Systemnews May 2014

Volume 13

Issue 5

May 2014

SYSTEMnews `` Charlotte Martin proudly displays the certificate she received for completing the IMPaCT Primary Care six-month program. With her is community health worker Irene Estrada who helped Martin reach the goal of lowering her blood pressure.

Creating a P O S I T I V E

IMPaCT

When you know what you did worked, it feels really good. I’ve always liked helping people meet their goals. Now what I do makes a huge difference, with their health.

CEO’s corner Ralph W. Muller

CEO, University of Pennsylvania Health System Delivering advanced patient care throughout the Health System requires a true all-group effort. A vital cog in that effort is the outstanding work of our information services team — a powerful blend of technical experts and research and clinical end-users dedicated to enhancing human health.

Penn Medicine IS is committed to helping our clinicians and researchers bring new ways of healing to life. By expanding the ways patient information and research data are transmitted and used, our IS experts are helping provide new pathways to a healthier future. Here are some of the ways they’re doing so.

PennOmics is a research data warehouse that consolidates information previously housed in several different data sources.

Researchers can use the platform to analyze patient populations and identify correlations between genes and certain diseases and test hypotheses. PennOmics also allows clinicians to tailor their care decisions by comparing patients within a population to each other. For example, by evaluating individuals with similar medical profiles, a physician might conclude that one blood pressure medication would be more effective than another.

Clinical dashboards, designed in-house at Penn, are visual displays with detailed charts and bar graphs providing data for informed decision-making about patient care. Dashboards are available for a host of topics including cardiovascular matters, cancer, infection control, and diabetes management.

As an example, the anticoagulation dashboard maintains data on clinical visits and critical blood-values on thousands of patients. It alerts physicians and nurses to reschedule patients who miss appointments for blood tests. And by providing immediate access to blood-test results for patients, the dashboard helps ensure accurate, potentially lifesaving care.

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Inside The Envelope...Please!.............2 Penn Medicine@Work..............3 NEWSmakers.............................4

Charlotte Martin now takes twice as long to do her food shopping as before. “My ride doesn’t wait any more. He tells me to call when I’m in line!” But it’s not due to a physical disability. She’s reading nutrition labels on almost everything she puts in her cart, making sure nothing has a high-sodium content…and that Irene Estrada, her community health worker, would approve. “Every time I look up, there’s Irene looking over my shoulder!” she said, jokingly.

While Estrada doesn’t really come on these shopping trips, what she has been teaching Martin has clearly made an impression. “I never paid attention till now,” Martin said. “I was on three medications for my blood pressure but since it’s dropped and stayed low, I’m on two…and I’m planning on getting down to one!

This turnaround in behavior resulted from Martin’s participation in Penn Medicine’s IMPaCT (Individualized Management for Patient-Centered Targets) program, which helps low-income patients with multiple chronic diseases stay out of the hospital. Partnering with specially trained community health workers, IMPaCT provides tools to help patients overcome the barriers to getting — and staying — healthy.

How Can We Help You Stay Healthy?

IMPaCT comprises two distinct models, both of which work with at-risk patients from five areas in West and Southwest Philadelphia identified as “hot spots” for chronic disease and high readmission rates. One focuses on the transition from hospital to home; the other, of which Martin is a part, works with outpatients.

Penn researchers relied on feedback from these patients to create IMPaCT. “We basically asked them, ‘What makes it hard for you to stay healthy?’” said project manager Casey Chanton, MSW. Based on responses to several questions, they decided to use community health workers from the patients’ own communities, “people they can relate to,” Chanton said. “CHWs are ‘natural helpers’ in their own communities. They have good listening skills and are nonjudgmental, patient and kind.”

The CHW helps patients navigate complex social services and health systems to reach their goals. They undergo one month of training to equip them with the necessary tools and skills to help patients. For example, they learn how to set patient-centered goals and motivate patients to change a health behavior. They also learn ways to help with the challenges of daily life, such as getting food, housing, child care and transportation. “If we don’t address these basic needs, how well can patients focus on their health needs?” Estrada said.

Safe Transitions from Hospital to Home In the Transitions model, which was recently studied in a randomized trial, CHWs connect with hospitalized patients and continue to partner with them for two to three weeks after discharge. “They’re a bridge between inpatient care and their outpatient clinic and home care,” Chanton said.

A top priority, Chanton said, is finding a convenient primary care practice at the place of their choice and addressing barriers that make it hard to get there. For example, during the initial community interviews, “patients told us they use the ER because they lack childcare, money for clinic co-pays or don’t have transport to the outpatient clinic.”

