Expanding Access

Car Clinics: The Dual Benefit of Drive-Through Care

Posted on Mar 17, 2020 in Carousel, Expanding Access, Innovation, Palo Alto Medical Foundation, Quality, Safety, Scroll Images, Uncategorized

Power, data cables and sanitation supplies topped Raymond Fellers long list.

No, Fellers wasn’t preparing to isolate during the COVID-19 outbreak—quite the opposite—he was opening the first ever “car clinic” at the Palo Alto Medical Foundation’s San Carlos Center. One of several across the Sutter network, the car clinic is designed as an in-person option for PAMF patients with serious respiratory symptoms who have already talked to a provider by phone or video visit.

“We’re solving two problems at once,” said Dr. Rob Nordgren, M.D., MBA, MPH and area CEO of PAMF peninsula region. “By keeping potentially contagious people in their car it means that doctors can assess and treat their symptoms, while minimizing exposure to patients who need routine or urgent care inside the medical facility.”

Making use of a covered garage, a procession of patients – each in their personal car – flowed through a series of stations that comprised the clinic. Every station had a laptop connected to Sutter’s electronic health record and the basic medical equipment you’d find in a regular exam room. A portable X-ray machine was even set up outside to help diagnose lung infections.

Arnold Layung, a licensed vocational nurse who usually sterilizes instruments during surgery, brought his sanitation skills to the car clinic.

“The key here, just like in the operating room, is to have one person per job so no steps are missed,” remarked Layung as he disinfected stethoscopes and other equipment after each use. Filling the role of medical technician, Layung was paired with a physician and registered nurse to form a three-person team—each in full gowns, goggles, gloves and masks—who saw patients through their open car window or in a chair just outside their vehicle.

With a background in emergency medicine, Dr. Nathan Bornstein knows the importance of conserving hospital capacity for those with acute illness. “My job out here is to find the people who need to be escalated to a higher level of care, while also helping people manage serious symptoms so they can safely return home,” he said.

Many of the patients who came through the car clinic had existing respiratory conditions, like asthma, which make them prone to serious breathing difficulty if their lungs are put under added strain. For these patients showing symptoms of a virus, Dr. Bornstein ordered a flu test. In accordance with Centers for Disease Control and Prevention guidelines, Dr. Bornstein also collected samples for COVID-19 testing from symptomatic patients in high-risk groups, such as those with certain pre-existing conditions, epidemiologic or social risk factors.

Dr. Bornstein listened to each patient’s lungs, and if indicated, ordered X-ray or CT scans to detect infection. Finally, Dr. Bornstein reviewed current medications to determine if a dosage change or new prescription would help ease a patient’s symptoms enough to keep them out of the hospital.

Every person had their temperature, respiration rate, heart rate and oxygen saturation checked and each left with a personalized plan for what to do if their symptoms worsened.

PAMF’s San Carlos Center is one location within Sutter Health’s integrated network that supports car clinics. This service is not available in all locations, nor is it open to the general public.

Sutter encourages patients who feel ill to schedule a video visit or call their doctor to receive guidance. If one’s symptoms are mild to moderate, they are encouraged to stay home to rest, get well and prevent exposure to others.

For more information about COVID-19, please visit Sutter Health’s resources page.

Live Oak Health and Housing Campus Moves Closer to Reality

Posted on Mar 6, 2020 in Carousel, Community Benefit, Expanding Access, Scroll Images, Sutter Maternity and Surgery Center, Santa Cruz, Uncategorized, Wellness

Courtesy of Santa Cruz Community Health and Dientes Community Dental Care.

SANTA CRUZ, Calif. — Santa Cruz Community Health (SCCH) and Dientes Community Dental Care (Dientes), today announced a $1 million dollar investment from Sutter Health to support the construction and operation of a 19,000-square-foot medical clinic to be run by SCCH and 11,000-square-foot dental clinic to be run by Dientes on the future site of a health and housing campus that will benefit the Live Oak community.

Rendering of the Santa Cruz Community Health medical clinic.

An Investment in Infrastructure

The future site of the health and housing campus is the ideal location for much-needed services. Supervisor John Leopold notes, “Five years ago there were no medical offices in Live Oak. A community of our size needs good access to medical and dental services and housing that is affordable to all families. This new development will help everyone in the community from small children to families to seniors.” The campus – the first of its kind in Santa Cruz County – will integrate the strengths and services of its three owners:

  • SCCH has been serving the medical and mental health needs of underserved Santa Cruz County residents since 1980, with a special focus on families.
  • Dientes has an over 25-year track record of providing affordable, high-quality and comprehensive dental care through three existing clinics and an outreach program.
  • MidPen Housing, already owns and manages 13 affordable housing communities in Santa Cruz County, providing residents with supportive services.

