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Hingorani A.,Lutheran Medical Center | Lamuraglia G.M.,Harvard University | Henke P.,University of Michigan | Meissner M.H.,University of Washington | And 8 more authors.
Journal of Vascular Surgery | Year: 2016

Background Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline. Methods The committee made specific practice recommendations using the Grades of Recommendation Assessment, Development, and Evaluation system. This was based on five systematic reviews of the literature. Specific areas of focus included (1) prevention of diabetic foot ulceration, (2) off-loading, (3) diagnosis of osteomyelitis, (4) wound care, and (5) peripheral arterial disease. Results Although we identified only limited high-quality evidence for many of the critical questions, we used the best available evidence and considered the patients' values and preferences and the clinical context to develop these guidelines. We include preventive recommendations such as those for adequate glycemic control, periodic foot inspection, and patient and family education. We recommend using custom therapeutic footwear in high-risk diabetic patients, including those with significant neuropathy, foot deformities, or previous amputation. In patients with plantar diabetic foot ulcer (DFU), we recommend off-loading with a total contact cast or irremovable fixed ankle walking boot. In patients with a new DFU, we recommend probe to bone test and plain films to be followed by magnetic resonance imaging if a soft tissue abscess or osteomyelitis is suspected. We provide recommendations on comprehensive wound care and various débridement methods. For DFUs that fail to improve (>50% wound area reduction) after a minimum of 4 weeks of standard wound therapy, we recommend adjunctive wound therapy options. In patients with DFU who have peripheral arterial disease, we recommend revascularization by either surgical bypass or endovascular therapy. Conclusions Whereas these guidelines have addressed five key areas in the care of DFUs, they do not cover all the aspects of this complex condition. Going forward as future evidence accumulates, we plan to update our recommendations accordingly. © 2016 Society for Vascular Surgery.


PubMed | University of Michigan, University of Washington, Lutheran Medical Center, Baylor College of Medicine and 8 more.
Type: Journal Article | Journal: Journal of vascular surgery | Year: 2016

Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline.The committee made specific practice recommendations using the Grades of Recommendation Assessment, Development, and Evaluation system. This was based on five systematic reviews of the literature. Specific areas of focus included (1) prevention of diabetic foot ulceration, (2) off-loading, (3) diagnosis of osteomyelitis, (4) wound care, and (5) peripheral arterial disease.Although we identified only limited high-quality evidence for many of the critical questions, we used the best available evidence and considered the patients values and preferences and the clinical context to develop these guidelines. We include preventive recommendations such as those for adequate glycemic control, periodic foot inspection, and patient and family education. We recommend using custom therapeutic footwear in high-risk diabetic patients, including those with significant neuropathy, foot deformities, or previous amputation. In patients with plantar diabetic foot ulcer (DFU), we recommend off-loading with a total contact cast or irremovable fixed ankle walking boot. In patients with a new DFU, we recommend probe to bone test and plain films to be followed by magnetic resonance imaging if a soft tissue abscess or osteomyelitis is suspected. We provide recommendations on comprehensive wound care and various dbridement methods. For DFUs that fail to improve (>50% wound area reduction) after a minimum of 4 weeks of standard wound therapy, we recommend adjunctive wound therapy options. In patients with DFU who have peripheral arterial disease, we recommend revascularization by either surgical bypass or endovascular therapy.Whereas these guidelines have addressed five key areas in the care of DFUs, they do not cover all the aspects of this complex condition. Going forward as future evidence accumulates, we plan to update our recommendations accordingly.


WORCESTER, Mass., March 1, 2017 /PRNewswire-USNewswire/ -- In response to a proposal by UMass Memorial Medical Center (UMMMC) to close 13 of its 28 inpatient psychiatric beds at its University Campus, Worcester District 4 City Councilor Sarai Rivera is proposing an order that would appear...


