Carolinas HealthCare System NorthEast: The Next Era of Healthcare is Here
Carolinas HealthCare System NorthEast: The Next Era of Healthcare is Here
From robot-assisted surgery to virtual treatment for
strokes, Carolinas HealthCare System NorthEast has become a power center for
clinical experts who are using modern technology to enhance patient care.
In the cardiac catheterization lab at Carolinas HealthCare System NorthEast on a sunny day in September of last year, under a bright light, Charles Napier was calm – a radial catheter in his wrist and a robot to his side. He watched on a nearby screen as a thin, flexible tube threaded its way from the radial artery in his wrist to a blood vessel in his heart.
Interventional cardiologist Paul Campbell, MD, and his team at Sanger Heart & Vascular Institute-Concord talked to Napier as they stood behind a cockpit on the floor. From there, they would control a robotic arm with two joysticks and a touchscreen. Their goal was to use the robot to measure the lesion in Napier’s artery down to the submillimeter and then insert a stent into his artery, currently 99 percent blocked, to allow blood to flow more freely.
“Charlie, are you doing okay?” called the technician. Napier, feeling comfortable and confident, nodded and said yes.
On a screen in Liverpool, England, a room of medical professionals watched, transfixed.
The intravascular robotic system at NorthEast is just one example of medical innovation that’s
allowing its doctors to enhance their care to patients in our community. From virtual stroke care, to being able to monitor changes in a tumor’s position in real time, to the intravascular robotic system used for Napier’s heart procedure, experts at NorthEast are frequently utilizing modern healthcare advancements to improve clinical outcomes and provide a better patient experience. Their progress has led to opportunities for Carolinas HealthCare System to take an international stage, such as the one Dr. Campbell found himself on while inserting a stent into Napier’s blocked artery.
“We’re in a period of innovation in healthcare where new technology is helping us reach our goal to achieve high-quality outcomes while providing an excellent experience for our patients and families,” says Tri Tang, assistant vice-president at NorthEast. “It’s incredibly exciting when we can say something like, ‘This hospital has the only FDA-approved intravascular robotic system.’ It shows the community that we are committed to raising the standard of healthcare they receive.”
The Robot in the Room
NorthEast installed the intravascular robotic system two years ago and has used it on upwards of 250 patients. The benefit, Dr. Campbell says, is that the robot provides experts at Sanger Heart & Vascular Institute-Concord with an extra layer of accuracy and safety: it provides precise movement of the equipment, better visualization of the coronary artery and more accurate measurements of the lesions in the heart, all while reducing the doctors’ radiation exposure by 95 percent.
“Traditionally, when we do heart catheters, we take images of coronary arteries and look at the plaque lesions that we then open with balloons or stents for patients,” Dr. Campbell says. “Historically, the size of that lesion – which determines the stent size – has been a visual estimate. There are ways to measure it, but not in real time. The advantage of the robotic system is, it can measure precisely down to the tenth of a millimeter. The robot gives us precision, accuracy, control and safety.”
Christopher Lyszczyk knows the benefits of the robot-assisted technology well, being one of the first patients to experience the robotic-assisted surgery at NorthEast.
Lyszczyk, 54 at the time, thought he was in fairly good health, until he jumped on the treadmill one day and found he could only run about eight minutes without his body giving out. He went to see his primary care physician, who escalated him immediately to Dr. Campbell.
Lyszczyk, it turned out, had four blockages in his heart. “I was a time bomb waiting to happen,” he says.
He didn’t know he’d be a prospect for the intravascular robotic system, but was awed by the teamwork and benefits. Dr. Campbell used the robot to insert one stent to cure two adjacent blockages, whereas older technology may have required a cardiologist to put in two stents – which would have increased the cost of the surgery.
He watched as the doctors worked. “They don’t put you under; you’re able to see everything,” he says. “It’s really cool, for lack of a better word. Being in there, you’ve got a magnitude of fright, but Dr. Campbell stuck with me the entire time. I have the utmost admiration for him; he is a magician with the instruments provided to him. It was amazing teamwork that saved me.”