“Planning for this project started in 2017, and I’m so pleased we are starting to secure large contributions that will make construction possible,” said Dientes CEO Laura Marcus. “Sutter Health has a proven track record of improving the health in this region, so it was no surprise that the not-for-profit system that includes Palo Alto Medical Foundation stepped up to help. This is truly a remarkable demonstration of how we can collaborate for the overall good of our community.”

Sutter Health has committed $1 million dollars, over five years, to the construction and operation of both clinics on the campus. SCCH will receive $160,000 and Dientes will receive $40,000 each year through 2023.

“As a not-for-profit health network, Sutter focuses on improving the health of those inside and outside the walls of our hospitals and care centers,” said Stephen Gray, chief administrative officer for Sutter Maternity & Surgery Center of Santa Cruz and operations executive of Palo Alto Medical Foundation Santa Cruz. “We know that when people have access to preventive screening and routine healthcare, their health improves. This investment builds on Sutter’s commitment to improve the health of the entire community we serve.”

Rendering of the Dientes Community Dental Care dental clinic.

Capital Campaign is Ongoing

“Projects like this one can transform communities. This initiative will bring affordable healthcare and housing to the heart of Live Oak – providing a lifeline to families, adults and seniors,” said SCCH CEO Leslie Conner. “We hope the early funding we’ve secured will be a catalyst for more donations in the coming weeks and months.”

The integrated, state-of-the-art health and housing campus will address a triple-goal of increasing access to healthcare, growing affordable housing, and creating economic opportunity. The project will provide health services to 10,000 patients annually and affordable housing for 57 households. In addition, it will create more than 60 new jobs.

Dientes and Santa Cruz Community Health will break ground on their clinic in 2020 and open in 2021. MidPen will break ground on the housing component in 2021 and open in 2022.

Renderings, photos and more information about the project is available here

Big Steps Toward Early Cancer Detection

Posted on Feb 18, 2020 in Affiliates, Expanding Access, Innovation, Quality, Research, Scroll Images

SACRAMENTO, Calif. – Cancer researchers worldwide seek new clues to aid early detection and better treatments for cancer. The future is now, however, as research to support the development of a blood test for the detection of multiple types of the disease is underway at Sutter.

cancer blood test

Last month, Sutter began inviting eligible patients into the PATHFINDER clinical study. Sponsored by GRAIL Inc., the PATHFINDER study will evaluate the diagnostic capabilities of an investigational, multi-cancer early detection blood test. Sutter also helped support the development of GRAIL’s early cancer detection test by participating in the ongoing STRIVE study, which closed to enrollment at Sutter in 2018.

The goal of the PATHFINDER study is to enroll patients across eight sites at Sutter, currently the only health system in California participating in the multicenter PATHFINDER study. Other sites across the U.S. include Intermountain Healthcare, with additional centers launching this year.

While blood tests to detect or monitor cancer progression are not new, existing cancer tests typically screen for one type of cancer (e.g., breast cancer) and must be used with other screening tools . The PATHFINDER study is assessing whether GRAIL’s blood test will help aid early detection for multiple types of cancer with a single blood draw before symptoms present. The study will evaluate the implementation of the investigational test into clinical practice, and marks the first time results will be returned to health care providers and communicated to study participants to help guide diagnosis.

If the investigational test detects a cancer signal, it is designed to identify where in the body the cancer arises from, to inform the appropriate diagnostic next steps confirming if cancer is present.

Charles McDonnell, M.D., FACR

“Insights from the PATHFINDER study may improve how we screen for cancers and expand the types of cancer for which we can screen. Sutter’s participation in this study could help pioneer breakthroughs in early detection that may help save lives around the world,” says Charles McDonnell, M.D., FACR, a Sutter radiologist in Sacramento and lead principal investigator for the study at Sutter.

Dr. McDonnell and Andrew Hudnut, M.D., a family medicine doctor in Elk Grove, saw the potential and importance of the STRIVE study. They were instrumental in securing Sutter as a site for PATHFINDER.

“We anticipate this trial may allow us to personalize cancer screening and may eventually enable earlier, safer care for those patients found to have cancer,” says Dr. Hudnut.

During the PATHFINDER study, blood samples will be collected from eligible Sutter patients who consent to participate in the study. Blood samples will be analyzed for small pieces of the tumor’s DNA (i.e., its genetic “code”). If a study participant is diagnosed with cancer, the participant will be counselled on the results of their blood test and followed during workup to diagnose their cancer. There will be 12 months of follow-up for all participants.

