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December Issue 2018
Inside This Issue
First UT System Clinical Collaboration Launches Between MD Anderson, UTMB Health Event Celebrates New Building, Expanded Services, Cooperation to Better Serve Patients
T Ben Taub and LBJ Hospitals Receive National Commendation for Surgical Care See pg. 9
INDEX Legal Matters........................ pg.3 Financial Outlook............... pg.4 New Technology................ pg.6 Oncology Research......... pg.7
Stopping Inflammation Before it Starts Could Lead to Longer, Healthier Lives See pg. 11
he University of Texas MD Anderson Cancer Center formally opened a five-story facility in League City that houses new and expanded cancer care services and a first-of-its-kind clinical collaboration with The University of Texas Medical Branch (UTMB Health). Supported by an initiative of The University of Texas System to spur collaboration, the partnership between the two UT health organizations will provide more convenient local access to specialized, multidisciplinary cancer diagnostics and care as well as routine check-ups, cancer screenings and survivor follow ups for residents in the growing region. Gathering to celebrate the milestones today were UTMB Health President Dr. David Callender; MD Anderson President Dr. Peter Pisters; The University of Texas System Chancellor James B. Milliken, UT Regents Janiece Longoria, David Beck and Student Regent Brittany Jewell; League City Mayor Patrick Hallisey and about 150 guests, including faculty, staff and patients. A colorful piece of art capturing the spirit of integration and collaboration was unveiled in recognition of the occasion. Created by San Antonio artist Constance Lowe, the piece will be displayed where the UTMB Health and MD Anderson buildings intersect on the League City campus. The new 200,000-square-foot MD Anderson facility features expanded services, including medical oncology, radiation oncology, surgical oncology, diagnostic pathology/labs, pharmacy, infusion therapy, multidisciplinary clinics, pain management, nutrition and social work. New services at the League City location include a full
Peter Pisters, M.D., president of The University of Texas MD Anderson Cancer Center, speaks at the launch of the clinical collaboration between MD Anderson Cancer Center and The University of Texas Medical Branch (UTMB Health). MD Anderson also celebrated the formal opening of its new outpatient clinic on the League City campus of UTMB Health.
complement of radiology services such as mammography, CT, combined PET/ CT, MRI and other technologies. “The opening of MD Anderson League City marks a new chapter in our effort to offer high-quality care to patients close to home. Not only will patients receive their care and see their teams in a spacious new building, but they will benefit from a new clinical collaboration between MD Anderson and UTMB Health,” said Pisters. “Working together, our organizations with long histories of outstanding patient care, will reach out to more patients with a broad range of services, provide a better experience and strive to end cancer.” The collaboration between the two UT organizations is the first clinical partnership to form under The University of Texas System’s initiative to drive more efficient and improved health care for Texans. Announced in 2015, the collaboration initially
included MD Anderson leasing space on the UTMB campus and working together to provide clinical care from screening to survivorship. Today, the collaboration is evolving to include deeper clinical integration as well as educational and research opportunities. MD Anderson also has full clinical partnerships with UT Health – San Antonio and UT Health – North Campus Tyler. “This collaboration of two world-class institutions coming together for the good of Texans exemplifies the mission of the University of Texas – to serve the people of our state,” Chancellor Milliken said. “I’m immensely proud of the work done by Presidents Pisters and Callender and their teams. This new clinical partnership ensures that patients will benefit from the expertise and unparalleled care provided by UT MD see Collaboration... page 13
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Legal Matters NPDB Quietly Announces October 2018 Guidebook
Alexis L. Angell, JD and Adam D. Chilton, JD Polsinelli, PC
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he National Practitioner Data Bank (“NPDB”) recently published an updated NPDB Guidebook. Unlike the previous April 2015 update to the 2001 edition, the NPDB did not issue a provisionary Guidebook or provide opportunity for public review or comment. Most of the Guidebook is unchanged; however, there are significant revisions that potentially expand reporting obligations regarding adverse actions against practitioners’ clinical privileges, including the following: • New Language: Proctoring Reportable After 30 Days
