News Article | May 5, 2017
Highmark Health today announced the appointment of Tony Farah, MD, to the newly created position of Executive Vice President, Chief Medical and Clinical Transformation Officer for the organization. “It is with great pride that I welcome Tony to our leadership team, as he has proven to be invaluable in accelerating Allegheny Health Network’s and Highmark Health’s collective efforts to reinvent the healthcare model and support long-term enterprise growth,” said Highmark Health President and Chief Executive Officer, David Holmberg. “Tony is a highly respected physician-leader who is passionate about changing the way health care is delivered, and he is the right person to take Highmark Health and Allegheny Health Network to the next level when it comes to transforming clinical care to achieve the best patient experience and best outcomes at an affordable cost.” Dr. Farah has been a leading clinician, physician educator and health care executive in the western Pennsylvania region for more than three decades. As a noted cardiologist at Allegheny General Hospital and former longtime director of the institution’s cardiac catheterization laboratory, he and his team have played a pivotal role in the development of many of the field’s breakthrough therapies for cardiovascular disease, including disease fighting medications and plaque clearing technologies. The same leadership qualities that have driven Dr. Farah’s success in the clinical setting throughout his career have defined his many accomplishments as a physician executive as well. He has served in numerous high-level positions over the past 15 years, including chief medical officer of AGH, West Penn Allegheny Health System and Allegheny Health Network, and as a Trustee of one of his field’s most prestigious scientific organizations, the Society for Cardiovascular Angiography and Interventions. For the last four years, Dr. Farah has also served as President of Allegheny Clinic, AHN’s employed physician organization. Under his leadership, the Clinic has doubled in size to now more than 1,200 members. Dr. Farah played a critical role in the formation of AHN in 2013, and in his new capacity with Highmark Health he will oversee clinical transformation, deploying innovative models to create more value for Highmark members and all of the patients AHN serves by way of enhanced experience, access, clinical outcomes and affordable cost in every care setting. “I am extremely grateful for and excited about this unique opportunity to help further redefine the delivery of health care in western Pennsylvania and across Highmark Health’s vast and diverse footprint,” said Dr. Farah. “By leveraging the clinical knowledge at AHN with the financing expertise and population health insights of Highmark Health, we are well positioned to create a high-quality, value-based care model that will set a new standard, locally and nationally, for the experience it affords.” In order to effect a seamless transition to new leadership in the roles of Chief Medical Officer for AHN and President of Allegheny Clinic, Dr. Farah will continue to provide oversight of those areas as part of his responsibilities for Highmark Health. Once the positions are filled, they will report dually to Dr. Farah and AHN President and CEO, Cynthia Hundorfean. “For many years, Dr. Farah has been a tireless advocate for patients and for his colleagues at AHN,” Hundorfean said. “We expect that advocacy to only grow stronger in his important new role at Highmark Health and congratulate him on his well-deserved promotion. It is yet more evidence that AHN and Highmark Health are committed to creating and sustaining an integrated health care delivery and financing system that is both patient-centered and clinician-led.” About Allegheny Health Network Allegheny Health Network (AHN.org), part of Highmark Health, is an integrated health care delivery system serving the greater Western Pennsylvania region. The Network is composed of eight hospitals, including Allegheny General Hospital, its flagship academic medical center in Pittsburgh, Allegheny Valley Hospital in Natrona Heights, Canonsburg Hospital in Canonsburg, Forbes Hospital in Monroeville, Jefferson Hospital in Jefferson Hills, Saint Vincent Hospital in Erie, West Penn Hospital in Pittsburgh and Westfield Memorial Hospital in Westfield, NY. The Network provides patients with access to a complete spectrum of medical services, including nationally recognized programs for primary and emergency care, cardiovascular disease, cancer care, orthopedic surgery, neurology and neurosurgery, women’s health, diabetes and more. It also is home to a comprehensive research institute; Health + Wellness Pavilions; an employed physician organization, home and community based health services and a group purchasing organization. The Network employs approximately 17,000 people, has more than 2,400 physicians on its medical staff and serves as a clinical campus for Drexel University College of Medicine, Temple University School of Medicine, and the Lake Erie College of Osteopathic Medicine. About Highmark Health Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people nationwide and serves nearly 50 million Americans in all 50 states, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, Davis Vision and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. To learn more, please visit http://www.highmarkhealth.org.
