelated person, provides the greatest chance for long-term success.
“Paired donor exchanges allow us to cast a much wider net to find compatible donors and recipients,” says Newell. “With a paired kidney transplant, one incompatible donor-pair is able to give a healthy kidney to a compatible recipient. In exchange, the second donor-recipient pair will give a compatible kidney to the first donor-recipient pair, making two compatible living donor transplants possible and increasing the potential number of available donor kidneys. This option can help those patients waiting for kidney transplants who have family members or friends willing to be donors and who are medically suitable, but who have an ABO blood type that is incompatible with the recipient’s blood type.”
Because of Pomenvilleâ€™s donation, a 7-year-old boy named Zion was able to receive a lifesaving kidney from an unrelated donor because his dad, Mike, was able to donate. His surgery took place at Children’s Healthcare of Atlanta at Egleston.
And Gerald Smith of Five Points, Ala., would receive his life-saving kidney because his son, Matt, a recent University of Alabama graduate, would donate his to Zion. And finally, 20 year-old Edward Hill of Macon, a young man with a history of health challenges, would also receive his transplant at Childrenâ€™s Healthcare of Atlanta â€“ completing the six-person cycle, although the donor of Edwardâ€™s kidney is still unknown.
And Zion and Matt Smith will not only share a common bond and connection throughout life in the form of a kidney, but something even sweeter that that â€¦ blue Powerade.
â€œIâ€™ve always really enjoyed drinking Powerade, particularly the blue flavor,â€ says Smith. Shortly after Zion awoke from his surgery, he inexplicably began requesting the blue-tinted soft drink too.
Other powerful kidney transplant stories out of Emory:
Dr. Demuth (pictured far right) was a key player in advancing legislation to call attention to the challenges of food allergies in children. She and several of her patients were on hand to witness Governor Nathan Deal signing a proclamation declaring May 8 to 14 Food Allergy Awareness Week in Georgia.
â€œThe new NIAID guidelines help providers understand food allergies,â€ Demuth says. â€œThey address when we should consider a food allergy and the utility of testing for food allergy. In addition, they address the management of food allergies, including acute reactions and follow-up of individuals with food allergy.â€
The guidelines are comprised of input from a panel of 25 experts and draw the important distinction between food allergies and food intolerances. Food allergies are defined as â€œan adverse health effect arising from a specific immune response hat occurs reproducibly on exposure to a given food.â€ Food intolerances produce an adverse reaction but are likely not related to an immune response.
The most common food allergies are to milk, eggs, peanuts, tree nuts, shellfish, fish and soy. Fortunately, the understanding of food allergies and the best ways to manage them is expanding.
â€œThe gold standard of treatment of food allergies â€“ avoidance â€“ has remained constant throughout the years,â€ Demuth says. â€œThere are new therapies on the horizon such as oral immunotherapy, vaccines and a Chinese herbal extract; however, these therapies are still considered experimental. At the Emory-Childrenâ€™s Center, we are active in research and advocacy in pediatric allergies so that we can bring new treatments to our patients when they are ready for widespread use. We are dedicated solely to the care of children with allergic and immunologic disorders and offer multidisciplinary clinics to offer a specialized level of care.â€
Emory Healthcare is a key player in plans to bring the worldâ€™s most advanced radiation treatment for cancer patients to Georgia.Â Emory Healthcare has signed a letter of intent with Advanced Particle Therapy, LLC, of Minden, Nevada, opening the door to a final exploratory phase for development of The Georgia Proton Treatment Center – Georgiaâ€™s first proton therapy facility.
For certain cancers, proton therapy offers a more precise and aggressive approach to destroying cancerous and non-cancerous tumors, as compared to conventional X-ray radiation. Proton therapy involves the use of a controlled beam of protons to target tumors with precision unavailable in other radiation therapies. According to The National Association for Proton Therapy, the precise delivery of proton energy may limit damage to healthy surrounding tissue, potentially resulting in lower side effects to the patient. This precision also allows for a more effective dose of radiation to be used.
Proton therapy is frequently used in the care of children diagnosed with cancer, as well as in adults who have small, well-defined tumors in organs such as the prostate, brain, head, neck, bladder, lungs, or the spine.Â And research is continuing into its efficacy in other cancers.
