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Saving Lives, One Device at a Time: Clinical Engineering
Behind every health care provider, or perhaps already in the palms of their hands, is a piece of equipment necessary to their patient’s health and survival. Modern medical treatment relies on complex equipment to keep patients alive and healthy during procedures and recovery. Take live-saving equipment such as telemetry monitors, MRI machines and ventilators as just a few examples. But what happens when all that equipment needs repair? Enter ChristianaCare’s clinical engineering technicians. This team of 35 employees — one of the largest clinical engineering teams in the nation — is responsible for overseeing the care, testing and repair of the roughly 50,000 pieces of medical equipment in use throughout the ChristianaCare system. The Clinical Engineering team is overseen by Director Blake Collins, MBA, CBET, CHTM, nationally recognized for excellence in the profession. He brings two decades of experience as a clinical engineer in the United States Navy, seven of which were served with the U.S. Marine Corps, to his role. His team has won numerous trade industry awards for its success as a “solutions provider” for the health system. "Think of health care as a triangle,” said Collins. “You have the patient, the provider and the equipment. You can’t have successful health care delivery without those three elements.” Begun in the 1970s as the hospital system’s “TV repair shop,” he joked, the Clinical Engineering department evolved dramatically after subsequent national developments in electrical safety testing and oversight for the care and functionality of medical equipment. ‘Everyone truly cares’ Today, the Clinical Engineering department maintains close to 50,000 pieces of medical equipment throughout the ChristianaCare system, including its three hospitals and all its imaging centers. “From thermometers to linear accelerators, MRIs, CTs — we manage all of it,” Collins said. Last year, the team completed 25,000 work orders, or roughly 2,100 per month. “We get to help people in so many different ways,” said John Learish, Clinical Engineering manager. Samantha Daws, Clinical Engineering supervisor, echoed the sentiment. “The Clinical Engineering Department within ChristianaCare is the most talented group of technicians I have ever had the privilege to work with,” she said. “Everyone truly cares about keeping the equipment working to ensure all caregivers have what is needed to provide quality health care to our community.” Saving lives, one device at a time What’s so important about what Clinical Engineering offers to ChristianaCare? In short: Anyone could need medical care at any time, and if medical equipment were out of commission or wrongly calibrated, lives would be at stake. Collins recalls a pivotal moment during his tenure in the Navy, when he needed an emergency appendectomy while stationed on board an aircraft carrier. “I was the only biomedical technician on the ship,” he said. “And the doctor doing the procedure asked me, jokingly, ‘Hey Collins, is this equipment going to work?’ “He was kidding, but it’s true that we never know when we or a loved one is going to end up under the equipment that we work on as engineers.” This experience gained new significance for Collins after successful open-heart surgery at ChristianaCare in 2022 — followed by his mother, who had the same procedure, also successfully, in 2023. “I had not one inkling or shadow of a doubt that the equipment was going to work fine,” he said. “You never know who will end up needing care. So we take it very, very seriously.” Icon in the field For his outstanding service as Director of Clinical Engineering at ChristianaCare, Collins was presented with the 2024 John D. Hughes Iconoclast Award from the Association for the Advancement of Medical Instrumentation (AAMI), a career-marking honor in health care technology management. The award recognizes innovation and leadership in the field; for Collins, it shows how well the Clinical Engineering team works together to deliver safe medical equipment across the ChristianaCare system. “Blake has been a relentless advocate for ChristianaCare,” read his nomination. “He has implemented numerous initiatives and processes to improve his department … and work smarter through the use of technology and automation.” The next time you see a ChristianaCare provider pick up an instrument or turn on a machine, think about the Clinical Engineering team — and rest assured that your equipment is ready to go.
