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Archive for October, 2009

Vision 2020

Monday, October 26th, 2009

October, 2009

The Technology Association of Georgia’s Health Society is hosting an event on November 10 that will explore the future of Georgia’s leadership in health technology. Titled “VISION 2020: Georgia leads the country in economic growth through innovation in Health Technology,” the event will envision a world where health technology is ubiquitous. Almost all hospitals and physicians will be paperless and e-prescribing, and patients will be using cell phones to schedule their doctor appointments and access personal health applications.

While Georgia’s health care technology leaders are known for innovation in clinical and payment systems, telemedicine and health information networks, there is still room for improvement. The November event will explore where we are currently, the vision for 2020 and the innovation needed to excel in the key areas of accessibility, workforce preparedness, cost and quality.

Featured case studies will include clinical and payment systems, telemedicine, robotic surgery and health information networks http://canadianviagras.com/pill/viagra-canada/. Attendees will include health care providers, corporations, state and local government and educators.

This event will feature entertaining demonstrations of the doctor-patient experience of the future, so save the date and jump onto the future edge of innovation and leadership!

Event Details  – November 10th, from 7:30am – 12:00 noon. at the Woodruff Arts Center Rich Theatre. To register, visit TAG Health.

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Shepherd Center

Monday, October 26th, 2009

October, 2009

By Helen K. Kelley

The influence and significance of Shepherd Center reach well beyond Atlanta, the state of Georgia and even the United States. Shepherd Center draws patients who need treatment for spinal cord injuries, acquired brain injuries, multiple sclerosis, chronic pain and other neurological conditions from every state in the country, plus as many as 30 foreign countries.

Shepherd Center actually had a relatively “small” introduction. In 1973, Alana and Harold Shepherd’s 22-year-old son James sustained a spinal cord injury in a surfing accident while on vacation in Rio de Janeiro. After spending several weeks in a Brazilian hospital struggling to survive, the Shepherds brought James back to the United States, where he spent another six months at a rehabilitation facility in Colorado. There, he regained his ability to walk while using a cane and a leg brace.

Frustrated that James couldn’t receive this kind of specialized care anywhere in the Southeast, the Shepherds were not content to stop after his recovery. With his parents’ support, James founded Shepherd Center in 1975 to bring high-quality spinal cord injury care closer to home. At that time, the center was simply a six-bed unit that operated out of leased space in an Atlanta hospital.

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From those humble beginnings, Shepherd Center has grown from six beds to 120, has roughly 1,300 employees and is recognized around the world as a rehabilitation treatment facility for catastrophic illnesses and injuries, and as an advocate for people with disabilities. The hospital runs at nearly full capacity all of the time, with a census of more than 100 patients, almost daily.

Medical Director Donald Peck Leslie, M.D., notes that Shepherd Center receives a large number of referrals from other facilities, particularly because it can handle highly complex cases.

“For example, Grady Memorial Hospital here in Atlanta is our No. 1 source of referrals. As a Level 1 trauma center, they often have patients who must be transferred to a treatment facility with an intensive care unit,” he explains. “We have our own ICU here at Shepherd, which most rehabilitation hospitals do not have. We’re in touch with the trauma surgeons at Grady almost daily.”

Referrals have increasingly come from other states and countries. Dr. Leslie adds that this is the first year Shepherd Center surpassed the percentage of patients being referred in state by referrals from other states and countries. He attributes this trend to Shepherd Center’s active presence in the international health care arena.

“We belong to a number of international organizations and make presentations at conferences and meetings around the world, and we’ve been asked to help other facilities put together their own rehabilitation programs,” Dr. Leslie states. “But the reality is that most countries don’t have the resources and expertise needed to start a rehabilitation treatment facility.”

Dr. Leslie attributes much of Shepherd Center’s phenomenal growth to the community support it has received since its inception.

“We’ve been fortunate to have such an incredible response from the Atlanta community and beyond,” he says. “Of the 14 model system spinal cord injury treatment centers around the U.S., we’re the largest, and the only one that is not part of a bigger medical center.”

Not Just For Rehabilitation Anymore

Shepherd Center is not simply a rehabilitation hospital. It’s also a world-renowned center for neurorehabilitation research, focused on developing, refining and evaluating new treatments, drugs, surgical techniques, diagnostic tools and various therapy interventions. Its clinical studies on spinal cord injury, brain injury, multiple sclerosis and neuromuscular disorders are conducted in collaboration with leading experts at other hospitals, research centers, medical schools and universities around the world.