QUINCY, Mass.--(BUSINESS WIRE)--Shields Health Solutions, creator of specialty pharmacies for hospitals and health systems, today announced a new agreement with Fairview Health Services, a Minneapolis-based integrated health system, to co-develop care-related products and services for hospitals to better serve patients living with chronic illness. The agreement builds on five years of partnership co-developing products and services for hospital-based specialty pharmacies. “Adding the depth offered by Shields Health Solutions to our co-development initiatives makes sense because our patient-first values align so seamlessly,” said Dave Fasching, Chief Financial Officer, Fairview Health Services Specialty Pharmacy. “Shields is a great business partner and they are even better people. Like our healers in the hospital system, Shields puts patient health above all. We are committed to doing a lot more in 2017 and beyond.” Innovation in Hospital-Based Specialty Pharmacy Placing a specialty pharmacy on site at Fairview Health Services and at other health systems has resulted in many population health and coordinated care improvements including: “Creating the best products for hospital-owned specialty pharmacies with partners like Fairview allows us take advances from one location and bring them to hospital systems across the country,” said Jack Shields, CEO, Shields Health Solutions. “This is the most efficient way of improving lives for patients. Hospital’s having their own specialty pharmacy program is the single biggest care model improvement I’ve seen for patients in my 30 years in healthcare. We look forward to accelerating the pace of innovation alongside Fairview to help bring the best healthcare in the country to people living with chronic illness.” Creating the First Specialty Pharmacy Patient Telemetry Center™ Today, the sickest five percent of the population spends fifty times as much on healthcare per person as the healthiest majority of the population. Five years ago there was no quantifiable, cost-effective way to treat the sickest patients, who are often those with chronic illness. For example, if a hospital had 3,000 chronically ill patients scheduled for appointments in a given week, an effort was made to contact each patient before she or he arrived at the hospital. But that was not always possible. Today there is a Shields Patient Telemetry Center™ capable of analyzing the needs of all 3,000 patients before they arrive for appointments. Analysis may show 185 patients require intensive intervention before or after hospital appointments. Screening for medication adherence counseling, drug interaction prevention and post surgical follow-up are just a few medical interventions that can be scheduled to keep a sub-set of those 185 patients healthy. Because chronic illnesses often involve more than prescriptions to maintain health, some other patients may receive financial aid support to afford medicines and co-pays, psychological counseling, or home education visits to teach home injections. All as a result of analysis performed in the Patient Telemetry Center. In the end, all 3,000 patients can be contacted today, but all at the appropriate level of intervention. Technology like the Patient Telemetry Center helps the hospital system focus care resources where they are needed most, improving overall population health while cutting overall healthcare costs. Shields continued, “We’re fortunate to co-develop and incubate ideas at places like UMass Memorial and the University of Minnesota. Both are leading academic medical centers and have a national reputation for leadership. Next year we’ve been challenged by James Hereford, the CEO of Fairview, to focus on innovation around oncology. And that’s really exciting because about half of all FDA pipeline formularies are in the oncology specialty area. Developing best practices will really make an impact on value-based care going forward.” About Shields Health Solutions Shields Health Solutions is a specialty pharmacy integrator and care provider, partnering with hospital leaders on every aspect of specialty pharmacy creation and management. The company provides the fastest, lowest risk model for Hospitals to create a hospital-owned specialty pharmacy business, eliminating risks associated with Limited Distribution Drug (LDD) contracts, payor contracts, pharmacy accreditations, infrastructure set up and more. Shields Health Solutions handles it all, whether hospital leaders want to build from scratch or add specialty capabilities to their existing pharmacy programs. In 2012 Shields Health Solutions broke new ground by introducing the first turn-key, hospital-owned specialty pharmacy for a health system. The project included design and build of the pharmacy facility, pharmacy accreditations, pharmacy staffing, payor contracts, Limited Distribution Drug (LDD) contracts and technology infrastructure such as telecommunications and analytics dashboards. Today many of the most respected hospitals in the country, including UMass Memorial, Hartford Healthcare and Bay State Medical Center, are serving their chronically ill, complex patient populations using specialty pharmacy best practices developed collaboratively with Shields. The breakthrough of Shields Specialty Pharmacy is based on 40 years of partnerships with 30 hospital systems, building Shields Dialysis Centers, Shields Advanced Imaging Centers (Shields MRI) and Shields Radiation Therapy Centers. What we are doing today with Specialty Pharmacy is once again bringing best practices into a new area of healthcare, returning patients to the center of the care model, while helping healthcare leaders deliver better care more efficiently. Today, Shields Health Solutions is one of the fastest growing companies in America. For more information about Shields Health Solutions, visit www.shieldshealthsolutions.com.