The gantry, or supporting structure, of a proton therapy machine.
The closest proton therapy facility to Georgia is the University of Florida Proton Therapy Institute in Jacksonville.Â Currently there are only nine proton therapy centers in the United States, including centers at Massachusetts General Hospital, MD Anderson Cancer Center in Houston and the University of Pennsylvania.
This is an exciting development in our ability to offer not only patients throughout Georgia and the Southeast the widest possible array of treatment options but patients from around the world who can come to Atlanta via the world’s busiest airport, Hartsfield-Jackson International. In addition, we will work to expand its utility and access for patients through collaborative research projects with Georgia Tech and other institutions. Winship physicians will also be able to reach out to their international colleagues and provide direction in how best to study and implement this technology in the care of cancer patients.
Under the letter of intent, Emory Healthcare faculty and staff will provide physician services, medical direction, and other administrative services to the center. Advanced Particle Therapy, through a Special Purpose Company, Georgia Proton Treatment Center, LLC, (GPTC) will design, build, equip and own the center.Â The facility, which will be funded by GPTC, will be approximately 100,000 square feet and is expected to cost approximately $200 million.Â Site selection for the facility is underway, and pending various approvals, groundbreaking is expected in the Spring of 2012.
The follow video presents a 3D simulation of proton therapy technology.
As parents we hope all babies are born with a healthy start in life, after a full 37 â€“ 40 weeks in the womb. Sadly, every year more than half a million babies are born prematurely in the United States. The rate of premature birth has risen by 30 percent since 1981 according to the March of Dimes. Itâ€™s not clear why some babies are born before full gestation – before their lungs, brains or other organs are fully developed. Thousands donâ€™t live to celebrate their first birthday as a result.
In Georgia more than 400 babies are born too soon each week.Â Dr. William Sexson, a neonatologist and professor of pediatrics at Emory University School of Medicine and March of Dimes Prematurity Campaign Chair witnesses the effects of preterm birth every day.Â He says, â€œPremature birth is the leading cause of infant mortality. Babies born just a few weeks too soon are at increased risk for newborn health complications, such as breathing problems, can face serious health challenges and are at risk of lifelong disabilities.â€
On Saturday April 30, 2011, a legion of more than 10,000 families and business leaders from across Georgia will band together for the March of Dimes annual â€œMarch for Babies.â€ With more than 30 â€œMarch for Babiesâ€ events planned throughout the state, the annual affair is the nationâ€™s oldest walk fundraiser dedicated to preventing premature birth, birth defects and infant mortality.
â€œMarch for Babiesâ€ supports research and educational programs aimed at helping women have healthy babies. Funds raised from the â€œMarch for Babiesâ€ event will support prenatal wellness programs, critical research and community grants, along with local resources such as the Angel II neonatal transport unit at Grady Memorial Hospital.
Most pregnancies last around 40 weeks. Babies born between 37 and 42 completed weeks of pregnancy are called full term. Babies born before 37 completed weeks of pregnancy are called premature. â€œWomen who have hypertension and diabetes are at higher risk to have preterm babies or babies with health problems,â€ says Sexson.
According to the March of Dimes, the most urgent infant health problem in the U.S. today is premature birth. It affects more than half a million babies each year and is the leading cause of newborn death within the first month of life. Last November, the March of Dimes issued a Report Card on Premature Birth, giving the nation a â€œDâ€ and Georgia, the grade of â€œF.â€Â Sexson adds, â€œWe have a long way to go before all babies in America get a healthy start in life and we are committed to working with state health officials, hospitals and health care providers to continue to fight for preemies.â€
The March of Dimes is the leading nonprofit organization with its mission to improve the health of babies by preventing birth defects, premature birth and infant mortality.
For more information, or to participate in â€œMarch for Babiesâ€ visit marchofdimes.com.
People don’t think of the Environmental Protection Agency as a public health agency, says EPA Administrator Lisa P. Jackson, but the EPA’s job is to protect the health of adults and children by safeguarding air and water and promoting clean communities. Jackson was the keynote speaker last week at a Children’s Health Town Hall at Emory’s Rollins School of Public Health.