As Dr. Campbell and the team at Sanger Heart & Vascular Institute-Concord became experts in these robot-assisted procedures, an opportunity arose for Dr. Campbell to demonstrate his technique to an international audience. He’d been looking for a platform to talk about radiation safety as well as the benefits of radial catheterization, which involves inserting the catheter through the radial artery in the wrist rather than the femoral artery (groin area). He found that performing the surgery from behind the interventional cockpit:
• Reduces radiation exposure by 95 percent;
• Eliminates the need for doctors to wear lead aprons, vests and glasses during the surgery;
• Reduces the need for doctors to bend over, preventing back injuries;
• Allows doctors to see the screen more closely.
Dr. Campbell’s interests and expertise culminated during the AimRadial International Conference held in Liverpool, England, in mid-September, during which he demonstrated the accurate stent measurement and placement on Napier, as well as the reduction in radiation to both physicians and staff, via a live-stream video.
“That was really the first time we had done that here in Cabarrus County in our cath lab,” says Amanda Thompson, assistant vice-president of cardiovascular services at Carolinas HealthCare System NorthEast. “It went off without a hitch. I was a little bit leery that something would not work in the audio/visual world, but it was great. We’re doing the case, and they’re sitting live in the audience at an international conference. We got feedback from the audience in Liverpool that they were absolutely mesmerized by what was happening.”
Medical Breakthroughs Abound
The intravascular robotic system at NorthEast is just one example of how the doctors are increasing their clinical expertise to improve the patient experience and outcomes. Another innovation is the state-of-the-art digital linear accelerator, which lets physicians monitor changes in a tumor’s position in real time in a patient, allowing them to adjust treatment rapidly if needed.
Surface-image guidance technology in the linear accelerator reduces the need for unnecessary radiation exposure for the patient. An additional benefit of the accelerator is that it allows doctors to deliver some treatments to patients in under two minutes, compared to prior techniques that took 15 to 20 minutes. And automated treatment delivery means therapists can devote more time to focus on patients’ wellbeing.
Tomain Murphy, administrative director of the radiation oncology department at NorthEast, says great thought went into selecting the most beneficial equipment for NorthEast’s patients. “One of the primary distinctions in the decision-making process for Carolinas HealthCare System is the fact that this supports the vision of Levine Cancer Institute to provide comprehensive cancer solutions closest to patients’ homes, thus dramatically reducing the need to drive to Charlotte for specialized services.”
Another advancement that’s allowing Carolinas HealthCare System NorthEast to move the needle on patient care is the progression of Telestroke, which is a larger Carolinas HealthCare System initiative within the Neurosciences Institute that allows a 24/7 neurohospitalist at NorthEast to virtually assess, evaluate and treat patients at other hospitals and emergency departments around the System, including the freestanding emergency departments in Harrisburg and Kannapolis.
When patients at Carolinas HealthCare System Kannapolis arrive with stroke symptoms, for example, the CHS Virtual Critical Care unit based in Mint Hill is alerted, and a page goes out to the neurohospitalist at NorthEast. The neurohospital virtually sees and converses with the patient and their family members in Kannapolis, in conjunction with the on-site emergency department doctor, to do a neurological assessment; a critical care nurse is also responding virtually. The neurohospitalist at NorthEast can see patients’ scans, determine appropriate treatment and suggest a transfer to NorthEast, if necessary.
By the end of 2015, close to 150 patients had been virtually treated through Telestroke.
One major benefit is that if the patient needs medicine, the physician on-site at the emergency department or hospital can administer it. “The patient does not have to waste more time to get the drug; they’re able to get the medication and treatment where they are and where they live,” says Angela Reid, assistant vice-president of neurological services at NorthEast. “We’re also able to expand that clinical expertise to more rural areas in our System, such as Anson County, to ensure expert stroke care is consistently provided to the patients throughout our entire region.”
