California Health News related to the Palo Alto Medical FoundationNavigation
The linkAges™ program of the Palo Alto Medical Foundation (PAMF) Innovation Center has received a grant of $714,000 over three years from the Robert Wood Johnson Foundation to help fund development of systems that support seniors aging in the community. The grant will support development and evaluation of linkAges Connect, part of the broader linkAges platform that fosters multi-generational community support for seniors living independently in their homes.
To complement traditional health care’s role in delivering high quality medical care, PAMF’s Innovation Center is focusing on non-medical aspects of health.
According to research conducted by Dr. Carla Perissinotto at University of California-San Francisco, seniors who are lonely have a 45 percent increased mortality over six years.
Innovative Program Supports Successful Aging
The Palo Alto Medical Foundation’s Successful Aging Shared Medical Appointments (SMA) Program has received a national award from the Patient Centered Outcomes Research Institute (PCORI). It was one of only 30 projects in the western United States chosen for the inaugural “Pipeline to Proposal” awards program, designed to “advance the field of patient- and stakeholder-driven health research,” said Anne Beal, M.D., MPH, PCORI’s deputy executive director and chief officer for engagement.
PAMF’s Successful Aging SMA program is the first of its kind in the nation. In this innovative program, adults ages 65 and older have 90-minute medical appointments in small groups, where they receive private, individual health assessments and participate in health discussions led by a doctor.
PAMF Regional Medical Director Susan Smith, M.D., believes there are distinct benefits to older patients who participate in this unique care model. “They get ample and dedicated time with a geriatrician, a physician who specializes in aging, and they do so in the company of fellow seniors, forming a natural support group,” she says. “The SMA empowers patients to make personalized decisions with their health care team.”
Through the Successful Aging Shared Medical Appointment program, “Our patients receive personalized evaluations, learn from one another, and work with us to develop preventive and proactive approaches to aging,” said SMA Nurse Care Manager Kelly Reilly, RN.
“This award provides us an exciting opportunity to further refine our program and define its future,” said Peter H. Cheng, M.D., chief of PAMF’s Palo Alto Center Geriatric Medicine Program and founder of the program. “Patients passionate about successful aging will partner with us to develop outcome goals that are meaningful to them, their families, their physicians, as well as the health care system.
“Ultimately, our dream is to have the opportunity to help spread this program across the U.S.,” explained Dr. Cheng. “We would love to help more Americans 65 and older design their own road map for successful aging, guiding them as they travel the journey of a lifetime.”
The Patient-Centered Outcomes Research Institute (PCORI) is an independent, non-profit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. PCORI is committed to continuously seeking input from a broad range of stakeholders to guide its work. More information is available at www.pcori.org.
Since the Palo Alto Medical Foundation (PAMF) restarted its walk-in flu vaccine clinics for patients at selected PAMF locations, on January 14, 2014, PAMF medical staff has administered more than 10,000 vaccines. This is in addition to the 104,400 vaccines that had already been administered to PAMF patients at walk-in flu clinics between September and December 2013. (These figures do not include the vaccines given during patients’ regular doctor’s appointments.)
The community’s increased demand for the vaccine in recent weeks is likely caused by news reports of deaths in the Bay Area due to the H1N1 flu virus, commonly known as the swine flu.
Charles Weiss, M.D., MPH, head of the Palo Alto Medical Foundation’s Flu and Infectious Diseases Committees, reports that PAMF medical centers have seen a steady, moderately elevated level of flu incidence for the last month.
“State indicators are mixed. In some areas, cases are still trending up, and in others cases are leveling off. Even if there is a leveling off, flu epidemics last an average of eight weeks so we can expect continued H1N1 activity and may see an increase in cases of other flu strains,” Dr. Weiss said.
PAMF’s Urgent Care Centers saw increases in cases in late December and cases have remained elevated thus far in January.
“Now and in the future, the best way to protect yourself and your loved ones against influenza is to get vaccinated each year,” Dr. Weiss recommends.
The walk-in flu vaccine clinics for PAMF patients will continue at selected PAMF locations as demand for vaccinations or vaccine supply lasts. The primary strain circulating (H1N1) is covered by the vaccine. PAMF’s flu vaccine clinic hours and locations are online at www.pamf.org/flu.
U.S. Centers for Disease Control and Prevention (CDC). Flu prevention and treatment information.
The Palo Alto Medical Foundation flu website.
