New intranet coming to MLH on January 28

Main Line Health is launching a new intranet on January 28 called Wellspring. Wellspring is built within the Office 365 environment allowing some users (dependent on type of Office 365 license) to access other Office applications and collaboration tools.

Wellspring will serve as a central hub for internal communication as well as knowledge management and resource portal by providing MLH users with information on and access to applications, policies, benefits, updates, and other information. We hope Wellspring serves as a valuable resource as you continue to make Main Line Health the best place to give and receive compassionate, human care.

Wellspring med staff tutorial

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Diabetes Seminar at Lankenau

“The RAGE of Diabetic Complications” will be the next Dynamic Duo seminar. Speakers will include Deebeanne M. Tavani, DO, PhD, FACE, System Chief of the Division of Endocrinology for Main Line Health; and Mel Reichman, PhD, Senior Investigator at Lankenau Institute for Medical Research (LIMR) and Director of LIMR Chemical Genomics Center.

The speakers will review mechanisms of action and clinical considerations of the newest treatment options for Type 2 diabetes, as well as pathogenic mechanisms of diabetic complications.

Continuing education credits are available for this talk, which is scheduled for Friday, Jan. 24 at Lankenau Medical Center in Annenberg 101 ABC. Lunch will be served at 11:45 am, and the talk begins at noon.

All clinicians and researchers are welcome to attend. Do come early, as Dynamic Duo talks are very popular and seating can be limited.

For additional information, check out this Flyer.

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Clinical Trial of the Week: Care strategy for patients suspected of having coronary artery disease

By Donna Loyle, communications specialist, LIMR

The PRECISE cardiac trial seeks to assess clinical outcomes; decision making regarding noninvasive testing and invasive angiography; and costs of using a precision-evaluation strategy vs. a usual-care strategy in patients with stable symptoms of coronary artery disease.

Participants are assigned to either guideline-recommended care without immediately planned testing (low risk) or cCTA with selective FFRct (elevated risk) using a risk tool based on pretest clinical characteristics.

Those assigned to guideline-recommended care without planned testing are treated with preventive and antianginal medical treatment per guideline recommendations and clinical judgment and are followed without testing.

For each patient randomized to the usual-care study cohort, the participant’s care team will select the specific test.

The principal investigator for the PRECISE trial is Thomas Phiambolis, MD. It is available at Lankenau Medical Center. For more, visit www.mainlinehealth.org/research/clinical-trials/precise

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RFID Go-Live for Main Line Health Begins January 13, 2020

After many months of planning Main Line Heath will begin using Stryker Surgi-Count Radio Frequency Identification (RFID) in the Operating Rooms, Labor and Delivery, and C-Section Rooms commencing January 13, 2020. This technology will take our sponge tracking process to a higher level of safety as all sponges used during a case must be scanned in and out to ensure no sponge is left behind.

The timeline and staff education are outlined in the table below.

Bryn Mawr Go-Live: Jan 13th Lankenau Go-Live: January 15th
Morning In-Service:   December 17th Morning In-Service:   December 6th
Hands-on training: January 3, 6, 8, 9 Hands-on training: January 6, 8, 9, 14
Paoli Go-Live: Jan 20th Riddle Go-Live: January 22nd
Morning In-Service:   January 8th Morning In-Service:   December 11th
Hands-on training: January 9, 14, 15, 17 Hands-on training: January 16, 17, 20, 21

Staff education via in servicing has begun and hands on training will begin January 3rd as outlined above. In addition, clinical resources from Stryker will be on site in all areas impacted throughout go-live and for follow-up support post go-live.

One key workflow change is that all sponges need to be removed from the surgical field and counted into SurgiCount prior to patients leaving the room. This means all sponges must come off of the field versus being thrown away in drapes that may occur in some instances at this time.

We ask your support and patience and we transition to this new technology to improve patient safety.

