Fall 2017 | MedStarHealth.org/Connect CONNECT pg. 3 Services Expanded Behavioral Health for Behavioral Health A New Placeto Turn pg. 10 in Mid-Atlantic Most Experienced Procedures Performed 100+ WATCHMAN See page6forthestory for care. knowledge, support andalong-termplan at increasedcancerunprecedented riskof Prevention Program willprovide patients A newHigh-Risk Assessment andCancer SURVIVE ASSESS, PREVENT,

™ A MAGAZINE FORPHYSICIANS pg. 11 Micro Technology Rhythm Management through Big Benefits Small Pacemakers,

2 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 1

Dear Readers, CONNECT IS A PUBLICATION OF MEDSTAR HEALTH. As part of our MedStar 2020 Performance Transformation initiative, It is published for physicians, and INSIDE THIS ISSUE we sought to develop a unique system of care that would make a is focused on MedStar’s regional difference in our patients’ lives. We knew that we were already providing service lines in Central Maryland. excellent care in our hospitals, outpatient facilities, and offices, but what The information provided in this could we do even better? How could we improve patient and family publication is intended to educate experiences and outcomes? How could we increase the collaboration and engagement of the entire care team? readers about subjects pertinent to their professional practice To find out, we asked our providers. We set up a series of large design or personal health, and is not sessions involving more than 200 associates from across the system that a substitute for consultation included representatives from all members of the care team. Physicians, with other physicians. nurses, therapists, pharmacists, social workers, case managers, and other team members gathered ideas and developed a plan designed Printed in the U.S.A. © 2017. to provide team-based, coordinated, and patient and family-centered MedStarHealth.org/Connect A NEW PLACE TO TURN care. The end result of this work was the Interdisciplinary Model of FOR BEHAVIORAL HEALTH Care (IMOC). MARKETING AND 3 6 IMOC revolves around three basic standards of excellence: First, every COMMUNICATIONS FEATURE: unit now has a physician-nurse leadership dyad that is accountable Michael Hartnett ASSESS, PREVENT, for the care and patient experience on that unit. Second, we have a Regional Vice President, commitment to daily, multidisciplinary team rounding that involves Public Affairs and Marketing patients and their families whenever possible, assuring that every [email protected] SURVIVE member of the care team participates in the development of the plan of is the mantra and driving theme of the day as well as discharge and transition of care planning. Third, every Michelle Kline our high-risk assessment program. day, each of our doctors and nurses will visit every one of their patients Regional Marketing Director, together and sit down for at least five minutes to chat—an old-fashioned MedStar Orthopaedics concept that’s at the heart of excellent care. [email protected]

We’re supporting these concepts with other means, including pamphlets Melissa Mullahey that educate our patients and give them tools for better communication Regional Marketing Director, GIVING ARTHROPLASTY and standards that give each member of the care team a clear and MedStar Health Cancer Network accountable role. 4A LEG UP [email protected] Maryland's first robotic Our referring physicians are playing a strong role in this plan Jennifer Freas total knee replacement as an extension of the care team. IMOC also provides for better Regional Marketing Director, was performed at MedStar communication with physicians outside the MedStar system, with MedStar Heart & Vascular Institute Union Memorial Hospital 12 ongoing contact throughout a patient’s hospital stay and preparing [email protected] in February. Q&A FEATURE for a transition of care at discharge. Raghuveer Vallabhaneni, MD, explains IMOC is currently being rolled out across our system, and has recently WRITING his vision for vascular surgery in the Baltimore region. been implemented on all inpatient units. It embodies every part of Christen Brownlee our mission, vision, and values that focus on providing world-class and collaborative patient care and an outstanding patient and family 10100+ WATCHMAN™ experience. It’s essentially why we all chose to enter the field of DESIGN AND PRODUCTION PROCEDURES healthcare in the first place: to make a difference in patients’ lives. Orange Element Sincerely,

A SPECIAL ANNOUNCEMENT Stuart M. Levine, MD, FACP We are very pleased to announce that Stuart M. Levine, MD, FACP, has been named President President and Chief Medical Officer, MedStar Harbor Hospital ON THE COVER: Yvonne Ottaviano, MD, and Chief Medical Officer of MedStar Harbor Hospital and Senior Vice President of MedStar Senior Vice President, MedStar Health chief, Medical Oncology; Kristie Davalli, CRNP, Health, effective Sept. 7, 2017. Dr. Levine succeeds Dennis W. Pullin, FACHE, who will be leaving and Emily Kuchinsky, MS, CGS. Photographed MedStar Harbor in September, after eight years of strong leadership, to become the President by O'Brien Media Group. and Chief Executive Officer of Virtua Health System in Southern New Jersey. 2 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 3