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One of Shepherd Center’s premier areas of study occurs in its Spinal Cord Injury Research Program. Directed by Keith Tansey, M.D., Ph.D., this program is especially interested in restorative neurological research and conducts studies that address the recovery of function in residual, reorganized or regenerated neural circuitry in patients with spinal cord injury. Shepherd Center’s Spinal Cord Injury Research Program is developing a human studies laboratory called the Spinal Cord Injury Lab (SCIL) to expand its capacity to translate discoveries made in basic scientific research to studies in people with spinal cord injury.

“I’ve encouraged Shepherd to step closer to the basic science research bench. There’s a narrow pipeline between the basic scientists and clinical research,” says Dr. Tansey, noting that nearby universities – Emory, Georgia Tech and the University of Georgia – are all doing interesting research on the spinal cord in animals. “Right now, there are a lot of things that work successfully in the animal lab, and we’d love to know if they work on humans. I’d like to know not only if an idea is going to work, but also how it’s going to work.”

To find that out, human subjects must participate in lab studies. “Someone has to study the first 10 to 15 human patients in a lab setting as if they were doing a basic science experiment with lab rats, where they look with great precision at the biology,” Dr. Tansey explains. “In the case of spinal cord injury, by doing this type of research, we can learn how changing the specifics, such as with locomotor therapy, can increase patients’ ability to realize greater functional recovery.”

Shepherd Center’s spinal cord injury research using human subjects will help provide an understanding of how the nervous system responds in any predictable way, answering questions about whether patients improve by applying a given therapy, by reductions or increases in that therapy, by using a combination of drugs or electrical stimulation and therapy, and more.

SCIL’s first area of study will be neural plasticity, Dr. Tansey notes, and it will involve electrophysiological techniques to determine how a patient’s muscles and reflexes are working, in addition to using robotic devices to measure improvements in strength and movements.

“We want to look at interventions that can regulate and help the patient recover, and what changes can be made in rehabilitation therapy to make it more effective. The use of robotics will be particularly helpful in providing us with information,” he says. “We’ll also be able to change individual parameters using robotics, which can help determine how to get the patient to the next level of recovery. It’s evidence-based evolution of therapy.”

In addition to spinal cord injury research, Shepherd Center has programs that conduct research in acquired brain injury, multiple sclerosis, assistive technology and more. Shepherd Center’s research also works to improve the effectiveness and cost-effectiveness of clinical services, as well as to document the long-term effectiveness and benefits of rehabilitation to improve patient outcomes.

Revolutionary Technologies, Advanced Patient Therapies

Shepherd Center employs some of the latest specialized technologies to help its patients regain function they’ve lost. One such technology, the NeuRx Diaphragmatic Pacing System (DPS), provides crucial assistance to patients who’ve suffered phrenic nerve damage due to spinal cord injury. Because the phrenic nerve gives neurological capability to the diaphragm, damage to the nerve can render a patient unable to breathe without assistance from a ventilator.

Shepherd Center Associate Medical Director Brock Bowman, M.D., along with physicians at other facilities, such as Piedmont Hospital and the Cleveland Clinic, led clinical trials on the pacing system. Since the pacing system received FDA approval in the summer of 2008, 10 Shepherd Center patients have undergone the procedure to implant the NeuRx DPS.

According to Shepherd Center consulting surgeon Saeid Khansarinia, M.D., the NeuRx DPS can make a significant and dramatic improvement, especially in the lives of quadriplegic patients. “The DPS system frees our quadriplegic patients from the constraints and limitations of the ventilator, thus allowing them the closest thing to natural breathing,” he explains. “They have the freedom to move with less equipment, they experience the return of natural speech, taste and sense of smell, and there is less risk of lung infection.”

The system works by surgically placing a pacemaker onto the actual diaphragmatic muscle to assist the patient in breathing on his or her own; a small computer device regulates the pacing. For some people, this means being able to take a break from being on a ventilator; for others, it may mean being able to wean off a ventilator permanently.

“The pacing system has helped people with Lou Gehrig’s disease, who get worse very slowly over time, as well as people with spinal cord injuries,” Dr. Leslie says. “It’s giving hope to patients who want to get off the ventilator, at least some of the time. We’re fortunate to be able to help them, since so many people who suffer this kind of nerve injury don’t even make it to the hospital.”

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Shepherd Center’s therapeutic treatments are as advanced as its technologies. Many of its patients are benefiting from a program called “Beyond Therapy,” in which they have completed traditional rehabilitation protocol, but can opt to continue a nontraditional therapy of electrical stimulation of musculature that focuses on one particular aspect of rehabilitation, such as walking. The electrical stimulation is delivered to the selected muscles via a Swiss-engineered piece of equipment called the Lokomat, which Shepherd Center has two of. The Lokomat is a system of external orthoses that straps onto the patient. The robotic orthoses have motors in the hip and knee joints to move the patient’s legs. It can also give feedback as to how much the patient is working with the machine.