Children eat more, drink more, and breathe more in proportion to their body weight than adults, and without the EPA our jobs as parents would be much more difficult, said Jackson. And although a renewed focus on reducing air pollution has significantly improved air quality, still millions of young people have asthma and are particularly susceptible to pollution, and there have been no limits on some pollutants, such as mercury emissions from coal-fired power plants.
Last month the EPA presented the first national mercury and air toxicity standards for power plants, Jackson noted. This effort to cut emssions of mercury, arsenic, and other neurotoxins is a common sense goal that would save lives and prevent 17,000 premature deaths annually, she said.
Laura Seydel, Paige Tolbert , Stephanie Owens, EPA
The EPA recently named Emory and Georgia Tech as one of four new EPA Clean Air Research Centers and awarded $8 million to the new Southeastern Center for Air Pollution and Epidemiology (SCAPE) center. Center directors Paige Tolbert from Emory and Armistead (Ted) Russell from Georgia Tech will lead programs aimed at quantifying health effects from air mixtures containing toxic pollutants and studying the specific effects of toxic air on commuters, pregnant women, newborns, and adults with cardiac illnesses.
Russell noted the tremendous cost of air pollution, including millions of lost school days for asthmatic children, and the important of using study results as the basis for changes in policy.
A “Call to Action” panel of experts and advocates at the town hall suggested steps everyone can take to improve environmental health.
Environmental health champion Laura Seydel called for “zero waste zones” in homes, churches, and offices, and the outlawing of toxic chemicals to help create “zero toxic waste zones” in the bodies of adults and children.
Maeve Howett, an Emory pediatric nurse practitioner and a faculty member in Emory’s School of Nursing, encouraged everyone to make a personal commitment to choosing transportation that is less harmful to the environment, for the sake of children with asthma.
A new pilot simulation laboratory at Emory University Hospital Midtown (EUHM) is providing medical students, residents, nursing students and staff with hands-on training to develop, perfect and maintain their skills. Located in the former obstetrics/gynecology (OB/GYN) operating rooms, space that wasnâ€™t currently being utilized, the lab focuses on team building, clinical competencies and research. This is the first simulation lab of its kind at EUHM.
The simulation lab is a joint venture of Emory Healthcare and Emory University School of Medicine, both providing equipment to outfit the lab and a wealth of expertise. Nursing Education, a department within Emory Healthcare, and the Emory School of Medicine have worked together in the development of the simulation lab. Some equipment being used has been donated or given to the hospital for training purposes.
One side of the simulation lab is set-up to train OB/GYN residents and students in deliveries and laparoscopic surgeries, cardiac arrests, mock codes and low volume/high risk procedures.
The other side of the lab focuses on nursing training, nursing education, central-line and intravenous insertion and medication dispensing. It is also being used by nursing for competency validation for new nursing employees and for annual skills assessment of current nursing staff.
Those instrumental in setting up the nursing side of the simulation lab are Sharlene Toney, PhD, RN, executive director, Professional Nursing Practice for Emory Healthcare, and Beth Botheroyd, RN, BSN, MHA/INS, nursing education coordinator for Emory Healthcare.
Toney says the lab is a critical part of the training and education of new nurses and current nursing employees, while also focusing on process improvement activities concentrated on patient safety. Nurses also have the opportunity to test their skills on training simulators and new equipment while in the lab.
Ander describes the lab as a â€œproof of conceptâ€ center, with the small set-up being only the first step in the process. Down the road, he envisions a larger simulation center for all Emory Healthcare employees, Emoryâ€™s School of Medicine and even the community.
Arluck observes as resident Hudson performs an ultrasound on Noelle, the birthing simulator.
Arluck says she uses the simulation lab regularly with OB/GYN residents, teaching them the basics of laparoscopic surgery on a training module and monitor. She also teaches students with the help of an adult-size doll named Noelle, which simulates delivering a baby and going into cardiac arrest.
The simulation lab has also opened the door to medical education research. Emory pulmonary critical care fellow, Jenny Han, MD, is studying to see if a standardized, advanced cardiac life support simulation training has any effect on real patient outcomes in the hospital.