If proctoring is imposed as a result of a professional review action related to professional competence or conduct and the period of proctoring lasts for more than 30 days, the action must be reported to the NPDB. • New Section: Length of Restriction In an apparent response to the 2017 federal court decision in Walker v. Memorial Health System, No. 2:17-CV-00066-JRG, 2017 WL 514325 (E.D. Tex., February 8, 2017), the NPDB added a new section to Chapter E entitled “Length of Restriction” to the 2018 Guidebook. The section clarifies that any clinical privilege action that results from a professional review action that adversely affects a practitioner’s clinical privileges for a period of more than 30 days must be reported to the NPDB, regardless of the manner in which the restriction is written. Thus, the “restriction begins at the time a practitioner cannot practice the full scope of his or her privileges and is reportable to the NPDB once that restriction has been in place for 31
days.” • New Question and Answer 22: Agreement Not to Exercise Privileges May Be Reportable The NPDB takes the position that a practitioner’s “agreement not to exercise privileges” pending an investigation is a form of “restriction” that is reportable as an “acceptance of the surrender of clinical privileges or any restriction of such privileges . . . while under investigation.” This statement is a significant departure from past protocol because informal agreements not to exercise privileges pending an investigation have generally been understood to be non-reportable
if in effect for 30 days or less. • New Question and Answer 24: Reappointment Review May Be an Investigation A practitioner’s resignation of privileges and membership while a reappointment application is pending, or a withdrawal of the pending reappointment application, may be reportable if circumstances support that the practitioner was under investigation at the time of the resignation or withdrawal. • New Question and Answer 25: Quality Improvement Plans May see Legal Matters...page 14
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Financial Outlook What are the Obstacles to Physicians Wealth? By Gail Stalarow Vice President The Clarity Group at Morgan Stanley
M
any Americans stereotypically think of physicians as rich. And while, many doctors eventually enjoy a fruitful career, most physicians are not wealthy upon completion of medical school. There are many obstacles to gaining wealth and managing it as a physician. Late Career Start A physician’s career starts later than most of their peers in other industries. While attorneys and accountants may also stay in school longer and incur more debt, a doctor’s path through education is considerably longer. Moreover, depending on the specialty, a physician may be in school well into their 40’s. High Student Loan Debt
We all know that student loan debt is a real obstacle to starting savings. How can you begin to put money toward retirement when you are just trying to manage your student loan payments? In 2016, the average medical school debt was $180,000 according to the Journal of the American Medical Association. Additionally, as young doctors begin to get married, have children, and buy a house, more debt can accrue as they borrow additional money or put expenses on credit cards, it can be overwhelming. Unsuitable Savings Plans Let’s face it, doctors are not always the best at asking for help. Physicians are used to people asking them for the answers, and therefore, aren’t always good at seeking out information for themselves. The problem is that doctors may follow bad or trendy financial advice or try winging it on their own. This may result in inappropriate investment plans, such as day-trading, disproportional stock allocations within asset classes, or taking on incorrect risk, be it too high
OR too low. The Good News The good news is that with a solid financial plan and smart preparation, everyone, including physicians, may be able to find positive outcomes. Luckily, there are strategies to help doctors focus on savings, allowing you to retire more comfortably. Follow some of these tips designed to help remove obstacles to wealth. Start Saving Now Although your career may get started later than your college roommate’s, do not get bogged down in fear of your financial future. Start saving now. You most likely had a smaller salary as a resident. Once you are in private practice, you may be making a significant 6-figure income. Resist temptations to splurge until you have a steady savings plan.
