January 16, 2015
MEDICAL UNIVERSITY of SOUTH CAROLINA
Vol. 33, No. 20
Telehealth alliance expands health care Inside
By Mikie Hayes Public Relations
L
iving in close proximity to a top–rated, specialized health care institution like MUSC is a comfort to most people, and, according to U.S. News & World Report, precisely what people
should look for as they consider relocating or retiring. But many South Carolinians don’t have that luxury, and in remote, underserved or rural areas, access to quality health care has long presented challenges. South Carolina has a population of 4,774,839 people,
with 753,364 South Carolinians living in what are considered rural areas, according to the Rural Assistance Center. And while farms, small towns and pastoral countrysides can provide a charming way of life, when someone is sick or injured, it can be terrifying living hours from
basic or advanced medical care. Under the worst of circumstances, health care may not be available at all in a rural area, with the closest provider hours away. And, where facilities are available, they often offer limited services.
See Alliance on page 9
Rural practice success case for telehealth
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An employee’s heartfelt tribute to a S.C. legend.
MUSC Family Says Goodbye
By Dawn Brazell Public Relations
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F
elicia Frasier knows her daughter’s weight could create issues that follow her through life. Duranda, 14, carries almost 180 pounds on her 5–foot–2–inch frame. It caused her to be teased at school and may be why her daughter now prefers to do online homeschooling rather than face the drama of high school. When Frasier heard from their pediatrician, Paul Hletko, M.D., of Georgetown Pediatric Center, that they could do a teleconsult with pediatric nutritionists at MUSC, she jumped at the chance. Her daughter was placed on a new diet plan and counseled in ways she can get more activity and make behavioral changes. She also is getting testing done to see if there may be other issues, such as thyroid problems. “It’s neat. It’s like they are in the room with you,” Frasier said of the pediatric nutritional consult that kept her from having to drive 90 minutes to Charleston. Frasier, who works two jobs, has transportation issues at the moment that would have made the trip difficult, she said. “It was very instrumental in telling us options she may have, and she’s
A Remembrance
In memoriam: MUSC honors James B. Edwards.
photo by Dawn Brazell, Public Relations Dr. Paul Hletko of Georgetown Pediatric Center examines a patient in his teleconsult room. On the television monitor above him is Dr. James T. McElligott, a pediatrician and medical director of the MUSC Center for Telehealth. already lost a couple of pounds.” Frasier isn’t the only one thrilled. Hletko, loves being able to offer his patients more services, and he practices in a region where obesity rates run higher. “Up to 30 percent of some practices deal with children who fall into the 97th
percentile on the body mass index graph. This is a tragedy and is truly going to negatively impact our ability to have a healthy working population and a healthy student population
See Rural on page 8
2 Monthly Awards 5 Meet Daniel 11 Wellness T h e C ata ly s t Online http://www. musc.edu/ catalyst
2 The Catalyst, January 16, 2015
Medical Center
‘Making a difference every day’ Employees of the Month Award Jason Bryan ART 5 East/Cardiac Acute Care “MUSC’s 5 East unit in ART is filled with compassionate, caring nurses who care for ill heart disease patients. The staff has formed special bonds and relationships with many of these patients as they have cared for them over multiple admissions and years. In an effort to honor and remember the patients we have lost to heart disease in the last year, Jason Bryan created a pin for staff to wear. This simple act was a way to show respect and compassion for some of our dearest patients, and at the same time, it fostered a sense of loyalty amongst the staff. It promoted multidisciplinary teambuilding as well. The MDs, case managers and social workers all wear a pin. In addition, Jason used this pin as an opportunity to raise money for the American Heart Association. Each year, our unit participates in the Lowcountry Heartwalk. Jason used the pins as a fundraiser to support the same cause that took the lives of all of these patients.
Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425. 843-792-4107 Fax: 843-792-6723 Editor: Cindy Abole catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu J. Ryne Danielson, daniejer@musc.edu Helen Adams, adamshel@musc.edu Sarah Pack, packsa@musc.edu Jeff Watkins, watkinsj@musc.edu
What a perfect way to honor patients and at the same time raise money for education and awareness. Raising money for a cause that directly impacts our patients also helped to create a sense of pride and loyalty on the unit, thus creating a better work place.” Nominated by Dawn Terzulli Melissa McFee Children’s Services “On Thursday, Nov. 13 Melissa was in the cafeteria grabbing lunch when she noticed a visitor was choking. Melissa sprang into action and successfully performed the Heimlich maneuver on the gentleman to relieve his choking. I am thankful Melissa was there to respond.” Nominated by Amy Richburg Taylor Parker Total Joint Replacement “One of our patients was on the unit for three weeks. The patient did not have many visitors. Taylor Parker, a PCT on 10E assisted the patient into The Catalyst is published once a week. Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.
a wheelchair and pushed him around the hospital for a while. When Taylor was leaving that afternoon the patient cried and wanted her to come back to care for him later. Taylor came in the next day, on her day off, and spent time with the patient along with pushing him around the hospital in his wheelchair. Taylor is compassionate and caring individual who left a lasting impression on this patient. Taylor is MUSC Excellence and an asset to our organization.” Nominated by Justin Morris Physician of the Month Award Bryce Wyatt, M.D. Department of Surgery-Residents “Dr. Wyatt continues to impress me in his interactions with staff, patients and family members alike. Most recently, during physical therapy exercises with a patient of mine, in which Dr. Wyatt was observing for possible adverse changes in vital signs, Dr. Wyatt, without hesitation, jumped in to assist with cleaning the
patient after an ‘accident.’ Further, Dr Wyatt, before leaving the room, recognized other staff for their efforts in caring for the patient, and encouraged the patient in his rehab efforts and progression of healing. Dr. Wyatt deserves recognition for his efforts as a member of the MUSC team. Nominated by Brent Paape
Call for Nominations: 2014 Teaching Excellence Awards A call for nominations to all faculty and students to recognize members of the MUSC faculty who have made outstanding contributions to the university through teaching. Awards may be given from the Clinical/Professional (EducatorMentor); Scholarship/Academic (EducatorMentor); Educator-Lecturer; and Developing Teacher. Deadline for nominations is Jan. 23 and can be found at http:// www.carc.musc.edu/nomination/.