A future with one plug: how universal EV outlets simplify charging for electric vehicle owners
Have you ever found yourself frustrated with the numerous types of charging plugs for electric vehicles when going to charge your car? Picture this: a future where every charging station supports a universal outlet. No more worrying about whether your plug will fit or if you need an adapter. Sounds like a dream, right? Well that dream is now real. University of Delaware professor Willett Kempton and his coauthors have recently released a new paper outlining a new universal EV outlet standard in World Electric Vehicle Journal. His coauthors include University of Delaware PhD graduates Rodney McGee and Garrett Ejzak. There are three standard EV charging connectors – the part you hold in your hand that plugs into EVs with matching inlets – in North America. Rather than requiring three charging stations at each location, Willett and his team proposed to have a universal EV outlet on the charging station, and cars would come with a cable with a universal plug to plug into the station. The solution for EV charging is similar to what has already evolved for charging cell phones and other portable electronics. Cell phones and laptops have many different types of power inlet connections on the device, incompatible with each other. This solution was deliberately designed so that todays’ EVs and charging stations do not need to be replaced. Because these new standards have resulted from a consensus of more than 150 participants from the automotive, charger, and power industries, new innovations will also be coming with the adoption of the new standards. These include lower-cost and lower-maintenance charging stations, higher energy efficiency. Kempton, McGee and Ejzak can be reached by clicking Kempton's contact button.
Cosmetic or Drug? The FDA's Classification of Sunscreen Limits Which Products Hit US Shelves
As stifling rays of sunshine beat down across the United States, it’s the time of year citizens flock to the store to load up on sun protection. It’s also the time of year consumers and media raise the annual question of why Europe is able to market sunscreen that contains more potentially effective ingredients, but the U.S. isn’t. The answer is not related to sunscreen or its ingredients, but rather how the country’s regulatory body – The Food and Drug Administration (FDA) – legally operates. “In order for the FDA to legally regulate products, those products are given classifying labels,” said Ana Santos Rutschman, a professor of law at Villanova University who studies health law. “A toothbrush, for instance, is labeled a medical device. That’s because it has to fit in one of the sources of authority of the FDA and the FDA, per the law, regulates drugs or medical devices.” Here is where it gets tricky. The FDA does not have to approve cosmetics, aside from certain color additives, before those products go to market. In the European Union’s European Medicines Agency (EMA), sunscreen is labeled as a cosmetic. Many other countries also classify it as such. In the U.S., however, sunscreen is labeled a drug because it has a therapeutic effect, and thus falls under the authority of the FDA. To make the classification system even more convoluted, some items are labeled as both a cosmetic and drug by the FDA. Shampoo, for instance, is inherently cosmetic. “But if it’s anti-dandruff shampoo, then it’s also a pharmaceutical,” said Santos Rutschman. “It’s super common for this to happen with a lot of products that you and I would not think are classified as drugs. It’s very natural under the regulatory regime that we have, but then it is very hard to bring anything to market – harder than other countries.” Case in point, sunscreen used in the EU that contains ingredients which may be more effective against certain types of ultraviolet rays cannot simply just come to market in the U.S. “If sunscreen fits the definition of a drug, then it must meet drug requirements,” said Santos Rutschman. “If you want a new drug to enter the U.S., you have to show efficacy and safety. But in order to do that, there must be clinical trials, and if those trials happened elsewhere, they would not conform to our domestic protocols. “Even if another country performed their own clinical trials, the odds the FDA would utilize the data are not incredibly high. If you think another country recognizes something we should, based on their data, then immediately this is going to raise questions of why we are deferring to a foreign regulator.” The FDA could go through the process of approving ingredients in question – and has indicated it will do so – but it’s a complicated process, and there is “also a matter of risk,” according to Santos Rutschman. “The FDA has always been less risk averse than its counterparts in Europe. I understand the market concerns, but this seems about right from a regulatory perspective… We aren’t talking about a specific drug that people need and cannot access. Sunscreen is available for the average American to purchase.” Barring an overhaul to the regulatory system in the U.S. to include an agency for cosmetics – an idea some argue has merit, but Santos Rutschman described as “not feasible” with the available funding – the only way Europe’s sunscreen would be available for Americans to purchase is if the FDA moved forward in regulating the ingredients. And that will continue to take time. “The FDA has never moved quickly on anything,” said Santos Rutschman. “It just can't.”
ExpertSpotlight: The iPhone turns 17 years old Saturday!