 

Patrick Ross, Jr., MD PhD – Chair, Department of Surgery

Joseph M. Gobern, MD, MBA, FACOG – Chair, Department of Obstetrics & Gynecology

Sean M. Rowland, CRNA, MS, MBA – Surgical Services Director, Health System

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LIMR innovation will be used to assist global efforts to further eradicate polio

By Donna Loyle, communications specialist, LIMR

Antibodies cloned by a team at the Lankenau Institute for Medical Research (LIMR), the research division of Main Line Health, and colleagues recently were adopted globally as the standard batch quality-control test for Sabin polio vaccines.

This means that, in the future, everyone around the world who gets a polio vaccine will receive doses whose quality and potency has been assured by the work done by LIMR Professor Scott Dessain, MD, PhD, his lab team, and colleagues from the U.S. Food and Drug Administration (FDA) and the Global Virus Network Center of Excellence in Baltimore.

“This important achievement by LIMR’s Dr. Dessain and his colleagues significantly advances worldwide polio-eradication efforts,” said George Prendergast, PhD, president and CEO of LIMR. “Dr. Dessain’s accomplishments in this effort attest to his many years studying methods to clone human monoclonal antibodies for medicinal purposes.”

Following worldwide vaccination efforts in recent decades, the annual number of polio cases has decreased markedly, from about 350,000 in 1988 to only 138 in 2018, according to the World Health Organization. The decrease has been attributed to the widespread administration of inactivated poliovirus vaccines (IPVs).

To meet the world’s ongoing demand for vaccines and minimize risks of reintroduction of wild strains of the poliovirus into circulation, several manufacturers began making IPVs from attenuated (or reduced) Sabin strains of the virus.

“That raised several new challenges,” said Dr. Dessain who serves as director of the Center for Human Antibody Technology at LIMR and holds the Joseph and Ray Gordon Chair in Clinical Oncology and Research. “Immunological differences exist between wild type and attenuated Sabin strains, leading to important questions about how to determine the potency of the new vaccines.”

One complication entails variability among the labs that are testing for vaccine potency, because not all labs use the exact same assay. To solve this challenge, Dr. Dessain and his team set out to select antibodies that would react equally with wild and Sabin strains, so the resulting protocol would be suitable for measuring potency of both conventional IPVs and Sabin IPVs.

Instead of using antibodies derived from mice, as other researchers had done, the Dessain team used human monoclonal antibodies cloned from volunteers who had received polio vaccination and who consented to the study. The antibodies were isolated by Rama Devudu Puligedda, PhD, who works in Dr. Dessain’s LIMR lab.

“Our assay is suitable for use to measure potency of conventional IPVs and Sabin IPVs, each against its own international standard,” explained Dr. Puligedda. “We’re pleased that the monoclonal antibodies we developed can be used to create a sustainable supply of reagents for determining potency of both types of IPV. These reagents harmonize the assay globally and make it unnecessary for every manufacturer to go through the tedious assay development and validation process.”

After identifying a panel of specific antibodies, the Dessain team shared those with Drs. Konstantin Chumakov and Diana Kouiavskaia at the FDA’s Center for Biologics Evaluation and Research, Silver Spring, Md. Dr. Chumakov is an internationally known poliovirus researcher and a member of the Global Virus Network Center of Excellence. Drs. Chumakov and Kouiavskaia have collaborated with the Dessain lab on four published manuscripts in the past six years, and they performed the antibody validation studies reported in the manuscript “Universal ELISA for quantification of D-antigen in inactivated poliovirus vaccines,” published recently in the Journal of Virological Methods.

The antibodies used in the test were cloned at LIMR and will be stored and distributed by the National Institute for Biological Standards and Control (NIBSC) in the United Kingdom. NIBSC plays a leading role in preparing, evaluating and distributing international biological standards and other reference materials, supplying more than 90 percent of these for the World Health Organization. The team’s work was funded by the PATH Foundation, a nonprofit global health organization based in Seattle.

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MLK Day System Wide Celebration

Join us for service events and a live-stream broadcast celebrating the life and legacy of Dr. Martin Luther King Jr.