MUSC, Fetter Network meeting set Jan. 21 MUSC Office of the Associate Provost for Research, SEView, the Office of Research Development and Fetter Healthcare Network have initiated a new project called the FHCN/MUSC Partnership for Education, Advocacy & Research in the Low Country of South Carolina (PEARLS) Initiative. FHCN is a Federally Qualified Community Health Center (FQCHC) network supporting Berkeley, Charleston, Colleton and Dorchester counties. PEARLS provides a platform to develop a sustainable model
to improve health outcomes and the quality of life for underserved patient populations. Through this initiative, organizers hope to facilitate primary care delivery research and/or education initiatives within FHCN and support joint grant application in support of this initiative. The project includes an Advisory Broad, a Project Review Committee and other personnel. Join us from 12 to 1 p.m., Jan. 21 in MUSC’s Basic Science Building, room 349, to learn more about FHCN.
The Catalyst, January 16, 2015 3
US News ranks MUSC’s online graduate nursing program No. 1 Staff Report The MUSC College of Nursing’s online graduate nursing program has earned the top spot on U.S. News & World Report’s 2015 Best Online Graduate Nursing Programs. The public nursing school received a perfect score of 100 and earned high marks for faculty training and student engagement. “This is a tremendous achievement and a reflection of the dedication of our faculty and staff to make our educational programs the best in the country,” said Gail Stuart, Ph.D., MUSC College of Nursing dean. “It is a high honor for MUSC and the state of South Carolina to be ranked number one in the nation.” The publication’s best online rankings were introduced in 2012 to provide prospective students an overview of the rapidly growing number of institutions that offer online education programs. Since then, the number of ranked programs has increased twofold, from 677 online programs in 2012 to more than 1,200 this year. For the online graduate nursing program rankings, U.S. News & World Report collected statistical information from 133 nursing schools with online programs from July 2014 until September 2014. So what sets MUSC’s online nursing program apart from the rest? According to Georgette Smith, Ph.D.,
photo by Anne Thompson, Digital Imaging
College of Nursing Dean Dr. Gail Stuart greets attendees during the Dec. 11 college reopening. associate dean for academics, it’s rooted in a deep commitment to student success and role-modeling of real-world nursing experiences in education, research and practice. “We want our graduates to become independent, advanced practice nurses who practice to their full potential and also lead change in health care delivery. We have developed an innovative and
rigorous asynchronous online curriculum that builds critical thinking through self-reflection throughout the program,” she said. “Our graduates are able to develop practice expertise, identify gaps in practice and generate new knowledge that reflects a nursing and transdisciplinary perspective that will inform health care systems, health policy and evidence based practice.” In addition to the MUSC College of Nursing’s online graduate nursing programs, the school began to offer an online Bachelor of Science in Nursing degree to registered nurses in fall 2014 due to an increasing demand from hospitals to hire nurses with a higher level of education. The MUSC College of Nursing offers online programs that award a Master of Science in Nursing degree, a Doctor of Nursing Practice degree and a Doctor of Philosophy in Nursing degree. More than 300 students were enrolled in the MSN, DNP, and Ph.D. programs in fall 2014. An upcoming application deadline for the MUSC College of Nursing’s online DNP and RN to BSN programs is March 15. To view the rankings, visit http://www.usnews.com/ education/online-education/nursing. Read more about MUSC’s nursing programs at http://www.musc.edu/ nursing.
4 The Catalyst, January 16, 2015
Charismatic president remembered for his humility, dedication to others By Jeff Watkins Public Relations
I
t began with a phone call: MUSC President Jim Edwards needed some prepared remarks for a ceremonial function the following week. The only problem was that the gentleman normally tasked with that duty was out of the country and would not be back in the office until the day before the speech. So a co–worker and I cobbled together some remarks, sent them upstairs and waited to be fired. Thus began an association that lasted about 13 years, to the day Dr. Edwards, who passed away Dec. 26, retired as president in 1999. To say that I was Dr. Edwards’ Watkins speechwriter would be technically correct: I put words to index cards that he would scan and oftentimes repeat. But the man needed a speechwriter like the Queen Mother needs a book on manners. When it came to engaging people, Dr. Edwards was a natural. Once Woodrow Wilson was asked how long it took him to prepare a speech. “That depends on the length of the speech,” the president answered. “If it’s a ten-minute speech it takes me all of two weeks to prepare it; if it’s a half–hour speech it takes me a week; if I can talk as long as I want to I’m ready now.” Likewise, Dr. Edwards could hold court on any number of issues and, with equal doses of humor and humility, entertain a packed auditorium or a solitary groundskeeper — everyone was equal in his eyes. He was an equally good listener as well. Once, standing outside his office after reviewing an early draft of a speech, he told me, “I don’t agree with everything you have in here, but you make me think.” I often wondered, ‘Think what?’ but, overall, I’m glad he left it at that.
