Tissue Procurement Makes it to the Cover of Science Magazine

The initial findings of the GTEx consortium were released on May 8th 2015.  I am proud to have served as one of the PIs on this most valuable project.  The full article can be found at Science, 8 MAY 2015 VOL 348, ISSUE 6235, PAGES 605-728.

Colors and shapes show variations between people and within individuals. The Genotype-Tissue Expression (GTEx) Consortium examined postmortem tissue to document how genetic variants confer differences in gene expression across the human body. 

Structured Education Leads to Improved Confidence and Application of Techniques to Patient Care

Hands-on education using cadaveric tissue has become a common tool for teaching new surgical procedures.  However, many medical device companies report that the physicians need to attend 2 perhaps 3 courses before they attain the confidence necessary to apply a new procedure to their patients.

Most professional educational courses have limited structure, generally a lecture component followed by a hands-on laboratory, and physicians are free practice their techniques and gain confidence guided by an expert faculty.

However, new studies suggest that physicians may benefit from a more structured approach and the time to adoption of new procedures can be markedly reduced by employing adult learning principles and reinforcement of the educational messages.

As professional education using human tissue continues to evolve, use of all modalities, including computer simulation and animal models are expected to be employed in a structured manner to reinforce and expand physician learning. 

Expansion of Hospital Based CME is Required

Did anyone see the article in the USA Today highlighting a study that demonstrates that a significant population of patients are dying from the care they received in the hospital?

http://www.usatoday.com/yourlife/health/healthcare/2010-11-16-Medicare_N.htm#uslPageReturn


Before anyone starts to make negative comments – I agree, its only one study but it does bring up important topics worthy of discussion. The landscape is changing – doctors and hospitals have greater responsibilities than ever before yet must find efficient ways to work together to ensure that process improvement initiatives are successful.

There needs to be increased funding for hospital based PI CME and there needs to be increased collaboration among the hospital departments for formalized process improvement. The next step is to make PI CME more approachable to the physician participants that are already struggling to keep up with increased patient loads and sweeping changes in the profession.

As we move into the a new age that includes healthcare outcomes as a mandatory part of CME, I expect that additional studies such as the one discussed in the USA article will come to light with increased frequency – and eventually the success stories will emerge as well.

Harold I Magazine is the Vice President of Professional Education at Science Care and may be reached at harold.magazine@sciencecare.com. The views expressed in this Blog are my own and do not necessarily reflect the views of Science Care.

Science Care Celebrates its 10-year Anniversary

I am pleased to announce the 10-year anniversary of Science Care. Ten years ago this month, Science Care began as a small company meeting the needs of people wishing to donate to science and medical researchers and educators who needed human tissue. Today, it is an industry leading, multi-accredited organization in a unique position to make a significant contribution to improvements in patient healthcare. 


I know of no other organization that is so committed to the pursuit of quality and making a positive impact. It is an honor to be part of such a unique organization.

Click HERE to watch a video featuring Science Care’s founder and CEO, Jim Rogers.

Click HERE for the press release celebrating Science Care’s 10-year anniversary.

Is technology in the surgical suite really helping patients or is it time for surgeons to go back to the basics?

A scalpel and surgical thread used to be the primary tools of surgeons. Now the surgical suite looks more like a sci-fi movie complete with HD monitors, robots and computer equipment galore. Surgeons continue to expand their use of minimally invasive procedures to avoid large incisions and associated tissue damage in an effort to reduce complications and time to patient discharge. But are these technological advancements really all good? New data suggests that all options from invasive surgery to laparoscopic and robotic procedures must be carefully considered as not all patients seem to benefit from advanced procedures. Surgeons may require additional education to be able to fully consider their options and to incorporate recent clinical evidence into their practice.


Why do surgeons use minimally invasive procedures?
Minimally invasive procedures can reduce the size of the incision that is required to gain access to the tissue of concern. Since tissue damage caused by the surgery itself can be significantly reduced, many patients experience a reduction in postoperative pain and a shorter time to discharge. Another benefit is that some patients who might not be able to tolerate a typical surgical procedure due to age, advanced disease or poor health status, can be considered as candidates for minimally invasive procedures.


Both laparoscopic and robotic surgeries are minimally invasive procedures but robotic technology may expand the view of the surgical site, provide greater accuracy, and control compared to laparoscopic instruments. Improved accuracy is thought to reduce surgeon-induced damage, blood loss and scarring.


Although the new techniques have been touted as a revolution, new data suggests that surgeons must carefully consider the actual vs. perceived patient benefit. Patients with endometriosis, for example, did not benefit from the use of robotic surgery and their clinical outcomes were comparable to non-robotic procedures. The actual time in the surgical suite was increased as was fatigue reported by the surgeons.


Don’t blame the robots
While it may be true that the use of advanced technology is on the rise and it is an attractive option for surgeons, new technology is not the only answer. Many studies have demonstrated that experience matters; the more familiar a surgeon is with a technique the better they perform. Experienced surgeons armed only with a scalpel can have clinical outcomes similar to or better than their colleagues using robots. The question is, can experienced surgeons armed with robots improve clinical outcomes?


The take home message
Technology is here to stay and its use in the surgical suite will continue to increase over time. However, it is not technology alone that will improve patient outcomes, it is technology coupled with experienced, trained surgeons. Advanced hands-on training using human tissue is one way for surgeons to both gain experience and fully incorporate technological advances into their practice.