Ellis C.N.,West Penn Allegheny Health System
Seminars in Colon and Rectal Surgery | Year: 2010
Mechanical and antibiotic bowel preparation is a time tested procedure that when done appropriately, significantly reduces the risk of infectious complications of colorectal surgical procedures, surgical site infections, and anastomotic dehiscence. Currently, a 3-tier regimen, which includes preoperative mechanical cleansing to reduce the fecal load, preoperative nonabsorbed oral antimicrobials effective against both aerobic and anaerobic bacteria, and perioperative parenteral antibiotics is most commonly used in the US. The vast majority of surgeons in the US today consider this approach as the cornerstone of elective colorectal surgery. However, randomized clinical trials from several countries have concluded that the role of mechanical and antibiotic bowel preparation should be re-evaluated. To date, there have been numerous randomized clinical trials comparing preoperative mechanical preparation to no preparation in patients undergoing elective colorectal surgery. When combined in meta-analyses, however, there is no statistically significant evidence that patients benefit from either mechanical or antibiotic bowel preparation. The data are overwhelming that the dogma regarding bowel preparation before elective colorectal surgery should be abandoned. © 2010 Elsevier Inc.
Geisler D.,West Penn Allegheny Health System |
Garrett T.,West Penn Allegheny Health System
Techniques in Coloproctology | Year: 2011
Background: Due to the recent heightened interest in even less invasive surgery, single port laparoscopic colorectal surgery is quickly gaining acceptance. While this access technique was first described in 2007 for colorectal resective procedures, large series are lacking. Methods: Between January 2009 and October 2010, all patients undergoing single port colorectal surgery performed by a single surgeon were prospectively entered into an IRB-approved database and studied with regard to perioperative events, morbidity, and mortality. Results: One hundred and two consecutive patients underwent a single port colorectal procedure. Mean age was 47 years (9-93 years), and average body mass index was 26 kg/m 2 (15-39 kg/m 2). Primary diagnoses included ulcerative colitis (51), neoplasia (23), Crohn's disease (14), diverticulitis (11), familial adenomatous polyposis (1), and other (2). Procedures included 23 total colectomies, 40 segmental colectomies, and 19 other procedures. There was 1 conversion to an open operation, and 18 (18%) patients required placement of additional ports (1 port: N = 13; 2 ports: N = 2; 3 ports: N = 3). Average operating room time was 99 min (13-245), mean length of incision was 3.7 cm (1.2-7.8 cm), and average estimated blood loss was 140 ml (0-750 ml). There was one postoperative death, and 39 (38%) patients experienced minor postoperative complications. Mean lymph node harvest for oncologic resections was 44 (14-142). The average length of hospital stay was 5.9 days (2-24 days). Conclusions: With proper patient selection and laparoscopic experience, single port colorectal surgery can be performed for even the most complex colorectal procedures. Further studies are needed to assess the benefits that single port colorectal surgery has over a conventional laparoscopic approach. © 2011 Springer-Verlag.
