Innovation

A Welcome Mat for Wherever You Are

Posted on Apr 3, 2020 in Innovation, Scroll Images

Nothing beats the comfort of home. And while many of us are staying as safe as possible under our own roofs to help curb the spread of COVID-19, there are still those essential workers who head out the door to their jobs each day—including front line health care workers.

As healthcare organizations across the nation prepare for the surge of patients with COVID-19, there will be a need for front line health care workers to travel and meet areas of greatest need. And Sutter Health just made it easier for those front line staff.

Sutter is collaborating with the newly launched Airbnb Work to help support front line health care workers find temporary lodging around hospitals where they may be relocated to support. This service can help support healthcare workers who are self-isolating from their families or who need rest immediately after shifts, as they continue to care for others in need.

“Sutter Health is supporting our front line health care workers in many ways during this unprecedented public health emergency. We are seeking solutions to support our staff as they are caring for our patients and communities,” Jill Ragsdale, chief people and culture officer for Sutter Health. “This service helps remove the added pressure for staff caring for patients in other locations from finding temporary lodging while working away from home. We greatly appreciate how the greater community has opened their doors through the Airbnb program to support our care givers.”

This is one example of how Sutter Health is using the breadth of its integrated network to increase critical care capacity. The Airbnb Work service will be offered in several locations near existing Sutter hospitals including: Burlingame, Castro Valley, Modesto, Oakland/Berkeley, Roseville, Sacramento, San Francisco, Santa Rosa, Tracy and Vallejo.

“The spirit of collaboration and innovation is exactly what’s needed right now as we tackle this unprecedented public health crisis,” said Chris Waugh, Sutter Health’s chief innovation officer. “We’re extremely pleased to partner with Airbnb to help support Sutter’s frontline healthcare workers who need temporary lodging near hospitals where they’ve been redeployed to care for patients. Through Airbnb’s collaboration, we can help care for them while they care for others.”

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.

An Endgame for Epilepsy

Posted on Mar 13, 2020 in California Pacific Medical Center, Innovation, Neuroscience, People, Quality

One man’s struggle with seizures is silenced thanks to a medical device implanted on his brain.

Reno, Nev. — Andy Fiannaca, a college student at the time, first discovered he had epilepsy when he woke up in an ambulance. His head was gouged and bleeding—the result of falling during an intense epileptic seizure. Even with no family history of epilepsy, Fiannaca would soon learn that is exactly what he had.

For years, severe daily seizures affected his quality of life, limiting his activities. He experienced speech problems, such as difficulty finding and forming words, and would often lose the ability to comprehend what people around him were saying, known as aphasia. Everything became a foreign language.

Andy Fiannaca displays his post-surgery scar from where his RNS device was implanted.
Andy Fiannaca’s surgery scar is on full display where his RNS device was implanted.

Fiannaca also suffered from the “Alice in Wonderland” syndrome. During episodes, his visual perception would become drastically distorted. He was either an ant looking up at giants, or a giant looking down at ants. Driving a car was out of the question, and continuing his studies at the University of Nevada, Reno became increasingly difficult.

To control his seizures, Fiannaca tried six different medications and then a surgery in which a series of shallow cuts were made in his brain tissue. The goal was to remove the part of the brain where his seizures originated. Unfortunately, his Reno surgeons found the source was too close to his speech center. His symptoms improved after the surgery, but within two years they returned.

Clearly, Fiannaca required more advanced help. But since he lives in Sparks, Nevada (outside Reno), where this level of advanced neurology is not available, his care team finally referred him to California Pacific Medical Center (CPMC) in San Francisco, part of the Sutter Health not-for-profit network of care.

At CPMC, neurologists David King-Stephens, MD and Peter Weber, MD, recommended the RNS System, an implanted device designed to continuously monitor brain activity, detect abnormal patterns and intervene to stop seizures before clinical symptoms appear. It is the first and only medical device that can monitor and respond to brain activity. This treatment, Fiannaca says, ultimately changed the course of his life.

