Archive for January, 2010
iPad, anyone? Hospitals looking at the mobile device
Young doctors have taken to iPhones – could iPad be next?
Apple’s new creation, the iPad, may be a novelty to many consumers, but hospitals are already starting to abandon paper-and-pen clipboards for hand-held digital tablets.
In Sacramento, Kaiser Permanente is in the midst of experimenting with one brand of computerized tablets – with the hope of freeing nurses and doctors from old-school tools and allowing them more time at a patient’s bedside.
“We want our nurses to have time to actually nurse and support the patient. We want to remove the barriers … to provide seamless technology integration,” said Ann O’Brien, a registered nurse and Kaiser’s national director of clinical informatics.
The trial being conducted in Sacramento is part of a broader program, dubbed “Destination Bedside.” Kaiser expects to choose an electronic tablet by the end of the year for use at its hospitals nationwide.
The idea is to improve care and safety by providing up-to-the minute medical information on the patient that can help prevent mistakes. X-rays, medical charts, prescriptions and notes would be readily available at a tap of a finger.
One tablet, the Motion C5, promoted by its manufacturer as a “mobile clinical assistant,” is about the size of a small bathroom scale. It has handles and is equipped with a pen-like stylus.
“I love it,” said Thomas Whiteford, a registered nurse at Kaiser’s Sacramento Medical Center, who took part in testing the device. “I can sit next to the patient and do my charting.”
The popularity of Apple’s iPhone among doctors could be a natural springboard for the iPad. But O’Brien, the health care giant’s informatics director, said the device isn’t even out yet to assess its potential.
Already, the iPhone has become a favorite tool among young doctors, who use many of the scores of health care-related apps, including encyclopedic information on pharmaceuticals.
Kaiser officials are considering whether the iPhone, now a ubiquitous accessory for hipsters and the tech-savvy, will become standard issue at its hospitals to more intimately bring technology to a patient’s bedside.
Jason Wilk, who authors the technology blog tinycomb.com” target=”_blank”>>tinycomb.com, reported last week that Apple officials had visited a Los Angeles hospital, ostensibly to market their products. He presumed it was the iPad.
“Considering what happened with the iPhone, it seems like it makes a lot of sense that they would be talking with hospitals,” Wilk said, noting the mobile device’s popularity among doctors. “You can do so much more with a larger screen, for medical charts. This is probably the future of computing.”
Perhaps it’s the future of medicine, said Dr. Javeed Siddiqui, associate medical director for the Center for Health and Technology at UC Davis Medical Center.
Nurses, doctors and pharmacists have already been using hand-held tablets, but wide-scale deployment would be expensive. The model that Kaiser is considering and that UC Davis is already using on a limited basis costs more than $2,000 per unit.
Many hospitals now use full-sized computers and monitors mounted on wheeled carts, but these don’t offer the same ease of use and mobility as hand-held tablets.
Laptops would seem an alternative, but aren’t as easy to use as they would seem, particularly in a clinical setting where doctors and nurses are always on the go. And they aren’t durable and can’t easily be swabbed down for disinfection.
The hope among hospital officials is that electronic tablets will further power the technological revolution already under way at hospitals. And it’s an obvious extension of the industrywide push toward paperless electronic medical records.
“Information at your fingertips is what medicine should be all about. It allows you to access information as you walk around or as you talk to the patient,” Siddiqui said.
“The paper chart is an antiquated way of providing health care,” Siddiqui said. “The paper chart is inefficient. It doesn’t allow for rapid dissemination of information and really is no longer, I believe, the standard of care in health care delivery.”
Siddiqui, if not caught up in all the buzz generated by Wednesday’s product announcement of the iPad, is excited about the technological strides the device could spur in the medical industry. “It’s portable and it’s lightweight. It has touch screen, a Web browser – and all those features can be utilized as a way to integrate technology in patient care,” he said.
Capital health care industry is booming
RN Julie Guardalabene checks in on Walter Whitenack on Thursday at Mercy San Juan Medical Center’s new patient-care wing.