Invest this money in your retirement. Additionally, ensure you are continuing to make payments on any debt, be it medical school loans, credit card bills, or other methods where you borrowed money. Refinance your Student Loans Do not get overwhelmed with your student loans. Come up with a plan to pay them off. You may want to refinance or consolidate your loans. The new loan will likely have a new minimum payment which may help you put money toward retirement or to your dream of opening your own practice. Finding the Right Investment Strategy for You Take this time to ask questions and read up on the right investment
see Financial Outlook...page 14
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December 2018
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FDA Restrictions On E-Cigarettes Important Step To Protect The Health Of Youth MD Anderson Supports Efforts to Lower Nicotine use in Teens and Adolescents
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he University of Texas MD Anderson Cancer Center applauds new actions announced today by the U.S. Food and Drug Administration (FDA) to limit the sale of most flavored electronic cigarettes (e-cigarettes) to age-restricted locations and require age-verification for online sales to lower the use of these products in children. In addition, the FDA plans to restrict the marketing of these products toward youth. “Today’s actions by the FDA represent a significant step toward protecting the health of our future generations,” said Peter WT Pisters, M.D., president of MD Anderson. “These flavored products often are appealing to children and adolescents, and we support measures to prevent young people from developing a lifetime of addiction to nicotine, which can lead to a variety of health problems and potentially future tobacco use.”
According to data today from the Centers for Disease Control and Prevention (CDC), more than 3.6 million middle and high school students were current e-cigarette users in 2018, up more than 1.5 million relative to 2017. Recognizing this as an epidemic among young people in this country, the FDA proposed actions to curb youth appeal in September 2018. “While we have been encouraged by the progress made in lowering tobacco use, we remain troubled by the epidemic rates of e-cigarette use among our young people,” said Ernest Hawk, M.D., division head and vice president of Cancer Prevention & Population Sciences. “It’s especially concerning because of the wide variety of products available, each with different ingredients and nicotine concentrations. We can’t really be sure what these products contain, what they deliver to users or what the
corresponding health concerns may be.” According to the U.S. Surgeon General’s report on e-cigarettes, the aerosol produced by these products is not a harmless vapor, but contains a number of volatile chemicals and known carcinogens. Further, the Surgeon General has affirmed a strong association between the use of e-cigarettes and conventional tobacco products. Nicotine itself is a highly addictive chemical that can disrupt adolescent brain development, impacting learning, mood and anxiety. Recognizing the importance of educating youth about tobacco use and its harms,
MD Anderson has a variety of programs designed to prevent tobacco initiation. Researchers led by Alex Prokhorov, M.D., Ph.D., professor of Behavioral Science, developed A Smoking Prevention Interactive Experience (ASPIRE), a youth-oriented tobacco prevention and cessation curriculum. The online program is designed to provide an engaging way for teens to learn about the dangers of tobacco products. Since its web-based launch in 2008, ASPIRE has reached 100,291 students in 8 countries. In 2018, the team launched an updated
see Restrictions...page 14
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New Technology
to relax and take some deep breathes.
Holiday Technology Gifts That Are Improving Healthcare By Mark Johnson President, Xtrii
I
t’s that time a year. You are looking for the right gift for the special people on you holiday shopping list. And technology and gadgets are frequently listed on the gift lists. In the past, technology items were often just neat gadgets or novelties that were entertaining. But now, technology gifts can provide significant healthcare benefits. So, as you look for that special technology gift, consider one the options listed in this article that has a healthcare benefit. Smartwatch: Smartwatches continue to evolve and provide new and improved health and tracking features. For example, the new Apple Watch 4 has many beneficial healthcare features, such as:
• Heart rate tracking – tracks your heart rate throughout the day and provides a history that can show heart rate ranges and anomalies. • ECG functionality that is endorsed by the American Heart Association and approved by the FDA. While it won’t replace a doctor’s visit, it does add valuable insight. • Activity monitoring – tracks your activity level and provides a history. How often are you working out? How long did you walk on the treadmill? What was your heart rate during the workout? It provides this helpful information that can help you monitor your workouts and overall activity level. It even provides healthy reminders to stand-up throughout the day, or
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All these features combine to provide a very helpful tool that can promote better health. There are numerous reports of people losing weight and improving their overall health by adding this technology into their life. Voice assistants: Voice Assistants, such as Amazon Alexa and Google Assistant, are changing the way you input and request information. They are more than just a convenience. They can also provide a lifestyle improvement for people that experience mobility or dexterity challenges. The ability to request help, retrieve information, and interact using voice can be life changing for those with disabilities or elderly that are not able to use keyboards or traditional technology methods. If you need help or want to look up healthcare information, just ask your new Voice Assistant. Amazon offers a line of varies Amazon Echo devices. Google and Apple have similar offerings.
