Lab Link newsletter

View the Winter 2019 issue of the LabLink newsletter:

  • Influenza and respiratory virus testing
  • 2019 Laboratory Satisfaction Survey results
  • Laboratory Service to Home-Bound Patients
  • Short-lived specimens

 

 

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Clinical Trial of the Week: Treatment trial for certain patients diagnosed with stage 3 colon cancer

By Donna Loyle, communications specialist, LIMR

Researchers are testing a combination of chemotherapy with or without the immunotherapy drug Tecentriq® (atezolizumab) in treating patients with stage 3 colon cancer and deficient DNA mismatch repair.

There are two study arms to this trial. Participants in both are administered chemotherapy. Those in Arm 1 also receive atezolizumab.

Eligible patients must not have been treated previously with chemotherapy, immunotherapy, biologic or targeted therapy, or radiation therapy for colon cancer (except for one cycle of mFOLFOX6). Other inclusion and exclusion criteria apply.

This study, #A021502, is available at all Main Line Health acute care hospitals. The principal investigators and Albert DeNittis, MD, and Paul Gilman, MD. For more, visit https://www.mainlinehealth.org/research/clinical-trials/a021502

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New Medical Image Viewer (eUnity) now live – Epic integration coming December 10

To prepare Main Line Health for the deployment of Windows 10, an IT initiative is underway to implement an enterprise image viewer platform (eUnity) which will provide the enterprise with a single image viewing solution for both radiology and cardiology. eUnity enables clinicians to quickly access fully diagnostic quality images from any location, on any device, in real time.

All clinicians are now able to access eUnity in a variety of ways.

  1. If you are on an MLH workstation, you will find an icon on your desktop
  2. By visiting the MLH homepage/Intranet ->Clinical Applications -> Enterprise PACS -> eUnity PACS Viewer
  3. If you are remote, you can log into Citrix at https://access.mlhs.org/vpn/index.html and there you will find a link to eUnity (please note, you will be prompted for Multifactor authentication when you log into Citrix and when you log into eUnity directly)
  4. You can go to the link directly by visiting: https://eunity.mlhs.org
  5. Integration with Epic will be available on December 10, 2019. This will also allow viewing of images through Epic for remote users.

If you require assistance using eUnity, the following resources are available:

  • User Materials:  Tip sheets and training guides are available on the MLH Home Page – Clinical Applications – Enterprise PACS or on the Physicians under the Frequently Used Links on the Physicians Internet page.

If you any questions on this effort, please call the IS Service Desk at 484-596-HELP (596-4357) or HelpDesk@mlhs.org.

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New event reporting system starting Monday, December 2

On December 2, 2019 beginning at 6:30am, Main Line Health is changing software for event reporting. STARS will be sunsetted and replaced with RL Risk.

The new program, RL Risk, will be available on MLH computers under this desktop icon.

Please refer to the attached brochure guide for helpful information when submitting an event (referred to as a “file” in the RL system). There are 2 options for entering a file:

  1. Anonymously – no patient lookup is available; all patient information to be entered manually
  2. Logging into the system with MLH network logon and password—this allows patient lookups by the staff entering the report to save time entering

Additionally, RL Risk offers the following features:

  • All locations are available for any report; locations are not restricted to campus computer IP addresses
  • Staff can save events to complete later (listed as incomplete files)
  • More event types/icons to choose to report

Additional training will be offered this week at all locations, with the exception of HomeCare & Hospice. We look forward to an easier, better process for staff to report events for the purpose of improving our care.

Please contact Anne Marie Browne, director, Patient Safety & Quality, or a member of the Patient Safety team with any questions related to this change.

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Introducing a New Medical Image Viewer (eUnity) – Coming December 3

To prepare Main Line Health for the deployment of Windows 10, an IT initiative is underway to implement an enterprise image viewer platform (eUnity) which will provide the System with a single image viewing solution for both radiology and cardiology. eUnity enables clinicians to quickly access fully diagnostic quality images from any location, on any device, in real time.

