 mory physicians are trying to fill a critical lack of donor organs by using an extracorporeal liver assist device (ELAD) that keeps patients alive until donor organs become available.
ELAD was a lifesaver for a 31-year-old Marietta man -- the first patient in the Southeast and the eighth in the nation to be connected to the new device now in Phase I clinical trials at Emory. Marc Mitchell was admitted to Emory Hospital in April after suffering from flu-like symptoms which unexplainedly developed into liver failure. "They told me that without that machine I had only a 1 in 1,000 chance of surviving," he remembers. He was on ELAD for 26 hours before receiving a liver transplant. This artificial liver works much like a kidney dialysis machine. It pumps the patient's plasma, which it separates from the blood, through an external canister. In it, millions of human liver cells perform all the functions of the real organ, including filtering the blood and producing clotting factors. "By using these liver cells, we can keep someone in liver failure in viable condition until he or she can get a donor liver," says transplant surgeon Thomas Heffron. With ELAD, the patient's brain and organs can be protected for up to 10 days, giving time for the liver to recover or for the patient to find a donor organ. Time is what most patients with organ failure need. Last year, more than 4,000 people died while waiting for donor organs. That number is expected to rise as more people need organs while the number of donors remains static. In two years, 40,000 people may need livers, says Heffron, but only 6,000 will be available. ELAD may help balance the ledger. |
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mory Healthcare is teaming with four other academic centers to launch a web-based e-healthcare venture that will provide evidence-based clinical guidelines for treating more than 400 medical conditions.
The start-up company, known as WebEBM (the last three letters stand for evidence-based medicine), is assembling guidelines written by faculty from Emory, Duke, Vanderbilt, Washington University (St. Louis), and Oregon. Clinical advisers from Emory are William Bornstein, chief quality officer and associate administrator of Emory Hospitals, and Kimberly Rask, assistant professor of medicine and health policy and management. Over the next three years, they will recruit faculty authors for about 100 guidelines, 40 of which will be launched later this year. Emory faculty and staff will have access to the guidelines for possible use in their practice and by their patients. Organizations licensing the WebEBM product will make it available to physicians and other health care providers and their patients. Patients referred to the site by their physicians will be able to see the recommended guidelines used by physicians and an easy-to-read and understand patient/consumer version of the same guideline. "And as the evidence mounts or changes, the Internet platform will allow us to update the guidelines almost immediately," says Rask. A mechanism for patients to provide feedback will allow physicians to compare their patient outcomes with other practices as a way of continually improving care. For more information about WebEBM, see www.webebm.com. |
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 n July, Atlanta Habitat for Humanity turned over the keys to the house that radiology built to new home buyer, Dorothy Crutchfield, and her 17-year-old daughter, Temika. The School of Medicine's department of radiology underwrote $45,000 of construction costs and provided as many as 35 volunteers, including department chair William Casarella, for seven Saturdays this summer. The project began last October, when radiology faculty, residents, and staff passed on their annual Christmas party to donate the initial fund-raising gift through monies raised at a silent auction. Contributions continued to roll in throughout the year through individual donations from a "buy a brick" campaign. |
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 atients and staff at Wesley Woods Hospital should see more patient flow between hospitals now that the long-time Emory neighbor is integrated into Emory Hospitals. The move, effective June 1, is designed to help the geriatric hospital weather the most challenging economic times it has ever faced.
Sweeping changes in reimbursements have hurt hospitals nationwide but disproportionately hit Wesley Woods Hospital, where most patients are senior citizens on Medicare. After a painful $4.2 million deficit last year, system-wide efforts to enhance how patients flow to Wesley Woods within the Emory Healthcare system, improved patient case management, and aggressive efforts to improve efficiency contributed significantly to reducing the rate of loss in FY2000 by almost $3 million. Fully integrating Wesley Woods Hospital with Crawford Long and Emory University hospitals will improve efficiency and effectiveness of care in all three hospitals, which are under the direction of Emory Hospitals CEO John Henry. Costs should go down by eliminating duplication and standardizing supplies, policies, and procedures. Emory wants to do more than create savings from the consolidation, however, says Michael Johns, executive vice president for health affairs. "We want to improve the continuity of care for patients at Wesley Woods and within Emory Healthcare, work better together as a family of institutions, and maximize Wesley Woods' potential." The mission of Wesley Woods will not change, according to John Fox, president of Emory Healthcare. The hospital will continue to focus on the complex needs of frail elders who have multiple diseases and conditions that are often difficult to diagnose and manage. |
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mory Hospital is one of only five medical centers in the country using the GliaSite Radiation Therapy System (GliaSite RTS) to control brain cancer. The results are promising.