Improve Communications: Need to check on an elderly family member or someone with a disability. Video conferencing technology makes it easier to communicate with them, and visually see their health status. The new video communication offerings are very affordable and easy to operate. Here’s a few options to consider: • Modern smartphones have built-in video calling capabilities, such as Apple Facetime on iOS phones, or Google Duo for Android phones. • Amazon Show – Voice assistant
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Oncology Research Creativity and Cancer: Using Art To Help With Healing By Caesar Tin-U, M.D., Texas Oncology
I
t’s no secret that enduring great challenges often ignites creativity. As renowned scientist Neil deGrass once said, “The most creative people are motivated by the grandest of problems that are presented before them.” As an oncologist, I’ve seen many cancer patients turn to creative expression, sometimes almost unintentionally and often with great deliberation. Every patient travels a unique, personal “cancer journey.” It’s different for everyone, but there are common threads – tightly bound and woven together like a colorful canvas – representing shared experiences. These shared experiences are sometimes
revealed through creative expression, or art. Being creative can be therapeutic and may help with healing. Whether it’s taking up a new hobby or musical instrument, joining a choir or dance group, writing, or taking art classes, there are countless opportunities for cancer patients to engage in artistic endeavor as a coping strategy. What qualifies as art? The answers are as diverse as the patient journey itself – there’s no right or wrong way of defining it. What matters is whether it supports the healing process and promotes a sense of emotional or spiritual wellbeing. Even if you don’t think of yourself as an artist or a highly creative person, you may be surprised once you find an artform you enjoy. Here are a few things to keep in mind as you find ways to use creativity to cope with cancer: • Find balance. If fitting creative pursuits into your busy schedule
feels impossible, it may be a sign it’s time to slow down. Balance is key to health and wellness, particularly for those with cancer. You may not feel well every day, and it’s understandable to want to use the days you’re at your best to take care of your obligations. Setting aside time to explore your creative side in the midst of it all can help you find balance and relax. • Express yourself. The decision to talk about your cancer is an intensely personal and private one. That’s why some people choose to use art as a way of telling their story from their own unique perspective
and in a unique way. Whether sharing your art widely or keeping it private, keep in mind there are no boundaries – just free expression of your thoughts and ideas. • Find a partner. Finding a partner to join you in your creative pursuits is not only fun, it helps strengthen connections with those close to you. Family, caregivers, and friends are usually fair game, but don’t shy away from joining a community art class or finding a local support network. see Oncology...page 13
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Healthy Heart Updated Guidelines Suggest a Lifetime Approach to Managing Cholesterol
READY, SET . . .
By American Heart Association
U
pdated cholesterol guidelines were presented last month at the American Heart Association’s 2018 Scientific Sessions conference in Chicago, the premier annual global forum for the latest advances in cardiovascular science for researchers and clinicians. More personalized risk assessments and new cholesterol-lowering drug options for people at the highest risk for cardiovascular disease are among the key recommendations in the updated cholesterol guidelines. These updates reinforce the importance of adopting a healthier lifestyle and ultimately prevention. They help identify those who may be at risk for cardiovascular disease and
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syndrome, chronic kidney disease, chronic inflammatory conditions, premature menopause or pre-eclampsia and high lipid biomarkers. This additional information can make a difference in what kind of treatment plan a person needs. Recognizing the cumulative effect of high cholesterol over the full lifespan, identifying and treating it early can help reduce the lifetime risk for cardiovascular disease. Selective cholesterol testing is appropriate for children as young as two who have a family history of heart disease or high cholesterol. In most children, an initial test can be considered between the ages of nine and 11 and then again between 17 and 21. Because of a lack of enough evidence in young adults, there are no specific recommendations for