News Article | November 15, 2016
Site: www.prweb.com

UMass Memorial Health Care in Worcester, MA, the largest healthcare system in central Massachusetts, has recently contracted with Mediware Information Systems, Inc. to implement HCLL™ Transfusion, HCLL™ Analytics, LifeTrak®, and Transtem™. The best-of-breed applications are the core software solutions comprising Mediware’s Blood Management Technologies division. HCLL Transfusion, Mediware’s 510(k)-cleared transfusion management system utilized by hundreds of prestigious hospitals and the Department of Defense (DoD), features robust patient safety protocols and multi-site and multi-facility inventory management capabilities. HCLL Analytics adds performance management tools to the transfusion management system. These applications will be implemented across the UMass Memorial Health Care system, which includes four community hospitals and a Level 1 trauma center with advanced emergency services. Mediware’s LifeTrak donor software, also with 510(k) clearance, and its Transtem cellular therapy software will be used at UMass Memorial Medical Center, which is the clinical partner of UMass Medical School. LifeTrak, relied on by the nation’s most renowned blood centers, hospitals, and the DoD, will reliably manage donor information and eligibility, product manufacturing, and distribution processes. Transtem, an innovative cellular therapy solution, will provide end-to-end process management from cell or material collection through all phases of manufacturing and, ultimately, product release for use in clinical therapy. “With all four systems in place, we are confident that we can continue to maintain our commitment to improving the health of people in central Massachusetts through excellent care, comprehensive health services, and cutting-edge research,” said Dr. Robert Weinstein, chief of UMass Memorial Medical Center’s Division of Transfusion Medicine. “Mediware is pleased to partner with the UMass Memorial Health Care System by providing our innovative, stand-alone applications and supporting seamless integration across the system’s multiple facilities,” stated Thomas Mann, Mediware’s president and CEO. About Mediware Information Systems Mediware is a leading supplier of software for healthcare and human service providers and payers. For more than 30 years, we have equipped the nation’s blood banks with the most comprehensive solutions on the market. Today, more than 1,500 hospitals and blood centers rely on our blood donor and transfusion management applications for fast, error-free collection, supply and usage. Our portfolio of solutions also includes human services, cellular therapy, home care, medication management, rehabilitation, and respiratory therapy, all developed by our 600+ subject matter experts who understand business and care processes in specialized acute, non-acute, and community-based care settings. For more information about Mediware products and services, visit http://www.mediware.com. About UMass Memorial Health Care UMass Memorial Health Care is the largest healthcare system in central Massachusetts. The system includes four hospitals and is the clinical partner of UMass Medical School, which provides access to the latest technology, research, and clinical trials. The hospitals are accredited by the Joint Commission or by Det Norske Veritas (DNV), a risk management company that helps improve healthcare services. In addition to fully equipped medical centers, the system also includes home health and hospice programs, behavioral health programs, and community-based physician practices.


