Nimble Storage Predictive Flash Platform Underpins Hutchinson Clinic Patient Care System

Nimble Storage, the leader in predictive flash storage, today announced that Hutchinson Clinic has selected the Nimble Storage Predictive Flash Platform, comprising of Adaptive Flash and All Flash arrays, to support a new disaster recovery (DR) strategy, and accelerate the performance of electronic health records, billing, and practice management systems. By improving the Clinic's IT operations, the staff will be able to access patient-related data faster, allowing them to better provide patients with comprehensive medical and surgical care.

The Hutchinson Clinic, based in Hutchinson, Kansas, is comprised of more than 90 physicians and providers and nearly 650 employees. To meet the requirements of evolving healthcare laws, the Clinic modified the structure of its records system which now enables high levels of analytics and data mining. The Clinic's poorly designed IT infrastructure lacked the ability to scale, forcing the IT organization to constantly hit limits on its database servers. To address the challenge, the Clinic deployed Nimble Adaptive Flash CS400 and CS700 arrays, achieving greater performance and non-disruptive scalability.

Moving forward, the IT organization intends to take full advantage of the Nimble Unified Flash Fabric which enables flash performance for all enterprise applications by unifying All Flash and Adaptive Flash arrays into a single consolidation architecture with common data services. Working closely with ISG Technology, the Clinic has purchased and deployed the All Flash AF7000 array to support massive databases for electronic health records, patient check-in and billing systems. The Adaptive Flash CS700 supports more than 200 virtual machines running file, exchange and web servers. To support its new DR strategy, the Clinic will also deploy the Adaptive Flash CS400 as a replication target and the CS235 as a Veeam back up repository. The entire infrastructure will be deployed as a SmartStack reference architecture-based solution, comprising of Cisco UCS integrated infrastructure and the Nimble arrays.

"As a Nimble Storage partner for the last five years, we experienced great success with the Adaptive Flash CS-Series arrays. We expect the same, if not more, interest in the Nimble All-Flash arrays based on the unique benefits of the platform," said Miles Franz, director, strategic solutions, ISG Technology. "Hutchinson Clinic was ready for a highly scalable storage solution that was able to support a cost-effective data protection strategy. Nimble was able to meet these requirements, while providing simplified management and the added features of InfoSight. I believe the depth and granularity of Nimble's predictive analytics will fuel rapid adoption of the Unified Flash Fabric by our customers."

"There are four things that really stand out about our Nimble deployment -- ease of deployment, the interface is easy to configure and manage, and the proactive support," said Christopher Swartz, senior network and server analyst at Hutchinson Clinic. "Most importantly, the performance is unmatchable. Our staff is working with patients in real-time and need to retrieve patient records quickly. In migrating to Nimble arrays we saw all data-related delays go away -- no more patients waiting to be checked in, delay in doctors pulling up records -- all data is flowing faster. This deployment gave me the confidence to expand my operations without having to worry about any system performance impact."

InfoSight predictive analytics provides Hutchinson Clinic's IT team with greater transparency, including the ability to see the performance of specific virtual machines (VMs). 

"The VMVision feature allows my team to see if there are specific VMs that have poor performance, and the team uses those analytics to see if things look too busy," said Swartz. "With InfoSight I have a lot of power at my fingertips, a lot more than I had before, which allows me to do my job more efficiently. Previously I couldn't tell how busy the arrays were, but now with the analytics I get from Nimble it's a much more powerful appliance."

Women's Wellness Requirements Have Changed

Hutchinson News 5.11.16

While every woman should continue to have an annual well woman’s exam, Hutchinson Clinic OB-GYN Stefanie Kempke said recommendations have changed when it comes to Pap smears, self-breast exams and mammograms. If a woman hasn’t gone in for a well woman’s exam, it’s a good time to have one, as this week is National Women’s Health Week. Kempke said research shows women are having Pap smears almost too often, which is producing a high number of false positives or abnormal findings that likely would have resolved on their own. “This means that women are getting more procedures and things like that done for not really detecting more (cervical) cancer,” Kempke said. Based on these findings, guidelines were recently revised – mainly in 2012, but again this January – to state that regardless of sexual activity, women don’t need to start having Pap smears until they’re 21. For women age 21 to 29, a Pap should be done every three years. At age 30, Pap smears and human papillomavirus testing should be done together. If both tests come back negative, women can go five years between Pap smears. The testing can stop at age 65 if a woman has 10 years of normal readings. The guidelines are different for those who are HIV-positive or if tests come back abnormal, Kempke said. Guidelines in the past recommended that women have Pap smears yearly after sexual activity.