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address those risks early. Having high cholesterol, at any age, can increase a person’s lifetime risk for heart disease and stroke. A healthy lifestyle is the first step in prevention and treatment to lower that risk. Nearly one of every three adults in America have high levels of low-density lipoprotein cholesterol (LDL-C), considered the “bad” cholesterol because it contributes to fatty plaque buildups and narrowing of the arteries. About 94.6 million, or 39.7 percent, of American adults have total cholesterol of 200 mg/dL or higher, while research shows that people with LDL-C levels of 100 mg/dL or lower tend to have lower rates of heart disease and stroke, supporting a “lower is better” philosophy. The guidelines now urge doctors to talk with patients about “risk-enhancing factors” that can provide a more personalized perspective of a person’s risk, in addition to traditional risk factors such as smoking, high blood pressure and high blood sugar to address under or over-estimated risk in some individuals. Risk-enhancing factors include family history and ethnicity, as well as certain health conditions such as metabolic
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that age group. However, it is essential that they adhere to a healthy lifestyle, be aware of the risk of high cholesterol levels and get treatment as appropriate at all ages to reduce the lifetime risk of heart disease and stroke. This lifespan approach to reducing cardiovascular disease risk should start at an early age. Kids may not need medication but getting them started on healthy behaviors when they’re young can make a difference in their lifetime risk. When high cholesterol is identified in children, that could also alert a doctor to test other family members who may not realize they have high cholesterol, because awareness and treatment can save lives. The 2018 guideline updates aim to provide all Americans with the chance to live longer, healthier lives by recommending more detailed risk assessments to help health care providers better determine a person’s individualized risk and treatment options. For more information on how you can take steps to lower your cholesterol go to – https://www.heart. org/en/ health-topics/cholesterol/ about-cholesterol
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Establishing Immunotherapy For Pediatric Liver Cancer T-Cell Editor Creating the Powerful Immunotherapy Weapon
A
s part of a $6 million effort to establish new therapies for highrisk pediatric liver cancer, Navin Varadarajan, associate professor of chemical and biomolecular engineering, will modify T cells to recognize and kill glypican-3, a molecule found in liver cancer cells. Inherently that’s what the immune systems’ white T cells do – they fight invaders or infections. It is also what Varadarajan does. With two previous awards from the Cancer Prevention & Research Institute of Texas (CPRIT), Varadarajan is working to improve effectiveness of T-cell immunotherapy. On this CPRIT multiinvestigator research award, he joins Andras Heczey, a physician researcher at Baylor College of Medicine, in examining one of the most common forms of liver cancer in adolescents, hepatocellular (HCC) carcinoma. HCC patient survival rates are under 30 percent. No effective cure is available for most metastatic hepatocellular tumors. Current treatment includes surgical resection or liver transplantation in combination with dose-intensive chemotherapy regimens -associated with significant morbidity in HCC – or which may cause low blood cell counts, hearing impairment, speech and cognitive delay and long-term damage to the heart. “It is thus critical to develop new, effective and safer therapies,” said Varadarajan.
T cell-based immunotherapy has worked in other types of cancers, like leukemia and lymphoma. The team at Baylor will isolate the T cells, modify them with synthetic receptors and then Varadarajan will get to work. “We have a platform for documenting how well T cells work and we will use it to determine which T cell properties are essential in fighting the cancer cells,” said Varadarajan, whose team built the microscopybased methods for monitoring cellular function. Once determined, certain functions can be added or subtracted through genetic editing to make the T cell the best cancer fighter possible. The modified cells will deliver targeted and tailored therapy in clinical trials at Baylor. “The hope is to get consistent and durable patient responses in pediatric HCC by using the power of immunotherapy,” said Varadarajan, who credits CPRIT with the steps forward in immunotherapy. “Texas taxpayers are amazing for funding CPRIT. Much of this research would not be possible without it,” said Varadarajan. CPRIT’s goal is to expedite innovation in cancer research and product development, and to enhance access to evidence-based prevention programs throughout the state of Texas.