Bell S.K.,Beth Israel Deaconess Medical Center |
Moorman D.W.,West Penn Allegheny Health System |
Delbanco T.,Beth Israel Deaconess Medical Center
Academic Medicine | Year: 2010
The emotional toll of medical error is high for both patients and clinicians, who are often unsure with whom 'and whether' they can discuss what happened. Although institutions are increasingly adopting full disclosure policies, trainees frequently do not disclose mistakes, and faculty physicians are underprepared to teach communication skills related to disclosure and apology. The authors developed an interactive educational program for trainees and faculty physicians that assesses experiences, attitudes, and perceptions about error, explores the human impact of error through filmed patient and family narratives, develops communication skills, and offers a strategy to facilitate bedside disclosures. Between spring 2007 and fall 2008, 154 trainees (medical students/residents) and 75 medical educators completed the program. Among learners surveyed, 62% of trainees and 88% of faculty physicians reported making medical mistakes. Of those, 62% and 78%, respectively, reported they did not apologize. While 65% of trainees said they would turn to senior doctors for assistance after an error, 26% were not sure where to get help. Just 20% of trainees and 21% of physicians reported adequate training to respond to error. Following the session, all of the faculty physicians surveyed indicated they felt better prepared to address and teach this topic. At a time of increased attention to disclosure, actual faculty and trainee practices suggest that role models, support systems, and education strategies are lacking. Trainees' widespread experience with error highlights the need for a disclosure curriculum early in medical education. Educational initiatives focusing on communication after harm should target teachers and students. © 2010 Association of American Medical Colleges.
Ellis C.N.,West Penn Allegheny Health System |
Essani R.,West Penn Allegheny Health System
Clinics in Colon and Rectal Surgery | Year: 2012
Obstructed defecation is a common problem that adversely affects the quality of life for many patients. Known causes of obstructed defecation include pelvic dyssynergy, rectocele, rectal intussusception, enterocele, pelvic organ prolapse, and overt rectal prolapse. Management of this condition requires an understanding of urinary, defecatory, and sexual function to achieve an optimal outcome. The goal of surgical treatment is to restore the various pelvic organs to their appropriate anatomic positions. However, there is a poor correlation between anatomic and functional results. As the pelvis contains many structures, a pelvic support or function defect frequently affects other pelvic organs. Optimal outcomes can only be achieved by selecting appropriate treatment modalities that address all of the components of a patient's problem. Copyright © 2012 by Thieme Medical Publishers, Inc.
Komori J.,McGowan Institute for Regenerative Medicine |
Boone L.,McGowan Institute for Regenerative Medicine |
Deward A.,McGowan Institute for Regenerative Medicine |
Hoppo T.,McGowan Institute for Regenerative Medicine |
And 2 more authors.
Nature Biotechnology | Year: 2012
Cell-based therapy has been viewed as a promising alternative to organ transplantation, but cell transplantation aimed at organ repair is not always possible. Here we show that the mouse lymph node can support the engraftment and growth of healthy cells from multiple tissues. Direct injection of hepatocytes into a single mouse lymph node generated enough ectopic liver mass to rescue the survival of mice with lethal metabolic disease. Furthermore, thymuses transplanted into single lymph nodes of athymic nude mice generated functional immune systems that were capable of rejecting allogeneic and xenogeneic grafts. Additionally, pancreatic islets injected into the lymph nodes of diabetic mice restored normal glucose control. Collectively, these results suggest the practical approach of targeting lymph nodes to restore, maintain or improve tissue and organ functions. © 2012 Nature America, Inc. All rights reserved.
Yazdanyar A.,Section of Hospital Medicine |
Wasko M.C.,West Penn Allegheny Health System |
Kraemer K.L.,University of Pittsburgh |
Ward M.M.,U.S. National Institutes of Health
Arthritis and Rheumatism | Year: 2012
Objective Rheumatoid arthritis (RA) is associated with an increased cardiovascular (CV) burden similar to that of diabetes mellitus (DM). This risk may warrant preoperative CV assessment as is performed for patients with DM. We aimed to determine whether the risks of perioperative death and CV events among patients with RA differed from those among unaffected controls and patients with DM. Methods We used 1998-2002 data from the Nationwide Inpatient Sample (NIS) database of the Healthcare Cost Utilization Project (HCUP) to identify hospitalizations of patients undergoing elective noncardiac surgery. Using established guidelines, surgical procedures were categorized as either low risk, intermediate risk, or high risk of having CV events. Logistic models provided the adjusted odds of study end points in patients with RA, DM, or both relative to patients with neither condition. Results Among 7,756,570 patients undergoing a low-risk, intermediate-risk, or high-risk noncardiac procedure, 2.34%, 0.51%, and 2.12%, respectively, had a composite CV event, and death occurred in 1.47%, 0.50%, and 2.59%, respectively. Among those undergoing an intermediate-risk procedure, death was less likely in RA patients than in DM patients (0.30% versus 0.65%; P < 0.001), but the difference in mortality rates among those undergoing low-risk versus high-risk procedures was not significant. Patients with RA were less likely to have a CV event than were patients with DM for procedures of low risk (3.38% versus 5.30%; P < 0.001) and intermediate risk (0.34% versus 1.07%; P < 0.001). In adjusted models, RA was not independently associated with an increased risk of perioperative death or a CV event. Conclusion RA was not associated with adverse perioperative CV risk or mortality risk, which suggests that current perioperative clinical care does not need to be changed in this regard. Copyright © 2012 by the American College of Rheumatology.
