Parkland Health & Hospital System
Parkland Health & Hospital System
News Article | May 11, 2017
DALLAS--(BUSINESS WIRE)--UT Southwestern Medical Center (UTSW) has entered into a strategic license agreement with Pieces Technologies, Inc. (Pieces Tech) to scale a novel program to improve outcomes of adult patients requiring long-term parenteral antibiotic therapy. The program was developed by a multidisciplinary team led by Dr. Kavita Bhavan, Associate Professor of Internal Medicine at UT Southwestern, and will be distributed nationally on the Pieces DS software platform. The self-administered outpatient parenteral antibiotic therapy program, “S-OPAT” as it is known, has been tested extensively at Parkland Health & Hospital System in Dallas. The program has demonstrated upwards of $7.6 million in annual direct savings and a 47 percent reduction in 30-day readmission rate for patients engaged in self-care versus standard forms of OPAT. The cornerstone of the program focuses on training patients and families to safely self-administer parenteral antibiotics at home. Pieces Technologies estimates that health systems could realize 40 percent in direct savings through the use of this program. “Licensing materials developed at UT Southwestern allows us to effectively scale this program to interested hospitals across the country,” says Dr. Bhavan. “Pieces DS will serve as the data backbone of the program in a health system,” says Anand Shah, MD, Chief Clinical Officer at Pieces Technologies. “Working with Dr. Bhavan and UT Southwestern Medical Center, we’ll be able to ensure consistent implementation across diverse healthcare systems. The Pieces DS Platform, and the analytics behind it, will allow for continuous learning and benchmarking in this area.” About Pieces Tech: Pieces Technologies, Inc. is a Dallas-based health information technology company on a mission to advance health at every decision. Pieces™ DS is a cloud-based software platform that improves quality and cost of care by applying key algorithms throughout a patient’s journey, in real-time. Pieces™ DS is fully integrated with the electronic medical record and leverages class-leading risk modeling, natural language processing, machine learning, and artificial intelligence directly at the point of care. For more information about deploying the S-OPAT program at your health system, please email firstname.lastname@example.org.
News Article | May 22, 2017
ARLINGTON, Va.--(BUSINESS WIRE)--Surescripts continues to put actionable patient intelligence in the hands of hospitals and health systems with the expansion of its Medication History for Panel Management (“Panel Management”) data service. With the addition of CVS Health and Express Scripts, the service now provides dispensed prescription data coverage for over three-fourths of U.S. patients. Surescripts launched Panel Management in September 2016, and now provides a single connection to 14 pharmacy chains nationwide, six PBMs and eight independent pharmacy aggregators, providing the most comprehensive prescription dispensed data to enable more effective population health management. “Prescriptions are a critical tool for treating chronically ill patients, who account for 91% of all prescriptions in the U.S. As such, timely and secure access to dispensed medication data is essential for hospitals and health systems pursuing more effective population health management,” said Tom Skelton, Chief Executive Officer of Surescripts. “The rapid expansion of our Panel Management service delivers critical data to providers about patient adherence, gaps in care, and other medication patterns for patient populations, particularly those who are chronically ill and high-volume users of the system.” To date, Surescripts has securely delivered more than two million HIPAA-compliant medication histories through its panel management service nationwide. This intelligence is allowing healthcare providers to better manage high risk patient populations and ultimately improve care. For example, Panel Management enables providers and care managers to quickly identify patients who pick up medications from out-of-network prescribers at incorrect dosages. Providers are also given insight into patient medication adherence patterns, such as patients who habitually pick up 30-day refills of hypertensive medication in 45-day intervals. “The PDC (Proportion of Days Covered) tool developed by Parkland’s Information Technologies division in collaboration with Surescripts has provided valuable clinical insight into the plan of care provided to our patients,” said Jon McManus, Director of Enterprise Data Governance at Parkland Health & Hospital System. The most recent pharmacies and PBMs to connect to Surescripts Medication History for Panel Management service include: “Dispensed prescription data is invaluable to providers looking to deliver high quality care, particularly when they are responsible for at-risk populations,” said Troyen Brennan, M.D., Chief Medical Officer at CVS Health. “Connecting with Surescripts to supply comprehensive patient medication information at the point of care advances interoperability and improves patient care by bringing pharmacists and physicians closer together.” “Access to complete and timely medication information is essential for positive health outcomes,” said Lynne Nowak, MD, VP, Clinical and Provider Solutions at Express Scripts. “With data provided through Surescripts Medication History for Panel Management solution, we are empowering providers to deliver the best possible care for their patients and drive better population health management.” For more information on Surescripts Medication History for Panel Management, please click here. Our purpose is to serve the nation with the single most trusted and capable health information network. Since 2001, Surescripts has led the movement to turn health data into actionable intelligence to increase patient safety, lower costs and ensure quality care. Visit us at www.surescripts.com and follow us at twitter.com/surescripts.