NEW CONNECTIONS A New Place to Turn for Behavioral Health Care HOSPITALS OFFERING ADULT INPATIENT PSYCHIATRIC CARE ARE SCATTERED ACROSS THE BALTIMORE AREA. BUT UNTIL RECENTLY, THERE WERE NO SERVICES OF THIS KIND NEAR CHERRY HILL, ONE OF THE CITY’S SOUTHERNMOST NEIGHBORHOODS. MEDSTAR PEDIATRIC ORTHOPAEDICS That’s why MedStar Health recently decided to make a $9 million investment to create Andrew J. Abramowitz, MD Pediatric Orthopaedic Surgeon a 40-bed inpatient unit at MedStar Harbor MedStar Orthopaedics—Westminster Hospital, explains Elias K. Shaya, MD, (new location) the MedStar North Regional Medical MedStar Orthopaedics—Ellicott City Director and Senior Associate Executive (new location) MEDSTAR HEALTH Director for Behavioral Health Services. MedStar Franklin Square CANCER NETWORK This new unit will provide treatment for Medical Center behavioral health disorders including 301-829-2552 Jennifer Flaim, DO schizophrenia, schizoaffective disorder, Radiologist bipolar disorder, mania, depression, and MedStar Health substance use disorders. In addition to Bel Air Medical Campus the inpatient unit, MedStar Harbor now MEDSTAR HEART & VASCULAR (new location) provides a comprehensive spectrum of INSTITUTE MedStar Union Memorial Hospital services including outpatient, a partial MedStar Good Samaritan Hospital hospitalization program, and specialized crisis intervention services at the Reza Abrishamchian, MD 410-554-2728 Cardiac Surgeon Emergency Department. MedStar Union Memorial Hospital William Krimsky, MD “It’s a major commitment to our patients 410-554-6550 (newly employed) and the community,” Shaya says of the ABOVE: The activity area in the new, state-of-the-art Inpatient Behavioral Health Unit is located adjacent to the nurse's Pulmonologist project, which involved renovating an station, so patients can be closely monitored. MedStar Franklin Square entire floor of the hospital. The new Medical Center facility joins MedStar Franklin Square After receiving screening by a nurse, any patient identified as being at risk Sandeep Jani, MD 443-777-2467 Medical Center as the only other MedStar Cardiologist hospital in the Baltimore region providing for addiction is referred onsite to MedStar Franklin Square inpatient psychiatric services. In addition a peer recovery coach, individuals who themselves have had addiction problems Medical Center Edward McCarron, MD to serving adults, MedStar Franklin According to the in the past and have demonstrated MedStar Union Memorial Hospital Surgical Oncologist Square’s inpatient unit also provides National Institute of a course of stable recovery over several 410-574-1330 MedStar Franklin Square treatment to adolescents. Mental Health, one in Medical Center years. These coaches are specially five adults in the U.S. MedStar Health Behavioral Health services at all four trained to implement a brief intervention experience mental Bel Air Medical Campus hospitals in MedStar’s Baltimore region then refer patients to community- illness in a given year. Antony Kaliyadan, MD (new location) have also started implementing an based treatment centers, following up Interventional Cardiologist 443-777-7911 important change in their Emergency afterwards to make sure patients made MedStar Union Memorial Hospital departments. With a new initiative known the connection. 410-554-2332 as SBIRT, short for Screening, Brief Saiyad Sarkar, MD Intervention, and Referral to Treatment, “Each of the four area hospitals will (newly employed) patients who come to the Emergency continue to provide outpatient behavioral Pulmonologist department for various reasons will be health services,” Shaya adds. MedStar Franklin Square screened for possible drug addiction risk. Raghuveer Vallabhaneni, MD Medical Center “We say in MedStar that our knowledge Director, Vascular Surgery— MedStar Health “It gives us an opportunity to identify and compassion is focused on you,” Baltimore Region Bel Air Medical Campus he says. “In Behavioral Health, our new MedStar Union Memorial Hospital and recognize those needs,” Shaya says, (new location) “and intervene before addiction can have services show that ongoing promise to 410-554-2950 443-777-2467 devastating consequences.” our patients.” 4 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 5

