Saint Alphonsus Hospital Update

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Idaho’s Only 2006 Distinguished Hospital for Clinical Excellence TM

DELIVERING ADVANCED HEALING TO THE REGION

inside N OV E M B E R / D E C E M B E R 2 0 0 6

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Saint Alphonsus Brings 64-Slice CT Technology to the Treasure Valley Saint Alphonsus is the first to provide 64-slice CT capabilities to patients in the Treasure Valley. This state-of-the-art scanning technology provides increased scanning speed and the ability to freeze images in motion. The outcome provides patients with a quicker, more accurate diagnosis.

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Saint Alphonsus Opens Expanded Family Maternity Center, Level III Neonatal Intensive Care Unit and Cancer Care Center Saint Alphonsus opens three new facilities as a part of the master facility plan to meet the healthcare needs of a growing and aging population.

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CME & Physician Specialty Resources


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Saint Alphonsus Brings 64-Slice CT Technology to the Treasure Valley BY R. JOSEPH GOBEL, MD AND CURTIS COULAM, MD BOARD-CERTIFIED RADIOLOGISTS

It was only a decade ago when multi-slice CT technology entered the market. Now, with the advent of 64-slice scanners, Saint Alphonsus is proud to announce it is one of the first sites in the nation to acquire Toshiba’s Aquilion 64-slice CT. Along with this honor, Saint Alphonsus was the first to provide 64-slice capabilities to patients in the Treasure Valley. This state-of-the-art scanning technology provides increased scanning speed, with 0.5mm slices, and improved temporal resolution, which results in the ability to freeze motion. The outcome provides patients with a quicker, more accurate diagnosis. CT’S USE FOR TRAUMA & EMERGENCY PATIENTS

“CT is already the modality of choice for trauma evaluation,” says Curtis Coulam, MD, Gem State Radiologist at Saint Alphonsus. An emergency room adult patient can have a full-body scan in approximately 30 seconds; a pediatric patient can be examined even more

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Coronary artery angio shown with a vessel probe montage. The vessel probe is a function of the 3D software that demonstrates an arteries’ anatomy in all 3 planes. You see the 3D vessel and all the views needed for a diagnosis on one screen.

quickly, reducing the need for patient sedation and additional anxiety. “You can apply CT technology to any organ, determining cause of symptoms or ruling out conditions in a matter of seconds,” Coulam notes.

The advances and increasing adoption have enabled CT technology to continually expand its clinical application throughout healthcare. Saint Alphonsus’ 4-slice and 16-slice CT technology has been

| 1055 NORTH CURTIS ROAD | BOISE, IDAHO 83706 | WWW.SAINTALPHONSUS.ORG


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Coronary CTA angio that demonstrates a significant blockage of a major artery.

extremely useful in trauma, orthopaedic and neurological care, and radiologists are also seeing CT’s increasing usefulness in cancer detection.

Cardiac CTA of a patient with stent.

According to Po Huang, MD, Medical Director of the Saint Alphonsus Emergency Department, time is of the essence, especially for patients

The newest 64-slice CT technology enables imagers to freeze motion, allowing physicians to reach accurate diagnoses quicker than before. CT’S ROLE IN CARDIAC IMAGING

Now, this new 64-slice CT will make strong advancements in CT angiography, with cardiac imaging receiving the greatest impact. “With improved resolution and the ability to virtually freeze motion, the routine noninvasive evaluation of the coronary arteries is now possible,” says Joseph Gobel, MD, Radiologist at Saint Alphonsus and with Gem State Radiology.

3D high resolution lung image showing lung tissue with emphysema.

with chest pain. Doctors need to rule out causes and determine the root of the problem. With the aid of 64-slice CT technology, physicians have the potential to rule out the most life-threatening causes of chest pain with one non-invasive scan. “Chest pain is a common complaint in the emergency department and physicians need to determine if the cause of the chest pain is life threatening or not,” says Dr. Huang. “The CT scan has been used to rule out

Abdominal Angio shows the great vessels of the abdomen, the aorta, renal arteries and mesentery.

Carotid and vertebral artery angio. This looks for blockages or strictures in the vessels supplying blood to the brain. An exam often used in post traumatic injury or common when looking for causes of neurological deficits.