“I still think an annual exam is really important,” Kempke said. Depending on age, a well woman’s exam goes over birth control, preconception counseling and talks about sex concerns and weight control. A screening is also done for health, cancer, depression and sexually transmitted infections, according to the American College of Obstetricians and Gynecologists:https://www.acog.org/-/media/For-Patients/Annual-Well-Woman-Exam-Infographic-lg.pdf?la=en

Kempke said the doctor will also screen for diabetes, osteoporosis, thyroid problems, depression, STIs or what issues the patient might have. A pelvic and breast exam is also typically done. Recent recommendations for self-breast exams have been slightly controversial, Kempke said. The United States Preventive Services Task Force suggests these exams should not be done as more women are going to the doctor and having more anxiety for lumps that were benign. “In their minds there was no evidence that it was helpful,” Kempke said about the task force. The ACOG notes that women often do find their own breast cancer, making self-breast exams beneficial. We talk about self-breast awareness now, Kempke said, so patients get to know their breast tissue – everyone’s feels differently. If, in fact, a patient feels like something has changed, she should talk to her doctor. The task force also recommends starting mammograms at age 50, as between ages 40 and 50, there are more false positives. This has been a significant change from other guidelines that suggest to start mammograms at age 40.

In the office, Kempke recommends starting mammograms at age 40 and getting them done yearly after that.

Hutch Clinic Surgeon Explains Weightlessness Effects in Space

Human bodies are made to live on Earth, so strange things happen to astronauts’ bodies when they spend long periods in outer space, Dr. Christopher Kain, an orthopedic and spinal surgeon, told visitors to the Cosmosphere on Saturday.

Without gravity to compress his spine, NASA astronaut Scott Kelly grew 2 inches during his nearly yearlong stay on the International Space Station, although that wasn’t a change that lasted long, Kain said.

“Within a week, he was his normal height,” he said.

Some other effects of weightlessness are reversible, but take quite a bit longer. Kain said astronauts lose about 20 percent of their muscle mass in as little as 11 days in space, because they don’t have to push against gravity.

A loss of bone density and strength during prolonged spaceflight takes even longer to reverse, Kain said. Physical stress – whether lifting things or the impact of every step a person walks – makes bones denser and stronger, he said, and a weightless environment robs bones of a lot of that workout.

“Your bone melts like butter in a frying pan” in weightlessness, Kain said.

He said astronauts can get their bone mass back over three to five years with a lot of work and treatment.

Other issues caused by weightlessness include a person’s heart getting weaker and face swelling, Kain said, both because the human body normally has to pump blood against the force of gravity.

“Nothing good, over time, happens in a weightless environment,” he said.

How to cope with those issues is one of the major challenges with the prospect of sending astronauts to Mars, Kain said.

Kain said willingness to accept these health risks in the name of science and exploration is part of astronauts’ heroism.

Hutchinson Clinic Recognized

Pfizer recently recognized the Hutchinson Clinic Clinical Trials team as one of the top 5 enrollers in the Spire trials, which involve a new medication to treat high cholesterol. There are two Spire trials that have a combined 3,176 sites active worldwide, with nearly 14,000 patients currently enrolled. The combined enrollment goal for both trials is 27,000. The Hutchinson Clinic has screened nearly 140 people with approximately 60 actively participating in the trial. The Hutch Clinic is still seeking trial participants. You may qualify if you are at least 18, and are taking medication to treat your high cholesterol. For more information about the trial, visit www.mycholesterolstudy.com, or call Juan Morales at 620-694-4123.

 

 

Crater Receives AMA Recognition

Dr. Timothy Crater of the Hutchinson Clinic was recently recognized by the American Medical Association (AMA) with a Physician’s Recognition Award with Commendation in continuing medical education (CME). The PRA certificate recognizes a personal commitment to career-long continuing professional development. Crater received a 3-year award for earning 270 CME credits. Since 1968, the AMA has been recognized as evidence of a physician’s commitment to keeping current with advances in biomedical science, as well as other developments in medicine. Dr. Crater is an internist and has been with the Hutchinson Clinic since 2001.