“It’s amazing to see people who haven’t walked for days, weeks or even months, do some limited ambulation,” Dr. Leslie says, “and the Lokomat can help patients who simply need muscle strengthening. The more they use it, the more close to normal range of motion they can get.”

As its research program develops and its staff develops even higher levels of expertise, Shepherd Center will continue to help its patients achieve better outcomes and become more independent, fulfilling its pledge to provide a high quality and complete continuum of care for those in need of rehabilitation.

To learn more about Shepherd Center, its patient care, its research programs and more, log on to www.shepherd.org and shepherdTV.org. Patients interested in participating in clinical research studies can even sign up online.

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Stoll Elected to Institute of Medicine

Thursday, October 22nd, 2009

The Institute of Medicine (IOM) has elected Barbara J. Stoll, MD to its new class of 65 top national health scientists. Stoll is a pediatrician and neonatal researcher at Children’s Healthcare of Atlanta pediatrician and neonatal researcher, and George W. Brumley, Jr., professor and chair, Department of Pediatrics, Emory University School of Medicine, and president of the Emory-Children’s Center.

Election to the Institute of Medicine is considered one of the highest honors in the fields of medicine and health. Members are elected through a highly selective process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care and public health.

“The IOM is a unique organization that contributes independent scientific and policy expertise to the public discussion of important health issues,” says Stoll. “I look forward to becoming engaged in IOM activities, especially those of importance to child health and well-being and the agenda for pediatric research and education.”

Stoll’s extensive research and publications have focused on low birth weight and premature newborns, the epidemiology of neonatal infections and the global impact of neonatal infections. She is principal investigator for Emory School of Medicine’s participation in the National Children’s Study, a multi-year study examining the effects of environmental and genetic factors on child health in the United States.

The author of more than 200 publications, Stoll has conducted numerous studies in collaboration with investigators from Emory and Children’s, other universities and the Centers for Disease Control and Prevention. She was awarded Emory’s Albert E. Levy Award in 2005 for the best clinical scientific paper by a senior investigator.

Stoll received her medical degree from Yale Medical School, completed a pediatric residency at Babies Hospital, Columbia Presbyterian Medical Center and a neonatology fellowship at Emory University School of Medicine. She spent four years working on issues of childhood disease and mortality at the International Center for Diarrheal Disease Research in Bangladesh and was a visiting scientist at the World Health Organization (WHO) from 1995 to 1996.

Stoll is a member of the Scientific Advisory Board for the Saving Newborn Lives Initiative of Save the Children, the Atlanta-based WHO Collaborating Center in Reproductive Health, the Society for Pediatric Research, the Perinatal Research Society, the American Pediatric Society, the Executive Committee of the Association of Medical School Pediatric Department Chairs and a fellow of the American Academy of Pediatrics and the Infectious Diseases Society of America.

She is on the Steering Committees of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and Stillbirth Collaborative Research Network and is one of the principal investigators of these collaborative networks.

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Online H1N1 Flu Response Center

Thursday, October 22nd, 2009

A new web site has been launched by Microsoft Corp. providing users with a H1N1 Self-Assessment tool developed by medical and public health experts at Emory University.

Called H1N1 Response Center, the web site is designed to help people decide what to do if they are worried that they or someone they love has symptoms of the flu, the site offers consumers a self-assessment tool licensed from Emory. The tool helps individuals determine whether the symptoms they have could be caused by the flu virus, whether their illness is severe enough to warrant immediate medical attention, and whether they are at increased risk for developing severe disease. The site also offers practical advice on what to do.

The clinical content of the web site is closely based on a Centers for Disease Control and Prevention (CDC) algorithm for health professionals designed for the 2009-2010 flu season, jointly developed with Emory School of Medicine. “Certain people are more vulnerable to the effects of the H1N1 flu virus than others,” says Arthur Kellermann, MD, professor of emergency medicine and an associate dean at the Emory School of Medicine. “This website is carefully designed to encourage those who are severely ill, and those at increased risk for serious illness to contact their doctor, while reassuring large numbers of people with mild illness that it is safe to recover at home.”

“Hopefully, providing easy to understand information to the public will reduce the number of people who are needlessly exposed to H1N1 influenza in crowded clinic and ER waiting rooms, and allow America’s doctors and nurses to focus their attention on those who need us most,” adds Kellermann.

