Appropriate Use of Human Tissue in Education

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

2011-06-18T17:58:00.000-07:00

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

2010-11-16T08:45:00.000-08:00

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

2010-06-22T11:22:00.000-07:00

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?

2010-06-18T10:43:00.000-07:00

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

2010-06-10T09:48:00.000-07:00

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

2010-05-06T15:09:00.000-07:00

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.

Continuing Medical Education for Medical Devices - The Time Is Now

2010-05-06T08:32:00.000-07:00

Continuing Medical Education: Now vs. Later
There has never been a better time to consider the incorporation of Continuing Medical Education into your corporate strategy. The Food & Drug Administration's Center for Devices and Radiological Health has released a plan for significant changes to the 510(k) and PMA approval processes. The changes are expected to go into effect this year and are designed to encompass a "total product life cycle approach" that will enhance communication and transparency, and address unmet public needs. The changes will intensify the scrutiny of new applications and could extend the time for device approval.

Due to changes in FDA approval and potential delays in product approval targeted CME could become a required part of your educational strategy in the near future.

Do Physicians Want CME?
Physicians not only want, but demand evidence-based education that can be immediately applied to their practice. Survey results demonstrate that the location, relevance of the topic, and ease of access to an educational event are primary considerations for clinician attendance at a CME activity. Currently, non-accredited hands-on training offered by medical device companies is the primary source for education of doctors about new devices.

Physician interest in evidence-based CME-accredited education has increased significantly in the past few years. Unfortunately with only few hands-on CME courses currently available, they rapidly fill to capacity and cannot accommodate the large population of participants that would have benefited from the education.

Although a standard didactic CME course can be effective at increasing clinician knowledge, without follow up intervention, clinicians begin to forget the education within 3 weeks of attendance (Magazine HI, et al., Alliance for CME 31st Annual Conference; 2006). Professional Education officials at various medical device companies have indicated that in the past, "there wasn't much value in the CME activity" and that "most of the discussion was beyond our corporate interests."

Our studies have demonstrated that the educational content of many CME courses currently offered is too diffuse and doctors may lose interest. A successful CME activity will provide education on a limited area of validated education need and provide the education in a setting and format that interests and engages the physician participant.

Science Care CME
A Science Care hands-on CME course is an example of optimized education. We conduct our CME activities at either of our state-of-the-art facilities in Phoenix or Denver or at any of our many partner facilities. Courses can be stand-alone, part of a regional initiative or provided to reinforce education at a Congress or annual meeting the doctors may already be attending. By incorporating adult educational principles with opportunities to reinforce the educational objectives with a hands-on component, clinicians are more engaged, have greater retention and may be prepared to change clinical practice after only one educational activity.

Our hands-on CME courses have resulted in improvements in physician competence (Figure 1) and have accelerated appropriate use of devices within the physician's clinical practice. The use of educational outcomes assessment tools Science Care has demonstrated rapid changes to clinical practice and significant improvement in patient outcomes (Figures 2, 3).

Figure 1:

Figure 2:

Figure 3:

Science Care hands-on CME courses provide:
• Intensive education focused on an area of validated educational need
• Evidence-based education limited to "relevant" medical devices including those that have not yet received
   510(k) approval
• Opportunities to improve physician competency and performance
• Educational outcomes that validate improved knowledge or competence, and rapid incorporation of
   enhanced clinical skills into their practice

Science Care CME has significant value compared to standard didactic CME and can complement the ongoing professional education conducted by your organization.

To find out more about Educational Outcomes and Performance Improvement Metrics or about Hands-on Education at Science Care email CME@sciencecare.com  or call 800.590.8132.

Cost-cutting Strategies for Professional Education

2010-04-05T09:56:00.000-07:00

The doctors were delighted, the educational session was flawless and the venue and staff support all met expectations at your important event. So why are you feeling a bit anxious? Your boss has asked you to once again sharpen your pencil and reduce costs…yet you are still accountable for even higher productivity. Something’s got to give!

Clarify the Problem
A common reaction is to locate vendors that can provide services at a lower cost, but is this really the best approach? A reduced-cost vendor may have a lot of unexpected or hidden pass-through expenses, that result is a much higher cost in the long run. Companies are often not fully aware of how much they are actually paying for a meeting because they only considered the fixed costs, such as facility fees and fees for procuring tissue. It’s the pass-through charges, however, that can really add up. What is the cost of food and beverage per person? Is there a separate charge for personal protective equipment (PPEs), tissue disposal and clean up?