Fortunately for me, he could also improvise on a moment’s notice. Once he was asked to speak to a rather large group near Georgetown. This was back in the days of slide shows, and the occasion called for what must have been the largest portable tripod screen the world has ever known, which in itself called for a van with the longest wheelbase in MUSC’s motor pool to carry it up Highway 17. Working solo, I moved the equipment into the main auditorium and began setting up while Dr. Edwards mingled with the attendees in an adjacent room. Admittedly, working with the world’s largest screen, trying to line it up with the projector, was no easy feat. The tiniest movement of the screen’s base caused the top to tip back and forth, nearly to the point of toppling over. It was a struggle to keep it upright. Beads of sweat were beginning to pop out of my forehead. At some point Dr. Edwards slipped in and surveyed the scene. Him being a former mariner, I can imagine the sight of the giant screen going to and fro summoned up in him images of the storm–tossed Flying Dutchman in its death throes, its tattered sails buffeted by gale–force winds. He walked over and said, “Look, these folks just want to have a good time and hear a few jokes. I can handle this. Why don’t you pack up and go home?” Just like that, he saved me. No backup script. No Plan B except what was in his head. As I said, he was a natural. I don’t think you can be that engaging a speaker without genuine warmth and compassion to go with it. Dr. Edwards and his wife, Ann, possessed those qualities in abundance and were generous to a fault. Often I had to drop off remarks or other materials at their Mount Pleasant home overlooking the harbor. If they happened to be there at the time, they would invite me in for a brief visit. When my father passed away in 1997, Dr. and Mrs. Edwards made a contribution to the university foundation in his name. Because of them, a furniture maker with only a high school education will forever be associated with
photo provided by the Waring Historical Library
Dr. James B. Edwards served as MUSC president from 1982 to 1999. During his tenure, MUSC’s campus tripled in size and the institution’s reputation soared nationally. The James B. Edwards College of Dental Medicine was named in his honor in February 2010. the growth and success of a top–tier academic health sciences center. There were several trips with Dr. Edwards across South Carolina, including some as a passenger aboard MUSC’s twin-engine King Air, but the one that I reflect on the most was just the two of us at a civic club luncheon. On a trip to Walterboro, with slide projector (but thankfully no screen), I drove as he rode shotgun, making last–minute notes on his cards. On the way back, however, he wanted to drive, and when we neared Charleston, I understood why. As we approached the Hollywood area, he turned off Highway 17, taking some of the side roads, driving by modest houses. He directed my attention to a nondescript house — the house where he spent part of his childhood. As we drove along the streets of his youth, he reminisced about those years before returning to the main road and continuing to Charleston. Every so often I think back to that trip and that diversion through his old neighborhood, and wonder why he took the time to share it with me.
This was a man who, as governor and energy secretary, had deliberated with some of the most powerful figures in the world. Me — at the time, going by seniority, I was the lowliest member of the Public Relations staff. But what I’ve come to realize — slower than most people, admittedly — is this: Dr. Edwards thoroughly enjoyed people — people from all walks of life — and when you were in his company, you had his full attention. Make no mistake — as MUSC president, Dr. Edwards recruited the best clinicians and researchers out there. But, as he often said, “When these patients come in the exam room, they’re not going to care about all those degrees and certificates you have on the wall. They want you to tell them you’re going to take care of them. That’s what they want to hear.” In his own way, that’s what Jim Edwards did. He was a man of vision, a great leader, but I think his greatest gift was that he let you know that you mattered to him. And you did. You really did.
The Catalyst, January 16, 2015 5
Meet Daniel
Daniel C. Williams Department Patient Transportation How you are changing what’s possible at MUSC Bringing a positive attitude to the work environment and trying my best to make sure each patient feels safe, happy and valued How long at MUSC 3 years Children and their names Daughter, Gabrielle Favorite football teams Oakland Raiders and the Miami Hurricanes Food that’s a must-have in your fridge Ground beef...I love making chili and spaghetti Best thing about living in Charleston Eating red rice and fresh seafood Greatest moment of your life Birth of my child Words of advice Don’t complain about the lack of change, be the one to make change happen.