Giving Arthroplasty a Leg Up At MedStar, we’re dedicated to Although the reasons for these poor exploring solutions that are new outcomes aren’t always clear, he adds, and better for our patients. Robotic it often stems from flawed sizing or joint replacement is the latest positioning of implants. Finding the perfect fit with jigs, eyes, and feel can be a challenge demonstration of our commitment." for even the most skilled surgeon. HENRY BOUCHER, MD ORTHOPAEDIC SURGEON Fortunately, he adds, technology has a solution. On February 6, 2017, MedStar Union Memorial Hospital performed the moves with it. Additionally, the plan first total knee arthroplasty in the state prevents a surgeon from exceeding a of Maryland using the Stryker Mako certain volumetric area, preventing them robot, a device that can provide patients from straying into critical structures. with a precisely customized size, position Once the patient is in the operating room, the surgical team—which might be led by “You can’t overpower the arm, which ROBOTIC APPLICATIONS ARE NOW IN USE FOR and alignment for total knee replacements. Boucher or other MedStar orthopaedic has incredible implications for safety,” To learn more about TOTAL, NOT JUST PARTIAL, KNEE ARTHROPLASTY. MAKOplasty, the term for comprehensive surgical procedures including partial knee surgeons who can perform MAKOplasty, Boucher says. MAKOplasty at MedStar Union Memorial Total knee arthroplasty greatly reduces and total hip arthroplasty that use this robot, including Jason Hammond, MD, Michael MAKOplasty’s unique features offer a Hospital, please visit the pain, inflammation, and stiffness that offers the promise of better outcomes, Jacobs, MD, Robert McKinstry, MD, or safer way to achieve potentially better MedStarHealth.org/ accompany severe knee osteoarthritis in Boucher says. Kenneth Tepper, MD—attaches trackers to the patient’s body that registers their outcomes, he adds, a goal that every Connect. To fast-track the majority of patients. a referral for your Before surgery, he explains, all MAKOplasty anatomy to the computer, confirming it surgeon wants to achieve. patients, please call However, says Henry Boucher, MD, patients receive a CT scan to assess limb with the pre-operative scan. “At MedStar, we’re dedicated to 877-34-ORTHO orthopaedic surgeon, MedStar Union alignment, leg length and other anatomical exploring solutions that are new and (877-346-7846). Memorial Hospital, a fraction of patients— parameters of the hip and knee. Surgeons The robot’s operative arm is also equipped better for our patients,” Boucher says. estimated between 15 and 20 percent— and technicians use this information for with a tracker that allows the surgeon “MAKOplasty is the latest demonstration aren’t completely satisfied after surgery. pre-operative planning to determine implant to work within a specific volumetric of our commitment.” “It nags them,” Boucher says. “They feel sizing and to decide placement—for example, plan based on the patient’s anatomic parameters. If the patient’s leg happens like their new knee doesn’t move right whether the leg receiving the procedure OPPOSITE PAGE: Joint replacement surgeon Michael Jacobs, MD, operates to move, Boucher says, the robotic arm on a cadaver in MedStar Union Memorial Hospital's orthopaedic surgical skills lab or feel right.” should be perfectly straight or bowed. in December 2016.

UPDATE MedStar quality activities are largely aligned with the six priorities within the CMS COMMITMENT TO QUALITY and HHS National Quality Strategy: 1. Making care safer by reducing harm caused in the delivery of care MedStar has a longstanding commitment to quality. Three years ago, alignment efforts 2. Ensuring that each person and family is engaged as partners in their care related to quality across the entire system evolved when Christine Goeschel, ScD, RN, joined 3. Promoting effective communication and coordination of care the Corporate Quality and Safety Department as assistant vice president, Quality. Goeschel 4. Promoting the most effective prevention and treatment practices for leading causes of mortality reflects that joining MedStar presented the type of opportunity that excites her. “MedStar 5. Working with communities to promote wide use of best practices to enable healthy living already had the requisite leadership commitment to take quality to the next level,” she says. 6. Making quality care more affordable for individuals, families, employers, governments, and communities “Our challenge is to understand quality demands in our complex and rapidly changing healthcare environment, and then work collaboratively to meet the demands. That means “MedStar is striving to deliver world-class healthcare,” Goeschel says, “and our commitment to quality centralizing activities where that is efficient, while respecting that local context matters.” will help us achieve that goal.” 6 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 7

ASSESS, PREVENT, SURVIVE A new High-Risk Assessment and Cancer Prevention Program will provide patients at increased risk of cancer unprecedented knowledge, support and a long-term plan for care.