Certification in Endocrinology Achieved

The Hutchinson Clinic announces that Jeremy Kempke, MD recently became board-certified in endocrinology. Dr. Kempke, originally from Ellsworth, completed his residency in internal medicine at KUMC-Wichita in 2012 and his fellowship in endocrinology, diabetes and metabolism at KUMC in Kansas City in 2015. He has practiced medicine at the Hutchinson Clinic since August 2015. Endocrinology focuses on the diagnosis and treatment of diabetes, problems of the thyroid, adrenal and pituitary glands, osteoporosis and other hormone-related diseases. Appointments can be made by calling (620) 669-2533.

 

Automated payer record requests with Allscripts eChart Courier

Payer requests for medical records can be time consuming. Because Hutchinson Clinic (Hutchinson, Kansas, U.S.A.) is an Allscripts TouchWorks® EHR user, it was able to deploy eChart Courier, a solution that automates the electronic delivery of medical information, at no additional cost. The solution went live in October 2014 and enables Hutchinson Clinic to securely share records directly with payers, usually within 24 hours.

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Big time data analytics in a small town

Search for examples on data analytics in health care, and you’re likely to find lots of stories featuring large integrated health systems in urban areas. But don’t overlook what’s happening in rural communities such as Hutchinson, Kansas. It’s the focus of a recent Healthcare Informatics article, Innovation on the Plains: Hutchinson Clinic’s Bold Data Moves. With Allscripts TouchWorks® EHR as its core solution, Davidson shares advice on the value of data.

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New Hospitalist Contract With HRMC

FOR IMMEDIATE RELEASE

Hutchinson Regional Medical Center and Hutchinson Clinic sign agreement to provide Hospitalist Services Sound Physicians to provide inpatient Hospitalist coverage beginning November 3, 2015

HUTCHINSON, Kansas – Sound Physicians will begin providing Hospitalist coverage for Hutchinson Clinic Physicians at Hutchinson Regional Medical Center beginning November 3, 2015 under an agreement signed today by all three parties. 

 “We are excited to partner with the Hutch Clinic on this initiative,” explained Ken Johnson, interim CEO and President. “The hospitalist program is designed to provide better access to physicians and more continuity of care for patients during their hospital stay. I am excited about any initiative which improves the quality of patient care," Johnson said. "Our hospitalist program enables Hutchinson Regional, as a community hospital, to make a doctor available 24 hours a day, seven days a week to the patient. That supports our goal to improve and maintain patient satisfaction."

 Hospitalist physicians are an integral part of the health care team, providing patient care in the acute care setting throughout a patient’s hospital stay.  They consult with specialists as necessary and coordinate care transitions with patients’ primary care physicians.

 “As the largest private, multi-specialty physician group practice in Central Kansas, the Hutch Clinic has successfully provided, and will continue to provide primary and specialist care for its patients in our offices in Hutchinson and the surrounding areas,” said Mike Heck, CEO Hutch Clinic.  “The addition of Hospitalist services allows our physicians to spend more time with patients in their office while improving coordination, efficiency, and quality of care for patients who transition across multiple health care settings,” Heck added.

 About Hutchinson Regional Medical Center:

Hutchinson Regional Medical Center is a not-for-profit, 200-licensed bed medical facility serving the health needs of more than 65,000 residents of Hutchinson, Reno County and the surrounding Central Kansas region. www.hutchregional.com

 About Hutchinson Clinic:

The Hutchinson Clinic is a team of more than 95 physicians and advanced practice providers and almost 650 employees. Our goal is the highest possible standard of comprehensive medical and surgical care. Representing the major specialties of medicine, the Hutchinson Clinic physicians bring their cumulative training and experience to each patient's needs. www.hutchclinic.com

About Sound Physicians:

Sound Physicians is a leading hospital medicine and post-acute care organization, focused on driving measurable improvements in quality, satisfaction and efficiency throughout the acute episode of patient care. Sound’s deep investments in developing and retaining exceptional physicians, coupled with a proven performance management model results in improved outcomes and significant value for its hospitals and post-acute partners. The organization is the practice of choice of more than 1,100 hospitalists and post-acute providers and the partner of choice to more than 100 hospitals and post-acute care centers nationwide. www.soundphysicians.com

 

 

Economist Article

CLINICAL TRIALS AND TRANSPARENCY

The Hutchinson Clinic is proud of its work with clinical trials. Many of these trials lead to break-through treatments to help our patients become healthier. These trials are not without controversy, though, and Dr. Tim Crater was recently interviewed about transparency. The article appeared in The Economist, a British news magazine with a large readership in the United States.

http://goo.gl/Djlp7i

Father Daughter Doctor Duo

Lindsay Nordwald was just 5-years-old when she began tagging along with her dad as he made the rounds at Hutchinson Regional Medical Center.