News Article | November 18, 2016
DALLAS - November 18, 2016 - Proactive outreach to cirrhosis patients in a safety net health system successfully doubled their screening rates for liver cancer, UT Southwestern Medical Center researchers found. Cirrhosis (liver disease) patients are at high risk to develop liver cancer, which is increasing in frequency an average of 3 percent annually and has a five-year overall survival rate of just 17.5 percent. "Finding ways to reach patients at high risk of liver cancer is critical. Liver cancer has the fastest increasing mortality rate among solid tumors in the U.S.," said first author Dr. Amit G. Singal, Associate Professor of Internal Medicine and Clinical Sciences, and a member of the Harold C. Simmons Comprehensive Cancer Center. "This high mortality is primarily due to low rates of liver cancer screening and high rates of late-stage diagnosis." The study randomly divided 1,800 cirrhosis patients at Parkland Health & Hospital System in Dallas into three groups. The first group received mailed outreach invitations for screening ultrasound. The second group received similar outreach plus patient navigation, and the third received their usual care. Researchers learned that the group receiving mailed outreach invitations were most likely to schedule an ultrasound, which doubled the overall rate of screening. The study appears in the journal Gastroenterology. "Our study is one of the first interventions to improve liver cancer screening and early detection among at-risk patients. The vulnerable patient population we studied in our safety net health system are those who are at highest risk of dying from liver cancer, so this intervention helped those who might benefit the most," said Dr. Singal. Only one-fourth of patients with cirrhosis in routine care are currently screened every six months for liver cancer with an ultrasound as recommended by national guidelines. Symptoms are not usually present when the cancer is in its early stages. "Our research previously demonstrated that liver cancer screening is underused in clinical practice, with lower rates of screening among racial/ethnic minorities and socioeconomically disadvantaged patients," said senior author Dr. Ethan Halm, Director of the Center for Patient-Centered Outcomes Research, Chief of the William T. and Gay F. Solomon Division of General Internal Medicine, and Professor of Internal Medicine and Clinical Sciences. "Our new study presents a model of a proactive, population health outreach strategy that can improve liver cancer screening and early detection among those at highest risk of adverse outcomes." Dr. Halm holds the Walter Family Distinguished Chair in Internal Medicine in Honor of Albert D. Roberts, M.D. According to the National Cancer Institute, liver cancer is diagnosed in an estimated 39,230 people annually. In 2013, there were an estimated 54,954 people living with this cancer in the U.S. Risk factors include a diagnosis of fatty liver disease, hepatitis B, hepatitis C, cirrhosis, or a combination of these diseases. Additional UT Southwestern faculty who contributed to the study include: Dr. Jasmin A. Tiro, Associate Professor of Clinical Science and member of the Simmons Cancer Center; and Dr. Jorge A. Marrero, Medical Director of Liver Transplantation, Associate Vice President, Clinical Transformation Officer, and Professor of Internal Medicine. Dr. Tiro, Dr. Marrero, Dr. Halm, and Dr. Singal are all members of the Simmons Cancer Center. Dr. Noel O. Santini from Parkland Health & Hospital System also contributed to the study. This study was conducted as part of UT Southwestern's Center for Patient-Centered Outcomes Research with support from the Agency for Healthcare Research & Quality, the National Institutes of Health, and the National Cancer Institute. Dr. Singal reported being on the speaker bureau for Bayer Pharmaceutical and receiving grant funding from Gilead Pharmaceuticals. The Harold C. Simmons Comprehensive Cancer Center is the only NCI-designated Comprehensive Cancer Center in North Texas and one of just 47 NCI-designated Comprehensive Cancer Centers in the nation. Simmons Cancer Center includes 13 major cancer care programs. In addition, the Center's education and training programs support and develop the next generation of cancer researchers and clinicians. Simmons Cancer Center is among only 30 U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site. Cancer that starts in the liver is called primary liver cancer. There are often no symptoms for early-stage liver cancer. Liver cancer can also develop in the bile ducts within the liver. UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution's faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. The faculty of almost 2,800 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in about 80 specialties to more than 100,000 hospitalized patients and oversee approximately 2.2 million outpatient visits a year. This news release is available on our website at http://www. . To automatically receive news releases from UT Southwestern via email, subscribe at http://www. .