In the future, plans include adding cardiac catheterization simulator capabilities, as well as emergency department and nursing station simulation space.
Emory Heart & Vascular Center cardiologist, Khusrow Niazi, MD, will answer questions about peripheral artery disease (PAD) in a live web chat today from 12:30 p.m. to 1:15 p.m. Also called peripheral vascular disease, PAD occurs when arteries in the legs narrow as a result of atherosclerosis, a buildup of fatty deposits and plaque in the lining of blood vessels. When plaque builds up in the blood vessels that carry blood from the heart to the rest of the body, they harden, narrow and clog, causing poor circulation. PAD often goes unrecognized, causing no symptoms at all – or symptoms you may think are something else, such as muscle cramps.
While difficulty walking may be the primary symptom, PAD can advance to complete arterial blockage and critical limb ischemia, causing painful foot ulcers, infections or even gangrene that requires amputation. It is associated with high blood pressure, diabetes, heart disease and stroke and affects eight to 12 million people in the United States.
Dr. Niazi, assistant professor of medicine, Emory University School of Medicine, will be available to answer questions and discuss various topics around PAD, including prevention, detection, healthy tips, rehabilitation and innovative new cardiovascular research on the horizon.
The recent Westlake Forum III at Emory brought more than 250 leaders from Chinese and U.S. academic and government institutions together to examine and compare health care reform in the two countries, focusing on cost, quality, and access to care.
â€œThis was an incredible human partnership, bringing together two countries with very different governments and cultures, recognizing our common problems and desires for improved health of all our citizens, working together on difficult issues and exploring workable solutions,” said Jeff Koplan, director of the Emory Global Health Institute.
Shanlian Hu, William Roper, William Hsaio, Jeffrey Koplan, Kenneth Thorpe
â€œNow China and the US are facing the same challenge: to push healthcare reform forward. Our two countries need to share knowledge and experiences with each other, and to learn from each other,â€ says Yu Hai, MD, PhD, director of China Medical Board Programs, Zhejiang University School of Medicine.
Howard Koh, assistant secretary for health, U.S. Department of Health and Human Services, presented an overview of U.S. health care reform.
Shanlian Hu, a professor at Fudan University, described Chinaâ€™s health care reform priorities: expanded coverage, equal access, improved benefits, improved care delivery systems and containment of soaring medical costs. These are remarkably similar to priorities of the recent U.S. Affordable Care Act.
In China, the government is committed to health care as a public good, with the goal of complete coverage by 2020. Although 90 percent of citizens are currently covered, cost and accessibility varies considerably. Hospital stays are longer than in the United States, medical training is less rigorous, and access to high-quality care is limited. As in the U.S., Chinaâ€™s public hospitals and providers struggle with the economic and quality issues generated by a â€œfee-for-serviceâ€ reimbursement mechanism.
Participants worked on developing concrete collaborations such as joint research, educational exchanges or partnerships.
Yet health care costs in China are only 5.13 percent of the countryâ€™s GDP, compared to 17 percent in the U.S.
William Roper, dean of the University of North Carolina School of Medicine and CEO of the UNC Health System, said health care in the United States is a â€œparadox of excess and deprivation,â€ and Americans need to rethink their long-held assumptions.
Americans believe they have the best health care system in the world, yet we spend more on medical care than any other country, we are the only rich democracy in which a substantial portion of citizens lack care, nurses are in short supply, quality and safety are not as high as they should be, and incentives for physicians are skewed toward specialization and expensive technical procedures, Roper said.
Harvard Professor William Hsiao noted that China has made significant progress in health care reform over the past seven years. In 2003, 75 percent of Chinese citizens were uninsured, whereas today China offers coverage on some level to 90 percent, with out-of-pocket payments continuing to decline. Problems persist in lack of well-trained physicians and equipment, distorted prices, and profit motives of public hospitals and officials.
Ken Thorpe, from Emoryâ€™s Rollins School of Public Health, outlined the newly passed U.S. health reform law, which aims to expand and improve coverage and access to quality care and control rising costs. Many of these improvements would likely be paid through Medicare reductions and increased taxes on higher income households, he said.