The gleaming new tower at Mercy San Juan Medical Center bustles with patients, nurses and doctors. Mercy plans to use its private rooms and airy lobbies as selling points in the competition for patients.
Opened a month ago, Mercy’s tower was cited in a recent report ranking Sacramento as the nation’s fastest growing market for health care jobs. The six-story project added 110 beds and nearly 200 new jobs to the hospital.
Despite some delays in construction projects, and even some layoffs, the health care industry has been a solid anchor for the region in a sea of job losses and sinking fortunes. Indeed, recession-battered workers have sought safe harbor by pursuing careers in high-demand health care specialties, such as radiology technology, physical therapy and nursing.
Already, the health care sector accounts for a fifth of the region’s payroll. About 120,000 people are employed by the industry, which pumped $33.5 billion into the regional economy in 2007, according to the Sacramento Metro Chamber of Commerce.
The region’s major health systems occupy four of the top six spots on the area’s list of biggest employers, with a combined work force of more than 30,000.
“It’s my view that outside of state government, the health care and bioscience industry is probably the most important industry sector to our region’s long-term economic stability,” said Matthew Mahood, chamber president and chief executive officer.
“The road to recovery is going to be a very slow process in this region. … But having an industry that can hold its own is progress,” Mahood said.
The industry’s high salaries buoy the rest of the economy. In 2007, according to the chamber, the average hospital worker earned nearly $68,000 a year, compared with the region’s average annual wage of $42,738.
Aging baby boomers, coupled with the region’s population growth, virtually guarantee that the demand for health services won’t diminish.
Proposed federal health care legislation could also increase the demand for medical care if more uninsured people wind up being covered.
“People will always have a need for a hospital,” said Brian Ivie, president of Mercy San Juan. One area that had seen declines – admissions for elective surgeries – is starting to recover, he said, adding, “People are starting to schedule those things that they were putting off.”
During the 12-month period ending in November 2009, the health and education category was the only sector to add jobs to the Sacramento-area economy, contributing 2,800 new positions – which outpaced the San Francisco Bay Area and accounted for about 14 percent of the state’s total in new health care jobs, according to the Sacramento-based Center for Strategic Economic Research.
“Throughout the recession, the health care sector has been providing jobs when every other sector has been losing jobs,” said center director Ryan Sharp.
With the Sacramento area’s population expected to add a million residents over the next two decades, job growth will be “tremendous,” according to Anette Smith-Dohring, work force development manager for Sutter Health’s Sacramento Sierra Region.
David Cherner, managing partner of Health Workforce Solutions, the San Francisco-based labor analysis firm that ranked Sacramento first for potential growth among 30 metropolitan areas, sees “a definite strengthening” in the region.
“The near-term demand for health care workers in Sacramento improved much more aggressively than in other markets in the country,” Cherner said. “We view this as very positive news for Sacramento moving forward into 2010.”
At Sutter Health, more than 300 jobs need to be filled right now in its capital region facilities. As the economy recovers, thousands more jobs will become available to job seekers, Smith-Dohring said.
Every two weeks, between 50 and 70 new employees are hired by the Sutter health care system. “Now is the time to work on a health care career,” Smith-Dohring said.
Indeed, many people are following her advice.
Los Rios Community College officials say demand exceeds the number of spaces available for nursing and more than a dozen other health care programs.
Combined, the American River and Sacramento City college campuses have 800 students enrolled in health care programs, according to community college officials.
Mark Williamson, 38, went through careers in media production and computer support before deciding five years ago to pursue a career as a radiologic technologist, a job that involves taking X-rays and doing other types of imaging.
The computer industry was already hurting, he said, when he took the leap.
“It sounded promising. It sounded like a secure job for the future,” said Williamson, who completed his program at Yuba Community College’s radiology program in Sacramento a little more than a year ago.
The starting salary for a radiology technologist is $65,000. After five years of experience and training in more advanced technologies, such as magnetic resonance imaging, salaries can quickly escalate to $100,000 and beyond.
The high demand makes the job nearly recession-proof.
“It was good timing for me, for sure,” Williamson said.