The Fiannaca Family
The Fiannaca Family.

Since Fiannaca had the RNS device implanted six years ago, his seizures have radically reduced. He hasn’t had a grand mal seizure in two years, and he’s finally able to drive a car again. His wife Sara has been by his side through it all. The couple worried for a long time that epilepsy would prevent them from starting a family, but with his condition now under control, Fiannaca and Sara welcomed their first child 18 months ago.

Epilepsy is a widespread condition characterized by recurrent seizures that often causes a severe impact on a person’s quality of life. It affects as many as one in 26 adults in the U.S., and in 50 percent of epilepsy cases, the cause is unknown.

Epilepsy Awareness Day is March 26, 2020.

New App Supports Growing Families at Every Age and Every Stage

Posted on Feb 27, 2020 in Innovation, Scroll Images

Personalized health guidance connects to vetted resources within the Sutter Health network via Wildflower Health’s digital platform

Mom, dad, and their toddler and infant daughters snuggle up together playfully on the couch. Big sis is kissing mom, dad is watching them, and little baby sis is staring at the ceiling.

SACRAMENTO, CALIF. AND SAN FRANCISCO–From the moment a woman realizes she’s pregnant, there’s so much to think about, from coping with morning sickness to remembering to take prenatal vitamins and preparing for delivery.

In hopes of making it easier for prospective moms to find all the information they may need, Sutter Health and Wildflower Health have teamed up to offer an app that supports women and their partners before, during and after pregnancy: My Family by Sutter Health™.

The app, which is intended for those 18 years or older, is powered by Wildflower’s digital platform. It is designed to help patients connect to trusted local resources available within Sutter Health, a not-for-profit health network serving more than 3 million patients in Northern California. It provides pregnancy guidance reviewed by Sutter network doctors as well as other helpful resources, including nutrition and exercise ideas, weekly pregnancy checklists and reminders, and a guide for discussing a woman’s labor and birth preferences with her provider. It provides tips for caring for newborns, too—from breastfeeding to safe sleeping. The entire family’s health can also be supported in the app. With the ability to create multiple profiles for parents and kids, users can manage their family’s health at every age and stage.

“What makes My Family by Sutter Health ™ app unique is that it offers advice that has been reviewed and vetted by Sutter physicians,” said Albert Chan, M.D., M.S., FAAFP, Sutter Health’s chief of digital patient experience. “The information comes from sources like the American Academy of Pediatrics, and is backed by the local doctors taking care of local families. It gives our patients convenient, accessible and reliable information, when and where they want it.”

The free mobile app joins Sutter’s comprehensive suite of maternity, pediatric, family medicine and women’s health care services, connecting families to hospital birth centers, classes, breastfeeding support, neonatal care services, emergency services and more.

“From Baby Friendly Hospitals, to well-child visits and high-quality women’s healthcare, Sutter Health and Wildflower Health understand the needs of growing families in Northern California,” said Leah Sparks, founder and CEO of Wildflower Health. “Our collaboration will build trusted solutions for families, personalized to their health needs.”

The results from a one-year pilot study with Sutter Health and Circle, another Wildflower Health pregnancy app, indicated that patient satisfaction was a key indicator of success. Of participants from the pilot study, 100 percent rated the app “easy to very easy” to navigate with a Net Promoter Score of 28. Almost 80 percent said they were likely to recommend the app experience to others.

Additionally, a peer-reviewed journal article found that users of a Wildflower Health app engaged in prenatal care earlier and had fewer low-birth weight babies than non-app users.

With the goal of creating greater access to the right care at the right times, the My Family by Sutter Health app helps support healthier families. The My Family by Sutter Health™ app seeks to help with the early identification of health issues to ensure that every individual receives the most appropriate level of care, decision support to enable healthy choices for a variety of scenarios, and adherence and compliance with care plans, appointments, vaccinations and prevention.

