From Our Annual Meeting
Lessons Learned By a Frightened Dad

“Heart transplant? Who’s talking about a heart transplant? What is going on with our kid? What is going on with her?”

Benjamin Anderson was stunned. His 30-day-old daughter, Naomi, had developed supraventricular tachycardia (SVT), a rare condition in one so young. 

In the hours since they were admitted to the small Ashland Health Center emergency department, no one had told him or his wife Kayla much of anything about what was happening. 

Ashland did not have the resources to deal with this case, so they flew Naomi from Ashland to a hospital in Wichita.

And now a nurse there was telling these new parents that their daughter may need a heart transplant. They should get her to Denver Children’s Hospital. 

“How did it to come to this?” he thought. “And we were not involved? What is going on?”

In the News
In Midst Of Financial Struggle, Vermont Hospitals Boost Workforce Programs
VPR

More than 100 rural hospitals have closed across the country in the past 10 years. In an effort to prevent that in Vermont, the state legislature has set up a task force, and its initial findings show hospitals here face a crushing shortage of doctors and nurses.

Nikki Boggs is a new nurse at Brattleboro Memorial Hospital. She’s in a new residency program that offers support to nurses as they navigate their first six months, and Boggs said it has made the transition from student to nurse a little easier.

“Being put on the floor with five patients, and they’re your patients, and you’re responsible for them – you’re scared,” she said. “So this residency sort of allows for you to still have that wiggle room, where you have somebody you can go to, and you don’t have it all loaded on you at once.”

Over the last 10 years, the number of registered nurses in Vermont dropped by about 25 percent according to a draft report by the state’s Rural Health Services Task Force. That report also shows that there will be almost 4,000 vacancies between now and the spring 2020. And as the state grows older, more nurses will be retiring in the coming years.

How Hospitals Are Battling the Opioid Epidemic
US News and World Report

At the front lines of the opioid crisis, health care providers and hospitals are reconstructing their approaches to treating pain and addiction, from implementing new prescription guidelines and creating personalized systems of care to addressing addiction as a disease rather than a moral failing.

"We all had to start this at about the same time," Dr. Halena Gazelka, director of inpatient pain services within Mayo Clinic's pain medicine division, said during a panel discussion this week on hospitals' role in the opioid epidemic during U.S. News' annual Healthcare of Tomorrow conference. "Everybody got concerned about the opioid crisis at about the same time, so there was no pattern, there was no game plan to follow when we've all kind of had to work at it along the way."

Gazelka, based in Minnesota, was joined on the panel by Dr. Alicia Jacobs, vice chair of clinical operations and a family medicine physician with the University of Vermont Medical Center; Christopher Freer, chairman of Saint Barnabas Medical Center's emergency department in New Jersey; and Jay Bhatt, senior vice president and chief medical officer of the American Hospital Association.

RRMC receives national recognition
Rutland Herald

The American College of Surgeons National Surgical Quality Improvement Program has recognized Rutland Regional Medical Center as one of 88 participating hospitals to achieve meritorious outcomes for surgical patient care in 2018.

Rutland Regional achieved the distinction on both the “All Cases” and “High Risk” Meritorious lists based on their outstanding composite quality score across eight clinical areas: mortality; unplanned intubation; ventilator >48 hours; renal failure; cardiac incidents; respiratory (pneumonia); SSI (surgical site infections); or urinary tract infection.

John Brumsted: The challenges and successes of rural health care
VT Digger

Nov. 21 is Rural Health Care Day across the United States. In honor of this day, I want to illustrate the work we are doing locally in northern New York and Vermont, as we adapt to meet the needs of aging populations, changes in how care is paid and reimbursed, and ever-increasing costs of serving every patient who walks into our clinics or emergency rooms. 

On one side of the exam table are the patients and their families who are relying on their local, rural community hospitals for primary care, emergency care, and for services ranging from delivering a baby to treating a patient with cancer. On the other side, the same providers delivering those babies and mending broken bones are facing rapidly aging patient populations, increased difficulty attracting doctors, nurses, and other necessary staff, and challenges staying current with the latest technologies absolutely necessary to provide care and run their clinics. Meanwhile, costs to provide this care (from pharmaceutical to utility costs) continue to rise faster than what we are getting reimbursed.

In this environment, it is no wonder rural hospitals all across the country – the anchors for so many of our communities – are closing at an alarming rate (more than 100 over the last decade), leaving many people wondering where they will go for care. And to make a tough situation even harder, with each facility that closes, it becomes more difficult for those who are left to meet the needs of the patients and families coming in the doors. 