6 The Catalyst, January 16, 2015
James Burrows Edwards 1927 - 2014
In Memoriam: remembering a beloved leader, mentor and friend By Dawn Brazell Public Relations
H
undreds of people including state dignitaries came to honor and celebrate the life of the late James B. Edwards Dec. 26 in a packed sanctuary at St. Philip’s Church. Gov. Nikki Haley joined former Govs. Dick Riley, David Beasley and Mark Sanford among a host of other state officials at the funeral in downtown Charleston. Edwards’ son–in–law Kenneth B. Wingate shared reflections during the service next to the flag-draped coffin. He described Edwards’ sense of humor, and said his humanity and humility really stood out. “The biblical definition of good is generous with a willing spirit that allows one to put another’s interest above one’s own. It’s rare to find a great man. It’s more rare to find a good man. It’s exceedingly rare to find a great man who is good.” Wingate also recapped highlights of the former Dr. Edwards took over the reins as president at a time when MUSC was a locally and regionally respected institution with finite resources, limited impact nationally and a small but dedicated faculty. With his leadership and vision, MUSC started to transform and grow in scope, scale and quality — a legacy and momentum that even today is still evolving. As an individual he was universally liked and respected. He had a personality that filled the room — truly, he never met anyone that he did not like. I had the privilege of joining the faculty as an assistant professor of surgery in 1994, and from day one he made me feel respected, included and at times like I quite possibly was his long lost younger brother. We, and the patients we care for, owe a huge debt of respect and gratitude to Dr. Edwards for his leadership. He will be sorely missed. — David J. Cole, M.D., FACS, MUSC president It was a true privilege to work with Dr. Edwards during his tenure at MUSC. I was actually on campus when he arrived in the Fall of 1982. I imagine that in your senior years you will look back on your life and think about those very few and extraordinary individuals who truly shaped and led your life. Other than my own father, Dr. Edwards will be the listtopper for me. His life story reads like a novel. He accomplished so much throughout his 87 years — enough for ten lifetimes. Yet, throughout it all, he maintained a sincere humility. I had the privilege of seeing him
governor of South Carolina’s career, including his military service, his work as an oral surgeon and his 17 years as president of the Medical University of South Carolina. He said Edwards did more than any other 10 people combined, but would joke that all the things he did in his life just showed he couldn’t keep a job. “Though he walked with kings and presidents and sat with leaders of commerce and industry, he never let the office go to his head.” Wingate also described Edwards as a Renaissance man who could do anything well. “His joie de vivre was contagious.” Following the funeral, H. Biemann Othersen, Jr., M.D., professor emeritus MUSC Division of Pediatric Surgery, reminisced about Edwards. The two were longtime friends. “He knew everybody by name and he would greet them with the same enthusiasm. He would
See Edwards on page 10 in the presence of national leaders and heads of corporate America. I was also with him through strolls across campus when he would have the opportunity to speak to University employees from all areas. He enjoyed and cherished both interactions. He would make all feel that at that moment they were the most important person in his life — and, they were! He simply loved people, all colors, creed and background. He was so sincere. When he asked, ‘how you doin,’ pal?’ he wanted to know All of us who had the honor of working with him knew him as a leader who would address every issue and challenge with a sense of optimism. He was eternally upbeat regardless of the situation. — Jim Fisher, VP for Development & Alumni Affairs Among Dr. Edwards’ greatest gifts was that he genuinely cared about people. And they knew it. I recall a man leaning out of a car and calling to Dr. Edwards as we were walking to the statehouse. Dr. Edwards greeted him by name and asked the young man how his aunt’s back was doing. Dr. Edwards had not seen the young man or his aunt (Dr. Edward’s patient) for decades. He never forgot a face. His leadership was inspirational and solution-driven; always listening with his heart and mind wide open, welcoming and valuing input. He accepted responsibility for everything that happened, never passing the buck. He was generous and gracious with praise at all times. One morning, during the attempted HCA merger, we received a less than
photo by Anne Thompson, Digital Imaging
In his last public MUSC event, President Emeritus Dr. James B. Edwards joins his wife, Ann, at the College of Nursing reopening event on Dec. 11. flattering headline and I was distressed. I apologized to Dr. Edwards as he was walking in. He just laughed and said, “Don’t worry a minute about that. The dogs bark and the caravan keeps moving.” He chose to live on the bright side, a philosophy that resonated in both his personal and professional life. I count it among my most treasured gifts to have known him. — Sarah King, DHA, Office of Public Relations I started working with Jim when I came to be dean July 1, 1990. We immediately hit it off. He was friendly and open. Rather quickly I learned that it was fun to joke with him. Early on I learned that many people could just wander into his office for a visit. He would often call me and say ‘Charlie or Jane Doe need a favor. You busy?’ He was eager to do favors. He sincerely enjoyed being helpful. As a leader he was masterful. He could envision things and help those around him see what could be done. You then wanted to get going and get it done. He was a master at making fun of himself and using that again to get things done. His vision was transformative in the history of our school. He started what I have called the era of great progress. His capacity to inspire philanthropic gifts was exceptional. We would not be where we are today as an institution without Jim Edwards’ leadership and vision. — Layton McCurdy, M.D., dean emeritus, College of Medicine and distinguished university professor
See Edwards on page 7
The Catalyst, January 16, 2015 7
Above: During his presidency, Dr. Edwards led much of MUSC’s growth and expansion. Below, Student recipients of the James B. Edwards Scholarship gather with Dr. Edwards in December 2013.
photos provided
photos by Anne Thompson, Digital Imaging
MUSC President Emeritus Dr. James B. Edwards, far right, joins then Interim President Dr. Mark Sothmann, President-elect Dr. David J. Cole and former President Dr. Ray Greenberg during the Ben Marino Heart Award luncheon held last April 25 in Charleston.
Edwards
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Edwards’ gift was for making others feel special. He was very vivacious and very positive and very upbeat. What I recall the most is Dr. Edwards frequently shared his vision for MUSC, which was for us to become a world class institution. Through his leadership and those who followed, I believe his vision has been fulfilled. — Lisa Montgomery, Executive VP Finance & Operations Today, MUSC is among the best academic health centers in the nation and we owe much of this to the legacy of Dr. Edwards, both while he was president and for the years he continued to serve musc after he left the presidency. — Patrick J. Cawley, M.D., Executive Director/CEO, Medical Center and VP for Clinical Operations I was lucky enough to know Jim Edwards for many years. He was one of the most remarkable individuals I have ever known. His life was one of high achievement, service to humankind, devotion to the people of South Carolina and dedication to the nation. However, to those of us who knew him as a friend, it was Jim’s character and personal qualities that we cherish and remember the most. Integrity, sincerity, warmth, concern for others, love of family, an ever positive attitude, personal humility and his wonderful sense of humor were the defining characteristics of his life, his friendships and his success. Jim knew instinctively that true
Above photo: Dr. Edwards practiced as an oral surgeon from 1960 to 1974 and 1979 to 1981 prior to serving as university president from 1982 to 1999.