Transitions CHW Cheryl Garfield sees her patients daily through hospitalization and then discharge, helping with barriers to health, such as stable housing, childcare, or access to food, and making sure they understand discharge instructions and can get their medications. Once patients returns home, she calls or visits a few times a week — or more — depending on their situation.

New Kiosks Improve Patient Satisfaction................................5 Outreach Efforts Help African Patients.......................................5

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Awards and Accolades.............6

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New Kiosks Improve Patient Satisfaction On any given day, Penn Orthopaedics at PPMC sees 200 patients or more. Up until early 2013, patients were asked to sign the check-in sheet when they first entered the practice. But, sometimes, several patients arrived at once, causing back-ups and a long waiting time. Or patients forgot to sign in or thought they were not taken in the order they arrived.

Now, thanks to the two patient service kiosks, that has all changed. Patients enter their demographic information (such as date of birth, name and address) as well as verify insurance and the name of the doctor they are seeing at a kiosk, all with increased privacy; the information is automatically entered into EPIC. This simple process allows the staff to better control the flow of patients, thus decreasing the wait time. Also, “staff has more patient interaction, helping at the kiosks, side by side,” said Fabian Marechal, director of Service Line Operations.

“We’d like to expand the kiosks’ functions, including additional languages, surveys [for clinical outcome statistics or research] and possible patient satisfaction surveys, for on-the-spot feedback,” he said. “ This is all part of better customer service.”

The inspiration for patient kiosks came from the first “Big Idea” Innovation Tournament, in which Penn Medicine faculty and staff were asked to submit ideas that could improve the experience for our patients and their families.

Outreach Efforts Help African Patients Spending two weeks on a cruise ship seems like the perfect escape from winter, but for Joli Chou, DMD, MD, of Oral & Maxillofacial Surgery, it was a “working” vacation. She spent most of her time performing surgical procedures on African patients who couldn’t otherwise get them.

Chou has volunteered her time — and skills – for the past two years, on the Africa Mercy. Operated by Mercy Ships organization, the ship stays docked at an African port for 10 months, providing an array of medical services. During her stint on the ship, Chou performed from three to five cases (depending on their complexity) each week day. She also taught local surgeons who assisted in the cases and showed the local nurses how to use the medical equipment that’s donated to Mercy Ships.

Many of Chou’s more complex cases stem from a lack of access to treatment. For example, last year an 18-year-old showed up with a huge benign tumor on his jaw. “It weighed five pounds!” Because it was left to grow untreated, he had to undergo multiple surgeries to remove and reconstruct his jaw. In this country, “we’d diagnose it much earlier and try to shrink it with injections,” she said. “But he did very well. He actually smiled.”

Several patients suffered from ankylosis (fused jaw joints). One hadn’t been able to open his mouth for more than 10 years. “It results from infection or trauma that was not treated properly,” she said. “I did many of these procedures while I was there and it was so rewarding. Patients can now eat real food.”

Chou is one of many health-care providers at Penn Medicine who find time in their busy schedules — and lives — to embark on these types of medical missions. Other outreaches have included providing cardiovascular services in Vietnam and orthopaedics in Nicaragua as well as the team of doctors and nurses who flew to Haiti shortly after the devastating earthquake.

`` Oral & Maxillofacial surgeon Joli Chou pays a post-op visit to one of her patients on the Africa Mercy ship.

Photo credit: Ruben Plomp. © Mercy Ships

Chou loves the work on the Africa Mercy. “It’s such a positive environment to work in. I plan to go back next year as well, “ she said, adding that “I’m very grateful to members of my department who are so supportive.”

UPHS Hospitals Receive Stroke Quality Achievement Awards Pennsylvania Hospital, Penn Presbyterian Medical Center and Chester County Hospital have received the American Heart Association/American Stroke Association’s Get With The Guidelines®– Stroke Silver Plus Quality Achievement Award. The award recognizes the commitment and success of these Penn Medicine hospitals in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations.

To receive the this Quality Achievement Award, these hospitals achieved at least 12 consecutive months of 85 percent or higher adherence to all of the program’s indicators and achieved at least 75 percent or higher compliance with six of 10 of its measures during that same period of time. HUP received the Guidelines-Stroke Gold Plus Quality Achievement Award in October 2013 for achieving 85 percent or higher adherence to all the indicators for two or more consecutive 12-month intervals and 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures.