In the era of actress Angelina Jolie publishing in the New York Times about her own inherited cancer syndrome, a growing number of patients are becoming aware that they, too, might be at heightened risk of cancer. Seeing clusters of certain types of cancer within a family suggests that an inherited genetic problem might be responsible, prompting many patients to have genetic testing to see if they have mutations linked to breast, ovarian, colon, or uterine cancer, for example. However, this new information leaves many at a loss, with no solid plan in place to decrease their risk, and no medical team tracking them to quickly catch any cancers that do arise and keep them abreast of new prevention and early detection strategies.

That’s why MedStar recently decided to open the High-Risk Assessment and Cancer Prevention Program. Led by Yvonne Ottaviano, MD, chief, medical oncology and director, breast oncology at MedStar Franklin Square Medical Center, and Emily Kuchinsky, MS, CGC, coordinator of the cancer risk assessment and counseling program for the MedStar Health Cancer Network, the twice-monthly clinic will focus on assessing patients’ cancer risk, outlining appropriate screening guidelines, developing a plan to help them prevent cancer, and improving their chances of survival if cancers do arise. 8 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 9

ANNOUNCEMENTS

BALTIMORE ORIOLES RENEW PARTNERSHIP WITH MEDSTAR HEALTH

When the Baltimore Orioles’ players get injured, they look to the top experts to get them back in the game quickly and safely. That’s why the Baltimore Orioles trust MedStar to be their Official Orthopedic and Sports ADVANCED HEART Medicine Team. In the dugout is Team Orthopedist, FAILURE PROGRAM Michael Jacobs, MD; team physician, Derek Papp, MD and assistant team physician, Leigh Ann Curl, MD. EXPANDS SERVICES About 10 percent of heart failure patients don’t respond By having this clinic that focuses solely to conventional heart therapies says, prevention with a hormone blocking FIRST LOW-RISK TAVR PATIENT IN MARYLAND and symptom management pill can slash breast cancer risk by half, and on a high-risk group, we’re hoping to strategies. For these advanced for many this is a viable strategy. For other For the first time in Maryland, a patient at low mortality risk for open heart failure patients in the take the sting out of this frightening patients at extremely high-risk, prophylactic heart surgery underwent an alternative approach to aortic valve Baltimore area, few options surgery to remove breast tissue, for replacement known as Transcatheter Aortic Valve Replacement, or diagnosis and provide patients with the existed for local providers with example, may be a preferred option. TAVR, when John Wang, MD, and his team at MedStar Union Memorial comprehensive support they need." Hospital replaced a man’s heart valve through a small flexible catheter expertise to treat this condition. Nearly all patients diagnosed with an placed in the groin. MedStar Union Memorial was selected as one Recently, MedStar’s Heart and EMILY KUCHINSKY, MS, CGC inherited cancer syndrome will require of 80 cardiac centers around the world to evaluate the safety and Vascular Institute expanded its Advanced Heart Failure Program “Learning that you’re at high-risk for cancer frequent screenings that differ significantly effectiveness of the transcatheter approach to replacing the aortic valve to encompass hospitals in can be terrifying for patients,” says Kuchinsky. from recommendations for the general in