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Stopping Inflammation Before It Starts Could Lead to Longer, Healthier Lives Researchers Find That Blocking a Specific DNA Repair Protein Stops Inflammatory Response
I
nflammation is typically the body’s way of dealing with infections or irritants and starting the healing process. But like anything else, too much of a good thing can be harmful. Chronic inflammation is associated with numerous diseases including different types of cancer, arthritis, Alzheimer’s and even aging. Current drugs are only able to suppress inflammation but researchers at The University of Texas Medical Branch at Galveston, in collaboration with scientists at the Karolinska Institute in Sweden, believe they may have found a way to stop inflammation before it begins. The research team published their findings in Science. Researchers, under the direction of Dr. Thomas Helleday,
professor in the Department of Oncology and Pathology at the Karolinska Institute, developed a small molecule that binds to a key DNA-repair enzyme. Blocking that specific enzyme not only prevents, but ameliorates, the body’s inflammatory response, said Istvan Boldogh, professor at Department of Microbiology and Immunology at UTMB, and senior author of the paper. The findings could lead to better treatment or prevention of a range of diseases including chronic obstructive pulmonary diseases, asthma, obesity, chronic arthritis, cardiovascular diseases, Alzheimer’s and others, according to the researchers. Boldogh and his colleagues found that the initiation and
exacerbation of the inflammatory processes are associated with damage to the body’s DNA. It is when the DNArepair enzyme called 8-oxoguanine DNA glycosylase1, or OGG1, responds to the damage that the expression of inflammatory genes begin. “This observation goes against the conventional dogma about the role of DNA repair protein OGG1,” said Boldogh. A team of researchers in Sweden were able to develop small molecule inhibitors that fit into the active pocket of the repair enzyme OGG1, preventing it from binding to the damaged DNA and starting the gene
expression needed for inflammation. In collaboration with Boldogh’s lab, they showed that the drug, called TH5487, could also decrease ongoing inflammation, a crucial finding for the treatment of chronic inflammation. “Only a handful of times over their entire scientific career, one has the opportunity to be a part of a team to make a historic leap,” Helleday said. “This is just what we are experiencing right now.” The small molecule has been
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Baylor St. Luke’s Medical Center, CHI St. Luke’s Health– The Woodlands Hospital and CHI St. Luke’s Health Brazosport Receive an ‘A’ for Patient Safety in Fall 2018 Leapfrog Hospital Safety Grade
B
aylor St. Luke’s Medical Center, CHI St. Luke’s Health–The Woodlands Hospital and CHI St. Luke’s Health Brazosport were awarded an ‘A’ from The Leapfrog Group’s Fall 2018 Hospital Safety Grade. The designation recognizes these three medical institutions’ efforts in protecting patients from harm and meeting the highest safety standards in the United States. Baylor St. Luke’s also received an ‘A’ grade in spring 2018. The Leapfrog Group is a national organization committed to improving health care quality and safety for consumers and purchasers. The Safety Grade assigns an A, B, C, D or F grade to hospitals across the country based on their performance in preventing medical errors, infections and other harms among patients in their care. “We are honored to have received an ‘A’ grade for patient safety at three of our Houston area hospitals, said Dr. Doug Lawson, CEO of CHI Texas Division. “This award is demonstrative of our extraordinary commitment to compassionate, quality healthcare and patient safety.” “Leapfrog’s Hospital Safety Grades recognize hospitals like Baylor St. Luke’s Medical Center, CHI St. Luke’s Health–The Woodlands Hospital
December 2018
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and CHI St. Luke’s Health Brazosport that focus on advancing patient safety. This ranking provides an important resource for patients, and a benchmark for hospitals, to determine how care at one hospital compares to others in a region,” said Leah Binder, president and CEO of The Leapfrog Group. “Hospitals that earn an A Hospital Safety Grade deserve to be recognized for their efforts in preventing medical harm and errors.” Developed under the guidance of a National Expert Panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public. Baylor St. Luke’s Medical Center, CHI St. Luke’s Health–The Woodlands Hospital and CHI St. Luke’s Health Brazosport were among 855 hospitals across the United States awarded an A in the Fall 2018 update of grades. To see Baylor St. Luke’s Medical Center, CHI St. Luke’s Health–The Woodlands Hospital and CHI St. Luke’s Health Brazosport’s full grade details, and to access patient tips for staying safe in the hospital, visit www.hospitalsafetygrade.org
Houston Medical Times