leadership was about motivating the human spirit in ways that enabled ordinary people to accomplish more than they ever thought possible. He knew that making a difference was a human endeavor which involved bringing people together in a way that allowed them to achieve more collectively than any one person could accomplish alone. The people who comprised his MUSC family were always Jim’s main concern. I was blessed to be one of them. — Lawrence C. Mohr, M.D., Division of General Internal Medicine & Geriatrics Dr. Edwards truly led by example. He advocated that health care professionals be involved beyond their profession. Involvement in the community, education, public policy, advocacy, and yes, politics, were important in making this a better world. Dr. Edwards brought out the best in all he met. He united people of different persuasions to accomplish common goals. He was larger than life and will always remain that way in my memories. I and all who knew him will truly miss him. — John J. Sanders, DDS, College of Dental Medicine dean I first got to know Dr. Edwards when I led MUSC’s Student Government Association in 1992. Dr. Edwards was an incredible mentor to me and he played an instrumental role in educating me about the business and political sides of academic medicine. He was an affable and approachable leader who always made
anyone he was talking with feel special and important. Dr. Edwards will be remembered fondly by all. — Mark Lyles, M.D., MUHA Chief Strategic Officer I had the honor of working for Dr. Edwards for over 15 years. I found Dr. Edwards to be the perfect gentleman and role model. Dr. Edwards’ personality never changed as he was the same person in private as he was in public. He had true respect for everyone and this was returned by everyone he met. MUSC chose the right leader to put MUSC on the map. As an additional bargain, MUSC got the support and leadership of Ann Edwards, whose behind–the–scenes activities made the Edwardses an unbeatable team. I mourn the loss of a true friend and mentor, but I will be eternally grateful for the positive influence he and Ann had on our community, MUSC and on my life. — Joseph C. Good, Esq., General Counsel Office Dr. Jim Edwards was a good friend and a strong leader. I appreciated his leadership gifts. He had an open spirit and was a good listener. I recall the stressful times when there was a threat of rain forecast for our graduation service in the Horseshoe. Dr. Edwards and Ann would ask me to pray the rain away. I would answer that if I could pray and change the weather I would have a job praying off hurricanes. I appreciated their strong faith as a couple and sense of humor. Dr. Edwards in every
See Memoriams on page 10
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Rural
Continued from Page One
for many years to come.” Integrating telehealth consults with the MUSC Center of Telehealth is giving him access to university-based pediatric nutritionists, weight loss experts and endocrinologists, just to name a few of the subspecialties he now can tap into. Hletko recalls he had to make a big adjustment coming from a university environment in Michigan to a small town in rural South Carolina in 1989. “It was clear to me from my first day in practice that we need to unite a major children’s medical university with rural areas. There’s no excuse in the 21st century to have two standards of care — one big city university and an other small town, very limited access to healthcare environment.” Hletko said his practice used to have MUSC specialists visit once a week, but with the electronic telemedicine consultations they now offer, he can get a range of pediatric specialists any day of the week whenever he has a difficult problem. It also means his patients may not have to take the time and expense of traveling to Charleston to see McElligott a specialist. “It’s made a great deal of difference in the quality of care we can get — and not just on one day of the week. We are very thankful that the Medical University has chosen to invest the capital it takes to launch a statewide telemedicine program,” he said. “It’s sort of like my Linus blanket. It’s so reassuring to not be alone in a rural community.” For example, he said he likes that he can call someone such as Julie Kanter-Washko, M.D., a sickle cell expert at MUSC who is a trained pediatric hematologist-oncologist, and have her on a teleconsult in four minutes, helping him quickly treat a child who is desperately ill. “That’s not just with sickle cell disease but for a whole rainbow of problems we face in pediatrics in rural communities. This is a move forward that will sweep the nation, and it’s nice to see MUSC at the
Dr. Paul Hletko likes how some of the telehealth tools, such as his new digital otoscope, can help him show parents what their child is experiencing. vanguard of this movement.” James T. McElligott, M.D., a pediatrician and medical director for the MUSC Center for Telehealth, said Hletko’s practice is the largest user of outpatient telehealth and he has no doubt Hletko’s enthusiasm in adopting numerous telehealth programs is accelerating the service development of this technology. As a longtime advocate of reducing disparities in health care that may be caused by poverty or living in rural areas with lack of access, McElligott said making strong partnerships with small town physicians and health centers will open opportunities for rural, underserved communities. “Georgetown Pediatrics is the most advanced primary care practice integrator of telehealth in the state. It’s one of the most progressive pediatric practices you could find anywhere, particularly in a rural region. The value cannot be overestimated. I have the utmost respect for Dr. Hletko as a person, a leader, a researcher, a clinician and an innovator.” The practice receives consultative services from MUSC in sickle cell management, nutrition counseling, Parent–Child Interactive Therapy that
deals with behavioral issues, Heart Health Program and telepsychiatry. The practice also plans to use telehealth services to join, via video, school individualized educational plan conferences to help guide educational planning for patients whose performance might be affected by medical conditions. Since Georgetown Pediatric Center has been an early adopter of telehealth, it has given MUSC the opportunity to pilot many of its programs, said Shawn Valenta, program director of the MUSC Center for Telehealth. These programs are expanding into many rural areas and also being used in hospitals. Georgetown as a region is receiving telehealth services in developmental pediatrics, sickle cell disease, nutrition counseling, stroke evaluation, mental health evaluation and pediatric critical care consultation, according to Valenta. “We look at telehealth as a way to enhance access to care and maximize the efficiency of the care system,” Valenta said. “Our vision is to facilitate the access of care at earlier points along the health
care continuum and create coordinated, co-management care between medical homes and specialists.” Hletko foresees many other rural practices integrating telehealth as a necessary part of growth as it can enhance the reputation of a practice to have the support of a wide range of subspecialties. “It’s but the beginning of a huge expansion of services for children in South Carolina,” he said, citing a long list of more complicated medical conditions where children would benefit from having expert specialty teleconsults, including patients who suffer from cystic fibrosis, seizures, renal failure or who have had organ transplants. “It’s a fabulous augmentation of our ability to help children,” said Valenta. “We have four pediatricians and two nurse practitioners, but we have more than that when you consider the assistance we get from the Medical University. So we actually have a whole department of pediatrics in Georgetown now, and it’s called telemedicine.”