New guidance for pediatricians on mental health care
WCAX

The American Academy of Pediatrics has new guidelines to help primary care providers diagnose children with mental health challenges. Our Galen Ettlin spoke with child psychiatrist Dr. David Rettew about the changes and how they could affect your child.

Living with HIV and AIDS
Brattleboro Reformer

Since HIV and AIDS entered the public consciousness in the early 1980s, there has been much progress made in testing, treatment, and prevention of this disease. While there is still much work to be done to combat the spread and to improve treatment of HIV and AIDS, we have made great strides over these past decades to understand and limit the transmission of the virus, to improve testing methods, and to develop better drugs with fewer side effects that help patients to live longer, healthier lives after diagnosis.

The Comprehensive Care Clinic at Brattleboro Memorial Hospital is part of a four-clinic system in Vermont providing confidential treatment and services for people living with all stages of HIV/AIDS. The Clinic provides a range of services, including free HIV testing, prevention counseling, social services, and access to medicine. The clinic system was established in 1994 and continues with support from the Ryan White CARE act. The other clinics are located in Burlington, Rutland and St. Johnsbury.

Be careful what you ask your primary doc – you might be billed
VT Digger

Patients at Integrative Family Medicine in Montpelier received a warning before they came in for their primary care check-ups: be careful what you ask your doctor. 

“Insurance coverage for yearly physical exams does NOT include review or discussion of new or current health problems,” patients were advised in a letter that went out this fall. If they ask their doctor about those health issues, “your insurer may have us bill you for the services above and beyond the yearly physical exam limit.”

The intent was noble -- to let patients know when and how they’d be charged for their exams, said Teresa Fama, a rheumatologist at Central Vermont Medical Center and chair of the committee that drafted the letter. “The goal was to try to protect patients, have them understand what to expect,” she said.

UVM Health Network's new system is live
My Champlain Valley

Phase one of a unified health network called Epic is now active at hospitals in the University of Vermont Health Network.

There are 6 hospitals and a home health and hospice organization apart of the UVM Health Network.

In phase one, Epic has gone live at Central Vermont Medical Center, Porter Medical Center, UVM Medical Center, and CVPH.

Dr. Doug Gentile is the Chief Medical Information Officer at the UVM Medical Center. He believes Epic is another step in the evolution of health care.

“I’m old enough to have practiced before electronic medical records when it was all paper. I work in the emergency room, so first of all I would hope that I could get the record because often times I couldn’t and when I did if it was a complicated patient it would be stacks of paper,” said Dr. Gentile.

Technology has made accessing medical records easier over time. However, there are different systems for each unit at the hospital and across UVM Health Network. Before Epic, it was hard to view all of a patient’s record.

AARP: Brand-name drug prices rose more than twice inflation in 2018
Vermont Business Magazine

Retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8% in 2018, more than twice the general inflation rate of 2.4%, according to new AARP Public Policy Institute (PPI) data released by the local Vermont chapter Thursday. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006. 

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices.”

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, according to the AARP PPI data.

Outcomes of Spineology US clinical trial for interbody fusion revealed
Vermont Business Magazine

 Spineology Inc, an innovator in anatomy-conserving spine surgery, has announced that John Chi, MD, MPH, Associate Professor of Neurosurgery at Harvard Medical School and the Director of Neurosurgical Spinal Oncology at Brigham and Women’s Hospital in Boston, Massachusetts, presented 24-month outcomes data from Spineology’s SCOUT clinical trial at last week’s Society for Minimally Invasive Spine Surgery (SMISS) Annual Meeting in Las Vegas, Nevada. Study sites included the University of Vermont.

The SCOUT study (Spineology Clinical Outcomes Trial), conducted under an FDA-approved IDE protocol, is a prospective, multi-center, non-randomized performance goal investigation designed to evaluate safety and effectiveness outcomes in instrumented lumbar interbody fusion procedures for the treatment of degenerative disc disease (DDD).

The fusion implant used in the SCOUT Study is Spineology’s porous graft containment mesh that deploys within the disc space as it is filled, permitting the packed bone graft to conform to the prepared vertebral body endplates. The system’s design allows for disc space preparation and implant placement through a small cannula.

People in the News
Mark Your Calendar!
Tuesday, December 3, 12 p.m.
Webinar

Wednesday, December 4, 5:30 p.m.
Webinar

Friday, December 6, 5:30 p.m.
Resillience Occupational Therapy, Montpelier