In addition, both HUP and Chester County Hospital have been recognized as recipients of the Association’s Target: Stroke Honor Roll, for improving stroke care.

DNA Comes Alive in Lights!

This spring — 20 years after scientists first cloned the BRCA1 and BRCA2 genes — Penn’s Basser Research Center for BRCA unveiled “Homologous Hope,” a new sculpture suspended from the glass atrium at the Perelman Center for Advanced Medicine. Created in a ribbon-diagram formation, the sculpture illustrates how a healthy cell repairs DNA that can cause inherited breast, ovarian, and pancreatic cancers. The repair occurs in three stages, as illustrated by a light show within portions of the piece.

The sculpture celebrates the hope that the establishment of the Basser Research Center is giving to countless families and their loved ones.

Homologous Hope By the Numbers:

400

Weight in pounds of the stainless steel ring supporting the sculpture from the ceiling

560

Pounds of carbon fiber used to form the three segments

600

Programmable LED lights in the “ribbons” formation

A New Approach to Smoking Cessation Frank Leone, MD, MS, and his team call themselves “pro-smoker.” That’s because smoking, he said, is a disease — one that should be treated with compassion and evidence-based therapies like any other.

“Getting people to quit is good for public health,” said Leone, director of the Comprehensive Smoking Treatment Programs at the Penn Lung Center. “But, we see our job as health-care providers is to relieve the burden of the disease, not to apply additional pressure on smokers.”

The Center recently launched its inaugural education program, Preparing for the Integration of Tobacco Use Treatment into Healthcare, an interactive training program for working health-care professionals designed to help them develop skills in tobacco dependence treatment. The fiveday class drew participants from across the region in a variety of specialty areas.

Patients may now be able to find help to quit smoking in places where they might not have before.

“We want to shift the burden of responsibility for fixing the problem of tobacco dependence onto the shoulders of ‘the system,’ and off the shoulders of the afflicted,” Leone said. “These new practitioners will help us make this leap.”

To learn more about the program, go to http://penn-stop.com/WP1/training.

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penn medicine

work

`` Telandria Boyd-Johnson leads training sessions for Pipeline Program mentors.

“The growth that the interns experience during this internship is impressive. They’re transformed from employees who are sometimes overwhelmed with the responsibilities at work to active contributors in their department.

TRAINING HIGH-ACHIEVING STUDENTS FOR CAREERS IN HEALTH CARE Penn Medicine Academy Internship Program Tyler Jackson is a charming, well-spoken high-school senior with a bright smile and a curious mind. “I like working with people who are different than me,” said Tyler, a current participant in the Penn Medicine High School Pipeline Program. “I became interested in the program because of the college credits that they offer and the work experience. That was a challenge for me, but I really enjoyed it. I also enjoyed meeting new people and seeing what goes on behind the scenes of Penn Medicine.” When he graduates from high school, Tyler will also graduate from the Pipeline Program, but he hopes it’s not the end of his time at Penn Medicine. As a high-performer in both his academics and work responsibilities, Tyler — who earned a full scholarship to attend Saint Joseph’s University — is eligible for the program’s optional third-year internship through the Penn Medicine Academy.

The Penn Medicine High School Pipeline Program offers high school students from West Philadelphia a unique opportunity to acquire specialized skills that prepare them to enter the workforce and achieve success in college. The Pipeline Program combines paid work experience — gained by placing places juniors and seniors in paid positions in one of Penn Medicine’s hospitals or other Health System facilities — with professional development and job readiness training. In addition, students take college classes to encourage them to continue with their studies after the program.

Qualified students who are interested in health care gain practical work experience and valuable exposure to different aspects of health-oriented careers. Students interact with Health System co-workers and colleagues while learning clinical, non-clinical and technical skills as well as the importance of professionalism and productive work habits. Ideally, these students will become a “pipeline” for the Health System and seek future employment with Penn Medicine.

Post-graduate Internship Opportunities at Penn Medicine Qualified participants who successfully complete all of the program’s components are eligible to remain in the program after graduation and become Penn Medicine Academy interns for one year. As part of this internship, they work part-time for 20 hours per week and receive pay for 40 hours per week with funding support from the program’s partner, the University City District. They do this while enrolled in college classes. Penn Medicine provides up to $8,000 in tuition benefits and continuing career coaching and mentorship.

Telandria Boyd-Johnson, a Workforce Development coordinator at Penn Medicine Academy, spearheads the High School Pipeline and Penn Medicine Academy

Internship programs. “I have seen our most successful pipeline graduates use the PMA internship to hone their skills and land part-time or full-time positions with the Health System,” she said. “The growth that the interns experience during this internship is impressive.

