The BMC Brief
September 1, 2011 Volume 1, Issue 8
Nick Heald was a 16-year-old singer and active member of his drama club in South Glens Falls, New York, when his drama club teacher noticed something unusual about his voice last summer.
She recorded him singing and compared it to a recording of him the year before, noting that his voice had changed. The change, coupled with a persistent sore throat, prompted the teenager to visit his doctor. What doctors initially thought was acid reflux and then tonsillitis turned out to be a synovial sarcoma on the back of his tongue, a rare form of cancer that usually occurs near the joints of the arm or leg. Knowing that cancer specialists could best treat the tumor, Heald’s doctors at Albany Medical Center referred him to Boston Medical Center, the preferred tertiary care provider for head and neck cancer care in New England.
Enter Scharukh Jalisi, MD, FACS, Director, Head and Neck Surgery and Skull Base Surgery at BMC. Jalisi met with Heald, reviewed his options, and devised a treatment plan to shrink Heald’s tumor using chemotherapy and radiation and then remove it using a minimally–invasive robotic procedure called transoral robotic surgery (TORS).
Using TORS, BMC surgeons can remove both benign and cancerous tumors of the throat, larynx and neck while sparing the patient a large incision and a recovery time of several weeks. BMC was the first hospital in New England to offer this new treatment and to date, has successfully performed the procedure on 30 patients, including Heald.
“First we were able to shrink Nick’s tumor by 75 percent,” says Jalisi. “Then we used the Davinci robot to remove the tumor in one day. By using TORS, we spared Nick from a five-inch incision from his jaw to his chest, a drastic procedure that would have required cracking his jaw open to reach the cancer and a recovery time of at least two weeks. This method also allowed us to preserve speech, swallowing, and other key quality of life issues.”
To ensure the cancer was gone, Heald received follow-up chemotherapy and radiation in his home state for a short time following the surgery. That spring, he participated in his school play, “Charlie Brown,” in which he played Linus, one of the main characters. He also graduated on time with his class. Now completely cancer free, he plans to attend community college this fall.
“I’m feeling great and am back to normal,” says Heald. “Boston Medical Center was awesome. Everyone was really nice and worked well together. I’m very grateful for the care I received there.”
“Our experience was wonderful,” says Amy Gurdo, Heald’s mother. “From the moment we met Dr. Jalisi, we felt comfortable. He spelled out all the options for us, and even when he explained the worst-case scenario, we left his office feeling better. All the care Nick received, from physicians and nurses, was fabulous. We couldn’t have asked for a better outcome.”
In a nod to the sophistication of Boston Medical Center’s electronic health record (EHR), the hospital was recently awarded certification from the Certified Commission for Health Information Technology for its inpatient EHR suite of applications, making it only the second hospital in Boston to be certified. The approval marks the first successful step in BMC’s participation in a new federal program that provides significant financial rewards for use of EHR to improve patient care.
BMC has made a significant investment in its EHR over the past decade to improve the quality, safety and efficiency of patient care delivered here. Most recently, BMC’s Information Technology Services department (ITS) has been working on the EHR applications as the organization strives to achieve “meaningful use” later this year.
“Meaningful Use” is part of the federal stimulus bill and is designed to incentivize the use of the EHR. When a qualifying organization can show that it’s using certified EHR technology to achieve health and efficiency goals in a “meaningful way,” a significant financial incentive is awarded through federal Medicare and state Medicaid programs. Examples of the required criteria include using a certified EHR for Computerized Physician Order Entry (CPOE) and for medication reconciliation to improve quality of health care, two systems currently in place at BMC.
“Boston Medical Center is well ahead of the game,” says Eric Podradchik, Manager, BMC’s EHR team. “We have spent years working with clinicians to develop our systems and as a result, many functions already existed. We were in a great position to receive this certification and now we can move forward with the next step.”
That next step is to submit data this fall to meet the meaningful use criteria for the year. BMC then stands to gain a financial incentive of more than $20 million from the program. Even as the work is being completed, ITS is working to qualify BMC’s individual eligible providers for their participation in the Meaningful Use program.
“Our performance in this program reflects BMC’s acumen in using advanced technology to deliver exceptional, high quality care,” says Meg Aranow, Chief Information Officer and Vice President of Information Technology Services. “We are thrilled that BMC’s early investments in patient-focused technology have the added benefit of delivering financial incentives to the institution.”
Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) researchers have identified unhealthy substance use as a risk factor for not receiving all appropriate preventive health services, such as mammography screening and influenza vaccination. These preventive health services can help reduce the rates of cancer and influenza, which area among the leading causes of mortality in the United States.
Influenza is preventable, in part, through vaccination, and mortality from cervical, breast and colorectal cancer can be reduced through routine screening. Nevertheless, many eligible U.S. adults do not receive these recommended preventive services, in particular, low-income persons, racial and ethnic minorities, the uninsured and the foreign-born.
Despite this knowledge, and the implementation of interventions targeting these groups, preventive services are still underused.
According to the researchers, future interventions to promote mammography screening might target women with unhealthy substance use, and those to promote influenza vaccination might target both men and women with unhealthy substance use.
“Clinical interventions could embed mammography screening and influenza vaccination in other services delivered to individuals with substance use problems,” says lead author Karen Lasser, MD, MPH, a primary care physician at BMC. “In addition, training interventions could enhance skills and systems for health care personnel who screen for substance use disorders to include referrals for preventive health services.”
Name: Dona Rodrigues, CNM, MPH
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Patients share their BMC experience
My husband was a patient in Newton Pavilion this past weekend. He had surgery for an odontogenic keratocyst and this was his second admission for this problem.
I am a nurse with 40 years of experience and the nurses that my husband had were phenomenal. Mary was his night nurse and made us feel so welcome and the fact that I and my sister-in-law (we both stayed overnight) were in the room did not hinder his care at all. She was so kind and thoughtful. It is hard enough to care for the patient, never mind two overbearing family members. Then we had Tammy for the day shift. She was equally as nice and thoughtful and made sure we were aware of any changes made to my husband’s care. I felt comfortable enough with the care he was receiving that I left to go home for a few hours. We were glad to see the return of both nurses the next night/day. They made sure we felt welcome and comfortable and gave exceptional care. I also felt that your staff on both shifts worked well together; Joan, on at night, came in to check on us when Mary was tied up, and the same with the day staff.
I could go on and on, but the bottom line is, thanks to the thoughtfulness and caring of these two nurses, our experience was great and we needed that. It was exceptional care without exception.
Shapiro family visits BMC’s new ambulatory center
Hochberg named Vice President for Quality and Patient Safety/Chief Quality Officer
Hochberg is Chairman of the Board of Massachusetts Health Quality Partners, a coalition of physicians, hospitals, health plans, consumers, academics, and government agencies working together to promote improvement in the quality of health care services. He has served as Chief Operating Officer and Medical Director at the Care Group Provider Services Network, where he developed sophisticated quality intervention systems for network physician groups, and Vice President and Regional Medical Director at Harvard Pilgrim HealthCare.
Biggio named Vice President of Facilities and Support Services
BMC scores well on patient safety survey
BMC met the full standards in five areas.
Lassonde represents BMC at Making Strides breakfast
Lassonde, a strong supporter of breast cancer research, attended the breakfast as a BMC representative. Pictured, from left to right, are event emcee Dylan Dreyer of 7News on 7NBC/CW56; Lassonde; Angela Hall Jones, American Cancer Society Community Executive for Health Initiatives; and co-emcee Candy O’Terry, of MAGIC 106.7.
William Kannel, MD, leader of Framingham Heart Study, dies
Daniel Alford, MD, MPH, Primary Care, and Steve Williams, MD, Chief, Chairman, Rehabilitation Medicine, have been named winners of the 2011 Rx for Excellence Awards, which honor best practices in medicine. Alford and Williams are recipients of Heroes from the Field awards, which will be presented at an awards ceremony on Nov. 4. The fourth annual awards ceremony and breakfast celebrates patient safety, health care quality and risk management.
BMC/BUSM's medical education and neurology residency training programs have been ranked among the top 20 of 120 U.S. programs according to a study published in the August issue of the Archives of Neurology. The analysis, conducted by researchers, assessed the impact of medical schools and residency training programs on the decision to pursue a career in academic neurology as well as an estimation of the most productive medical schools and residency programs based on the academic productivity of their respective graduates.