WWW.SAINTALPHONSUS.ORG | PHYSICIAN RESOURCE LINE 1-866-480-3840 |

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Curtis Coulam, MD Medical School: University Of Utah School of Medicine Residency: Duke University Medical Center Subspecialty: Body and cross-sectional imaging Fellowship: Body Imaging, Stanford University School of Medicine Employment: Clinical Instructor, Stanford University School of Medicine Awards and Honors: Co-authored several articles and abstracts ranging from coronary artery angiography and CT to reproductive topics

pulmonary embolus and aortic dissection, and now it has the potential to evaluate a patient for coronary artery disease.” “The 64-slice CT can get a full cardiac scan in 10 seconds with one breath hold and one contrast injection.” Coulam states. This offers nearly 100% negative predictive value for noninvasive coronary artery evaluation, allowing the physician to rule out coronary artery disease non-invasively. This same scan is also used to evaluate other causes of the patients symptoms such as

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pulmonary embolism and aortic dissection, commonly referred to as the triple rule out. “There is no inherent increase radiation dose with the 64-slice CT scanner in comparison to other CT scanners,” states Dr. Gobel. “However, radiation exposure of a cardiac CT is greater than an invasive catheter cardiac angiogram. So, radiation exposure should be a consideration in choosing CT versus invasive cath for younger patients, particularly female patients due to breast exposure.” “We now have a test that, in the right patient population, will quickly tell us if a patient has coronary artery disease without an invasive procedure,” echoes Huang. “The question now is which patients are appropriate candidates for the CT coronary angiogram.” Preliminary publications support the use of 64-slice CT angiography to rule out coronary artery disease in low risk symptomatic patients with chest pain. This technology is also of use in evaluating patency of bypass grafts and anomalous coronary vessels. Broader use of this exciting technology for evaluation of cardiac disease is expected in the near future, but will await further published peer reviewed literature. While the 64-slice CT has great diagnostic potential, many insurance companies have not yet approved use of the technology for cardiac testing. Saint Alphonsus cardiologists, radiologists and emergency

R. Joseph Gobel, MD Medical School: University Of Utah Medical Center Residency: Medical College of Wisconsin Special Interests: Abdominal Imaging, Musculoskeletal Imaging and Interventional Radiology Awards and Honors: Outstanding Medical Scholar Award for Anatomy and Pathology Certifications: American Board of Radiology

physicians are collaborating to develop the appropriate protocols for patients who present with acute chest pain to the ED. “With the aid of this new imaging technology, plus the other initiatives we’ve implemented to care for cardiac patients in our ED, Saint Alphonsus is establishing the gold standard for cardiac care throughout the Treasure Valley,” concludes Huang.

For more information about Saint Alphonsus’ 64-slice CT scanning technology, contact Joseph Gobel, MD or Curtis Coulam, MD at (208) 367-5670.

| 1055 NORTH CURTIS ROAD | BOISE, IDAHO 83706 | WWW.SAINTALPHONSUS.ORG


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New State-of-the-Art Clinical Facilities Foster Hopes, Dreams, and Healing

Expanded Family Maternity Center and Level III Neonatal Intensive Care Unit.

September marked an exciting milestone for Saint Alphonsus and Treasure Valley residents. On Saturday, September 16, we hosted an Open House for the community to preview our new expanded Family Maternity Center and Level III Neonatal Intensive Care Unit and newly renovated and expanded Cancer Care Center. These two centers are part of our $200-million-plus construction and renovation master facility plan to meet the health care needs of a growing and aging population. Our new maternity and cancer program spaces were designed with input from our physicians and nurses. These two facilities are unique to our area in that they combine state-of-the-art medical technologies and

The group infusion area in the newly expanded second floor of the Boise Cancer Care Center.

treatments with architectural design principles proven to enhance healing. The end results are buildings that provide patients, families, and staff with safe, soothing environments that offer privacy, promote healing, foster hope, and ensures comfort and support for patient and families. In just a little less than a year, we will open the new nine-story Center for Advanced Healing, one of the most modern clinical environments in the Northwest. Within the hospital, dozens of patient care areas have also been renovated to incorporate the healing design principles that have come out of recent architectural research studies. While we’re proud of our new facilities, and excited to see the

completion of the new tower, we remain grounded in our passion and promise to the community – to provide the safest, highest quality, compassionate care to patients and families, and to offer comprehensive services to help heal body, mind, and spirit. That’s what Advanced Healing is all about. Sincerely,

Sandra Bennett Bruce, President & CEO

Sandra Bennett Bruce President and CEO

WWW.SAINTALPHONSUS.ORG | PHYSICIAN RESOURCE LINE 1-866-480-3840 |

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Family Maternity Center and Neonatal Intensive Care Unit Physicians Renee Bobrowski, M.D. Board Certified: Maternal-Fetal Medicine, Obstetrics/Gynecology Medical School: Wayne State University School of Medicine (Detroit) Residency: Indiana University Fellowship: Maternal-Fetal Medicine and Critical Care Obstetrics – Hutzel Hospital/Wayne State University School of Medicine

Stewart Lawrence, M.D. Board Certified: Neonatology, Pediatrics

Matthew Sell, M.D. Board Certified: Neonatology, Pediatrics Medical School: University of Wisconsin Medical School