They’re transformed from employees who are sometimes overwhelmed with the responsibilities at work to active contributors in their department.”

`` Pipeline graduate Sadio Wilder now works as a nursing assistant on Silverstein 11 at HUP.

Mary Denno, a nurse manager at HUP who currently supervises PMA intern Amir Nash on Rhoads 3, sees the real-world experience as one of the programs greatest strengths. “The opportunity for Amir to regularly interact with patients and families and hear their stories has been the most valuable. Collaboration with health-care leaders within their disciplines has also given him the opportunity to hear different viewpoints and shape his way of thinking.”

Amir, who has been in his internship for six months, hopes to pursue a degree in biology and eventually go to school to become a doctor or physician’s assistant. “What I found most valuable is learning professional skills on how to interact with people,” he said.

“Amir has learned to collaborate with many members of the health-care team,” Denno said. “This collaboration has enabled him to move outside the walls of a classroom and learn how to interact professionally with nurses, physicians, and many others who work within the health-care industry. I would encourage him to stay with the Health System after he completes his internship because he is ambitious. He takes great satisfaction in setting goals and working hard to achieve them.”

Since the program’s inception, 19 graduates have taken advantage of the Penn Medicine Academy internship program. Sadio Wilder is just one example of the Pipeline Program’s success. Sadio started out with the High School Pipeline Program, and worked as an intern through the PMA Internship. She is now a Health System employee, working as a nursing assistant on Silverstein 11 at HUP. “The Penn Medicine Pipeline Program has changed my life for the better. It has given me the opportunity to experience many things in the health-care field and experience college life. This program has taught me job skills so I can work at HUP, be independent and pay my bills. I really appreciate this program and would definitely recommend it.”

Earn Points and Get Healthier with Healthy Rewards The new 2014 Healthy Rewards program is live and ready for you to sign in and start participating! The more points you earn, the more you can win … and the healthier you get! For each healthy activity or challenge you complete, you earn points that allow you to move through the levels to earn a $150 Healthy Reward Credit and be entered into quarterly raffles to win prizes! Get started by going to www.uphshrandyou.com and clicking on Healthy Rewards.

Be sure to participate in the Wellfocused Walk-Off starting May 5. This is the first-ever entity vs. entity steps competition — and anyone can participate! Two sets of winners will be recognized at the end of the eight-week challenge: the UPHS entity with the highest average number of steps and the top five individuals who have the highest total steps.

To track your steps*: »» Use a regular pedometer to manually enter your steps in the challenge. »» Use an electronic device such as a Fitbit, the Nike+ or the RunKeeper app. Those

electronic devices automatically sync to the Healthy Rewards site and log your steps for you once.

* Note: To sync your device in the Healthy Rewards site, go to Settings, then click on the Apps & Devices tab and connect your device.

Sign in to the Healthy Rewards site on May 5 to join the Wellfocused Walk-Off challenge and start walking!

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Penn Medicine

NEWSmakers / / / Study Gives Hope of Altering Genes to Repel HIV In the first successful clinical test of any gene editing approach in humans, Penn researchers engineered the immune cells of 12 HIV positive patients to resist infection, reported CBS Evening News, The New York Times, and The Wall Street Journal. The phase I study, led by Carl H. June, MD, professor of Pathology & Laboratory Medicine; Bruce L. Levine, PhD, associate professor of Pathology & Laboratory Medicine; and Pablo Tebas, MD, professor of Medicine in Infectious Diseases, appeared recently in The New England Journal of Medicine. Researchers used zinc finger technology to induce the CCR5 mutation in patients’ T cells to lock out HIV. The modified cells persisted in all patients, they found, and reduced viral loads in some taken off treatment entirely. “Gene therapy had a lot of hype and the expectations were unrealistic; it still has no approved therapy,” June told The Philadelphia Inquirer.

“But I think we’re on the threshold. We now know it’s possible to do genetic editing with exquisite precision at levels with therapeutic relevance.” The study was also covered by CBS affiliates around the country, Reuters, Associated Press, CBS News.com, NBC News.com, BBC News, among others.

/ / / Penn Medicine Exploring Unique Health Needs of LGBT Community Penn Medicine’s unique forum brought health-care providers together with experts in the LGBT community to educate them on the unique health care needs of this population. Baligh Yehia, MD, MPP, MSHP, assistant professor of medicine and director of Penn Medicine’s Program for LGBT Health, told KYW Newsradio that he is thrilled with the response. “I think a lot of people recognize this as an area that isn’t discussed a lot. And I think that people just want to really learn more about the LGBT community and what we can do to advance health care,” he said prior to the event.

