Earlier this year, Valley-Mount Sinai Comprehensive Cancer Care — part of Valley Health System — became the only hospital on the East Coast and the fourth in the nation to use new technology that improves radiation therapy precision by accounting for the continual motion of a patient’s anatomy. Such advances have made a big difference in patient care. But they come at a price.
“With this technology [the newest version of ExacTrac Dynamic from Brainlab] we are scanning 300,000 points on the surface of a patient’s body — over 10 times more than other systems — to analyze a patient’s shape, which will improve our treatment precision,” according to Dr. Chad DeYoung, co-medical director of radiation oncology at Valley. “When we combine that benefit with thermal imaging and the ability to see the inside anatomy, we achieve unparalleled accuracy for virtually every cancer type that we treat.”
Another Valley System institution, The Valley Hospital, performed its first implant of a breakthrough device that uses neuromodulation to link the brain and the nervous system to improve the symptoms of patients with heart failure.
“The Barostim NEO is a pacemaker-like minimally invasive implant device that is an effective alternative for patients with heart failure who have a left ventricular ejection fraction of 35% or less, and are not candidates for other forms of therapy, such as cardiac resynchronization therapy,” Valley announced in May. “It is designed to send signals to the brain to regulate cardiovascular function and rebalance the body’s ‘fight or flight’ and ‘rest and digest’ reflexes.”
The procedure was performed by Dr. Suneet Mittal, director of electrophysiology, and Dr. Daniel Char, director of vascular surgery, collaborating with Dr. Kariann Abbate, director of Valley Health’s Center for Comprehensive Heart Failure Care. “I’ve seen a lot of technological medical advances since 2014 [when she completed her medical studies],” Abbate said. “Some of them, like the TAVR [transcatheter aortic valve replacement — a heart procedure to replace a thickened aortic valve that can’t fully open] meant that this kind of formerly complicated heart surgery has become a minimally invasive procedure where the patient may be discharged the next day.”
Other New Jersey-based medical systems, like Capital Health, deploy robotic and other devices, according to Chief Medical Officer Dr. Eugene J. McMahon. The organization works with vendors like Intuitive, which developed the daVinci robotic surgical system that can deliver a less-invasive approach to many types of surgery.
“We’re also working with Johnson & Johnson’s Auris Health division on trials for the company’s new Monarch Platform,” he added. “It is similar to the da Vinci system, but Monarch is undergoing studies to determine its efficacy in delivering pharmaceutical therapeutics directly to lung tumors. It could be a real game changer.”
Capital Health urologists are also in talks with J&J about a new robotic instrument that may be able to extract challenging kidney stones in a less-invasive manner, he noted. “Other technological advances include devices used by our gastroenterology physicians that enable the physician to enter directly into a patient’s bile duct through the digestive system to relieve gall bladder blockages without invasive surgery.”
A holistic approach
While giving kudos to surgeons, McMahon points out that technical and electronic advances in other areas, like mental health, should not be ignored. “For example, Capital Health utilizes state-of-the art technological connections for patient psychiatry,” he said. “Our crisis center is connected around the clock with not only our on-site psychiatrists, but also other professionals who can connect remotely and assist in the diagnosis and treatment of patients in real-time. They can remote in without being a distraction to the patient, and identify giveaway signals like tremors, particular eye movements, and many other signs that can help them to deliver a more-accurate diagnosis in a timely manner.”
But progress doesn’t come cheap. McMahon said the robotic surgical and other instruments, a new electronic medical records system, and other enhancements carried a tab of some $100 million. “It’s important to engage in detailed financial planning before you undertake these kinds of capital expenditures,” he said. “I’m pleased to say that we’ve never missed a debt payment; moreover, as an independent, not-for-profit, locally controlled health care entity serving primarily Mercer and Bucks counties, our board of directors and senior management are committed to prudent growth to most efficiently improve the health and well- being of patients.”
Medtech advances are helping to improve patient outcomes, but the rollout is uneven, cautioned Zeeshan Ahmed, an Assistant Professor of Medicine at Rutgers Robert Wood Johnson Medical School and the Rutgers Institute for Health, Health Care Policy and Aging Research. “The implementation and growth of AI and machine learning in healthcare has been incongruent in low- and middle-income setups compared to high-income ones,” he said. “Major reasons include low budget, lack of computational resources and unavailability of trained personal, specialist medical professionals and investigators for innovative research, development, and practice in healthcare. Going forward, we need to implement Findable, Accessible, Intelligent, and Reproducible (FAIR) AI and ML-based intelligent health systems for dealing with the challenges, including, but not limited to the prevention, timely detection, and monitoring of infectious, chronic, and other complex diseases.”