The My Family by Sutter Health™ app is available in English and Spanish. It can be downloaded in both the Apple App Store and Google Play Store by following the links provided, or searching “My Family Sutter” in the app stores.

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.

Sutter Launches Ferrum’s AI Quality Platform to Prevent Medical Errors, Fight Cancer, and Reduce Healthcare Costs

Posted on Feb 18, 2020 in Innovation, Scroll Images, Uncategorized

Sutter is the first health system in the U.S. to run quality review on applicable CT lung scans; Ferrum’s AI quality platform aims to reduce medical errors across the patient journey

SAN FRANCISCO—Sutter Health, a not-for profit healthcare network in Northern California, today announced the launch of Ferrum’s artificial intelligence (AI) powered quality platform to deliver higher quality and more consistent care to its patients. Ferrum Health’s next generation technology is designed to improve quality in medical imaging, with the goal of helping Sutter find important diagnoses like lung cancers in their early stages. Ferrum’s technology is helping Sutter support patients through improved outcomes, an enhanced care experience, and a reduced total cost of care over time.

Ferrum’s quality platform analyzes medical images alongside physicians’ written notes. It uses computer vision and natural language algorithms to identify abnormalities and flags them for Sutter clinicians to follow-up with patients and change care plans as necessary.

In August 2019, Sutter Medical Foundation went live with Ferrum’s AI-powered quality system in Sacramento, Calif. to improve lung cancer care, becoming the first in the country to run the technology on applicable CT scans and radiologist reports. The system analyzed documented findings that match, or don’t match, the algorithm’s review of the image.

“For those rare instances where a nodule is overlooked, we can in a very quick time period—usually within 24 hours—continue the care process instead of waiting until larger nodules are detected at a later medical visit,” said Charles McDonnell III, M.D., a Sutter Medical Group radiologist and associate medical director of risk management. “Having a system for quality coverage of our diagnostic decisions makes us stronger, more effective advocates for our patients, and gives patients greater comfort and peace of mind.”

If there is a potential discrepancy (i.e., a nodule or other abnormality found in the scan but not mentioned in the report), the scan is “flagged” and sent to chest radiology subject matter experts and the department quality committee for further review. Any discrepancies that the subject matter expert finds to be actual nodules which were not found in the initial reading of the scan go back to the initial radiologist. That radiologist can then update his or her report and quickly provide the patient with recommendations for appropriate high-quality care, such as a follow-up at Sutter’s Lung Nodule Clinic.

According to Jason Wiesner, M.D., a radiologist and medical director of the health system’s Diagnostic Imaging Service Line, estimated discrepancy rates at Sutter were already four times lower than the estimated rate of error nationally. With the implementation of Ferrum’s AI technology within the pilot, this number was reduced even further. In the first 90 days of deployment at Sutter, Ferrum’s AI technology reviewed more than 10,000 CT scans containing lung tissue. Eighty-three of its flagged findings warranted additional radiologist review and intervention. A subset of these patients was confirmed to have findings that needed follow-up care.

“This is a testament to the quality of work done by our radiologists on behalf of our patients,” Dr. Wiesner said. “We are giving our doctors and patients a safety net and ensuring we continue to provide the highest quality of care. This project shows the commitment of Sutter Health to providing the highest reliability healthcare to the communities we serve.”

“We’ve shown the profound impact that quality monitoring technologies can have on identifying opportunities to improve care and prevent potential medical errors,” said Pelu Tran, co-founder and CEO of Ferrum Health. “Most importantly, thanks to the advanced work of both IT teams, it took us just a single day to deploy a platform that improved the quality of diagnostic care for Sutter patients across all of Sacramento – all without impacting their physicians’ workflows. The work we’ve done here is the beginning of a new era in healthcare’s battle against medical errors, and we’re excited to continue to move the field forward alongside quality luminaries like Sutter.”