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That’s where telemedicine comes in. Telemedicine is the ability to provide secure health care from a distance through such technologies as live interactive videoconferencing, remote monitoring and storeand-forward imaging. It was conceived as a way for specialists to provide what was needed in a remote medical situation: a consultation, evaluation, diagnosis, confirmation, or treatment recommendations. Not only does telehealth offer a way by which smalltown providers can access the expertise of specialists quickly and conveniently, it far exceeds the effectiveness of the old method: physicians conferring by phone, one trying to gauge a patient’s condition sight unseen. No one understands this better than David McSwain, M.D., an MUSC pediatric critical care doctor, who sees lots of complicated pediatric cases via telemedicine. Where a community doctor may see a few critically ill children per year, McSwain and his colleagues treat them day in and day out. That level of experience and expertise is a huge relief for parents, and in many cases, he is able to reassure nervous parents while assisting the doctor on the other end of the video camera. “We had a baby who came into one of the outside emergency departments with an extremely elevated heart rate — over 200 beats per minute,” he said. “The baby was 6–months old — and they were calling to arrange a transfer to the Pediatric ICU. When a heart rate is that high, the first thing we worry about is that the child may be in septic shock, which would normally result in an immediate helicopter transfer to the MUSC PICU. But when I saw him over telemedicine, he was sitting happily in his mom’s lap and looking at me on the screen. I could tell immediately he was not in severe shock. So, the next thing I did was to zoom the camera in on his heart monitor, and I could see that he had an arrhythmia. I asked the pediatric cardiology fellow to come take a look, and she confirmed the little guy had an arrhythmia called supraventricular tachycardia.” He continued, “Together, we guided the providers at the outside hospital through a series of maneuvers to try to convert this child out of the arrhythmia. We would never have felt comfortable doing that over the phone in the middle of the night. We watched the heart rhythm on the monitor during the maneuvers to see if they worked. When they didn’t, we picked the child up via helicopter and brought him here. I gave our ED a heads up that he was coming, and once he arrived, they were able to convert him out of the arrhythmia. It ended up saving the child an ICU admission. One other neat thing was, I could talk to the mother via the video conference, explain to her what was going on and reassure her before they ever left for MUSC.” This is the type of collaborative effort that makes telemedicine so successful — the combination of hightech with the human connection. James McElligott, M.D., medical director of MUSC’s Center for
photo by Sarah Pack, Public Relations Dr. David McSwain, an MUSC pediatric critical care doctor, examines a patient using a telehealth cart he designed. Telehealth elaborated, “The magic of telehealth is not only in the technology, but in the enhanced collaboration and coordination that it catalyzes. With each telehealth effort we seek to improve the care system and improve cost efficiency. By maintaining these ideals at the core of our service development, we believe telehealth will truly improve the delivery of health care throughout the state.” While many areas of the state enjoy immediate access to specialists, there are areas in South Carolina where, for instance, there is no obstetrician, dermatologist or psychiatrist in the entire county. For South Carolinians living in areas such as these, telemedicine can be a lifeline, connecting rural providers and their patients to providers at a distant site like MUSC, which means access to specialized health care where little to none had been available in the past. This capability not only enables patients to receive care in their own communities, thereby avoiding long travel times, but in emergency cases like the child with the arrhythmia, this type of access can be the difference between life and death. Given the shortage of medical specialists in many areas throughout South Carolina, both health care providers and legislators alike recognized telehealth needed to play an even more integral and expanded role in the delivery of health care services. In August 2013, the Legislature allocated $12.4 million to MUSC to expand its telemedicine program and create a comprehensive statewide initiative. The South Carolina Telehealth Alliance was born.