News Article | February 17, 2017
Site: www.marketwired.com

Mesothelioma expert, Mary Hesdorffer, has been selected to receive the Gabriella Graham Patient Advocacy award at the 12th International Regional Therapies conference in Snowbird, UT. ALEXANDRIA, VA--(Marketwired - February 17, 2017) - The Mesothelioma Applied Research Foundation has announced today that its executive director, Mary Hesdorffer, has been selected as the recipient of the Gabriella Graham Patient Advocacy Award. This award honors individuals who have dedicated significant time and effort to help patients obtain the best care possible; have increased awareness and provided education of the disease to health care providers; and have promoted research efforts to expand understanding of the disease and improve treatment. The award is presented by the coordinating committee for the 12th International Regional Therapies meeting, taking place on Saturday, February 18th in Snowbird, UT. "Through Ms. Hesdorffer's efforts at the Foundation, she has clearly exemplified the meaning of the word advocate," said Dr. Laura Lambert of UMass Memorial, a spokesperson for the event. "Not only does she provide people with the information and resources they need to get the optimal treatment for mesothelioma, even more importantly, through her personal connection with patients and their families, she helps them with the even harder process of healing from this life-threatening disease," Dr. Lambert added. Mary Hesdorffer has been working in the field of mesothelioma for nearly 20 years, during which she has cared for mesothelioma patients in a number of roles, including her most recent as executive director of the Mesothelioma Applied Research Foundation. "Mary works tirelessly on behalf of the mesothelioma community and I am thrilled that her work is recognized with this award. Recognition is not something she seeks, but she truly deserves it," said Melinda Kotzian, chief executive officer of the Mesothelioma Applied Research Foundation. The purpose of this conference, which is sponsored by the David C. Koch Regional Cancer Therapy Center, the University of Pittsburgh School of Medicine Center for Continuing Education in the Health Sciences, and UPMC CancerCenter, is to facilitate an exchange of regional cancer therapies information among physicians. Mesothelioma is a malignant tumor of the lining of the lung, abdomen, or heart known to be caused by exposure to asbestos. With the life expectancy of less than one year after diagnosis, medical experts consider it one of the most aggressive and deadly of all cancers. An estimated one-third of those who develop mesothelioma were exposed while serving in the Navy or working in shipyards. Currently, few treatment options exist. There is no cure. ABOUT THE MESOTHELIOMA APPLIED RESEARCH FOUNDATION The Meso Foundation is the only 501(c)(3) nonprofit organization dedicated to eradicating mesothelioma and easing the suffering caused by this cancer. The Meso Foundation actively seeks philanthropic support to fund mesothelioma research; provide patient support services and education; and advocate Congress for increased federal funding for mesothelioma research. The Meso Foundation is the only non-government funder of peer-reviewed scientific research to develop life-saving treatments for this extremely aggressive cancer. To date, the Foundation has awarded over $9.4 million to research. More information is available at www.curemeso.org.


News Article | February 21, 2017
Site: www.businesswire.com

QUINCY, Mass.--(BUSINESS WIRE)--Shields Health Solutions, a creator of specialty pharmacies for hospitals and health systems nationwide, today announced Prashant K Dilwali has joined the company’s executive team as Director of Business Operations. In his new role Prashant is responsible for establishing best practices across the patient support systems that the company has put in place to serve thousands of chronically ill patients. He also provides support identifying and analyzing new business opportunities. “Prashant is widely recognized as one of the most brilliant minds in healthcare today and we are delighted to have him join our growing executive team,” said Jack Shields, CEO, Shields Health Solutions. “We are adding the top talent in the country to our executive team right here in Quincy, heading into another year of double-digit growth. I know Prashant will play a vital role helping us meet the aggressive goals we have set out for the next few years, especially because we put patient health above all else and he is responsible for ensuring our operations continue to be the best in the industry at doing just that.” Prior to joining Shields, Prashant was Director of Finance at US Anesthesia Partners where he was responsible for budgeting and analytics. He has worked as a turnaround management consultant at Alvarez & Marsal’s Healthcare Industry Group – implementing both financial and operational restructuring. Prashant has also worked at Trinity Partners and Scientia Advisors as a strategy consultant to healthcare and life sciences companies – identifying new business opportunities and forecasting market capture. Prashant holds a Masters of Health Administration from the Johns Hopkins Bloomberg School of Public Health and a Bachelors of Science in Biology with a minor in Economics from the Massachusetts Institute of Technology. About Shields Health Solutions Shields Health Solutions partners with hospital leaders on every aspect of specialty pharmacy creation and management. The company provides the fastest, lowest risk model for Hospitals to create a hospital-owned specialty pharmacy business, eliminating risks associated with Limited Distribution Drug (LDD) contracts, payor contracts, pharmacy accreditations, infrastructure set up and more. Shields Health Solutions handles it all, whether hospital leaders want to build from scratch or add specialty capabilities to their existing pharmacy programs. In 2012 Shields Health Solutions broke new ground by introducing the first hospital-owned specialty pharmacy for a health system. Today many of the most respected hospitals in the country, including UMass Memorial, Fairview Health Services and Hartford Healthcare, are serving their chronically ill, complex patient populations using specialty pharmacy best practices developed collaboratively with Shields. The breakthrough of Shields Specialty Pharmacy is based on 40 years of partnerships with 30 hospital systems, building Shields Dialysis Centers, Shields Advanced Imaging Centers (Shields MRI) and Shields Radiation Therapy Centers. What we are doing today with Specialty Pharmacy is once again bringing best practices into a new area of healthcare, returning patients to the center of the care model, while helping healthcare leaders deliver better care more efficiently. Today, Shields Health Solutions is one of the fastest growing companies in America.