The iPhone revolutionized the tech industry and transformed how we communicate, work, and interact with the digital world. This topic is not only newsworthy due to its technological innovation but also because of its significant impact on global culture, economics, and societal norms. The iPhone’s evolution over the past decade and a half has shaped consumer expectations and driven the development of the mobile and app economy, affecting everything from entertainment to education. The history of the iPhone offers a wealth of story angles that highlight its enduring influence and ongoing evolution, including: Technological Innovation and Evolution: Exploring how the iPhone has advanced in terms of hardware, software, and design, setting new standards in the tech industry. Economic Impact and Market Dynamics: Analyzing the iPhone's role in shaping the global smartphone market, influencing economic trends, and driving Apple's financial success. Cultural and Social Influence: Investigating how the iPhone has changed social behaviors, communication methods, and media consumption patterns worldwide. Privacy and Security Challenges: Assessing the iPhone's impact on privacy concerns and cybersecurity, including Apple's stance on data protection and encryption. App Economy and Ecosystem Development: Understanding how the introduction of the App Store transformed the software development industry and created a new economic ecosystem. Environmental and Ethical Considerations: Examining the environmental footprint of iPhone production, Apple's sustainability initiatives, and ethical issues related to manufacturing and labor practices. The history of the iPhone offers journalists an opportunity to delve into the multifaceted ways this device has shaped and continues to shape technology, economy, and society. Connect with an Expert about the History of the iPhone: Alex Cequea Editor in Chief · iPhone Life magazine Meredith David, Ph.D. Associate Professor, Marketing · Baylor University Mark Jamison Director/Professor · University of Florida Gokila Dorai, PhD Assistant Professor · Augusta University Liran Ma Professor · Texas Christian University To search our full list of experts visit www.expertfile.com Photo credit: Tron Le
A new study conducted by CAA Manitoba (CAA MB) shows that 59 per cent of Manitoba drivers have witnessed a close-call collision or distracted driving traffic violation. For many Manitobans, these close calls are fueling safety concerns, as 89 per cent of drivers in the province feel somewhat or very concerned about distracted driving. “Distracted driving is the leading contributing factor in fatal motor vehicle collisions in Manitoba,” says Ewald Friesen, manager of government and community relations at CAA Manitoba. “By raising awareness of the risks of distracted driving, we hope to do our part to save lives and increase safety." Distracted driving has a direct impact on road safety Manitoba’s ban on using hand-held devices while driving has been in effect since July 2010. However, distracted driving caused by technology continues to be a concern across the province. The survey found that 60 per cent of Manitoba drivers have been behind a driver in another vehicle who missed a traffic light change because that driver was distracted. “Safe driving requires focus and concentration. It is always best to set up your navigation system and send your text messages before driving,” says Friesen, “Using this technology while driving is simply not worth the risk of potential charges and the danger it poses to both the driver and others on the road.” The survey also found that 51 per cent of Manitoba drivers stated that they had met the criteria for being distracted drivers in the past, with three per cent admitting to having been charged. While there can be many distractions on the road, the top five most concerning distractions for those surveyed are: 1. Holding a mobile device 2. Watching TV 3. Making a video call 4. Grooming 5. Wearing headphones or earbuds “It is always best to send your text messages and make your video calls before driving,” says Friesen, “Engaging in these behaviours is not only illegal, but they put the life of the driver and those around them at risk.” Manitobans believe fines, penalties and public education remain the most effective methods to combat distracted driving According to Manitoba Public Insurance (MPI), using a mobile device while driving is illegal. If ignored, this can result in a $672 fine and possible license suspension. The survey also found that 57 per cent of Manitoba drivers support increasing fines and penalties for distracted driving convictions. For more information, please visit https://www.caamanitoba.com/distracted The online survey was conducted by DIG Insights from January 22 to February 5, 2024, with 506 Manitoba drivers aged 18 and older. Based on the sample size of n=506 and with a confidence level of 95 per cent, the margin of error for this research is +/- 3%.)