/ / / Penn Study Finds Kids Unlikely to Outgrow Eczema Doctors have long thought that kids with eczema usually grow out of the disease, WHYY Radio reported, but a study published in JAMA Dermatology now shows that’s far from typical. David Margolis, MD, PhD, professor of Dermatology and Epidemiology, who led the latest study, and his team, tracked more than 7,000 kids diagnosed with mild to moderate eczema. At every age, more than 80 percent of the participants had eczema symptoms or were still using medication to treat the condition.

During the five years of follow-up, 64 percent of patients never reported a six-month period when their skin was symptom-free without medications. A syndicated HealthDay article was picked up by Philly.com and Yahoo! News, and ABC News Radio affiliates from Kansas City to Jacksonville, Florida.

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/ / / The Emerging Role of Robots in Rehab Michelle Johnson, PhD, assistant professor of Physical Medicine and Rehabilitation, and head of the new Penn Medicine Rehabilitation and Robotics Lab, is featured in WHYY‘s “The Pulse.” Johnson designs and tests robots to assist stroke victims with upper body disabilities. Some of the robots that Johnson works with are humanoid and can provide therapeutic interactions in the home extending the capabilities of human health aides.

Other robots can be attached to injured limbs to aid in movement and provide feedback to patients. Johnson stressed that robots are not intended to take the place of humans. “My goal is not to replace a therapist or a clinician. The goal is to develop systems and machines that can be intelligent assistants.”

/ / / The Path to a Stronger Heart Cardiac rehabilitation programs are opening up to more people with chronic heart failure following a recent change in Medicare reimbursement rules, The Wall Street Journal reported. The new decision affects about 50 percent of patients with chronic heart failure. Doctors expect the trigger for coverage for many patients will be their first hospital admission for heart failure. At that time, doctors would discuss starting an exercise program with a patient after six weeks on medications.

The first episode “is your teachable moment,” said Mariell Jessup, MD, professor of Medicine and president of the American Heart Association. Upon hearing the diagnosis, people think it is a death sentence. “We say, ‘You’re not going to die. We’re going to work on you living.’ “

/ / / Sleep in the News CNN reported on a new study by Penn Medicine researchers showing that lost sleep may lead to irreversible damage of brain cells. The widely held idea that you can pay back a sizeable “sleep debt” with long naps later on seems to be a myth, said lead study author Sigrid Veasey, MD, associate professor of Medicine and a member of the Center for Sleep and Circadian Neurobiology, in a study published in the Journal of Neuroscience. FOXNews.com, U.S. News & World Report, the BBC, and the Huffington Post also covered the new research.

TIME magazine reported on the increased understanding and support by the medical community regarding the importance of sleep for overall health.

While diet and exercise have been a part of public health messaging for decades, doctors and health advocates are now beginning to argue that getting quality sleep may be just as important for overall health. “Sleep is probably easier to change than diet or exercise,” said Michael Grandner, PhD, instructor in Psychiatry and member of the Center for Sleep and Circadian Neurobiology. “It may also give you more of an immediate reward if it helps you get through your day.” Abramson Cancer Center patient Lynn Mitchell was also interviewed about how sleep therapy was added to her treatment for lung and brain cancer.

/ / / Alzheimer’s Is Expensive, Deadly and Growing. So Where’s the Research Money?

In a Newsweek article about funding for Alzheimer’s disease, John Trojanowski, MD, PhD, co-director of the Center for Neurodegenerative Disease Research and director of the Institute on Aging, said, “The epidemic is upon us. It’s a very difficult thing to say to a patient that there’s nothing we have for you, but that is the honest response. There are no disease-modifying therapies for Alzheimer’s.” Alzheimer’s is one of the costliest chronic diseases to the country. Total costs of caring for Americans with Alzheimer’s and other dementias is expected to reach $214 billion this year, with Medicare and Medicaid covering $150 billion and out-of-pocket expenses reaching $36 billion.

/ / / Penn Researchers Study a Drug that Slows Heavy Drinking Personalized medicine is all the rage in cancer treatment. Now, the approach is making its way into addiction treatment, The Philadelphia Inquirer reported.

A new Penn study found that heavy drinkers significantly reduced their drinking when they took the anticonvulsant drug topiramate - but only if they had a specific genetic profile. Henry R. Kranzler, MD, director of the Center for Studies of Addiction and the study’s lead author, said researchers also have found that genes affect response to two other drugs being tested in alcoholics: naltrexone and ondansetron, an antinausea drug.