To view the noontime flyer, click here.

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Remote Access Multi-Factor Authentication Upgrade Coming January 18th

Main Line Health Information Services will be upgrading our Multi-Factor Authentication process that is used to verify users who are attempting to remotely access our systems. Multi-factor authentication sends a random 6-digit code to your registered mobile device when you remotely access MLH systems. The upgrade provides MLH with enhanced security features that support the protection of sensitive MLH data such as clinical, financial, personal and other business information.

The Multi-Factor Authentication upgrade will occur on Saturday, January 18th between 2:00 AM and 6:00 AM.  Remote access will not be available during this time.

After the upgrade, ALL users will be required to re-register their mobile phone number BEFORE their next attempt at getting remote access.  This will impact ALL remote users including employees, physicians, 3rd parties with access including non-MLHC physician practices, and vendors.

View instructions to re-register here.

Please remember, Mobile phones are the only option supported for communication with multi-factor authentication.

More information, including instructions on how to re-register your phone number will be shared closer to the upgrade date.

Thank you for your attention as we work to keep our network secure.

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NRC Health: Ratings and Reviews on MLH.org

By Rick Mankin, MD, President, Main Line HealthCare

Colleagues—I hope your New Year is off to a good start.

The year of 2020 is one that will further put the tremendous expertise and service of our MLHC providers on the map with the implementation of ratings and reviews posted online from Press Ganey data.

Did you ever look yourself up on Google? Discover a rant from an angry or disgruntled patient? We may be appreciated and valued by the vast majority of the patients we touch, but it only takes one unhappy patient to sully a reputation, and those comments can live on in internet perpetuity.

It’s human nature to only “go online” to air grievances and take satisfaction for granted. But these sporadic comments can stand out and draw undue attention, influencing other potential patients indefinitely. It seems particularly unfair when we have objective evidence that we provide excellent service to our patients, from consistently high ratings we receive in our validated Press Ganey surveys. We have no control over reviews posted on third-party sites (Yelp, Vitals, Facebook, Healthgrades, younameit.com). This is one reason why it’s so important to include our very strong ratings and reviews on our website for the public to view.

We have a solution! As part of our commitment to excellence, integrity, and patient centered care, we have partnered with NRC Health to post provider ratings and reviews on our website. Starting in Spring 2020, we are going to use our MLH website to share star ratings derived from our Press Ganey surveys (1-5 star), followed by a selection of actual comments from your patients.

We are going to let all consumers know all the good things our patients have to say about us. Our overall ratings are consistently in the top tier in our market, and our comments are going to help attract new patients. In fact, our ratings are typically very high—with a mean of 4.84  out of a 5 point scale.

We are not the first to use this strategy. It started years ago very successfully with the University of Utah, and now includes Penn and Lehigh Valley locally, and Duke, MD Anderson, Northwell, Inova, Aurora, MedStar (Georgetown et al), and numerous other large group practices around the US. We can anticipate a few likely concerns you may have about this program:

  1. Why post any negative comments?

It’s about credibility. We collect comments every month for each of our providers, and reading them is generally a pleasure, because they accurately reflect your compassion, skills, and professionalism.  No question there are some complaints in there, because we’re not perfect, and our patients are going to tell us when we’ve let them down in some way. But if we are going to share our comments, we need to post a realistic sampling. Nothing turns off patients faster than an artificially curated sample that disingenuously leaves out any criticism. We reflexively ignore such reviews when we see them, and we are more likely to give credence to reviews when they seem to have a full range of comments, without obvious filters.

  1. What about complaints that are simply untrue, or reveal personal health information, or are profane or otherwise inappropriate for public viewing?

In advance, we will share with you all comments proposed for publication. You will have an opportunity to flag any comments that you see as inappropriate for further review. Mind you, not every negative comment is inappropriate, but a committee that includes peer physicians, as well as lawyers, social media and communications leaders and others, will review every one of your objections, and strike comments that do not fit a series of criteria we will establish and share with you. We will not post reviews that are libelous, slanderous or profane or those that risk the privacy of our patients and families.