PATHFINDER AT-A-GLANCE:

  • Study participants who are diagnosed with cancer will have their study test results communicated to them by qualified, Sutter clinical research staff and PATHFINDER study physicians. Participants will also receive e-mails and newsletters with information about follow-up appointments and study milestones.
  • The PATHFINDER study is part of Sutter’s coordinated efforts to improve cancer research and treatment outcomes for patients. Sutter also participates in large, phase 1-3 national clinical studies sponsored by the National Cancer Institute (NCI) and collaborates with pharmaceutical companies on cancer research.

Early cancer detection may be part of the “holy grail” for cure. Find out how you can help! Learn more about PATHFINDER by contacting the study team at pathfinderstudy@sutterhealth.org or call 916-746-2161.

Find more clinical trials and research at Sutter.

To Prevent Stroke, Start with the Heart

Posted on Feb 13, 2020 in Affiliates, Cardiac, Carousel, Expanding Access, Innovation, Mills-Peninsula Health Services, Neuroscience, Quality, Research, Scroll Images, We're Awesome, Women's Services

BURLINGAME, Calif. – Does it sometimes feel like there are butterflies in your chest? Does your heart race or skip a beat? If it’s not your crush making your heart go pitter-pat, it could be a common heart condition called atrial fibrillation or AFib for short. This Valentine’s Day, take heart and consider seeing an expert if you are experiencing these symptoms. After all, AFib dramatically increases the odds of having a life-threatening stroke.

“Stroke occurs when arteries in the brain are either blocked by a blood clot or burst under high pressure,” said Ilana Spokoyny, M.D., neurologist who cares for patients at Sutter’s Mills-Peninsula Medical Center. “So when we talk about stroke prevention, it’s natural that we emphasize how to keep clots from forming or keep blood pressure regulated—and both start with the heart.”

Heart health and stroke prevention were the focus of a recent educational event, hosted by United Airlines, and led by Sutter Health. Attendees toured Northern California’s only Mobile Stroke Unit – a specialized ambulance that has the staff and equipment on-board to start stroke treatment while enroute to a hospital – and heard from the unit’s director, Dr. Spokoyny, about two common heart conditions that increase stroke risk.

Atrial fibrillation

AFib is caused when the upper part of your heart beats out of sync with the lower half. While not usually life-threatening by itself, AFib alters the normal function of the heart which leads to the formation of blood clots in the heart. Eventually these clots are pumped out of the heart and can travel to the brain where they causes a stroke.

According to Dr. Spokoyny, nearly one in every six strokes is the result of AFib, and these strokes are often more serious. “Not only are AFib patients nearly five times more likely to suffer a stroke than those without the condition, AFib-related strokes are nearly twice as fatal and twice as disabling as non-AFib-related strokes.”

“AFib may be asympomatic or symptoms show up intermittently, and because they come and go many people don’t take them seriously,” Dr. Spokoyny explained. “We need to spread the word that you shouldn’t ignore the butterfly feeling in your chest or dismiss the occasional fatigue or shortness of breath you experience.” When diagnosed, AFib is treatable with medication or medical procedures, including surgery, to reduce your risk of stroke.

High blood pressure

High blood pressure increases the strain on blood vessels transporting blood throughout your body. When blood is routinely pumped through arteries at a higher than optimal pressure, the arteries may become weakened or narrowed, creating conditions where they burst or clog more easily.

Dr. Spokoyny reminds patients that high blood pressure is the single most important risk factor for stroke. “About three out of four people who have a stroke for the first time have high blood pressure.” High blood pressure often presents along with atrial fibrillation. The good news is that blood pressure can be managed with lifestyle changes and medications.

Expertise in action

Not-for-profit Sutter Health encourages doctors to work across specialties to ensure that patients receive high quality, coordinated care. Sutter includes sixteen Primary Stroke Centers across its integrated network.

Helping Mind the Gap on Cardiovascular Diseases

Posted on Feb 7, 2020 in Alta Bates Summit Medical Center, California Pacific Medical Center, Cardiac, Expanding Access, Innovation, Quality, Research, Scroll Images, Sutter Medical Center of Santa Rosa, Sutter Medical Center, Sacramento, Sutter Medical Foundation, Sutter Roseville Medical Center

Heart valve imaging
Heart valve imaging

Lifesavers appear in big sizes and small. For patient Adam Livingstone, rescue was a dime-sized clip that restored his heart’s normal rhythm and size. For months, Livingstone had been experiencing shortness of breath, chest pain and fatigue. Diagnosed with mitral valve regurgitation, a minimally invasive procedure to repair the valve was performed at Sutter Medical Center, Sacramento—one of Sutter’s sites where researchers evaluate new devices for treating damaged or diseased heart valves.