All clinicians will be able to access eUnity in a variety of ways.

  1. If you are on an MLH workstation, you will find an icon on your desktop
  2. By visiting the MLH homepage/ Intranet > Clinical Applications > Enterprise PACS > eUnity PACS Viewer
    1. On December 10, a new intranet will be launching. eUnity will be found on the homepage under Resources > Clinical Applications > eUnity PACS Viewer
  3. If you are remote, you can log into Citrix at https://access.mlhs.org/vpn/index.html and there you will find a link to eUnity (please note, you will be prompted for Multifactor authentication when you log into Citrix and when you log into eUnity directly)
  4. You can go to the link directly by visiting: https://eunity.mlhs.org
  5. Integration with Epic will be available on December 10,2019. This will also allow viewing of images through Epic for remote users.

If you require assistance using eUnity, the following resources are available:

  • User Materials:  Tip sheets and training guides are available on the MLH Home Page – Clinical Applications – Enterprise PACS or on the Physicians under the Frequently Used Links on the Physicians Internet page.

If you any questions on this effort, please call the IS Service Desk at 484-596-HELP (596-4357) or HelpDesk@mlhs.org.

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One week left to get your mandatory flu vaccination

The Main Line Health 2019-2020 mandatory flu vaccination program is underway for employees, physicians, specified healthcare professionals and volunteers. Since 2010, MLH policy has required all physicians, specified health professionals, employees, contracted clinical personnel and volunteers to be vaccinated against influenza as a condition of employment or use of MLH facilities.

Vaccinations are free and will take place across MLH until December 2, 2019, which is the deadline for compliance with our flu vaccination policy. Open the PDF to view the complete vaccination schedule.

An MLH badge is required at the time of vaccination.

2019-2020 Flu Schedule

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Proposed Changes to the MLH Medical Staff Rules and Regulations

As per the Medical Staff Bylaws, the following proposed changes to the Medical Staff Rules and Regulations are being communicated to the Medical Staff prior to the Medical Executive Committee voting on the changes at their December 16, 2019 meeting.  The System Medical Records Committee has submitted a recommendation to change the current timeframe for dating and signing Verbal Orders from 24 hours to 7days. If you should have any questions/concerns, please contact Drs. Ned Carp, James Gengaro, or Jon Stallkamp.

Section VII.B.2

All verbal orders shall be entered into the electronic medical record and signed, dated and timed by the appropriately authorized person to whom the order was dictated with the name of the practitioner, certified registered nurse practitioner, physician assistant, certified nurse midwife or resident physician who issued the verbal order.  The practitioner, certified registered nurse practitioner, physician assistant, certified nurse midwife or resident physician who issued the verbal order or a physician familiar/involved with the care of the patient shall verify, sign, date and time promptly but within 24 hours 7 days. The verbal orders by a Certified Registered Nurse Practitioner and Nurse Midwife do not require a physician co-signature. The verbal orders by Physician Assistants are required to be co-signed/countersigned by the supervising physician within 10 days of the original date of the verbal order. by the supervising physician.

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Thomas Oliver, DO, Chief Medical Resident and Hospitalist, Wins in Overall Category at Jefferson Health Hack 2019

By Nicholas Francis, Creative Services

Thomas Oliver, DO, chief medical resident and hospitalist, Lankenau Medical Center, won in “Health by Zip Code” category earlier this month at the 2019 Jefferson Health Hack. Dr. Oliver and his team proposed the creation of a chatbot designed to interact with Oncology patients, called “OncMate.”

OncMate is a patient-centered chatbot that targets vulnerable oncology patients based on unique social determinants of health after they are diagnosed with cancer. OncMate automatically communicates with patients on their cell phone via text messages, providing easy access for all patients—even those without a smartphone. OncMate works in tangent with clinicians to help manage patient’s symptoms and utilizes deep learning and machine learning to predict those most at risk. Overall, the hope is that OncMate can assist and engage our most vulnerable oncology patients whilst helping them achieve a better quality of life.