David Richman had no idea how those times together were affecting his daughter’s life.

The doctor just wanted to spend time with his daughter and her two younger brothers, Brent and Scott. Bringing them along was the only way to make it happen.

Pertussis Outbreak Causes Concern

Health department looks into pertussis concerns

By Kathy Hanks The Hutchinson News khanks@hutchnews.com | Posted: Monday, May 18, 2015 7:15 pm

 

The Reno County Health Department is investigating a possible outbreak of pertussis after three cases were reported at both Hutchinson High School and Faris Elementary School in recent weeks.

The health department is awaiting confirmation, said Ivonne Rivera-Newberry, assistant director of clinical operations.

While an outbreak is considered more cases than expected, Rivera-Newberry said each disease has its own definition of what is considered an outbreak.

“With pertussis, an outbreak is defined as two cases that are clustered in time, such as cases occurring within 42 days of each other, and in one building where transmission is suspected to have occurred,” said Rivera-Newberry.

She stressed the cases are still under investigation, but added it was important that those with a cough that persists for more than two weeks see their health care provider to rule out pertussis.

Also known as whooping cough, the highly contagious bacterial infection can be fatal in infants less than one year of age. Pertussis was the cause of death of an infant and left five people ill earlier this year in Barton County.

“It’s frightening,” said Dr. Ellen Losew, a pediatrician at the Hutchinson Clinic. “We have a lot of young patients too young to receive their immunization.” For those infants less than six months of age, there is a 20 to 25 percent chance of life-threatening complications if they come down with the infection.

Not vaccinating is dangerous, Losew said, because it threatens what is known as “herd immunity.” If enough children are vaccinated, the whole population is protected. But if even a small number of children aren’t getting their shots, the immunity rate of the entire community can drop below safe levels.

Because of a drop in vaccination rates, Losew said there are now outbreaks of various vaccine-preventable diseases.

She sees cases of pertussis every year in small bits, perhaps one or two a year in the 12 years she has been practicing medicine in Hutchinson.

“It happens. But certainly the immunization rates not being as high as they should be, we will continue to see more outbreaks,” Losew said.

While the state’s immunization rate isn’t drastically low compared to states like Minnesota, California, Oregon or Colorado, Losew wants people to understand the importance of being vaccinated.

“We need to get people protected and covered,” she said. Being vaccinated is safer and more effective than not being vaccinated. “I would rather take a 92 percent chance of being protected over zero.”

“Heart attack treatment is not 100 percent effective,”Losew said. “But someone goes into the ER and accepts treatment for a heart attack because it has the potential to save a life. “

According to the Kansas Department of Health and Environment, the state’s children are 86 percent or above for the standard vaccination coverage at kindergarten, and 81 percent complete at school entry. Losew says that’s not great. It needs to be higher.

The KDHE recommends every adult should have one dose of Tdap (diphtheria, tetanus, pertussis adult vaccine) and pregnant women should get a Tdap with each pregnancy. Children should receive DTaP (diphtheria, tetanus, pertussis childhood vaccine) at 2, 4, 6, 12 and 18 months, and 4 to 6 years of age.

Meanwhile, symptoms generally appear 7 to 21 days after exposure to pertussis, and usually start out with a cold or flu-like symptoms including a runny nose, sneezing, fever and cough which lasts one to two weeks. Symptoms worsen over time and the cough becomes more severe. But not everyone makes the whooping sound. A complication of pertussis is pneumonia.

Dr. Tim Crater in US News & World Report

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Inside the Clinical Research Machine

Doctors involved in clinical research share why it’s so expensive and why they get involved.

To develop a drug and gain approval from the Food and Drug Administration, it costs about $2.6 billion.

By Lacie Glover Jan. 26, 2015 | 9:25 a.m. EST + More

Pharmaceutical companies have their share of critics, mostly because of the cost of the drugs they make. And prescription drugs – which most Americans take – are much more expensive in the U.S. than in other countries, by as much as 40 percent. 

That’s partially because American pharmaceutical companies are allowed to set their own drug prices. In most other countries, governments negotiate prices with the companies and cap the cost of medicines.

But that’s not the only reason drugs in the U.S. are so expensive. 