The Heart’s Finely Orchestrated Blood Flow

Heart valves
Heart valves

Like a musical conductor, the heart oversees rhythm and flow, circulating blood to each of its chambers in a coordinated, unidirectional symphony.

THE MITRAL VALVE

Mitral regurgitation, the most common type of heart valve disorder, occurs when blood leaks backward through the mitral valve when the left ventricle closes.

Some patients undergo non-surgical heart valve repair with transcatheter mitral valve repair (TMVR) with MitraClip®.2 During the procedure, doctors thread a catheter into a large leg vein reaching the heart. Then a dime-sized clip clamps the improperly working valve, allowing it to close more tightly with less backward blood flow.

“Some research participants recover faster and resume normal activities within a week of the procedure, and may not require lifelong anticoagulant medications, repeat surgeries, or re-hospitalization,” says David Roberts, M.D., FACC, FSCAI, medical director of cardiovascular services at Sutter in the Valley Area.

A new clinical trial at Sutter called PASCAL CLASP IID/IIF will test the safety and effectiveness of TMVR with the PASCAL Transcatheter Valve Repair System® compared with MitraClip® in patients with mitral regurgitation.3

For patients with severe mitral regurgitation, Sutter’s CPMC seeks to enroll patients in a clinical trial called SM3, which assesses the safety and efficacy of the SAPIEN M3 System™.4

“In this study, we are evaluating a new type of mitral valve that may provide a minimally invasive alternative to surgery for high-risk patients with severe mitral valve disease,” says David Daniels, M.D., co-director of Sutter’s Structural Heart Program in the Bay Area, and principal investigator of the SM3 clinical trial at Sutter.

Some patients develop mitral valve disease when calcium deposits accumulate on the fibrous ring attached to the mitral valve leaflets. For these patients with mitral annular calcification (MAC), Sutter will begin offering enrollment in the Summit clinical trial, which will test the safety and effectiveness of the Tendyne™ transcatheter mitral valve.5

“Previous approaches to treat patients with MAC have mainly involved the off-label use of transcatheter aortic valves,” says Dr. Roberts. “But this strategy may lead to residual mitral regurgitation and the need for open-heart surgery. Sutter’s participation in Summit may lead to novel ways to care for this hard-to-treat subset of patients.”

THE TRICUSPID AND AORTIC VALVES

Although a skilled conductor, sometimes the heart needs help to maintain proper blood flow for musical perfection. To the rescue: Sutter researchers test interventional devices designed to treat patients with diseased or damaged tricuspid and aortic valves.

In one new clinical trial, Sutter researchers will collect information about treatment for severe aortic regurgitation, a condition typically treated with aortic valve replacement surgery.

This study will examine the use of TAVR (Transcatheter Aortic Valve Replacement), a minimally invasive procedure designed to replace the aortic valve inside the heart. In this study, TAVR will be performed using the JenaValve™ Pericardial TAVR System, designed to help treat patients with severe aortic regurgitation or severe aortic stenosis.6

“Until now, all commercially available TAVR valves have focused on aortic stenosis, or a restricted valve,” says Dr. Daniels, co-principal investigator of the TAVR with JenaValve™ clinical trial at Sutter. “The JenaValve™ may allow researchers to treat patients with a leaky valve in the absence of any calcium. Currently these patients are only candidates for open-heart surgery.”

Additionally, Sutter researchers at CPMC and Sutter Medical Center are seeking to enroll patients who have tricuspid regurgitation in a clinical trial called TRILUMINATE.

The TRILUMINATE study will evaluate the safety and effectiveness of the Tricuspid Valve Repair System™ (TVRS) for treating moderate or severe tricuspid regurgitation in patients currently on medical management and who are deemed appropriate for percutaneous transcatheter intervention.7

  • Learn more about Sutter cardiovascular diseases research and clinical trials.
  • If you are suffering from mitral or tricuspid valve regurgitation, aortic valve stenosis or other heart valve disorder, talk to your cardiologist to see if research participation and/or valve replacement or repair is right for you.