South Carolina Telehealth Alliance The SCTA is an unprecedented collaboration of stakeholders in telehealth, including MUSC Health, Palmetto Health and Greenville Health — three of the state’s leading health systems — as well as community hospitals, government agencies and health care providers. The goal is to improve access to quality health care while managing the cost of providing care. The alliance also works closely with Palmetto Care Connections, a group that assists with navigating the steps of telemedicine, to integrate these novel approaches into South Carolina’s communities and existing health systems. Kathy Schwarting, executive director for PCC, said, “Palmetto Care Connections is looking forward to its partnership with the new South Carolina Telehealth Alliance as we work to improve access to care for all of South Carolina through the use of telehealth technologies. SCTA will work diligently with specialists around the state to make health care services available as PCC looks at the broader spectrum of connecting the rural communities with these services. Together we should be able to make a difference in the lives of South Carolinians.” Mark Lyles, M.D., MUSC’s chief strategic officer, also sees the tremendous potential the alliance holds. “MUSC is grateful for the substantial support the Legislature and the South Carolina Department of Health and Human Services have provided to enable us
See Alliance on page 12
10 The Catalyst, January 16, 2015 A Memoriams Continued from Page Seven way was a gentleman. — Chaplain Terry L. Wilson, MUHA Pastoral Care and Interpreter Services Growing up in a small town near Charleston, my perception of leaders was largely based on media images at the time. When I first met Dr. Jim Edwards, I was the singer at the University of Charleston Graduation Ceremony while he was the keynote speaker. We chatted briefly prior to the event, and Dr. Edwards proved to be the polar opposite of my preconceived notions of leaders. As it was my first time interacting so closely with someone of his stature, it made a tremendous impact on me that he would demonstrate such kindness and courtesy to me, a young Hispanic undergrad at the time, as well as the others whom he interacted with. I will always remember that he revolutionized the construct of ‘what it means to be a leader’ for me on that day 15 years ago. — Cristina Reyes Smith, OTD, Division of Occupational Therapy, CHP I am a 1986 graduate of the College of Dental Medicine. When I was a sophomore in dental school, we as members of the Student National Dental Association met with then President Edwards about the lack of African–American faculty in the dental school. He was very gracious and kind to meet with all of us. At the time there were only seven African– American students in the whole dental school of approximately 200 students. I am now director of Diversity for the college. — Gwendolyn Brown, DMD, College of Dental Medicine Back in November of 2013, President Edwards and I were walking through the connector of Rutledge Tower. We talked about the growth of the university and how we are now able to walk over Ashley Avenue. He stated that the connector was much needed and it provides safety for our patients, students and employees. I have been
employed here since 1974. He was a very nice man and he would take the time to talk with you. — Valerie Bailey, Ambulatory Preop Clinic On behalf of the MUSC Stroke Team, I would like to express our deepest sadness for the passing of Dr. James B. Edwards and extend our sincerest gratitude to him and his wonderful family for their support of our Stroke Program. We could not have asked for a better ambassador for our program and he will be deeply missed. — Tanya N. Turan, M.D., MUSC Neurology & Neurosurgery, Stroke Neurology Division Dr. Edwards was a charismatic story teller and always seemed to have an anecdote for anything life would throw at you. One of my favorites that he turned to since his stroke in 2013 was in regards to how thankful he was for the care Dr. Chaudry and his team provided when they removed the clot which caused his stroke. Dr. Edwards would say how thankful he was to our stroke team for “adding years to his life and life to his years.” I couldn’t agree more, that the extra time we were all graced with his presence was a true gift for which to be thankful. — Meredith Gale, Department of Neurosciences Development Dr. Edwards was always a constant, stable figure in the Medical University. I was very young when I started working here, but he was an iconic figure who positively influenced my efforts as an employee and citizen. When seeing him at community events, he was always friendly and happy to recognize staff members. — Katherine B. Taylor, Transplant Center “I had the extraordinary pleasure of working closely with Dr. Edwards for the past 21 years at the Medical University. During those years, I learned so many important life lessons through his gift of inspiring and uplifting the spirit of anyone that interacted with him. He was an outstanding mentor, an amazing leader and my personal hero. I used to say
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greet the janitor.” Othersen said Edwards knew how to make people feel good, and he did it with sincerity. “It wasn’t put on, it wasn’t false. It was just him.” During Edwards’ 30–plus years as president and president emeritus at MUSC, he remained a staunch supporter of the institution. Wingate said, after Edwards had a stroke in 2013 and could no longer take potential donors out to restaurants, he and his wife Ann would entertain them at home. Othersen said Edwards had a gift for getting others to give for a good cause. “I always thought he was a good fundraiser because he made you feel good and made you feel good about giving.” Philanthropy was just one gift of many in a varied career. Edwards was born in 1927 to a pair of teachers in Hawthorne, Florida. After high school, Edwards became a Merchant Marine as World War II was winding down, then headed back to study at the College of Charleston. He married Ann Darlington in 1951, went to dental school and served in the Navy. Edwards that if all of us had a small fraction of his grand personality and character, the world would be a much better place. Dr. Edwards built his legacy upon the most important lesson for all of us . . . How to build a life that you love, and to celebrate each and every moment. I cherish the example you set for all of us and the inspirational legacy you have left behind today and every day. “ — Leigh Manzi, Office of Development It was really a privilege to have worked with Dr. Edwards, and I will be forever grateful for our friendship. I have learned so much from him through his storytelling to colleagues, donors and friends. While his accomplishments where extraordinary, he personified a simple and humble man who enjoyed the outdoors, spending time with Mrs. Edwards and his family and helping people. He will surely be missed but his legacy will live on through so many