His boss, Tony Campos, the operations supervisor for diagnostic imaging at Sutter Medical Center Sacramento, has a staff of nearly 60 and expects to hire an additional 20 over the next two years as Sutter Health completes a major expansion at its medical complex on 28th and L streets in midtown Sacramento.
“Our department is going to need a whole lot of techs to work the rooms we’re putting in,” he said.
Certainly, hospitals haven’t been immune to the faltering economy. With increasing worry over personal finances, fewer people scheduled elective surgery. That meant empty hospital beds and lower revenues. As a result, major projects were delayed, including plans by Sutter Health to build an ambulatory care facility and hospital in Elk Grove.
Because of uncertainty over pensions and other investments, older nurses delayed retirement – resulting in fewer job openings and increased frustration for nursing school graduates.
The tighter job market prompted Julie Guardalabene, 25, a registered nurse, to think hard before deciding to return to California with her fiancé after a few years in Portland, Ore.
To Guardalabene’s surprise, she quickly found a job – at Mercy San Juan’s new tower. But her fiancé, R.J. Cervantes, had to temporarily settle for a job at an area casino while he looks for a post in government or as a political staffer. “It’s been rougher for him,” Guardalabene said.
Robust population growth and healthy competition among the area’s four largest health systems – Kaiser Permanente, Sutter Health, UC Davis Health Systems and Catholic Healthcare West’s Mercy hospitals – have produced a surge of construction projects.
At UC Davis Medical Center, a $450 million surgery and emergency services pavilion, which was to have been completed last year, is expected to be finished in late summer – about nine months behind schedule. More than 300 construction workers are swarming the 143-acre campus.
Last year, Kaiser Permanente opened its Women’s and Children’s Center in Roseville, and it is continuing work to expand its south Sacramento hospital.
Officials at Kaiser, which laid off more than 1,000 employees statewide last year because of falling enrollments, declined to be interviewed.
While few new jobs will be created by Sutter’s expansion of its midtown medical center, a wave of retirements will open up hundreds of positions – amounting to as much as 30 percent of its Sacramento work force when the project is completed by 2012.
Filling those jobs will “be very challenging for us, but we are planning for it,” Smith-Dohring said.
Looking down the road, Sutter sees a need for a new hospital in Elk Grove, but planning has been pushed back, said Nancy Turner, a spokeswoman for the health system.
Sutter also would like to break ground soon on an ambulatory care center in Elk Grove, but there, too, the economy has delayed plans.
“We are still very much committed to this project; unfortunately, we are not able to keep to the original timeline because of the downturn in the economy,” Turner said. “We will continue to move forward so that when the market turns we can be absolutely ready to move forward with construction.”
Mark Williamson, a radiologic technologist at Sutter General Hospital, prepares to X-ray Terrance Randle’s sore ankle. Williamson, 38, changed careers five years ago and says he made the right choice.
Mercy San Juan Medical Center opened a new patient tower in December, adding 110 beds and nearly
200 new jobs, while a recent report ranks Sacramento as the fastest-growing market for health care jobs.
Kaiser doctor is named medical chief in Folsom
Dr. Anthony Retodo has been appointed director of medical services at Kaiser Permanente’s Folsom medical offices.
The Shingle Springs resident has a biochemistry degree from the University of California, Davis. He graduated from the Medical College of Wisconsin and trained in internal medicine at Santa Clara Valley Medical Center in San Jose.
He has been an adult medicine leader at the Folsom site for four years and has been with Kaiser Permanente for six years.
Ailing Fairfield boy realizes dream, visits Obama
Jabril Debrow, who suffers from a rare cancer, gets an autograph from Sacramento King Kevin Martin before Tuesday’s game. One of Jabril’s wishes was to meet Kings players.
Jabril Debrow’s type of kidney cancer is so rare that only 140 cases have been documented, ever.
The fourth-grader from Fairfield was diagnosed in October with renal medullary carcinoma, a malady doctors discovered just 20 years ago. Its cause is a mystery, though researchers have found a linkage to sickle cell traits. Patients usually live five months after diagnosis.
More than four months in, Jabril’s body is struggling – but his mind and spirit are soaring.