Dr. Thomas and his team demonstrated OncMate by developing an iOS User Interface, a web application and a sample chatbot.

The purpose of Jefferson Health Hack, hosted by Jefferson Health, is to bring the healthcare community together to discuss and propose tech-related solutions for the challenges of providing high-quality healthcare to vulnerable communities. The conference took place from November 1-3 with 47 teams, and more than 300 people, participating.

Thomas Oliver, DO (center), and his team at the 2019 Jefferson Health Hack

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Clinical Trial of the Week: Device trial for patients diagnosed with tricuspid valve regurgitation

By Donna Loyle, communications specialist, LIMR

 The Edwards Cardioband™ tricuspid valve reconstruction system is being evaluated in an early feasibility study to treat patients with tricuspid regurgitation (TR). Data collected in this prospective, single-arm, multicenter device trial include safety, effectiveness and performance information on qualified subjects for up to five years.

Benefits to this valve reconstruction may be a decrease in tricuspid regurgitation, alleviation of symptoms related to tricuspid insufficiency, and/or improved morbidity and mortality.

Eligible patients include the following:

  • Must have been diagnosed with chronic functional tricuspid regurgitation (deemed moderate or greater)
  • Must be symptomatic despite medical therapy including treatment with a diuretic
  • Must be younger than 91 years old
  • Must have tricuspid valve anatomy appropriate for device deployment and function

Other inclusion and exclusion criteria apply.

The Main Line Health principal investigator for the Cardioband TRICUSPID EFS study is William A. Gray, MD, and it is approved for Lankenau Medical Center. For more, visit https://www.mainlinehealth.org/research/clinical-trials/cardioband

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Greater clinical surveillance recommended for younger African American women presenting with cardiac events

African American women younger than 50 years old and who were diagnosed with acute myocardial infarction (AMI) had markedly higher rates of hyperlipidemia, hypertension, acute renal failure and type 2 diabetes than their white female counterparts, noted the authors of a recent study of Main Line Health’s four acute care hospitals.

The researchers’ aims were to 1) characterize patients who had been diagnosed with AMI and were discharged from Main Line Health’s emergency departments (EDs) and inpatient care; and 2) to investigate the care pathways female patients, in particular, received in Lankenau’s ED. The study was conducted by investigators in the Main Line Health Center for Population Health Research (CPHR) at Lankenau Institute for Medical Research and Lankenau Heart Institute’s Women’s Heart Initiative program.

Cohort study

The researchers performed a cohort study of all adult patients discharged from Main Line Health’s acute care hospitals between October 2015 and March 2018. They found that about 60 percent of the 3,729 AMI cases were male, and on average, younger than females (72 vs. 78 years). Among those younger than 50 years old, only 50 percent of women and 53 percent of men received orders for a cardiac consult.

The study also found that among women in the younger-aged group, African American women had higher rates of hyperlipidemia (50% vs 40%), hypertension (59% vs 40%), acute renal failure (27% vs 16%), and type 2 diabetes (41% vs 16%) than their white female counterparts.

“Given those results, care providers should consider giving greater surveillance to younger African American women who present with symptoms of a cardiac event,” said Justin Beaupre, EdD, the lead author of the study and a postdoctoral fellow at CPHR. “We found that these female patients are very likely to have comorbidities that require clinical attention.”

Chart review

The study also included a chart review of all adult female patients who came to Lankenau Medical Center’s ED with symptoms suggestive of a cardiac event. The researchers compared the care pathways to age- and race-matched male controls.

“We found that Lankenau’s ED does an exemplary job of ensuring there are no disparities among patients in services provided, such as ECGs, chest X-rays and troponin tests,” said Maribel Hernandez, MD, of the Lankenau Heart Group. “That was a great finding, and we applaud our ED practitioners for their continued diligence in ensuring high-quality cardiac care is delivered to Main Line Health patients.”

The authors presented their results in the abstract “Characteristics of patients diagnosed with acute myocardial infarction within a community health system” at the American Public Health Association’s recent annual meeting held this past month in Philadelphia.

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