It costs about $2.6 billion to develop a drug and win approval from the Food and Drug Administration, according to a November 2014 report from the Tufts Center for Study of Drug Development. Pharmaceutical companies pay that money up front, and part of the reason they charge so much for drugs is to recoup the investment. 

Here’s why it costs so much, and why physicians get involved. 

Costly Development 

According to the Tufts report, increasingly complex clinical research is responsible for the hefty drug development price tag, and industry experts agree. “Every level of research is expensive,” says Marie Csete, the chief scientific officer of Huntington Medical Research Institutes in Pasadena, California. 

As the drug moves through the research pipeline, efforts are increasingly expensive, Csete says. Before drugs are ever tested on humans for safety and efficacy, they must first be discovered and then often tested on animals – both expensive processes. 

By the time a drug makes it to a human subject, millions of dollars have already been invested. “Human studies are the most expensive and often must include hundreds or thousands of subjects,” Csete says. “It all adds up, and many drugs fail only after millions of dollars are invested.” 

Perils of Human Clinical Research 

Human clinical research has four possible phases, and drugs must go through at least three of them to get to market. Phase I studies only seek to determine toxicity at various doses in healthy subjects. As such, they’re difficult to enroll patients in, says Cary Presant, an oncologist at the City of Hope National Medical Center's cancer center in Southern California, where he conducts research trials. “These trials may not give a high enough dose of a new drug to a patient, so patients are sometimes reluctant to enroll,” he explains. 

Only after the drug passes Phase I trials can it be tested to see if it works, so these trials are crucial but can be a bottleneck in the road to approval. 

Phase II studies determine efficacy of a drug, while Phase III trials are the largest, including hundreds or thousands of patients. Phase IV trials only occur after a drug has achieved FDA approval, and are usually conducted to prove superiority to another drug. Since Phase II and III trials must compare the drug to existing alternatives, patients enrolling in these trials run the risk of receiving placebo or previously approved drugs. 

Taking an approved drug is usually preferable to taking a placebo, but many patients enroll in trials in the first place because existing options have failed. 

“These patients want to receive the new drug,” Presant says. So patients considering those trials should ask about switching treatment if they don’t do well, he says. 

Subject Safety and Protection 

If a patient doesn’t do well in a trial, he or she usually has several options. In clinical research, nothing is more important than patient safety. In fact, most pharmaceutical companies and their contractors require research staff to have good clinical practice certifications on top of other ongoing safety trainings. 

“Trial subjects may actually be safer than other patients,” says Timothy Crater, a research physician at Hutchinson Clinic in Hutchinson, Kansas. “They see a doctor more regularly and are followed very closely.” 

Third parties, called contract research organizations, are hired by the pharmaceutical companies funding the research to oversee the trial in minute detail. CROs also often provide laboratory services and materials to research centers. But as objective third parties, their most important function is preserving subject safety.

“There is an enormous amount of work involved,” says Jeffrey Spaeder, chief medical and scientific officer at Quintiles Transnational, a top CRO. He oversees and makes high-level medical and ethical decisions in trials. “It is a heavily regulated field; there are all sorts of audits.” 

This includes FDA inspections to research sites and audits by the CRO and pharmaceutical company, or sponsor. 

Another organization, called an institutional review board, serves only to protect subject safety and privacy and to document serious adverse events and privacy breaches. IRBs do not assist in actual operations of the trial like a CRO might; instead, they help ensure everything is on the up-and-up. 

The result is an extensive network of checks and balances built into the research infrastructure. Extensive, that is, and expensive. By the time the clinical trial data is presented to the FDA for market approval, thousands of people and billions of dollars have been involved in the development of a drug. 

And it still might fail. 

Motivation 

Most physicians don’t get involved in research, either because of the amount of work involved or all the money involved. 

But that’s not true for everyone. 

“I was led to do clinical research by my hope for patients to live longer and be happier,” Presant says. He adds that a commitment to science and patients was always a driver. 

“As clinicians, research brings back that sense of wonder, like you can see around the cutting edge to what comes next in medicine,” Spaeder says. “You feel like a pioneer.” And stronger than that, he continues, is the sense that this work is helping people. Others agree. 

“I tell these patients they have the opportunity to be a part of something big, and it can help a lot of people down the road,” Crater says. “You wouldn’t expect it, but that’s been the clincher.” 

Csete says this also rings true for many patients she sees. “This is a very powerful motivation for participation in research,” she says. “I have seen many critically ill or dying patients determined to make a difference for others that follow them – by contributing to knowledge.”