Collaboration Continued from page 1
Anderson and UTMB without having to leave the support of their families and communities--an important part of the treatment and recovery process.” Under the collaboration, 41 UTMB Health faculty and staff who work in medical oncology, gynecologic oncology and radiation oncology at the League City and Galveston campuses have become MD Anderson employees. Additionally, MD Anderson now provides medical oncology, radiation oncology and gynecologic oncology care to patients seen at UTMB Health’s Galveston campus. “We are extremely proud and excited to be collaborating with a UT System health institution to provide easier access to high-quality care,” said Dr. Callender. “The expertise that MD Anderson and UTMB provide will greatly enhance and expand the health
care services that will be available for residents in this area.” Since September 16, when the new League City facility opened to patients, care teams have been integrating to maximize resources and ease patients’ transition. Faculty and staff work in open-space environments designed for collaboration and impromptu discussions. The new facility has 150 open workspaces, eight huddle rooms, two large collaborative rooms and two conference rooms. Collaboration was a key priority for the team that advised planners and designers. The League City facility features a new check-in technology that allows patients to scan their palms to verify identity and secured medical information. The technology is new to MD Anderson, and is expected to be installed in new facilities in West Houston and The Woodlands in 2019. MD Anderson has had a presence in the Bay Area since 2007 when it opened a radiation oncology service and later added medical oncology and
Page 13
Peter Pisters, M.D., president of MD Anderson and David Callender, M.D., president of UTMB, celebrate the clinical collaboration of their two organizations.
other disciplines. Previously located in a 40,000 square-foot leased space in Nassau Bay, the new MD Anderson Cancer Center League City clinic is five times larger and is approximately the size of the clinical area of the Mays Ambulatory Clinical Building on MD Anderson’s Texas Medical Center campus. UTMB is adding 60 beds to its existing 37-bed League City Hospital, which includes an emergency room and medical/surgical services for adults. In addition, UTMB is preparing to
reopen the hospital that was the former Bay Area Regional Medical Center in Webster; it will be called UTMB Clear Lake Campus. In 2016, UTMB dedicated the 250-bed Jennie Sealy Hospital in Galveston, and work to modernize the nearby John Sealy Hospital is ongoing. Both hospitals are connected to UTMB’s Level 1 Trauma Center. In addition, UTMB operates a hospital at its Angleton Danbury Campus in Brazoria County, as well as numerous clinics throughout the Greater Houston/Galveston area.
motivation when energy isn’t easy to come by, particularly during treatment. Yet I am constantly inspired by my patients who use art in its various forms to help them cope and tell their own truths about their cancer experience on their terms. I’m proud to work for a
network that supports patients as they find new ways to express themselves on their cancer journey.
options. Offerings such as Teladoc. Bring the whole family com bring the doctor to you. When you are shopping for the together for a face to face conversation this holiday season with this easy to right gifts this holiday season, consider these technology ideas that can bring use technology. better health and convenience to your Telemedicine To provide convenient access loved ones. Happy Holidays! Mark Johnson is a global to medical care for someone that is technology leader that has advised and remote or is challenged with traveling led the top healthcare organizations. to a physician’s office, check out the rapidly improving telemedicine He currently serves as President of
Xtrii, www.Xtrii.com. For additional information on healthcare technology and to see more of Mark’s technology tips and insights, visit www.Xtrii. com.
“We believe that controlling inflammatory diseases could also extend human lifespan, a remarkable
significant.”
Oncology
Continued from page 7 Interested in tapping into your creative side, but not sure what to do or where to begin? Check out your local community center or local events calendars for resources near you. You may also find resources and information online about creativity as
a way of coping with cancer. Perhaps the easiest way is to simply get started. Find a creative project and pursue it. The emotional and physical toll cancer takes can hinder a patient’s desire to do something unfamiliar or different. It’s also hard to find
New Technology
Continued from page 6 that also provides video conferencing and a “drop-in” feature. • Desktop video conferencing: Just simply use the webcam built into your laptop or add a webcam to your PC. Then use a video conferencing service such as Skype or Zoom to connect you with one or more family and friends. Both Skype and Zoom offer free service
options.