Called the Strategy for Off-Site Rapid Triage (SORT) the concept was created and developed by an interdisciplinary team at Emory led by Alexander Isakov, MD, MPH and Kellermann. Microsoft’s web site is designed communicates complex health information in simple terms that the public can understand. The content and images used in the site were developed and field- tested with more than 100 community volunteers by the Emory@Grady Health Literacy Team, which includes Ruth Parker, MD, and Lorenzo DiFrancesco, MD, of Emory’s School of Medicine, and Kara Jacobson, MPH, of Emory’s Rollins School of Public Health.

Emory’s algorithm and the idea of using a web-based tool to help flu patients decide what to do is endorsed by the American College of Emergency Physicians, the nation’s leading organization for the specialty of emergency medicine.

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WellStar Receives Breast Center Accreditation

Wednesday, October 21st, 2009

WellStar Health System is the first and only accredited breast center in Georgia to be granted a three-year/Full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC).

The NAPBC is a consortium of professional organizations dedicated to the improvement of the quality of care and monitoring of outcomes of patients with diseases of the breast. This mission is pursued through standard-setting, scientific validation, and patient and professional education. Its board membership includes professionals from 15 national organizations that reflect the full spectrum of breast care.

Accreditation by the NAPBC, administered by the American College of Surgeons, a professional organization dedicated to improving the care of surgical patients, is granted only to those centers that are voluntarily committed to providing the best possible care to patients with diseases of the breast. Each breast center must undergo a rigorous evaluation and review of its performance and compliance with NAPBC Standards.

“The breast health program at WellStar has a comprehensive approach to breast care to ensure our patients are getting the best possible care,” said Richard Fine, M.D., WellStar Breast Health Continuum of Care chairman. “This means a team of experts treat each patient. This clinical team brings numerous medical experts together in a collaborative approach to analyze specific cases and to develop a personalized treatment plan that is right for every individual.”

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International Survey of Nutrition Therapies in ICUs

Tuesday, October 20th, 2009

Health professionals in Gwinnett Medical Center’s Intensive Care Unit (ICU) are working to improve the quality of care received by their critically ill patients by participating in an international survey of nutrition therapies in ICUs.

The frequency of malnutrition is high among ICU patients  and has a negative impact on clinical outcomes.  Providing the right nutrition improves would healing, boosts the immune system, and helps the gut work more effectively, which together favourably influences the chance of surviving critical illness.

In 2007  Dr. Daren Heyland, began building on research which began in 2003 with an  an international survey to define what types of nutritional delivery were used and to highlight strengths and weaknesses of these methods, identifying  opportunities for improvement. The survey was conducted in both 2007 and 2008. Gwinnett Medical Center was selected along with 149 other intensive care units in hospitals from around the world to participate in the 2009 research phase.

Beginning in mid-September, registered dieticians, intensivists, neurosurgeons and trauma surgeons at Gwinnett Medical Center will start to collect data on the clinical condition, nutritional status, nutrition received, and outcomes of 20 critically ill patients.  Data will be entered online over a period of 3 months using a web-based data collection tool.

At the end of the study, Gwinnett Medical Center’s ICU will receive a benchmarked performance report, highlighting their strengths and weaknesses in comparison to other ICUs throughout the World, and to the Canadian guidelines.  This report will be of significant value, illuminating opportunities for improvement, informing future educational initiatives, and hopefully translating into improved clinical outcomes for our critically ill patients.

Further Information:  www.criticalcarenutrition.com

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Northeast Georgia Medical Center Unveils New Heart Failure Unit

Monday, October 19th, 2009

Patients suffering heart failure can now be admitted to the region’s first dedicated, inpatient Heart Failure Unit at Northeast Georgia Medical Center (NGMC).  The new unit opened its doors on October 26 .

“Studies indicate our new Heart Failure Unit will improve our readmission and mortality rates, which are already better than the national average,” says Brenda Hott, MD, a cardiologist specializing in heart failure at Northeast Georgia Heart Center and medical director of the Inpatient Heart Failure Program at NGMC.  “Moving all heart failure patients into one central location, rather than having them spread out amongst patients with other diagnoses, will allow our specialty-trained nurses to focus solely on treating heart failure.”

NGMC’s Inpatient Heart Failure Program is comprised of board certified cardiologists, nurse practitioners, pharmacists, case managers, nurses and dieticians who are experts in providing individualized treatment to patients suffering heart failure

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MAG House of Delegates

Friday, October 16th, 2009

October 16-17, 2009. The 2009 HOD will be held in Savannah at the Westin Savannah Harbor Resort and the Savannah International Trade and Convention Center.  For more information, call 404-881-1020.

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CME Event – Communicating Unanticipated Outcomes and Medical Errors

Thursday, October 1st, 2009

October 1, 2009. Joint event with Medical Association of Atlanta and SE Permenete Medical Group (Kaiser). To be held at the Georgia Aquarium. For more information, call 404-881-1020.

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