patients with severe aortic stenosis who are low-risk for traditional the Baltimore area with care “By having this clinic that focuses solely on population, such as yearly breast MRIs open heart surgery. The 78-year-old man is the first patient in the state from experts including George a high-risk group, we’re hoping to take the for patients with BRCA mutations (which of Maryland to receive the heart valve as part of this clinical trial. Ruiz, MD, Sandeep Jani, MD, sting out of this frightening diagnosis and increase the risk of breast and ovarian and Jane Lashley, CRNP, RN. provide patients with the comprehensive cancer) or yearly colonoscopies for Patients who require mechanical support they need.” patients with Lynch syndrome (at high- risk of colon, uterine and ovarian cancer). NEW CLINICAL TRIAL AT MEDSTAR FRANKLIN circulatory support such as a left Kuchinsky explains that the clinic, which Patients with strong family cancer histories SQUARE MEDICAL CENTER ventricular assist device, or those began in late April and will be a “one- but inconclusive genetic tests will also who require a heart transplant stop shop” for patients concerned about need updated testing as new gene panels A new clinical trial at the Weinberg Cancer Institute at MedStar Franklin to treat this condition, can be a heightened cancer risk, coordinating develop, Ottaviano explains. Square Medical Center is currently enrolling patients with newly referred directly to MedStar Washington Hospital Center, a To refer a patient, call specialties including genetic counseling, diagnosed, Stage III or Stage IV Ovarian, Fallopian Tube or Primary “This is an evolving field,” she says. “It’s hospital that leads the country in 855-218-6282, or visit and medical oncology. Peritoneal Cancer. The study will test the immunotherapy agent the number of these procedures MedStarCancer.org/ never ‘one and done,’ with patients tested Atezolizumab in combination with chemotherapy as neo adjuvant Prevent for more After providing an in-depth family and a single time and never coming back.” or adjuvant treatment. Participants will be randomly assigned to one performed. “We are a full information. personal history and results of any genetic of the two treatment arms of the study: Atezolizumab + Paclitaxel service shop,” says Ruiz, chief Being able to follow patients while tests, patients meet with Kuchinsky to + Carboplatin + Bevacizumab vs. Placebo + Paclitaxel + Carboplatin of cardiology, MedStar Union providing continuing information and discuss their likelihood of having an + Bevacizumab. After six cycles of chemotherapy patients will continue Memorial Hospital and MedStar support is one of the biggest benefits inherited cancer syndrome. On the same on Bevacizumab + Placebo OR Bevacizumab + Atezolizumab for a total Good Samaritan Hospital. “Our of the clinic, she adds. “For these patients,” day, patients can meet with Ottaviano and of 22 cycles of Atezolizumab and 20 cycles of Bevacizumab. The two co- goal is to connect Baltimore-area Ottaviano says, “the knowledge and a nurse practitioner to develop a plan to primary endpoints are progression free survival and overall survival. patients with the latest technology move forward. For many patients at high- continuing monitoring we provide will and a comprehensive approach risk for developing breast cancer, Ottaviano be power.” Please contact Jean M. Flack, BSN,OCN,CCRC, at 443-777-7364 for more information. to their advanced heart failure.” 10 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 11