Inflammation
Continued from page 11 tested successfully in mice. The next step is to begin clinical trials, which is what the research team is doing now, Boldogh said.
achievement,” Boldogh said. “Possibilities like that make us believe that this discovery is going to be very
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December 2018
Page 14
Houston Medical Times
Legal Matters
HOUSTON
Continued from page 3 Be Reportable as Restrictions and May Qualify as Investigations Here, the NPDB states that if a quality improvement plan is (1) a result of a professional review action relating to a practitioner’s competence or conduct, and (2) restricts the practitioner’s privileges for more than 30 days, the plan itself may be reportable itself as a restriction of privileges. • New Question and Answer 31: Requirement to Operate with a Qualified First Assistant May Be Reportable The NPDB addresses a specific example in new Question 31 regarding whether the requirement that a surgeon operate “only with a qualified first assistant” for more than 30 days is a restriction of privileges and requires reporting. If such a requirement is
“imposed on one specific surgeon, is a professional review action about professional competence and [or] conduct, and runs for more than 30 days,” it is reportable as a restriction of privileges. • New Question and Answer 46: Lapse of Privileges During an Investigation is Reportable Question 46 provides the following example: A physician is up for reappointment and the Medical Executive Committee recommends non-renewal. The physician is entitled to a hearing based on the recommendation, but the hearing cannot occur before the physician’s privileges lapse at the end of their two-year term. Under the new guidance, such a non-renewal of privileges is reportable to the NPDB at
the time of non-renewal, even though the hearing has not been held, as a non-renewal while under investigation. • New Question and Answer 49: Reporting a Court Order Changing a Prior Report The NPDB describes a reporting entity’s obligation once a court order has changed a hospital’s initial adverse clinical privileges action. Determining whether an action taken against a practitioner must be reported to the NPDB is highly fact-specific and many circumstances need not be reported. Nevertheless, the NPDB’s 2018 Guidebook update reemphasizes that the NPDB reporting mandate will continue to be interpreted broadly.
Continued from page 4
investments are diversified. Educate yourself and become financially literate. Additionally, you may also want to seek guidance from a financial advisor. By following these tips and staying on top of your savings, retirement, and
investment plans, doctors can take steps towards a comfortable retirement and enjoy the fruits of their labor in their post-medical career years.
culture on all UT System campuses. This effort led to all 14 institutions of the UT System becoming tobacco-free as of June 2017. Additionally, EndTobacco has served as an educational resource to policy makers considering actions to limit youth tobacco exposure, such as raising the minimum legal sale age for tobacco products from 18 to 21 and a law adopted in 2017 to prohibit the sale of e-cigarettes to minors under 18. EndTobacco is an initiative of the cancer prevention and control platform, part of MD Anderson’s Moon Shots Program™, a collaborative effort to accelerate the development of scientific discoveries into clinical advances that save patients’ lives. “Tobacco use remains the leading cause of cancer in the United States and, unfortunately, the leading preventable
cause of death,” said Hawk. “We would encourage parents and educators to learn more about the health risks associated with e-cigarettes and talk to children about avoiding these products. Together, we remain committed to advancing evidence-based programs and policies that will lower current and future tobacco use, with the goal of saving lives and reducing current and future suffering from tobacco-related conditions.”
Restrictions
Continued from page 5 version of the curriculum, including new content focused on alternative tobacco products, such as e-cigarettes and hookah. Further, as founding partners of the CATCH Global Foundation, MD Anderson and UTHealth School of Public Health support distribution of a youth e-cigarette prevention curriculum, CATCH My Breath, to middle schools across the country. MD Anderson also has served as a resource for statewide tobacco control policies to protect the health of future generations. Through MD Anderson’s EndTobacco® program, MD Anderson collaborated with The University of Texas System to launch the system-wide Eliminate Tobacco Use initiative in 2016, which supports a variety of collaborative actions designed to advance a tobacco-free
December 2018
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Financial Outlook strategy for you and your family. You are an expert in the medical field; allow financial professionals to guide you on saving, investing, and debt reduction. One size does not fit all. However, you can do simple things like max out your 401(k) or IRA and ensure your
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