  1. Why now?

Actually, this is nothing new. Those MLHC physicians currently on ZocDoc already have your reviews published online, and some of our payer partners already collect and publish similar comments on their own web sites. Of course, there are third party web sites (e.g. vitals.com) that are collecting reviews on you and using it for their own proprietary (advertising) purposes. This is simply taking control of the existing environment and using it for our own purposes to promote you and your practice. 

You soon will have the ability to review your comments before they are published via our hosted internal preview environment and monthly StarCard, which you will receive via email next week with instructions on how to access.

 

We invite you to join our Town Halls to learn more details including the way that we will share your patients’ comments with you in advance, the criteria for physician appeals and the composition of the review committee. If you are unable to attend one of the sessions below, we will also share a recording after the fact.

TOWN HALLS:

Thursday, January 30, 7 am in the LMC auditorium (breakfast will be served)

Thursday, January 30, noon, in the RH Vakil Conference Room (lunch will be served)

 

We strive to deliver excellent care and superior service. We have a great story to tell and given that 77 % of consumers begin their health care search online and 88% of consumers trust online reviews as much as personal recommendations, we are committed to adapting to the digital realities of our consumer-driven world and meeting our patients’ expectations. This is one way that we will change, and we welcome your active engagement in this new initiative.

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Important information regarding PAMA and outpatient radiology services

By Don Klingen, MD, CMIO

Some of you may have already received communications from other regional health systems regarding the PAMA act and what’s needed to order outpatient radiology studies.

The Protecting Access to Medicare Act of 2014 (PAMA) introduced a new regulation called the Medicare Appropriate Use Criteria Program (AUC). Effective January 1, 2020, ordering professionals must consult a qualified Clinical Decision Support Mechanism (qCDSM) when ordering advanced diagnostic imaging (CT, MRI, NM, PET) for Medicare Part B beneficiaries.

This year is an educational and testing year, with payment denials to begin promptly in 2021. We are beginning our education and messaging work now to prepare folks for 2021.

Providers who fail to consult a qCDSM, or those who frequently elect to order imaging studies that are considered “not appropriate,” will be evaluated by the Centers for Medicare & Medicaid Services (CMS). Providers who rank in the bottom 5% of ordering professionals will be subject to prior authorization for these services.

Main Line Health has already integrated radiology decision support (ACR select) with the Epic medical record system in our Emergency Rooms and Ambulatory environments for this purpose. We will be sending out a separate communication to those clinicians to give more details on what they need to do.

For independent providers the expectation is that your EMR software would be able to provide the needed decision support codes.

To see if your EMR supports decision support or to find out where to go to access online resources if your EMR does not- see information in the attached FAQ.

CDS FAQ FINAL

This is the first of many communications you will see on this act. Our intent this year is to make folks aware of the requirement and provide education.

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Clinical Trial of the Week: Study to determine if aspirin prevents breast cancer recurrence

By Donna Loyle, communications specialist, LIMR

Can treatment with simple aspirin prevent breast cancer recurrence in patients with node-positive, HER2-negative, stage 2 or 3 breast cancer after chemotherapy, surgery and/or radiation therapy? That’s the question this trial seeks to answer.

Participants receive either aspirin or a placebo orally once daily for five years, as long as the disease does not progress and there is no toxicity.

Inclusion criteria:

  • Must have been diagnosed within the past year and completed chemotherapy, surgery and/or radiation therapy, if applicable.
  • Any ER/PgR status is permitted.
  • Must be able to use acetaminophen, rather than aspirin, for minor pain relief and fever during the trial.
  • Must not be allergic to aspirin.
  • Other inclusion criteria apply; see website for details.

Study #A011502 is approved for all Main Line Health acute care hospitals. The principal investigators are Albert DeNittis, MD, and Paul Gilman, MD. For more, email cancertrials@mlhs.org or visit https://bit.ly/2qq2efw.

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