Every patient is unique—patients with advanced disease may benefit from technology in ways that patients in early stages may not.  The decision for each patient should be left to the trained surgeon.

SCIENCE CARE OPTIMIZED EDUCATION™ 2010

Science Care announces two Continuing Medical Education (CME) courses for September 2010, the first courses to employ Optimized Education™. As the first non-transplant tissue bank to be accredited by both the American Association of Tissue Banks and the Accreditation Council for Continuing Medical Education, this year’s innovative CME program has been developed by new professional education leadership and the introduction of Science Care Optimized Education™.

Science Care Optimized Education™ incorporates adult educational principles, hands-on interaction and time-aligned reinforcement with targeted follow up education to improve learning and retention. Optimized Education™ is associated with accelerated incorporation of clinical knowledge and improvement in clinical performance and healthcare delivery.
Percutaneous Endoscopic Gastrostomy (PEG) and Percutaneous Dilational Tracheostomy (PDT), both scheduled for September 2010, will feature an interactive lecture session and a hands-on competency assessment module and demonstration using human tissue.

Percutaneous Endoscopic Gastrostomy (PEG) is an endoscopic procedure that facilitates placement of a stomach feeding tube as a long-term means of providing nutrition to patients who cannot productively take food orally. Compared with traditional surgical gastrostomy, PEG takes less time to complete, has a reduced risk for adverse events, and can be performed with a significant reduction in cost. Attendees will learn to identify appropriate candidates for PEG, manage complications and demonstrate proper procedural preparation and technique. In addition, participants will review privileging, credentialing and billing procedures that can be immediately applied to their practice.

Percutaneous Dilational Tracheostomy (PDT) is the placement of a tracheostomy tube (breathing tube) without direct surgical visualization of the trachea. This procedure is considered minimally invasive, and may be easily performed in the intensive care unit or at the patient’s bedside. This may avoid difficulties associated with scheduling an operating room and anesthesiology teams for critical care patients. Attendees will learn to identify appropriate candidates for PDT, manage complications and demonstrate proper procedural preparation and technique. In addition, participants will review privileging, credentialing and billing procedures that can be immediately applied to their practice.

Both of these courses were planned in accordance with the guidelines set forth by the Accreditation Council for Continuing Medical Education (ACCME) with the intention of increasing the learners’ competence, performance and patient outcomes. The expert faculty was selected for their clinical expertise in the area of critical care procedures and prominent standing in their field. These courses will be executed free of bias from any commercial supporter in order for learners to provide the best medical care for their patients.

To register for one or both of these courses, please visit http://www.sciencecare.com/calendar.htm or call 602.288.0063. To read about the healthcare outcomes associated with this activity, visit http://humantissue.blogspot.com/2010/05/continuing-medical-education-for.html


For more information about Science Care Continuing Medical Education, please visit www.sciencecare.com/CME.htm, email cme@sciencecare.com, or call 800.590.8132.

Science Care
Science Care (http://www.sciencecare.com/) sets the standard of excellence for the donation and responsible use of human tissues for medical research, training, and professional education. Science Care’s program contributes to new breakthroughs and developments in medicine, including advanced physician training, development of new medical devices and safer, more effective treatments for patients. Each development provides hope for a healthier future and enhances the generous bequests of our donors.

Science Care is accredited by the American Association of Tissue Banks (AATB), licensed by the state of New York Department of Health, and is an approved provider for the Accreditation Council for Continuing Medical Education. For more information about Science Care contact 800.417.3747 or info@sciencecare.com.

Hands-on Education: Make It Practical

The Status of CME
For years, we’ve been educating physicians about the latest therapies and medical devices. However, equal emphasis should now be placed on helping them to integrate the educational information into changes in performance and to navigate the complexities of the current healthcare system to ensure that barriers to implementation are removed or overcome.

Diagnostic and therapeutic challenges faced by physicians continue to increase, while the escalating requirements and expectations of insurance companies leave them (and their patients) exasperated. The end result is that physicians are left to figure out how to do it all.

As CME providers, how can we continue to help physicians overcome the barriers of improving their clinical practice? The answer may be simpler than you think: Use CME to complete the educational cycle and provide clinicians with tools and strategies to implement what we've taught them.

Make it Simple
In a recent CME activity, clinicians were educated about a new surgical procedure and how to coordinate patient follow up with their non-physician staff. This single educational intervention resulted in a profound reduction in adverse events noted after the procedure due to improved patient screening before the procedure and follow up at the right time. Patient care and health outcomes were improved. How was this accomplished? By giving physicians a simple plan of action to implement what was taught. Of equal importance, the activity raised awareness of potential barriers that should be avoided in the physicians' clinical practices.

If we develop CME activities that address the administrative realities of modern clinical practice, the results can be profound. Here are a few ideas to consider:

• Provide education that gives a hands-on or informal discussion component to accelerate integration into physicians’ clinical considerations.
• Addresses the administrative components of the physicians' and non-physicians’ daily duties.
• Include resource materials that can serve as follow up education that can reinforce and sustain the learning related to the content of the CME activities.

Efforts such as these can arm clinicians with strategies that can be put into practice immediately and may contribute to improvements in patient care.

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