/ / / $3.25 Million Gift Creates Penn Medicine/CHOP Friedreich’s Ataxia Center of Excellence Three longtime allies have joined forces to create the new Penn Medicine/CHOP Friedreich’s Ataxia Center of Excellence. Establishing the Center was catalyzed by a $3.25 million gift from the Friedreich’s Ataxia Research Alliance (FARA), in partnership with the Hamilton and Finneran families. For the past 16 years, Penn Medicine, The Children’s Hospital of Philadelphia, and FARA, a nonprofit organization dedicated to curing FA, have collaborated to provide and push forward the care needed by FA patients. The Philadelphia Business Journal, NBC10, 6ABC, and KYW Newsradio covered the gift.

To reach the Penn Medicine news website, go to www.PennMedicine.org/news

Creating a P O S I T I V E (continued from cover)

IMPaCT

Garfield makes sure patients have a follow-up appointment with a primary care clinic — and that they keep it. “I’ll call a couple days before to remind them!” She’ll also arrange transportation to the clinic, if necessary, and accompany them to the appointment, if the patient requests it. “I want to make sure I break down barriers so they can focus on their health.”

At the appointment, Garfield speaks with both the doctor and social worker about the goals the patient has set up and potential problems in attaining them. “IMPaCT gets them started on reaching their goals and then the patients work with their primary care doctors and social workers,” she said.

Both during and after the transition period, Garfield encourages her patients to call with questions or concerns. “I have patients I worked with last year who still call me just to say hi and let me know how well they’re doing,” she said. “It’s so good to know that they haven’t returned to the hospital.”

Reduced multiple readmissions was just one of the positive results from IMPaCT’s first randomized trial. The participants, all of whom live in low-income communities that account for a significant portion of readmissions to participating hospitals, also had improved engagement in medical care, patient experiences, and mental health.

The model has now been integrated into routine practice on inpatient general medical teams at HUP and PPMC. “We learned a lot from the trial but we continue to tweak the model,” said Shreya Kangovi, MD, MS, director of Penn Center for Community Health Workers. “Why is it working for one patient and not another? How can we make it better?”

Changing Health Behaviors With the success of the transitions model, a new IMPaCT study started last summer, adapting the intervention for chronic disease management in the primary-care setting.

The IMPaCT Primary Care focuses on patients in the same high-risk neighborhoods.

`` CHW Irene Estrada reviews the sodium level of food with patient Charlotte Martin to make sure she’s keeping her intake at a low level.

Although participants in the study have multiple chronic conditions, tackling all can be overwhelming so patients work with their health-care provider to determine one achievable goal. “We ask patients what they want to focus on and then help them reach that goal,” Chanton said. “The program is very patient-centered.”

A community health worker partners with the patient to break the goal down into achievable steps and then provides the necessary resources, for example, finding a free smoking cessation class if the patient’s goal is to quit smoking. To help motivate patients and keep them on track to meet their goals, the CHW might participate in an activity with the patient. Estrada has attended nutrition classes with her patients, gone on walks, and even worked out at the gym. “That’s the bonus. It helps me as well,” she said, smiling.

During the six month primary-care program, CHWs meet with each of their assigned patients at home at least three times in the first month and at least once in each of the other five months. Weekly calls keep tabs on the patient’s progress and more.

“Sometimes patients just need us to listen, especially if they’re under a lot of stress,” Estrada said.

“When you know what you did worked, it feels really good,” she continued. “Even before coming to this program, I liked helping people meet their goals. Now what I do makes a huge difference, with their health.”

The IMPaCT model was specifically created to be universal and scalable for any group, disease or setting. “We started with a transition model and adapted it for chronic care,” Kangovi said. “Now we’re working with other departments at Penn and organizations across the country to adapt IMPaCT for their needs.”

Pereleman School of Medicine graduates will part ways for the next phase of their medical training when they begin their residency training this summer.

The Envelope… Please!

Each spring, fourth year medical students across the country wait anxiously for Match Day, when they learn where they’ll do their residency training from the National Residency Match Program. Simply put, “med students submit their top choices and institutions submit theirs,” said Eve Higginbotham, MD, vice dean of Inclusion & Diversity. “The information is then put in a massive data base and a computer decides — in 6 seconds — how everyone will match.”