Kerry P.J. Pulver, M.D., Ph.D Board-certified in medical oncology and hematology

Residency: Pediatrics, University of Iowa Hospitals and Clinics Fellowship: Neonatology, University of Iowa Hospitals and Clinics

Timothy E. Sawyer, M.D. Board-certified radiation oncologist

Cancer Care Center Physicians Alice M. Forsythe, M.D. Board-certified in medical oncology and internal medicine Medical oncologist/ hematologist

Karl J. Schulthesiss, M.D. Board-certified in medical oncology, hematology, and internal medicine

Medical School: Mount Sinai School of Medicine (New York) Residency: Pediatrics, Duke University Medical Center Fellowship: Post-doctoral Fellowship, Neonatalperinatal medicine — University of Texas Health Services Southwestern Medical Center

Jennifer Merchant, M.D.

Stephanie B. Hodson, M.D. Board-certified in medical oncology, hematology, and internal medicine Medical Director, Cancer Care Center, Director of the Comprehensive Breast Care Program

Jennifer L. Suida, M.S., N.C.R.N.P. Oncology nurse practitioner

Board Certified: Neonatology, Pediatrics Medical School: University of Minnesota Residency: Department of Pediatrics, University of Minnesota

Jerry Perez, M.D. Board-certified gynecology oncologist

Esther Sears, M.S., F.N.P.-C. Oncology nurse practitioner

Fellowship: Division of Neonatology, Department of Pediatrics, University of Minnesota

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| 1055 NORTH CURTIS ROAD | BOISE, IDAHO 83706 | WWW.SAINTALPHONSUS.ORG


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Saint Alphonsus CME Ada Canyon Medical Education Consortium (ACMEC) Grand Rounds Lectures Calendar N O V E M B E R 1 Mental Health Issues in the Hispanic Population Rosalia Richardson, MD 8 Management of Migraines Jan Brandes, MD 15 Vaccine Update Speaker TBA 17 Critical Care Case Conference 22 Nutrition through Life Cycles Kristin Ritzenthaller, PHD 29 Lead Poisoning John Rosen, MD

WEDNESDAY 8:00 a.m. St. Luke’s RMC Meridian St. Luke’s RMC Wood River St. Luke’s Gooding County Memorial Hospital McCall Hospital 12:30 p.m. Mercy Medical Center F R I D A Y 8:00 a.m. Saint Alphonsus RMC St. Benedict’s Family MC Weiser Memorial Hospital McCall Hospital

D E C E M B E R 6 Best of the American Heart Association Meeting Brent Muhlstein, MD 13 Urodynamics in the treating of Female Urinary Incontinence Avery Seifert MD, Alan Swajkoski MD

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Critical Care Case Presentation Conference

Program topics and speakers are subject to change. Please check www.acmec.org for daily schedules or call (208) 331-1478

Saint Alphonsus Physician Specialty Resources Bariatric Surgery Program Coordinator (208) 367-8309

Idaho Orthopaedic Institute Referral, consultation (208) 367-4289 Joint Care Center (208) 367-7015

Palliative Care Kevin Clifford, MD, Medical Director (208) 367-6030

Cancer Care Center Physician referral, consultation (208) 367-6627

Life Flight — Critical Care, Cardiac, Maternal-Fetal, & NICU Transport (800) 521-2444 - Dispatch (208) 367-3207 - David Kim, MD, Medical Director

Pathology Kenneth Algino, MD, Medical Director (208) 367-2153

da Vinci® Surgical Robotic System (208) 367-6464 Emergency Department Po Huang, MD, Medical Director (208) 367-3221 Heart & Vascular Center (208) 367-2700

Maternal-Fetal Medicine Renee Bobrowski, MD, Medical Director (208) 367-5544 Neonatal Intensive Care Unit Matthew Sell, MD, Medical Director (208) 367-6483

Hospitalist Program, Inpatient Adult Medicine Referral/admission coordination Pager (208) 855-7604

Novalis — Shaped Beam Surgery System Timothy Sawyer, MD, Medical Director (208) 367-6627

Idaho Neurological Institute Referral, consultation (208) 367-2233

Pain Management Daniel Marsh, MD, Medical Director (208) 367-4343

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Rehabilitation (208) 367-2660 - In-patient (208) 367-3315 - Out-patient Sleep Disorders Center Information, referral (208) 367-6119 Transfusion-Free Medicine (Bloodless Surgery Program) (208) 367-6464 Trauma Center Frederick Foss, MD, Medical Director (208) 367-7676 Wound Clinic Program information, referral (208) 367-3420

WWW.SAINTALPHONSUS.ORG | PHYSICIAN RESOURCE LINE 1-866-480-3840 |

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