References:

  1. American Heart Association.
  2. MitraClip™ is manufactured by Abbott Medical Devices.
  3. The PASCAL clinical trial is sponsored by Edwards Life Sciences, makers of the Transcatheter Valve Repair System®.
  4. The S3 clinical trial is sponsored by Edwards Life Sciences, makers of the SAPIEN M3 System™.
  5. The Summit clinical trial is sponsored by Abbott Medical Devices, makers of the Tendyne System™.
  6. The JenaValve™ clinical trial is sponsored by JenaValve Technology, Inc., makers of the Pericardial Transcatheter Aortic Valve Replacement (TAVR) System.
  7. The TRILUMINATE clinical trial is sponsored by Abbott Medical Devices, makers of the Tricuspid Valve Repair System™.

Sutter Health and Lyft Collaborate to Provide Patients and Staff With Improved Transportation Options

Posted on Jan 13, 2020 in Expanding Access, Innovation, Scroll Images

Collaboration increases access to care and enhances patient/provider experience

SACRAMENTO, CALIF. AND SAN FRANCISCOLyft, the transportation network company, and the not-for-profit network Sutter Health are collaborating on an opportunity to help support patient and staff transportation needs. Starting today, Sutter hospitals and care centers around Northern California will have the option to start implementing customized, individual transportation programs — an important next step in simplifying access to care.

How clinical staff get to and from work isn’t always considered when evaluating pain points within a workflow, but it plays an important role in health care delivery. Sutter recognized this when looking for ways to better support its home health care teams, who can use their own vehicles to travel to and from patient homes. As an alternative, Lyft can arrange transportation for Sutter home health providers who support patients with needs ranging from wound care, physical therapy or nutritional support. This arrangement can help maximize a clinician’s time with each patient, while also saving wear and tear that comes with using a personal vehicle for work.

“We are reimagining the ways we provide and deliver care, which includes increasing access to services and making them more convenient,” said Chris Waugh, chief innovation officer for Sutter Health. “For some, it’s not as simple as traveling from Point A to Point B. There are numerous real-world factors in between. Our approach takes the burden away from our patients and staff, and puts them in the best position to receive the care they need or deliver the care they are trained to give.”

Sutter and Lyft were able to test several transportation scenarios through previous pilot work over the course of the past couple of years. Several examples, below, resulted in increased efficiencies, including faster, more reliable pick-ups, lower costs, and an understanding of the unique needs of a healthcare environment.

Reduced wait times: At Sutter’s California Pacific Medical Center Pacific campus, patients discharged from the emergency department were offered a ride to a location of their choice. In three months’ time, the program reduced wait times from an average of 23 minutes to three minutes.
Cost savings: The pilot achieved a cost savings of approximately 25% compared to other transportation services previously used.
Greater transportation efficiency: Ambulatory surgery center staff throughout Sutter’s Palo Alto Medical Foundation were able to more easily transport staff between care centers as compared to services previously used.

“At Lyft, we’re committed to improving access to care while also increasing operational efficiencies and driving down costs for medical providers. Sutter’s headquarters in Northern California are home to some of the greatest diversity in the nation – socioeconomic, ethnic and geographic – resulting in an incredibly unique set of transportation challenges for both patients and staff. We’re looking forward to a continued partnership that allows us to provide innovative transportation options that make an impact in urban, suburban and rural settings alike. Pilot results have already shown reduced wait times and improved rider experience,” explained Megan Callahan, VP of Healthcare at Lyft.

The diverse needs of Sutter’s patient and staff call for flexible options, and this partnership with Lyft allows different care sites to customize their rideshare services to best support their communities.

For example, in more rural areas where transportation options historically aren’t as reliable, patients can count on rides to and from chemotherapy, radiation or dialysis appointments. In cities, Sutter staff can take a Lyft ride from public transit centers to Sutter care centers as an affordable alternative to parking. This allows Sutter to positively impact social determinants of health – notably, making care more accessible through transportation and increasing opportunities for patients to get the treatment they need.

“We’re excited for how these results will interplay,” said Waugh. “We believe they can help spur fundamental change on a macro level, and also help relieve stress and create comfort for individuals on a micro level. Big or small, these shifts can help create a more meaningful experience that gives patients the opportunity to stay on track with their care plans.”

Forward-Looking Statements 

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements generally relate to future events or Lyft’s future financial or operating performance as well as Lyft’s other expectations, strategies, priorities, plans or intentions. Lyft’s expectations and beliefs regarding these matters may not materialize, and actual results in future periods are subject to risks and uncertainties that could cause actual results to differ materially from those projected, including those more fully described in Lyft’s filings with the Securities and Exchange Commission (“SEC”), including in Lyft’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2019, filed with the SEC on November 4, 2019.