A new study conducted by CAA South Central Ontario (CAA SCO) shows that over half of Ontario drivers (66 per cent) have witnessed a close-call collision or traffic violation caused by distracted driving. For many Ontarians, those close calls are fueling safety concerns. Ninety-one per cent of drivers in the province feel somewhat or very concerned about distracted driving, a number that remains unchanged from 2023. “Distracted driving continues to be a leading factor in collisions on highways and city roads,” says Michael Stewart, community relations consultant for CAA SCO. “We continue to raise awareness of the risks associated with using your mobile device or in-vehicle technology while driving.” Distracted driving has a direct impact on road safety Ontario’s ban on using hand-held devices while driving has been in effect since October 2009. Despite this ban, distracted driving is still a common sight on our roads. The survey found that 63 per cent of Ontario Drivers have been behind a driver in another vehicle who missed a traffic light change because that driver was distracted. "It takes only a split second of inattention to cause a close call or even a tragic collision. Staying focused behind the wheel is not just a personal responsibility but a crucial act of safety for everyone on the road,” adds Stewart. The survey also found that 42 per cent of Ontario drivers stated that they had met the criteria for being distracted drivers in the past, with two per cent admitting to having been charged. While there can be many distractions on the road, the top five most concerning distractions for those surveyed are: 1. Holding a mobile device 2. Watching TV 3. Making a video call 4. Grooming 5. Typing a destination into a GPS or navigation app “Safe driving requires focus and concentration. It is always best to set up your navigation system and send your text messages before driving,” says Stewart, “Using this technology while driving is simply not worth the risk of potential charges and the danger it poses to both the driver and others on the road.” Ontarians believe fines and penalties remain the most effective methods to combat distracted driving Ontario drivers can face a minimum fine of $615 up to $1,000, three demerit points and a three-day licence suspension for their first conviction of distracted driving. According to survey data, 60 per cent of drivers support increasing fines and penalties for distracted driving convictions – however, only 32 per cent were aware of all the penalties that come with your first conviction. “As we continue to see a trend in these behaviours behind the wheel, we understand the public’s concern and desire for stronger repercussions,” says Stewart. “CAA SCO will continue to advocate for road safety through education and community member insights to help us create safer roads for all.” For more information, please visit www.caasco.com/distracted DIG Insights conducted the survey from January 22 to February 5, 2024, as a follow-up to research to previous CAA reports. The online survey was conducted with 1,513 Ontario drivers aged 18 and older. Based on the sample size of n=1,513 and with a confidence level of 95%, the margin of error for this research is +/- 2%.)
MEDIA RELEASE: CAA survey reveals an increase in distracted drivers across Ontario
A recent survey conducted on behalf of CAA South Central Ontario (CAA SCO) indicates 44 per cent of Ontario drivers admit to driving distracted at one point – up four per cent compared to last year. The most concerning distractions drivers noted include: Holding a mobile device. Grooming. Making a video call. Typing in a destination. Watching TV. Eating and drinking while driving is also a growing concern. In-vehicle features, including connected apps and console screens, are another source of distraction for drivers, especially if adjusted while on the road. “Anything that can divert a driver’s eyes and mind off the road will always pose a threat while driving,” says Teresa Di Felice, assistant vice president for CAA SCO. Distracted driving remains a significant concern among 90 per cent of drivers in Ontario. Despite the growing number of self-identified distracted drivers, only three per cent admit to being charged for distracted driving. “While a vast majority of drivers recognize fines and penalties, including increased insurance rates, as the most effective ways to reduce distracted driving, our data shows that drivers have become less supportive of penalties that currently exist for distracted driving convictions,” says Di Felice. Of those surveyed, 57 per cent support increasing fines and stricter penalties for distracted driving convictions. “Currently, a driver can face a minimum fine of $615 up to $1,000, three demerit points and a three-day licence suspension for their first conviction of distracted driving,” says Di Felice. “But that’s not the only way it can cost you. A brief moment of distraction is all it takes for a collision.” Almost two-thirds of drivers in Ontario (63 per cent) have witnessed close-call collisions or traffic violations caused by distracted drivers – up four per cent compared to last year. Meanwhile, 12 per cent of drivers reported being involved in a collision due to distracted driving, mainly because of using a mobile device. “Whatever it is that you need to do – whether it’s sending that text, inputting your destination or setting up your playlist – do it all before you drive,” says Di Felice. “The risks of distracted driving are simply not worth it.”