The first patient to have the procedure is undergoing outpatient rehabilitation for the brain injury caused by the tumor itself. No unusual side effects have been noted in three patients treated to date, says neurosurgeon Jeff Olson, who is working with radiation oncologist Ian Crocker in a safety trial for the new therapy. "One patient, however, has succumbed, a not unexpected event in this difficult group of patients." The GliaSite RTS places high-dose radiation directly into the tissue likely to contain residual cancer cells following tumor removal. A temporarily implanted balloon-tipped catheter delivers site-specific internal radiation with limited exposure to healthy brain tissue. The internal radiation inhibits tumor regrowth by injuring tumor cells and impairing the cells' ability to reproduce. "At the time the tumor recurs, treatment options can be limited because of prior radiation and chemotherapy," says Olson. "The GliaSite RTS offers a simplified, alternative method of delivering intense local doses of radiation to recurrent malignant brain tumors." The GliaSite RTS device is implanted when the tumor is removed and is later filled with a liquid radiation source. The catheter is removed within three to seven days. The procedure uses minimal surgical intervention and offers a less disruptive option to the patient and an opportunity to avoid the side effects associated with chemotherapy. "This device has provided the patient and family an additional period of disease control," says Olson. "But more important, hope." |
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 omponents of the Woodruff Health Sciences Center continue to shine. Most recently, Emory University Hospital (EUH) scored high in eight of 17 medical specialties ranked in U.S. News & World Report's best hospitals issue.
EUH's cardiology program, ranked ninth, has been among the top 10 programs in the nation since U.S. News began ranking hospitals in 1990. This year, Emory is the only hospital in Georgia and the Southeast included in the top 10 in cardiology. Ophthalmology, one of the few specialties ranked entirely on reputation, rose from 10th in 1999 to eighth in 2000. In the magazine's first rankings of hospitals treating kidney disease, EUH came in 13th. Also highly regarded were EUH's programs in urology (18), neurology/neurosurgery (25), geriatrics (31), gynecology (34), and gastroenterology (37). Most of the programs are ranked with a system that combines reputation among specialists with death rates and other measures that physicians and social science researchers believe reflect quality of care. These rankings also reflect the strengths of Emory Healthcare as a system. The School of Medicine placed 19th among the nation's medical schools in U.S. News' annual ranking of graduate and professional schools. Emory moved up a notch from last year in student selectivity and reputation by residency directors. The school's physical therapy and physician assistants programs were ranked third and fourth in the nation, respectively. At the Veterans Administration Medical Center (VAMC), where Emory physicians practice, teach, and conduct major research, the multidepartmental research program ranked 11th among 106 VA medical centers for FY99. The VAMC program includes more than 200 projects conducted by 88 principal investigators. |
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 ice president and presidential candidate Al Gore pledged to double the national investment in cancer research over the next five years. In his June visit to Emory, Gore called for greater access for cancer patients to prevention and treatment, including full Medicare coverage for cancer screenings. He proposed a national initiative to detect and treat colon cancer early, to encourage paid time off for cancer screenings, and greater access to clinical trials
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magine the frustration of making a reservation at a hotel, expecting a bed after a long day on the road, only to be told "sorry, you'll have to wait" because the previous guest hasn't vacated.