Vendor travel is also an area where cost can easily get out of control. Booking air travel early can result in huge savings, but there is no incentive for a vendor to do so if it’s a pass-through cost. Make sure you are examining all the costs, fixed and hidden, as well as the vendors’ policies, procedures and their general culture and values of how they do business.

Initial savings with a reduced-cost vendor can result in a failed event if the vendor is unable to properly implement your event. Tissue that is not of sufficient quality to achieve the educational objectives of the program will leave a negative impression with the doctors. Also, mistakes that result in legal or safety concerns can be potentially devastating to the health of your attendees and the reputation of your company. In the end, is it worth cutting costs when quality and safety are concerned?

Take control
If you are working with vendors that have served you well in the past, ask them to sharpen their pencils. Are they willing to consider a reduction in fees in exchange for a guarantee of greater business volume? Volume discounts are a win-win for clients and vendors alike. Make a list of expenses that commonly spiral out of control and have a conversation with your vendor about your concerns. Request bundled fees when possible. Science Care has recently moved to a model where staff support fees are fixed (including staff time, airfare, lodging, meals, and local transportation. In general, this results in a significant savings to our clients and guarantees that they know the final cost of their event, up front.

Reaching Success
You and your company can mitigate potential risk by being assured of the highest quality and safety standards. Working with a high quality and ethical partner will achieve your desired results every time, and you may also enjoy a reduced cost for your event.

The views expressed in this Blog are my own and do not necessarily reflect the views of Science Care.

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Human Tissue for Research and Education: Use of Human Tissue for Medical Research and Education: Is It Time to Regulate the Industry?

Scrutiny of the Pharmaceutical and Medical Device Industry: Its Time for Change

2010-04-04T13:04:00.000-07:00

Continuing Medical Education has experienced extreme scrutiny over the past few years, a trend that is expected to intensify. Unfortunately the defense of the industry and appropriate business practices has been slow to come. In my opinion we have failed to demonstrate that educational events can improve healthcare and reduce costs.

In this economy we all need to be innovators in this industry and elevate our level of performance. We must collectively publish our educational outcomes data, but, even more importantly, we must have meaningful data to publish. Our success stories must be showcased at national meetings and receive the media attention they deserve. Only then can we assume our place as catalysts for improvements in healthcare delivery.

On a daily basis, we meet individuals who have been silently touched by CME. The woman walking in the street who would have been debilitated by severe asthma, the custodian whose rheumatoid arthritis is in remission and can still work, and even closer to home — the beloved family member who, in her battle against advanced lung cancer, has responded to new therapies when standard chemotherapy had failed. In each instance, off-label use of agents, which is openly discussed in CME activities, has dramatically improved the lives of these individuals. These stories are now commonplace because of industry, government, and foundation support that has led to increased availability of CME. As providers, we must all work harder to ensure that clinicians continue to receive cutting-edge CME that addresses their validated educational needs, and that the benefits of CME to society are transparent to all. Perhaps Mahatma Gandhi said it best: “Be the change you want to see in the world.” Let's all heed that call.

This post has been adapted from the original article that appears in the citation below

http://meetingsnet.com/cmepharma/cme/meetings_fight_cme/

The views expressed in this Blog are my own and do not necessarily reflect the views of Science Care.

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Use of Human Tissue for Medical Research and Education: Is It Time to Regulate the Industry?

2010-04-02T09:45:00.000-07:00

I work at Science Care in Phoenix, Arizona. We are one of the largest American Association of Tissue Banks (AATB)-accredited non-transplant tissue banks. Only a few of the organizations that supply human tissue for use in medical education and research are accredited. As a former professor and medical researcher I feel all organizations that supply human tissue for research and education should be accredited.

Why is this important? Accredited organizations have rigorous procedures they must follow to ensure the safety of the individuals that use the tissue (and the staff in their employ) and the quality of tissue that is procured. Organizations that are accredited have external validation of their businesses practices to confirm that they are safe and that the vendors they use have been evaluated and are trustworthy. Perhaps if there were increased regulation that required all organizations that supply human tissue be accredited, human remains would not have ended up in a truck at a Kansas medical waste facility as reported by Maria Sudekum Fisher of the Associated Press on March 30th.

What do you think? Is accreditation the answer or are things ok the way they are?

The views expressed in this Blog are my own and do not necessarily reflect the views of Science Care.

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