opened a practice in oral and maxillofacial surgery in Charleston in 1960. Edwards became politically active in the 1960s and won election to the state Senate in 1972. Two years later, he became the first Republican governor of South Carolina since reconstruction. Edwards went on to serve as energy secretary in President Ronald Reagan’s cabinet and then was recruited to become president of the Medical University of South Carolina. During his tenure, the university’s budget quadrupled and key construction and renovation projects were completed, including the Institute of Psychiatry, the Student Life Center and Children’s Hospital. In 2010, the new MUSC dental building and dental school were named in Edwards’ honor. The Right Rev. Dr. C. FitzSimons Allison said Edwards’ generosity and commendable activies were rooted in a strong faith that he passed along to his family. His favorite verse was Micah 6:8 that reads in part ‘What does the Lord require of you but to do justly, to love mercy and to walk humbly with your God?’ FitzSimons said it was a standard that served as Edwards’ guiding force — one that he lived by. people and places where he left an indelible mark. — Jane B. McCullough, Department of Medicine Development JBE was a sincere and kind leader, and people were devoted to him. I was blessed to work directly with him on a long–term project and spent a great deal of time with him and Ann. Some of my best memories were when we would travel. I’ll never forget stopping in Georgetown at Kudzu Bakery to get his favorite pecan pie and eating it out of the box with spoons in the car while we drove home. He genuinely cared about people. He knew your child’s name, dad’s name, Labrador retriever’s name. He was the most important man in this state, and yet, he treated everyone with love and respect. What an example he set for other leaders. What a legacy he leaves to us of all. — Mikie Hayes, Office of Public Relations
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Wellness Center offers lifestyle services These new services compliment the The MUSC Wellness Center is unveiling personal training program and other lifestyle exciting new services to facilitate lifestyle programs at the Wellness Center and will behavior changes for members and nonenhance strategies for long term behavior members. These “a la carte” offerings are change success. For more information email individually priced for members and nonnewtonj@musc.edu, call 792-9001 or visit the members but could be bundled to provide a membership desk at the Wellness Center. personalized and holistic wellness program based on individual needs and preferences. New and upcoming services include Wellness Events nutritional counseling, health coaching, postq Take the Monthly Mindful Challenge and rehab/injury wellness consultations, fitness be eligible for prizes by completing a short testing and goal setting consultations. survey at the beginning and end of the month. Nutritional counseling includes education Susan Johnson The January challenge is to ‘Let Go’ of what and counseling in chronic disease such as no longer benefits you. To begin, take the diabetes, high blood pressure, high cholesterol, survey at http//tinyurl.com/lvvmgdw. and pre–diabetic conditions. Registered Dietitian Keely q Employee Fitness Series Class — Piloxing from Flynn will work with overweight and obese clients as 12:15 to 1245 p.m., Wednesday, Jan. 21 at the well as sports nutritionists and athletes to help create a Wellness Center; To register, email musc-empwell@ balanced, healthy diet to support individual goals. musc.edu. Integrative health coaches work with the whole q Weight Management Lunch and Learn Series person, take time to listen to client concerns and ask — Learn a positive approach to losing those extra powerful questions to help motivate clients to make pounds. 12:15 to 12:45 p.m., Wednesday, Jan. 21, changes. Coaches use both innovative and practical "Don't Fall for Fad Diets" Colbert Education Center/ strategies to help individuals clarify what they want, Library, room EL-118; To register, email muscexplore options, enhance personal accountability and empwell@musc.edu. take action for optimal health.
Health at work
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to partner with others and create a statewide telehealth alliance. We think the collaborative approach that currently is being operationalized in South Carolina is unique in the United States and provides an innovative model for others to follow. We’ve established ourselves as leaders in this field, and recently, we were invited to present two oral and two poster presentations detailing MUSC’s successes at the upcoming 2015 American Telemedicine Association’s annual meeting,” Lyles said. This recognition does not come out of left field as MUSC has long been at the forefront of telehealth technology, having actively been involved with telemedicine since 2008. With a dedicated telehealth team, led by James McElligott, M.D., medical director of the MUSC Center for Telehealth, and Shawn Valenta, RRT, center director, a diverse group of specialists has been assembled to create and operationalize the South Carolina Telehealth Alliance. Valenta expressed his expectations for the future of telehealth. “We are excited to collaborate with other South Carolina providers as telehealth grows to transform the delivery of health care in our state,” he said. “The alliance is establishing the foundation for a coordinated network of compatible technology that will provide a ‘smart grid’ approach to statewide patient triage. South Carolinians will have improved access to quality medical care that is not financially feasible in
SC Telehealth Alliance Telehealth in S.C. in 2014 had: q 20,000 tele-consultations
q More than 100 connected sites
q More than 20 different services Some examples of services include: ICU, acute stroke, general neurology, EEG, pediatric emergency and critical care, pediatric GI, burn, psychiatry, and infectious disease. See the new South Carolina Telehealth Alliance website at http://www.sctelehealth.org/ Visit the MUSC Center for Telehealth at http://www.muschealth.org/telehealth/about/index.html
the traditional health care delivery system.” While still a relatively new initiative, MUSC has made swift progress related to getting the word out about the alliance. MUSC’s Business Development and Marketing Services department has created both a website and a statewide public service advertising campaign, and according to Lyles, both are “first–rate.” The goal for the campaign, he said, is to prime all South Carolinians for the use of telemedicine throughout the state. “This campaign was created in a
creative way in that it allows all alliance members to run the web–based ads or television PSAs in their respective markets, using their own logos, in combination with the alliance’s logo. This is an effective way to reduce costs and share resources.” Although telemedicine is still evolving, it is clearly the wave of the future, according to Lyles. “We think in the very near future it will become an integral and seamless part of the way medicine is practiced not only in South Carolina, but also throughout the entire world.”