This total (which includes procedures performed at MedStar Union Memorial Small Pacemaker, Big Benefits Hospital and MedStar Washington Hospital Center) is more than any other institution from Delaware to South Carolina to date, CARDIAC PACEMAKERS HAVE UNDERGONE A SUBSTANTIAL TECHNOLOGICAL making MedStar Heart and Vascular Institute REVOLUTION SINCE THEIR INCEPTION IN THE 1950s, GOING FROM BULKY, the most experienced WATCHMAN™ site on EXTERNAL DEVICES TO SMALL IMPLANTABLE ONES TYPICALLY THE SIZE OF the Mid-Atlantic seabord. TWO SILVER DOLLARS.

™ The WATCHMAN is inserted endovascularly Although there’s no doubt that conventional through the groin and into the LAA through pacemakers are lifesavers, says Glenn the interatrial septum, a procedure guided Meininger, MD, FACC, director, Cardiac This device highlights the transition to smaller, by transesophageal echocardiogram and Electrophysiology Services for the Baltimore less invasive therapies that may allow rhythm fluoroscopy that takes less than an hour. region of the MedStar Heart & Vascular management through micro technology." After 45 days, patients receive another TEE Institute, they have definite drawbacks. to make sure the LAA closure is complete The device leaves behind a substantial GLENN MEININGER, MD, FACC and that no blood clots have formed on the scar and lump; recovery requires weeks DIRECTOR, CARDIAC ELECTROPHYSIOLOGY SERVICES 100th WATCHMAN™ device. If these results are clear, they can of restricted activity; and, although rare, discontinue their anticoagulants for life. implantation carries a small risk of infection and complications. Procedure Performed Not all those with atrial fibrillation qualify for this device, Wang says. Patients must That’s why Meininger says that he and ™ MHVI IS THE MOST EXPERIENCED WATCHMAN have a CHADS2 score of 2 or greater, or his colleagues are excited about a new PROGRAM ON THE MID-ATLANTIC SEABOARD. a CHA2DSs-VASc score of 3 or greater, technology known as Micra™ transcatheter both measures of stroke risk. Patients must pacing system (TPS). This new pacemaker Anticoagulant therapies, such as warfarin also face significant risk from long-term is about a tenth the size of traditional and novel oral anticoagulants (NOACs) anticoagulation therapy. Other patients can’t ones—about the dimensions of a vitamin can be lifesavers for patients with atrial ™ use the WATCHMAN due to having an and the weight of a penny—is leadless, fibrillation, the most common arrhythmia LAA that doesn’t fit the standard five sizes and is implanted through an endovascular in the United States. These drugs prevent currently available. technique. In March, Meininger and David blood clots caused by blood pooling in Schamp, MD, chief, Electrophysiology at the left atrial appendage. MedStar Union Memorial Hospital, became IMAGE COURTESY OF MEDTRONIC But for some patients, the risk these some of the first in the region to take Because the device itself delivers electrical therapies carry outweighs the benefits, says advantage of this novel device when they To refer a patient to signals, no leads are necessary. The battery interventional cardiologist John Wang, MD, implanted it in a patient. MedStar Union Memorial lasts as long or longer than a traditional Cardiac Catheterization chief, Cardiac Catheterization Laboratory “This little device is quite sophisticated pacemaker due to lower energy output Lab, please call: at MedStar Union Memorial Hospital and in its design,” Meininger says. “Because required when pacing. 410-554-2332 scientific director, Baltimore Cardiovascular it’s implanted minimally invasively, there’s Research. Patients who are at risk for significantly less risk of complications or In its current form, the TPS is limited to hemorrhaging can’t take these drugs, infection. It’s cosmetically invisible—no treating brachycardia and other single leaving them at significant risk for strokes surgical scar, and the patient can be active chamber cardiac rhythm disorders. or a systemic embolism. But for patients who qualify, Wang says, this almost immediately after it’s implanted. This Those with limited vascular access, such Weighing the same device can be life changing. is truly an exciting advancement in cardiac as patients who are elderly, have kidney as a penny, TPS is However, since 2015, patients have a one-tenth the size of rhythm pacing therapy, and I am happy to disease, or have a history of cancer, are the new option to decrease their stroke risk: “It’s a great feeling for these patients, who standard pacemakers. be able to offer the option to our patients.” best candidates for this device, Meininger the WATCHMAN™ Left Atrial Appendage really don’t want to be on bloodthinners,” explains. Eventually, he says, new versions Closure device, a mesh filter that fits he adds. “For us to be able to implant this The device is implanted by inserting a might have expanded indications. over the LAA, promoting the growth of device that allows them to end these lifelong wire catheter through a small incision in endothelial tissue that closes it off within drugs is very gratifying.” the groin and threading the TPS through “This device highlights the transition to weeks of implantation. the femoral artery directly into the right smaller, less invasive therapies that may ventricle of the patient’s heart. Tines that allow rhythm management through micro MedStar Heart and Vascular Institute recently STARTING AT TOP: John Wang, MD, chief, Cardiac Catheterization Lab, ™ technology,” Meininger concludes. implanted its 100th WATCHMAN™. MedStar Union Memorial Hospital; WATCHMAN is designed to prevent blood clots project from the TPS hold it in place. from exiting the left atrial appendage in patients with non-valvular atrial fibrillation 12 MEDSTAR HEALTH CONNECT MAGAZINE VOL. 2 ISS. 1 FALL 2017 13

INNOVATIONS TODAY: MEDSTAR WEBSITE PROVIDES EDUCATION BEFORE CARDIAC CATHETERIZATION

COMMUNITY FOCUS: HUNT VALLEY

MedStar Health at Hunt Valley combines sports orthopaedics, sports medicine primary care, physical therapy, and sports performance at one convenient location. At Hunt Valley, on the campus of U.S. Lacrosse's national headquarters, we apply the principles of caring for elite professional athletes to all our athlete patients, including youth competitors and weekend warriors.

