By Ruthan Brodsky
October 16, 2008
Corp! applauds the courage and creativity of people and organizations working to improve Michigan’s health care system. This article profiles five innovators, showing us that ingenuity is alive and well in the state.
Two years ago, Spectrum Health Systems, Western Michigan, studied how it could help employees develop their innovative ideas and extend them into practical applications for better health care. This resulted in establishing a creative culture which encouraged employees to present their ideas and follow a process leading to a possible prototype product.
“Over 600 employees have presented their ideas as a first step,” says Kris White, vice president of patient affairs at Spectrum Health.
“One idea, presented by a nuclear medical technician, focused on the problem of getting children to lie still while being scanned. Strapping them to a table didn’t work.
The solution was a blanket that resembled a puppy or bunny. The legs and paws were used to restrain the children. The children felt more secure with these stuffed-animal blankets, moved less, and scanning results improved.”
A second Spectrum idea, developed by a nurse and housekeeping employee, resulted in a cord management device which harnessed the many electrical cords plugged in under a bed, keeping them in place so they weren’t in the way when patients were examined or the room was cleaned.
“This device was recognized as an additional safety feature we could provide our patients,” explains White.
Health care is changing rapidly, integrating complex technology, clinical devices, sophisticated database programs and pharmacology. For the past four years, there has been some resistance about adopting electronic prescribing, even with the creation of the Southeastern Michigan ePrescrib-ing Initiative in 2005. The picture is now changing as doctors realize that electronic prescribing helps prevent many prescription drug errors and injuries caused by adverse drug reactions.
“About 18 months ago, 500 members of the United Physicians (UP) Association in Michigan started using ePrescribing in their practice,” says Dr. Steven Grant, president and CEO of UP, an independent physician association of over 2,000 physicians in Southeastern Michigan.
“Participating doctors found they used their time more efficiently with ePrescribing because there is a significant reduction in pharmacy and related patient calls. The good news for patients is that the system also lets the doctor know if there’s a generic drug available, reducing costs as generic use increases. The other good news is that the numbers of possible errors is reduced because the prescriptions are legible and the orders go straight to the pharmacist,” says Grant, who is based in Bingham Farms.
Dr. Jeffrey Williamson, of the Family Practice Group in Cedar Springs, says doctors and patients in his practice have embraced ePrescribing.
“I’m providing better medical delivery to patients because ePrescribing is mobile,” says Williamson. “For instance, while examining patients I access their charts and send a prescription order directly to their pharmacy because ePrescribing integrates with our electronic medical record system. Plus the system alerts me to patients’ drug allergies, drug interactions and if there’s any duplication of medication.”
Drs. Mark Florek and Bruce Miller of Birmingham were the first physicians in Michigan to join MDVIP, a national network of primary care physicians with a unique approach to health care that focuses on prevention and wellness.
“My goal as a physician is to provide my patients with the best medical care possible,” says Florek. “However, my ability to provide quality care eroded over the years because of the increased tasks required by insurance companies monitoring health insurance. The time on these tasks doesn’t improve the quality of my patients’ care and I didn’t want to hire a physician assistant or nurse practitioner to work with my patients because I no longer had the time. I had to go through more and more layers to solve my patients’ health problems and less time was spent on patient care. I wanted to change that.”
Florek reduced his practice of over 2,000 patients to no more than 600. In return for this system of preventive care, participating patients pay a membership fee of $125 to $150 a month.
“Limiting my practice was the most difficult part of this transition because many patients have been with me for over 20 years,” recalls Florek. “However, I understood that this system for providing patients with comprehensive primary care, including a personalized wellness plan, more time during office visits, annual physicals and 24-hour physician availability, only works with a smaller practice. For the return on their investment, my patients are likely to be spending less on their health care because preventing potential medical problems by advanced screening and tests will decrease hospital visits. I wanted to practice medicine in a more personal way and the MDVIP system enables me to do just that.”
Innovation is critical in health care, in particular when it comes to clinical advancements. Sometimes, however, the medical field is slow to change.
Dr. Bruce Dall, an orthopedic spine surgeon at Borgess Hospital in Kalamazoo, is a leader in sacroiliac (SI) joint fusion, having devised a new, inventive and proven procedure that is less invasive and provides more relief from debilitating lower back pain.
“SI fusions were done as early as the 1930s but fell out of favor because surgeons preferred lumbar spine surgery to reduce lower back pain,” explains Dall. “I went back to that procedure, realizing that damage to the SI joint is the cause of pain for many patients. I changed the procedure and made it less invasive. I’ve done over 150 of these surgeries to date and our success rate is 85 to 90 percent.”
Dall is now demonstrating his procedure to other surgeons across the country and his third paper on the surgery was recently accepted for publication in a peer reviewed journal. Sometimes innovation takes a little longer-in this case 75 years.
Innovation can also occur as a response to consumer demand, the need to overcome constraints, and a desire to pursue a new opportunity or a need to achieve greater efficiency.
Dr. Alan Koffron, director of multi-organ transplantation at Beaumont Hospital, arrived at his medical innovation-the development of a laparoscopic procedure for harvesting liver tissue from a living donor-using all of the above.
One of the primary reasons living donor liver transplants are so important is that the number of patients awaiting liver transplantation in the United States is far more than the supply of cadaver donor organs.
“In a living donor transplant, a segment of a healthy person’s liver is transplanted into the sick patient,” explains Koffron. “This can be done because the liver is the only organ that can regenerate itself. Both the donated segment and the remaining section of the donor liver will grow to normal size within weeks.”
The problem? The surgical procedure for harvesting the liver segment from the donor was a major procedure, with the donor in the hospital for at least two weeks and recovery lasting another eight weeks. This added up to a donor possibly being away from their job or caring for their children for two to three months.
“We’ve been removing gall bladders laparoscopically for years and often use laparoscopic procedures for removing a patient’s damaged liver tissue, so why not apply the same to the liver donor?” recalls Koffron. “We tried it and it worked very well. Donors now spend two days in the hospital and just two weeks for recovery. It is easier now to recruit donors because the procedure is more acceptable and less risky.”
Innovation can change existing processes and procedures as well as information flow and control. This kind of disruption can be disconcerting, yet at the same time exciting. In Michigan, medical and health innovation has created opportunities for the state’s medical community to distinguish themselves as leaders in their respective field.