Earlier this year, 161 medical students (82 men and 79 women) from the Perelman School of Medicine tore open the envelopes that told them where they are headed for their residency training. “There are so many emotions in one room,” said Barbara Wagner, director of Student Affairs.

“Match Day makes it real, that we are really graduating in a few weeks and starting a new adventure all over the country — wherever our envelope tells us,” said med student Liza Sonnenberg.

161 49

Perelman School of Medicine graduates who took part in the residency “match”

20

States where students will begin residencies

Students who will train at Penn and CHOP

Top Three Specialties: Emergency Medicine

Pediatrics

52

Students who matched in PA

Internal Medicine

it Takes More than an Apple a Day Developing a healthy lifestyle and nutritious diet can be challenging for anyone. For those in one West Philadelphia neighborhood, a new program brings fresh fruits and vegetables to an area previously lacking them and empowers residents with the tools to incorporate them in their meal planning.

`` Program leaders include (l to r) Asheta Goins, Sharon Brokenbough, Tammy Pullins, Gweny (Love) Owens, Denise Anderson, Mawusi Arnett, MS4, and Yawei Song.

Started by Perelman School of Medicine student Mawusi Arnett, the West Philadelphia Empowerment Initiative invites locals to Transfiguration Baptist Church to re-evaluate their diet and lifestyle. The program’s three-pronged meetings start with groups preparing a healthy meal.

While the group enjoys their meal, Arnett offers a presentation on healthy eating, which includes setting individualized goals for the participants. A Penn Medicine CAREs grant funds the purchase of food ingredients and other supplies for the meetings.

One of the session’s attendees and project leader from the beginning was Denise. A recovering drug

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addict facing high blood pressure and diabetes, Denise sees the need for the program for her and many of her peers. “I came on board to help because I am in the community, so I can tell the others how we can best be served and reach the masses.” Until this program brought a non-profit Philly Fresh Food Hub produce truck to the neighborhood, residents like Denise needed to travel to other areas of Philadelphia to obtain these healthy ingredients.

The group is considering partnering with a local school to give kids the same nutritional life skills. As her medical school schedule takes more of Arnett’s time and energy, the torch will next pass to Yawei Song, a Penn student working on her master’s of social work who volunteered in Arnett’s workshops.

“Sustainability is important,” said Arnett. “The great buy-in from both the community here and students and staff at Penn as well is encouraging as we hope to help for generations to come.”

AWARDS AND ACCOLADES New Leadership in Department of Medicine

CEO’s corner

Michael S. Parmacek, MD, has been named chair of Penn’s Department of Medicine.

For the present, he is retaining his role as director of the Penn Cardiovascular Institute but is stepping down from his role as chief of Cardiovascular Medicine.

(continued from cover)

Parmecek is a nationally recognized expert in cardiovascular biology and medicine.

At Penn, he has made significant research advances and also built one of the nation’s leading cardiovascular medicine divisions. He has been named to multiple important local, regional and national leadership positions, including the Advisory Council of the National Institutes of Health/National Heart, Lung, and Blood Institute.

Over the course of his career, he has made multiple seminal discoveries which have had an impact on understanding the molecular and genetic basis of congenital heart disease, atherosclerosis, aortic aneurysm and dissection and heart failure. He has published a substantial body of scholarly work in high-impact journals, including Science and The New England Journal of Medicine.

Daniel Kolansky, MD, has been named the acting chief of Cardiovascular Medicine. He is nationally and regionally recognized for his expertise in performing diagnostic and interventional procedures. He is also known for his research focused on acute coronary syndromes, resuscitative medicine and hyperlipidemia.

Johnson Named CHRO at Pennsylvania Hospital Sarah Johnson has been named the chief Human Resources officer for Pennsylvania Hospital.

Previously, Johnson was CHRO for Home Care and Hospice Services. In that role, she developed creative recruitment strategies for rehab positions, registered nurses, and LPN’s across agencies. She also established many communication forums for staff with Joan Doyle, HCHS executive director, and the senior leadership team and also implemented many strategies to improve overall employee engagement at HCHS. Johnson began her career as a Human Resources Manager for Aramark and was the on-site representative for the HUP and PPMC locations.

Jeffrey Drebin, MD, chair of Surgery, has been elected the 2014 president of the Philadelphia Academy of Surgery. It is the oldest surgical society in the U.S. Founded in 1879, the Philadelphia Academy of Surgery’s mission is to cultivate and improve the science and art of surgery, elevate the profession, and promote public health and any other matters that may fall within its sphere.