“If the patient is at one of our partner hospitals or emergency departments, and they meet criteria to receive an intravenous ‘clot busting’ medicine, the patient can receive the medication on-site without delays. This allows for partner hospitals without an on-site neurologist to obtain expert stroke care virtually in a timely fashion,” adds Dr. Chut Sombutmai, stroke medical director for CHS NorthEast and physician lead for Telestroke initiatives.
These medical innovations, breakthrough procedures and operational improvements to enhance the patient experience are all part of Carolinas HealthCare System’s ultimate goal of transforming the delivery of healthcare services in the communities it serves.
A Higher Level of Care
Back in Dr. Campbell’s cardiac catheterization lab on the day of the live stream to England, Charles Napier is finished having his stent inserted. Because the robot-assisted surgery is an outpatient procedure, he’ll be headed back home to Albemarle in two hours with just a Band-Aid on his wrist.
Napier says he was glad to be a part of a procedure that was live-streamed to an international audience. “I was getting the latest, most advanced medical care, and also I saw this as my being able to participate in showing others in the medical field this procedure that could help somebody else. I was happy to do it.” His friends and family, he adds, were amazed by the procedure.
Dr. Campbell adds that using the intravascular robotic surgery has been a positive development for Sanger Heart & Vascular Institute-Concord, as it’s enhanced the technical skills of the staff and lab, and even boosted morale.
“I can tell a patient when I’m done that I’ve given them the right stent in the right place because we measured it precisely with a robot,” he says. “It’s medical reassurance.”
Lyszczyk, two years removed from the surgery, adds that his results have been amazing. His three kids got him a Fitbit for Father’s Day last year so he can monitor his heartbeat.
National Cancer Prevention Month
If your New Year’s fervor to get healthy is already losing steam, February – National Cancer Prevention Month – is a great time to give yourself a second chance.
The American Institute for Cancer Research’s (AICR) three guidelines for cancer prevention can help you focus on what’s most important.
• Choose mostly plant foods, limit red meat and avoid processed meat.
You already know that limiting high-calorie treats is a good idea. But did you know that if you make an effort to prepare meals focused around vegetables, fruits, whole grains and beans, you’ll help fortify your body against cancer?
That’s what AICR’s groundbreaking expert report concluded. The report also found a convincing scientific link between red and processed meats and colon cancer, so it’s a good idea to limit red meat to 18 ounces of lean cuts per week and avoid processed meats like ham, hot dogs, sausage and bacon.
• Be physically active every day in any way for 30 minutes or more.
Remember: Every day – in any way. That means you don’t need a gym membership – you just need to get your heart pumping. Being physically active for a total of at least 30 minutes a day – whether you’re walking, vacuuming, dancing or scuba diving – will lower your risk for colon cancer and possibly several other cancers as well.
You might need to get more than 30 minutes a day in order to prevent weight gain – which is very important – but you don’t have to do it all at once. Try breaking your activity into several 15- or 20-minute sessions to fit your schedule.
• Aim to be a healthy weight throughout life.
Carrying excess weight has been linked to six different types of cancer. The good news is that once you start following the first two guidelines about diet and physical activity, you’ll find it easier to accomplish this one.
Notice anything about these guidelines? Like, for example, how closely the advice for cutting cancer risk resembles advice for preventing other chronic diseases like heart disease and diabetes – not to mention for getting in shape?
It’s true: these simple steps offer many different health benefits, and National Cancer Prevention Month is as good a time as any to start putting them into action.
So this month, especially, keep these three guidelines in mind and remember: It’s never too early and never too late to start making choices that improve your chances for good health (and good looks!) for 2016 and beyond.
Article written by: Kimberly Cassell
Robotic Arm Photo: Michael A. Anderson photography
Remaining photos Courtesy: CMC-Northeast