In his condition, it is common for charities like the Make-A-Wish Foundation to step in and make something good happen. In November the foundation asked Jabril for his one wish.
For several days he wrestled with the question: A PlayStation 3? A laptop? A flat-screen TV?
In the end, he said, there was one wish his thoughts kept returning to: a meeting with President Barack Obama.
“He’s just awesome,” he said. “Awesome” is Jabril’s highest praise. His usually soft voice turns deep and robotic when he says the word. He’s been obsessed with the president for the past year, because Obama “wants to make the world a better place.”
Make-A-Wish made it happen; Jabril met with Obama in December, then wrote a book about it.
This week he got a bonus wish fulfilled: He attended his first Kings game, sitting courtside and meeting his favorite players.
Jabril is so thin he disappears under his trendy red hoodie and black puffy jacket. Despite his stature he acts like an adult: There’s no fidgeting typical of preteen boys. He’s fond of minimalist, grand statements.
When his mother cries over his cancer, 10-year-old Jabril comforts her. When the nurse takes five blood samples, he looks her in the eye, unfazed.
That mature veneer melted away, however, when Jabril entered the White House.
He said Obama poked his head out of the Oval Office and said, “Hey Jabril, how are you doing?”
“His mouth was hanging open,” said his mother, Jennifer Debrow. “And then Jabril asked him, ‘How do you bowl in the White House?’ “
Obama laughed, Jabril said, and invited him to bowl a few frames if he wanted to. The president then advised Jabril to do well in school, and gave him a yo-yo and some M&Ms.
When they came back, Jabril wrote a book, “Wishes Do Come True,” about his experience with cancer and his trip to the White House.
“I want other kids who get sick to not be scared,” he said.
Jabril’s grave prognosis is due to the cancer’s aggressiveness and rarity. Because so few cases have been diagnosed, it took doctors five months to figure out what he had.
Last May, his mother noticed Jabril was losing weight and there was blood in his urine. In June, his blood pressure started rising. His mother wasn’t worried because he had never been really sick before.
“Blood in the urine is a symptom for a lot of things,” said his doctor Inessa Gofman, a UC Davis fellow in pediatric hematology oncology.
It wasn’t until Jabril had an episode of excruciating abdominal pain that doctors ran a CT scan, revealing the tumor in his kidney. The cancer had already spread to his liver and lungs.
Such a rare cancer is difficult to treat, Gofman said, because there’s no standard of care. The only literature that exists on renal medullary carcinoma treatment are individual case studies.
One of the only things known about renal medullary carcinoma is the majority of patients – Jabril included – also have sickle cell trait. Sickle cell trait means a person carries one of two genes necessary for sickle cell disease, a condition where red blood cells form an abnormal, curved shape.
Gofman said it does not mean sickle cell trait – which afflicts mostly African Americans – in any way causes renal medullary carcinoma.
There are over 300 million people with sickle cell trait, she said.
“It’s really a mystery,” she said.
At Tuesday’s Kings game, Jabril and his family sat courtside, watching the players warm up. One by one, they took a break from shooting hoops to kneel down and introduce themselves to the 4-foot-5 Jabril. Tyreke Evans was teary-eyed after meeting him.
“Mom, I had such a good time I forgot I had cancer,” Jabril said.
Jabril Debrow bowls at the White House bowling alley last month after meeting with President Barack Obama, who also gave him a yo-yo and M&Ms. Jabril wrote a book, “Wishes Do Come True,” about his experience with cancer and his trip to the White House.
Sutter Health CEO takes hospital advocacy post
The chief executive officer of the Sutter Health network assumed his post this month as chairman of the California Hospital Association board of trustees, the trade group announced Tuesday.
As chairman, Patrick Fry will help direct an association representing more than 400 hospitals and health systems.
The association handles policy and advocacy concerns on the state and national levels for California’s hospitals.
Fry’s term is for the current year. He became secretary-treasurer of the board in 2008 and was elected chairman a year later, but his term did not start until this month, said association spokeswoman Jan Emerson. Fry joined Sutter Health in 1982 and rose to CEO in 2005.