300 million tonnes of rice straw are burned after harvest in Asia every year Aston University will be contributing to new international project to unlock renewable energy potential Its researchers will lead on calculating the greenhouse gas emissions savings of new systems. Aston University researchers are helping to make rice straw processing in India and the Philippines less environmentally damaging. The University will be contributing to a new international collaboration, the Renewable, Inclusive Carbon-negative Energy (RICE) project, funded by Innovate UK Energy Catalyst programme to unlock renewable energy for rice farmers. Already the University has worked with UK company Straw Innovations in the Philippines and now the two are expanding their collaboration to benefit more of the continent. Aston University working with UK company Straw Innovations and Indian enterprise, Takachar Rice straw is a crop waste byproduct and each year across Asia 300 million tonnes of it go up in smoke when burnt after harvest. This releases emissions and air pollutants that triple risks of increased respiratory diseases and accelerate climate change. India and the Philippines are the world’s second and eighth largest rice producers respectively and together they produce 130 million tonnes of both rice and straw per year. Aston University and Straw Innovations and will be collaborating with an Indian award winning small and medium sized enterprise, Takachar. The firm has developed small scale, low-cost, portable equipment which can convert agricultural waste on-site into higher value bioproducts such as fertilizer blends, chemicals and biofuels. "The company will develop a super-sized version which is 10 times bigger than their current device, make it adaptable to rice mills, and will send it to Straw Innovations, so the two firms can test out different business models for farmer adoption/benefit. Straw Innovations will also send their machines from the Philippines to India mid-project and the two countries will test out different business models for farmer adoption/benefit. And for the first time they will tap into the heat produced in the waste process to dry rice, instead of using diesel or kerosene. University researchers will lead on assessing the sustainability of the project, calculating the greenhouse gas emissions savings of the new systems introduced by Straw Innovations and Takachar. Sustainability expert Dr Mirjam Röder will also engage with the farming community and rural stakeholders to quantify how the systems can increase farmer incomes, equality of opportunity, food security and decarbonisation benefits, whilst highlighting any trade-offs. Dr Röder who is based at Aston University’s Energy & Bioproducts Research Institute (EBRI) said: “Environmentally, rice produces 48% of all global crop emissions, due to methane from flooded fields. This is halved when the straw is removed and reduced further when its carbon is stored in biochar. We are aiming for carbon negative which means removing carbon dioxide (CO₂) from the atmosphere or sequestering more CO₂ than is emitted. “Our new research leads on from our rice straw bio gas hub project with Straw Innovations, SEARCA and Koolmill and we’re pleased to be building further relationships with new partners in India. In January Biomass and Bioenergy published a paper about the topic written by Dr Röder, the director of EBRI Professor Patricia Thornley and Craig Jamieson of Straw Innovations called The greenhouse gas performance and climate change mitigation potential from rice straw biogas as a pathway to the UN sustainable development goals. Craig Jamieson from Straw Innovations said "We’ve been pioneering rice straw work with the team at Aston University for the past seven years. We're delighted to continue that strong partnership and widen it to include Takachar in this new project. “Takachar is a leader in making biochar from crop residues and our partnership with them is very strategic. We look forward to combining our new improved straw harvesting technology with their scaled-up biochar production. It will be a step change, creating a new, more efficient system for carbon negative energy and soil improvement for rural communities across Asia." Vidyut Mohan who founded Takachar said: “We are excited to partner with Aston University and Straw Innovations. “Our combined solutions can significantly move the needle in reducing crop residue collection costs and biochar production costs for carbon removal." Notes to Editors Rice straw is a crop waste byproduct and each year across Asia 300 million tonnes of it go up in smoke when burnt after harvest https://tinyurl.com/2afjhhsj To read The greenhouse gas performance and climate change mitigation potential from rice straw biogas as a pathway to the UN sustainable development goals visit https://www.sciencedirect.com/science/article/pii/S0961953424000254, Biomass and Bioenergy Volume 182, March 2024, 107072 Mirjam Röder and Patricia Thornley Energy & Bioproducts Research Institute (EBRI), College of Engineering and Physical Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, United Kingdom Craig Jamieson Straw Innovations Ltd., Lawes Open Innovation Hub, Rothamsted Research, West Common, Harpenden, HERTS, AL5 2JQ, United Kingdom https://doi.org/10.1016/j.biombioe.2024.107072 About Aston University For over a century, Aston University’s enduring purpose has been to make our world a better place through education, research and innovation, by enabling our students to succeed in work and life, and by supporting our communities to thrive economically, socially and culturally. Aston University’s history has been intertwined with the history of Birmingham, a remarkable city that once was the heartland of the Industrial Revolution and the manufacturing powerhouse of the world. Born out of the First Industrial Revolution, Aston University has a proud and distinct heritage dating back to our formation as the School of Metallurgy in 1875, the first UK College of Technology in 1951, gaining university status by Royal Charter in 1966, and becoming The Guardian University of the Year in 2020. Building on our outstanding past, we are now defining our place and role in the Fourth Industrial Revolution (and beyond) within a rapidly changing world. For media inquiries in relation to this release, contact Nicola Jones, Press and Communications Manager, on (+44) 7825 342091 or email: n.jones6@aston.ac.uk
This Is a Critical Moment: Delaware Must Not Go Backward in Health Equity
The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way. By LeRoi S. Hicks, M.D., MPH, FACP As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals. While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time. A tale of two cities To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter. Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive. The key to lowering health care costs is to improve quality, access and equity Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments. The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care. Let’s do more—not less—of what we already know works Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone. One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition. The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas. These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy. The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department. When we work together, we succeed We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state. Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems. By narrowly focusing on cost, we risk losing the progress we have made Delaware House Bill 350, as it’s proposed, would cause harm in two ways: First, it would compromise our ability to invest in these kinds of interventions that work. Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware. In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable. These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish. At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them. LeRoi Hicks, M.D., is the campus executive director for ChristianaCare, Wilmington Campus.