News Article | November 28, 2016
Site: www.chromatographytechniques.com

Three Massachusetts hospitals are among several nationwide cited by federal regulators for failing to properly report patient deaths and injuries that may have been caused by medical devices. The Boston Globe reports that Massachusetts General, Brigham and Women's, and UMass Memorial were among 17 hospitals inspected last December by Food and Drug Administration. Regulators were concerned about infections possibly linked to contaminated instruments used to examine the small intestine. It was part of a renewed effort to detect problems before they cause widespread harm. Inspectors found that Mass. General failed to report two patient deaths. The FDA faulted Brigham and Women's for failing to report one death and for submitting four reports on patient injuries late. UMass Memorial was cited for failure to report infections in patients, three of whom later died.


Hauspurg A.K.,Yale University | Allred E.N.,Childrens Hospital Boston | Allred E.N.,Harvard University | Vanderveen D.K.,Harvard University | And 10 more authors.
Neonatology | Year: 2011

Objective: This study tested the hypothesis that preterm infants who had a blood gas derangement on at least 2 of the first 3 postnatal days are at increased risk for more severe retinopathy of prematurity (ROP). Method: 1,042 infants born before 28 weeks' gestational age (GA) were included. An infant was considered to be exposed if his/her blood gas measure was in the highest or lowest quartile for GA on at least 2 of the first 3 postnatal days. Results: Multivariable models adjusting for confounders indicate that exposure to a PCO2 in the highest quartile predicts ROP (stage 3, 4 or 5: OR = 1.6, 95% CI = 1.1-2.3); zone 1: 2.0, 1.1-3.6; prethreshold/threshold: 1.9, 1.2-3.0; plus disease: 1.8, 1.1-2.9). Estimates are similar for a low pH for zone 1 (2.1, 1.2-3.8), prethreshold/threshold (1.8, 1.1-2.8), but did not quite achieve statistical significance for ROP stage 3, 4, or 5 (1.4, 0.9-2.0) and plus disease (1.5, 0.9-2.4). A PaO2 in the highest quartile for GA on at least 2 of the first 3 postnatal days was associated with a doubling of the risk of ROP in zone 1 (2.5, 1.4-4.4) and of prethreshold/threshold disease (2.1, 1.4-3.3), a 70% risk increase for plus disease (1.7, 1.04-2.8), while a 40% risk increase for ROP stage 3 or higher did not achieve statistical significance (1.4, 0.96-2.0). Conclusion: Infants exposed to high PCO2, low pH and high PaO2 appear to be at increased risk of more severe ROP. Copyright © 2010 S. Karger AG, Basel.

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