Robotic surgery and other technology that supports surgery is continually advancing and a robotic surgery program at Englewood Health has grown in recent years, according to Dr. Nimesh Nagarsheth, the medical director of gynecologic oncology at The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health and the medical director of the robotic surgery program at Englewood Health.
“We currently have two of the latest generation da Vinci Xi robots, as well as a simulator that gives us the ability to train other providers,” he said. “In fact, beginning in January, Englewood Health will be a case observation site for gynecologic robotic surgery among just a handful of other institutions in the United States. We are also beta testing a robotic application that allows surgeons to see how well they performed their surgeries compared with benchmark performance standards. This application allows us to continually fine-tune our surgical skills.”
The Stryker SPY-PHI camera is another tech advancement, Nagarsheth noted. “It utilizes fluorescence imaging technology to allow surgeons to visualize blood flow in vessels and lymphatic mapping. At Englewood Health, we are excited for the future and continually looking to grow our team of robotic experts and the use of robotic and technology-supported surgery.”
Size is no barrier
Hospital systems don’t have to be large to access medical technology advances. This year, Cape Regional Health System — which serves residents and visitors throughout Cape May County — installed a new pharmacy robot called XR2, and a carousel, according to Director of Pharmacy Dr. Richard Artymowicz.
“The carousel looks like a Lazy Susan turned on its side, with shelves that move vertically and the XR2 has a robotic arm that moves back and forth on a pneumatic rail,” he explained. “The Omnicell XR2 Automated Central Pharmacy System represents the latest in medication dispensing technology, and uses bar coding to correctly identify medications. This limits the number of human touches that it takes to deliver patient medications to the bedside, thus limiting the potential for error.”
The system also reduces expired medication waste by dispensing medication on an “earliest-to-expire” basis, is configurable and can easily be tailored to meet an institution’s needs and can adapt to an institution’s medication dispensing needs, according to the manufacturer. It also “provides complete, real-time visibility to every dose and corresponding expiration date managed in XR2.”
There are plenty of advantages, but they also come at a price, noted Artymowicz. “The challenges with this technology were space and cost. The robot and carousel take about a week to build and another week to fill with medications. Using the technology is relatively easy, but staff needs to be trained to change consumable parts and troubleshoot minor issues.”
And the robot, which has a telemetry system that allows offsite crews to monitor and address any of its IT related issues, “cost $1.4 million and was financed through a capital lease,” he added. “But in the long run, this technology helps save on labor costs as well as improve patient safety. Before robotics, we would print a list of every patient and the meds they needed for the next 24 hours. A person would pick up the medications and place them in a bin, and then the pharmacist would follow up. The entire procedure, which must be done every day, would usually take two technicians and two pharmacists for up to eight hours. Now we can accomplish this daily procedure with one technician and one pharmacist, and it only takes about 30 minutes to perform checking.”
Another smaller organization, Holy Name, is the first health care system in New Jersey and one of very few health systems nationally to participate in the Centers for Medicare & Medicaid Services’ Hospital at Home program, according to Cedar Wang, vice president of nursing operations. “This enables Holy Name to use our advanced technology capabilities to bring acute inpatient care right into patients’ homes. In the post COVID-19 environment, minimizing patients’ exposure to potentially infectious diseases — while providing world-class acute services in the comfort of patients’ homes — could drastically alter the healthcare landscape for decades to come.”
With Hospital at Home, each qualifying patient receives two nurse visits every 24 hours, she added. “Patients’ communications and vital signs are instantly delivered to the hospital via a Wi-Fi enabled VitalCare health care tablet issued by Holy Name. Each person is assigned a personalized care team comprised of doctors, nurses, specialized therapists and others, who monitor recovery and, if needed, initiate an in-person or telemedicine visit with a physician or nurse practitioner. Patients are given the flexibility to control their care and may elect to return to the hospital at any time.”
1 of 1 article
0 articles remaining
Advance your business edge with news from NJBiz. Register now for more article access.