Garret A. FitzGerald, MD, director of the Institute for Translational Medicine and Therapeutics and chair of Pharmacology, received the inaugural St. Patrick’s Day Science Medal from Enda Kenny, the prime minister of Ireland. The award, from the Science Foundation Ireland, recognizes the achievements of a distinguished Irish scientist or engineer, living and working in the U.S. Jennifer Prah Ruger, PhD, of Medical Ethics & Health Policy, has been elected to membership on the Council on Foreign Relations. The CFR is an independent, nonpartisan membership organization dedicated to providing resources to help people better understand the world and the foreign policy choices facing the United States and other countries.

Alan Wein, MD, chief of Urology, received the 2014 Rodney Appell Continence Care Champion Award from the National Association for Continence. The award honors health-care providers who have made outstanding contributions in research, education and clinical practice.

Electronic provider documentation (ePD), a new tool in our electronic medical record, is now standardizing medication reconciliation at admission and discharge for the benefit of our patients and enhancing the quality of discharge documentation. The ePD rollout will continue this spring with electronic admission and progress-note templates for hospitalist and orthopaedics services.

PennChart, a fully integrated, system-wide electronic medical record, is coming! Our IS team is hard at work expanding and rebranding our outpatient electronic medical record to include the inpatient setting as well. The new system will encompass all hospitalized patients, the emergency department, and radiology. As a result, Health System physicians and staff will have instant access through a uniform platform to all of our patients’ medical records wherever they’re housed. Practice management software will be included as well. This is a complicated effort but we’re well on pace to meet our early 2015 go-live target dates for several of our departments. Others will follow in stages. You’ll be hearing a lot more about this important project over the coming months.

I’m also pleased to report that HUP, PPMC, and PAH has each just achieved Stage 6 designation for electronic medical record usage by the Healthcare Information and Management Systems Society. According to the organization, “Stage 6 institutions have established clear goals for improving safety, minimizing errors, and prioritizing IT implementations.” Only 13 percent of hospitals in the United States carry a Stage 6 designation.

Bar code medication administration automatically ensures correct dispensing of medications. Nurses and respiratory therapists scan the barcodes on medications before they’re given to the patient. Our electronic health record then verifies the “five rights:” right medicine in the right dose at the right time by the right route from the right caregiver. If any of these conditions is not met, the screen prompts the nurse and helps avert a potential medication error.

Our early warning system uses the electronic medical record and laboratory and vital-sign data to identify patients at-risk for serious conditions such as sepsis. When certain data thresholds are detected, the system automatically prompts our staff to take early, precautionary action to avert an emergency situation and stabilize the patient.

Finally, UPHS recently became the first local health-care institution to electronically share patient data with another health system using a different electronic health record platform. This was a decisive beginning-step toward full regional provider-access to crucial patient care information; it will be particularly valuable when patients need emergency care away from their home institution.

At Penn Medicine, our extraordinary talented IS professionals and faculty are leading the way in using information and technology to help deliver exceptional care and carry out life-saving research. I know you join me in thanking them for all of their efforts.

Systemnews Editorial Staff: Sally Sapega, M.A. Editor

/// New Mother and Baby Pavilion at Chester County Hospital Chester County Hospital will soon open 24 private maternity rooms in its new Lasko Tower. Located on the same floor as Labor and Delivery and the hospital’s CHOP-affiliated Level III neonatal intensive care unit, the spacious rooms include a sofa that converts into a bed for overnight guests, a comfortable glider, and a European-style bathroom that fills with natural light.

In addition, because everyone’s journey to parenthood follows different paths, a nesting room has been created where adoptive families and families with gestational carriers can comfortably stay with their child until the baby is discharged from the hospital. A well-baby nursery is centrally located on the unit

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/// Support the Ride to Conquer Cancer Philadelphia’s first annual Ride to Conquer Cancer will take place October 11-12, to benefit Penn Medicine’s Abramson Cancer Center.

The 150+ mile cycling adventure through the picturesque landscapes around Philadelphia is designed with more casual riders in mind, and organized training activities are available to help you prepare. Hundreds of survivors, family members, students, alumni, faculty, and friends are expected to participate. CEO Ralph Muller and Chi V. Dang, MD, PhD, director of the Abramson Cancer Center, are co-captains for the UPHS/ACC Team.

To register and learn more, please visit: www.penncancer.org/patients/giving/ride-toconquer-cancer.

Trissy Harding Graphic Design

Administration:

Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications

Let Us Hear From You: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 E-mail the editor at sally.sapega@uphs.upenn.edu.