A similar scenario often plays out at Emory University Hospital (EUH). Unlike a hotel, at a hospital it's hard to predict how long a patient will need a bed. Patients checking in for scheduled procedures often have to wait for a bed to free up. The result is disgruntled patients and strained EUH staff. The goal of the new care initiation unit (CIU) at EUH is to alleviate long waits. The brainchild of the admission discharge and transfer task force, the 17-bed unit - with nine beds dedicated to care initiation and eight for overflow patients - can now accept any patient with doctors' orders for routine lab work, x-rays, nutrition, or medication. When a patient checks into the CIU, one of the newly recruited 10-member staff enters him into the admissions database, so ancillary services can begin tests and provide other services before the patient reaches his final destination. That wasn't possible when patients were stuck in an anonymous waiting room. Because the CIU takes over these duties, it not only speeds the admissions process but takes away additional responsibilities from the floor where the patient is finally destined. "So far, the response has been fantastic," says Jane Vosloh, director of nursing for perioperative services at EUH. "We've exceeded our expectations. Doctors and patients alike say less time is wasted. Patients and their families are more comfortable waiting in a private room with the comforts of television and the attention of a nurse. "The barometer for admissions backup used to be the coffee and cookie cart that comes out when patients and families have been waiting there a long time," Vosloh notes. "One admissions staffer told me she hadn't seen that cart in a long time." In fact, patient intake time is down from as long as two to four hours to 51 minutes from admissions to the CIU. The ultimate goal, of course, is to make admissions even faster. Because the project's success depends on receiving patients with doctors' orders, the unit works closely with physician groups to fast-track patients to the CIU. New clients of the CIU include patients needing renal transplant evaluations, vascular and neurology patients, and direct admits from the ER. As doctors are becoming more familiar with CIU services, the unit has experienced steady growth since opening in February. Vosloh hopes that the renovated Crawford Long Hospital will have room for its own CIU. |
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 t a time when most hospitals in the country are struggling with spiraling drug costs and deep federal budget cuts, Grady Health System has saved more than $44 million on operations since 1997. In a recent report from the senior partner of Deloitte Consulting, one of the nation's top firms, Grady received an "A" for hospital management.
The savings is $12 million more than APM, another top consulting firm, thought possible just three years ago when it gave Grady a B+ rating. Grady today leads the nation in most benchmark measures for large public hospitals and locally ranks in the top quartile for cost-effectiveness and labor productivity. Emory's 85-year affiliation with Grady is key to many of the university's teaching and research programs. Emory faculty, residents, and medical students are responsible for providing most medical care at Grady. (See "The Grady Crunch," Winter 2000 Momentum.) |
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n the first major joint venture of Emory and HCA (formerly known as Columbia/HCA) since they allied a year ago, Emory Peachtree Regional Hospital is seeking state approval to build a new $65-million facility in Newnan. Emory and HCA would share the cost of the facility, which would replace the current hospital.
The new 118-bed hospital, located about 3.5 miles from the current facility in fast-growing Coweta County, would be more convenient for outpatients in particular, says Emory Peachtree CEO Linda Jubinsky. Currently, more than 40% of Coweta County residents go to hospitals out of the county for care. Emory Peachtree provides the area's only obstetrical labor and delivery services, 24-hour emergency services, workplace health programs, and outpatient testing, diagnostics, and surgery. When the current 143-bed facility opened nearly 40 years ago, inpatient stays were the norm. Today, advances in technology and medicine offer more patients convenient outpatient services, which the hospital plans to offer in a patient-friendly setting. Renovating the existing facility would cost almost as much as building a new hospital. With state approval, groundbreaking for the new facility is planned for late this year, with an opening date targeted for spring 2002. It will be located on a 24-acre site, one mile west of I-85, on Bullsboro Road. |
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number of new Georgia laws effective July 1 are expected to have immediate health care implications for Emory.
Perhaps the most important is House Bill 1300, says Betty Willis, associate vice president, government and community affairs. It responds to the pharmaceutical industry's concern that a 1999 law protecting confidential raw research data from litigation would actually prohibit research. HB1300 stipulates that the earlier law applied to research affected by litigation only and not day-to-day operations of clinical trials. (See "Getting into the act...and the act into law," Winter 2000 Momentum). A number of other new measures became law this summer:
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Web version by Jaime Henriquez.