Innovative EEG Brain Monitoring Program Provides Optimal Care for Critically Ill Patients
ChristianaCare has launched an innovative electroencephalogram (EEG) brain monitoring program that represents a significant leap forward in the diagnosis and management of neurological conditions. The easy-to-use EEG program is the first of its kind that can be performed at the bedside to measure the electrical activity of the brain, providing a vital sign for brain function to help diagnose seizures more quickly. ChristianaCare is the first hospital system in Delaware to use the Ceribell point-of-care EEG monitoring system, which can reduce the time it takes to diagnose certain neurological conditions from hours to mere minutes. Using the system, clinicians have immediate access to EEG information so they can triage at-risk patients in just five minutes and monitor patients for treatment optimization. “With this new program, our team of expert clinicians will have the diagnostic information they need to provide high-risk patients with the right care at the right time, ensuring the best outcomes for our patients and their families,” said Kim Gannon, M.D., Ph.D., service line leader for Neurosciences at ChristianaCare. New technology detects ‘silent seizures’ Critically ill patients are at high risk of harmful brain electrical discharges called seizures. Some of these patients experience a type of “silent seizure” with no noticeable symptoms (non-convulsive) that can only be detected using EEG. If prolonged, non-convulsive seizures can lead to permanent brain injury and higher risk of morbidity and mortality. Demonstration of EEG device on patient at ChristianaCare Newark Campus. As a result, guidelines from the Neurocritical Care Society recommend EEG should be initiated within 15-60 minutes when these seizures are suspected. Meeting these guidelines has proven difficult due to the limitations of conventional EEG systems, which were not designed for use in emergency situations. Even top academic centers that have 24/7 EEG capabilities may experience wait times of four hours or more for conventional equipment. When relying on clinical judgement alone while waiting for these conventional EEG systems, diagnostic accuracy has been shown to be only slightly better than chance (65%). The value of this new technology for patients is that it provides accurate results quickly so that the care team can intervene early. “The neuroscience and critical care teams at ChristianaCare believe that ‘time is brain’ not only applies to stroke but also when dealing with seizure,” Gannon said. Gannon is referring to the fact that for every minute that passes when someone is having a stroke, 1.9 million brain cells are lost, increasing the chance of disability or death. That same kind of speed and urgency can now more easily be brought to bear for patients when a seizure is suspected. “This monitoring system is easy to use and can be set up in about five minutes,” said Richard Choi, D.O., medical director of the Neurocritical Care Unit at Christiana Hospital. “It consists of a simple headband, pocket-sized recorder with intuitive software and an on-line portal for remote viewing. Using the system, we can review EEG data, assess response to treatment and optimize care, all in real-time.” Neurosciences at ChristianaCare ChristianaCare’s multidisciplinary neurosciences team provides comprehensive and advanced care for neurologic illnesses across the acute and ambulatory settings. As the largest and most comprehensive neurology practice in Delaware with more than 55,000 patient visits last year, ambulatory subspecialties include stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular disorders, headaches/migraines, pediatric neurology and Botox specialists. The inpatient team of experts includes neurosurgeons, neurointerventional surgeons, neurocritical care physicians and vascular neurologists. The Newark Campus serves as the only comprehensive stroke center in the state and includes the only Epilepsy Monitoring Unit in Delaware.