News Article | March 2, 2017
DALLAS - March 1, 2017 - A large national study suggests that treating pregnant women for mildly low thyroid function does not improve the IQs of their babies or reduce preterm births or other negative outcomes. The 10-year study, conducted at UT Southwestern Medical Center and 14 other universities and medical centers in the National Institutes of Health's (NIH) Maternal Fetal Medicine Units Network, found no benefit in treating the women during their pregnancies. The results are published today in The New England Journal of Medicine (NEJM). Full-blown hypothyroidism during pregnancy, especially when untreated, has long been associated with lower mental functioning in offspring, as well as low birth weight, stillbirth, and preterm labor. It is commonly treated by giving expectant mothers a synthetic substitute to boost their low thyroid hormone, thyroxine. In 1999, another NEJM study raised concerns that the same problems might occur in women with even mild, or subclinical, hormone abnormalities. As a result, several physician groups called for routine testing of all pregnant women in the U.S. -- about 4 million women a year -- and treatment for these marginal hormone problems. The American College of Obstetricians and Gynecologists has recommended against universal screening for thyroid disease in pregnant women. "Our study found that treatment did not benefit children born to these women," said Dr. Brian Casey, Professor of Obstetrics and Gynecology at UT Southwestern Medical Center and first author of the new study. "There's no evidence that treatment improves either pregnancy outcomes or the children's neurodevelopmental or behavioral outcomes through 5 years of age." Dr. Casey is Division Director of Maternal-Fetal Medicine at UT Southwestern and holds the Gillette Professorship of Obstetrics and Gynecology. He is also Chief of Obstetrics at Parkland Health & Hospital System. The NIH study grew out of research begun in 2000 at UT Southwestern, when Dr. Casey and his colleagues performed a study on thyroid disease during pregnancy in over 25,000 women at Parkland Memorial Hospital. That study culminated in his proposal of a multicenter treatment study to the NIH in 2005. Dr. Casey now is principal investigator of the NIH study and chair of the protocol subcommittee. Starting in October 2006, researchers screened more than 97,000 pregnant women for the study and enrolled 1,203 who had either subclinical hypothyroidism or isolated hypothyroxinemia. Subclinical hypothyroidism is characterized by high levels of a pituitary gland hormone, TSH, which stimulates the thyroid to produce thyroxine. In isolated hypothyroxinemia, the pituitary hormone level is normal, but thyroxine, or free T4, is abnormally low. Half the study participants were given levothyroxine, a synthetic substitute for their thyroid hormone; the other half received a placebo. Researchers then analyzed pregnancy outcomes of both groups and followed the neurocognitive development of the women's babies for five years. IQ levels and other test scores were not significantly different between the children of women given levothyroxine and children whose mothers received a placebo, Dr. Casey said. Children of the women treated for subclinical hypothyroidism scored an average of 97 on the IQ test, compared with 94 for those born to women in the placebo group. In the hypothyroxinemia part of the study, the children of those treated averaged 94, while offspring of those given placebos averaged 91. These scores are considered normal and the three-point differences are not viewed as significant, Dr. Casey said. The results suggest there is no benefit to widespread testing and treatment for subclinical thyroid problems during pregnancy, he said. "If treatment doesn't improve outcomes, then it calls into question whether we should be screening every pregnant woman for this mild degree of thyroid deficiency." A 2012 study published in The Journal of Clinical Endocrinology & Metabolism estimated a cost of $25 (in 2009 dollars) for the TSH test and $13 to test the free T4 thyroid hormone level, in addition to the cost of the physician visits and consultation. Pregnant women diagnosed with a thyroid problem would then need continued testing, as well as potential treatment with levothyroxine at an estimated cost of $170 (again, in 2009 dollars) for a year's supply. The current study's findings followed those of a large British study, published in NEJM in 2012, which screened more than 20,000 pregnant women. That study concluded treatment for reduced thyroid function in pregnant women did not improve cognitive function in their children at age 3. The newly published study was funded by the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, along with the National Institute of Neurological Disorders and Stroke. UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution's faculty includes many distinguished members, including six who have been awarded Nobel Prizes since 1985. The faculty of almost 2,800 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in about 80 specialties to more than 100,000 hospitalized patients and oversee approximately 2.2 million outpatient visits a year. This news release is available on our website at http://www. To automatically receive news releases from UT Southwestern via email, subscribe at http://www.