Our network of sports medicine specialists provide a wide range of services, including concussion testing, pediatric/adolescent sports CONNECT WITH: RAGHUVEER VALLABHANENI, MD medicine, and injury prevention. We also offer a variety of rehabilitation services, such as diagnosis and management of concussions, return-to- play assessments, and post-surgical rehabilitation, as well as an athletic Dr. Vallabhaneni, a fellowship-trained vascular surgeon who is board certified in both enhancement program designed to improve abilities such as speed, vascular surgery and general surgery, recently joined MedStar Heart & Vascular Institute agility, power, strength, flexibility, and coordination. as the director, Vascular Surgery for the Baltimore region after serving as an assistant Through our partnership with U.S. Lacrosse, the national governing body for To help put patients and their this sport, we are working to raise awareness and reduce the risk of lacrosse professor of Surgery in the Division of Vascular Surgery at the University of North families at ease before cardiac injuries. As lacrosse participation continues to grow nationwide, MedStar catheterization, the MedStar Carolina. He spoke with CONNECT about his expertise and plans for the future. Health and U.S. Lacrosse have established a groundbreaking lacrosse Heart & Vascular Institute’s Cath sports medicine program, collaborating on research, education and injury Lab teamed up with the health prevention in youth lacrosse. AS A NEW MEMBER OF THE MEDSTAR severe detrimental impacts on their quality system's own Simulation Training TEAM, WHAT SERVICES DO YOU BRING of life. Many procedures can be performed & Education Lab (SiTEL) to create TO PATIENTS? using catheters and stents that have previously an engaging Patient Education Portal to dispel fear by explaining RESEARCH TODAY: My practice covers the whole spectrum required long, painful incisions. Now, patients the process, from before of vascular disease, from treating in their 80s can have limb and life preserving IMMUNOTHERAPY MEDICINE CONFIRMED BETTER patients arrive until after they are thoracoabdominal aneurysms, lower leg surgery and may be home in a day or two as discharged. This portal is currently THAN CHEMO IN SOME CANCERS revascularizations, carotid disease, dialysis opposed to several days in the hospital and available to patients at MedStar access, venous disease and helping other potentially months of recovery with some A recent study co-authored by MedStar Franklin Square Medical Center Union Memorial Hospital. specialties deal with the blood vessels of the open surgeries. oncologist Suman Rao, MD, and published in the New England Journal body. I am particularly interested in complex of Medicine confirms that immunotherapy produces better results than Patients and their family members aortic operations, and I’m well trained in both WHAT PLANS DO YOU HAVE AS THE NEW chemotherapy in first-line treatment of patients with metastatic non- may view the videos as often open and endovascular procedures. It is a DIRECTOR OF THE BALTIMORE REGION? small cell lung cancer. The immunotherapy medicine used in the study, as they would like. The videos To schedule a patient privilege to be able to provide this range of Keytruda, which targets the programmed cell death 1 (PD-1) receptor, I’d like to standardize the care that patients are short—none longer than consultation, please call services for my patients. I really try to assess won Food and Drug Administration (FDA) approval in November 2016 receive across our four area hospitals. It is very two minutes—and highlight key 410-554-2950 the right treatment for each individual patient based on the results of this study. important that patients are certain that they portions of the process, including whether it is an open operation, a minimally are getting the highest quality of care from what patients should bring to Rao enrolled the most patients in the trial across the U.S., which involved invasive procedure or medical management. MedStar vascular surgeons. I care deeply for the hospital, the personnel they 305 patients from 16 countries. In the study, patients with advanced non- the quality and safety of our patients and am will meet, the procedure itself, small cell lung cancer and the PD-1 expression on at least 50 percent WHAT DO YOU FIND MOST REWARDING implementing programs to make sure these questions they should ask their of tumor cells, had a much longer time to progression of their cancer, ABOUT THIS FIELD? are achieved. We would also like to expand our doctor, discharge information and and had fewer adverse reactions than patients who were treated with chemotherapy. Some of these patients have continued to remain in In the past few decades, there’s been a big services to all of the MedStar hospitals in the resources available. remission after stopping all treatment for their advanced lung cancer. paradigm shift in how we treat vascular disease. Baltimore region. We are now able to provide care for complex procedures that previously This is particularly true regarding complex “Where we are seeing progress with using immunotherapy,” said aortic problems such as aneurysms and have only been available at larger academic medical centers. But no matter how large we Dr. Rao, “is in difficult to treat cancers, such as advanced non-small cell dissections. Being able to provide less invasive lung cancer and bladder cancers. This is a huge leap for those of us on become, we’ll always strive to maintain the endovascular treatments for these issues has the journey with patients whose diseases have been most challenging. excellent communication and care that our allowed us to treat patients who would not There are more studies underway, and much more work to do, but this system is known for. have been able to survive open surgery or have ABOVE: A patient views videos before her procedure. is a very exciting finding.” MedStar Care Connection Non-Profit Org. 8094 Sandpiper Circle, Suite F US Postage PAID Baltimore, MD 21236 Baltimore, MD Permit No. 0000

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