This week Google announced its latest innovation: a smart contact lens developed to help people with diabetes monitor their glucose levels. Patients are more likely to comply with monitoring that does not require frequent pin (lancet) pricks for blood samples, and maintain better health as a result.
Google says that the lens, currently in prototype form, will use a wireless chip and a tiny glucose sensor planted between two layers of material designed for soft contact lenses to measure glucose levels in tears. The lens will use miniature lights to warn the diabetic person if their glucose readings reach a dangerous level. Google reports that they have “completed clinical research studies that explore tear/blood glucose correlation and test lens functionality and comfort.”
Dr. David Klonoff, medical director at the Diabetes Research Institute at Mills-Peninsula Health Services, worked with Google on a clinical study to evaluate that ability to detect glucose in tears. He was Principal Investigator and co-author of the protocol for the first study in the Google contact lens project. Mills-Peninsula Health Services and the Palo Alto Medical Foundation form the Peninsula Coastal Region of Sutter Health.
“We measured tear glucose levels with a unique sampling system and a special measuring method that were developed by Google for very small volumes and very low glucose concentrations. We compared tear glucose levels with blood glucose levels to see how closely these two measurements tracked,” Dr. Klonoff explains.
Test results are still being analyzed by Dr. Klonoff’s team but he reports that he is optimistic about the outcomes and eventual benefit to patients.
“It was exciting working with scientists from Google and to collaborate with such a dynamic creative company. They do not let any barriers stand in their way. I have been following the work of the Google scientists for many years and they are extremely creative,” Dr. Klonoff says.
Read the official Google blog, Introducing Our Smart Contact Lens Project by Brian Otis and Babak Parviz, project co-founders.
He founded the Dorothy L. and James E. Frank Diabetes Research Institute of Mills-Peninsula Health Services to facilitate development of new devices and drugs for people with diabetes. He has chaired the scientific advisory board for developing the first FDA-approved insulin patch pump and participated in development of the first FDA-approved dedicated diabetes telemedicine system, the first FDA-approved inhaled insulin, and the first three FDA-approved incretin drugs for diabetes. He recently published his findings in the New England Journal of Medicine as the lead investigator for the first-ever randomized controlled multicenter trial of the world’s first artificial pancreas product for outpatient use.
The 12-member delegation of physicians and executives from the two organizations spent a week meeting with physicians, government and business leaders. The intensive schedule included tours of hospitals and biopharmaceutical and technology companies, and members participated in large panel discussions in both Bangalore and Delhi.
“Despite our differences, what we found at every stop is that we both share a common purpose – to improve the health of our communities and deliver quality, affordable health care,” said Tomi Ryba, president and chief executive officer, El Camino Hospital. “In the coming months, we will be solidifying specific memoranda of understandings (MOUs) to continue our collaborations and grow our collective body of knowledge around health care delivery and medical practice in our respective communities.”
Read More about Improving Health Care in India
Lawrence Shapiro, M.D., a pulmonologist and Managed Care Director for the Palo Alto Medical Foundation, has worked with PAMF doctors to develop a highly successful approach to managed care that saves costs while putting patients first. Shapiro outlines the collaboration that saved $40 million in health care costs over the past four years in his new book, Quality Care, Affordable Care: How Physicians Can Reduce Variation and Lower Healthcare Costs, published by Greenbranch Publishing.
“The key to managing the cost of care is to make your doctors the experts, listen to them, and work with them to develop local standards that meet the needs of local patients,” Shapiro said. “It improves affordability and the value of the care that we provide to the patients.”
In his book, Shapiro outlines the five pillars that successfully reduced variation in care at PAMF, and that can help any medical group trying to manage costs while improving quality. The pillars include focusing on affordability, engaging physicians and a commitment to useful data. He also shares examples from his team’s work.
More than three million Americans suffer from severe emphysema, a form of COPD (Chronic Obstructive Pulmonary Disease). This chronic, debilitating disease causes irreversible damage to delicate lung tissue, leading to shortness of breath and reduced capacity to manage activities of daily living, leading to diminished quality of life.
The Palo Alto Medical Foundation is collaborating with El Camino Hospital and Fogarty Clinical Research Inc. to conduct a clinical trial to evaluate the investigational use of the RePneu® (pronounced ‘RENEW’) Lung Volume Reduction Coil (LVRC) for patients experiencing symptoms of emphysema. Read More about RENEW Clinical Trial – Evaluating a Treatment for Patients with Emphysema