Singal A.G.,Parkland Health Hospital System |
Singal A.G.,Southwestern University |
Yopp A.C.,Southwestern University |
Gupta S.,Parkland Health Hospital System |
And 9 more authors.
Cancer Prevention Research | Year: 2012
Hepatocellular carcinoma (HCC) surveillance is underutilized among patients with cirrhosis. Understanding which steps in the surveillance process are not being conducted is essential for designing effective interventions to improve surveillance rates. The aim of our study was to characterize reasons for failure in the HCC surveillance process among a cohort of cirrhotic patients with HCC. We conducted a retrospective cohort study of cirrhotic patients diagnosed withHCCat a large urban safety-net hospital between 2005 and 2011. Patients were characterized by receipt of HCC surveillance over a two-year period before HCC diagnosis. Among patients without HCC surveillance, we classified reasons for failure into four categories: failure to recognize liver disease, failure to recognize cirrhosis, failure to order surveillance, and failure to complete surveillance despite orders. Univariate and multivariate analyses were conducted to identify predictors of failures. We identified 178 patients with HCC, of whom 20% had undergone surveillance. There were multiple points of failure - 20% had unrecognized liver disease, 19% had unrecognized cirrhosis, 38% lacked surveillance orders, and 3% failed to complete surveillance despite orders. Surveillance was more likely among patients seen by hepatologists [OR, 6.11; 95% confidence interval (CI), 2.5-14.8] and less likely in those with alcohol abuse (OR, 0.14; 95% CI, 0.03-0.65). Although a retrospective analysis in a safety-net hospital, our data suggest that only one in five patients received surveillance before HCCdiagnosis. There are multiple points of failure in the surveillance process, with the mostcommonbeing failure to order surveillance in patients with known cirrhosis. Future interventions must target multiple failure points in the surveillance process to be highly effective. ©2012 AACR.
PubMed | Parkland Health & Hospital System, Southwestern Medical Center, Texas Health Resources and PCCI, Inc.
Type: Journal Article | Journal: Journal of general internal medicine | Year: 2016
Vital sign instability on discharge could be a clinically objective means of assessing readiness and safety for discharge; however, the association between vital sign instability on discharge and post-hospital outcomes is unclear.To assess the association between vital sign instability at hospital discharge and post-discharge adverse outcomes.Multi-center observational cohort study using electronic health record data. Abnormalities in temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation were assessed within 24hours of discharge. We used logistic regression adjusted for predictors of 30-day death and readmission.Adults (18years) with a hospitalization to any medicine service in 2009-2010 at six hospitals (safety-net, community, teaching, and non-teaching) in north Texas.Death or non-elective readmission within 30days after discharge.Of 32,835 individuals, 18.7% were discharged with one or more vital sign instabilities. Overall, 12.8% of individuals with no instabilities on discharge died or were readmitted, compared to 16.9% with one instability, 21.2% with two instabilities, and 26.0% with three or more instabilities (p<0.001). The presence of any (1) instability was associated with higher risk-adjusted odds of either death or readmission (AOR 1.36, 95% CI 1.26-1.48), and was more strongly associated with death (AOR 2.31, 95% CI 1.91-2.79). Individuals with three or more instabilities had nearly fourfold increased odds of death (AOR 3.91, 95% CI 1.69-9.06) and increased odds of 30-day readmission (AOR 1.36, 95% 0.81-2.30) compared to individuals with no instabilities. Having two or more vital sign instabilities at discharge had a positive predictive value of 22% and positive likelihood ratio of 1.8 for 30-day death or readmission.Vital sign instability on discharge is associated with increased risk-adjusted rates of 30-day mortality and readmission. These simple vital sign criteria could be used to assess safety for discharge, and to reduce 30-day mortality and readmissions.