Essani R.,West Penn Allegheny Health System
Seminars in Colon and Rectal Surgery | Year: 2012
Stoma prolapse after formation of an ileostomy or colostomy is a late complication. Prolapse is less common than parastomal hernia. This article reviews the incidence of prolapse, technical factors related to the construction of the stoma that may influence the incidence, and different options for repair. Stoma prolapse affects 2%-47% of individuals with ostomies. Transverse loop colostomy has the highest rate of stoma prolapse, especially because of the large redundant distal loop. Loop ileostomies were thought to have a higher prevalence rate in the past, but recent literature shows only a 2% prolapse rate for ileostomy as opposed to 47% for loop colostomy. The role of extraperitoneal stoma construction is uncertain. Fascial fixation and size of the fascial defect have not been proven to affect the incidence of prolapse. Local care of stoma prolapse is possible, especially if stoma is not incarcerated; however, reversal of stoma is preferable if possible. The options of surgical repair include reversal, resection, revision, and relocation. © 2012 Elsevier Inc.
Strahotin C.S.,West Penn Allegheny Health System |
Babich M.,West Penn Allegheny Health System
Advances in Virology | Year: 2012
Hepatitis C (HCV), a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma, is the most common indication for liver transplantation in the United States. Although annual incidence of infection has declined since the 1980s, aging of the currently infected population is expected to result in an increase in HCV burden. HCV is prone to develop resistance to antiviral drugs, and despite considerable efforts to understand the virus for effective treatments, our knowledge remains incomplete. This paper reviews HCV resistance mechanisms, the traditional treatment with and the new standard of care for hepatitis C treatment. Although these new treatments remain PEG-IFN-α- and ribavirin-based, they add one of the newly FDA approved direct antiviral agents, telaprevir or boceprevir. This new "triple therapy" has resulted in greater viral cure rates, although treatment failure remains a possibility. The future may belong to nucleoside/nucleotide analogues, non-nucleoside RNA-dependent RNA polymerase inhibitors, or cyclophilin inhibitors, and the treatment of HCV may ultimately parallel that of HIV. However, research should focus not only on effective treatments, but also on the development of a HCV vaccine, as this may prove to be the most cost-effective method of eradicating this disease. © 2012 Cristina Simona Strahotin and Michael Babich.
Neal Ellis N.,West Penn Allegheny Health System
Diseases of the Colon and Rectum | Year: 2010
PURPOSE: The purpose of this study was to determine how patients with anal fistulas would rank clinical scenarios describing various management options for anal fistulas. METHOD: A survey was administered to 74 consecutive patients with anal fistulas. On each survey, 10 clinical scenarios describing various treatment options for anal fistulas were scored from 1 (most likely to select) to 10 (least likely to select). Mean scores for each scenario were calculated and compared by use of a Student ttest. RESULTS: When combined, 74% of patients selected a sphincter-preserving technique as their primary choice compared with 26% who chose a fistulotomy (P <.0001). Compared with the highest ranking sphincterpreserving techniques, the mean scores of the scenarios involving a fistulotomy were significantly (P <.05) lower (less likely to select). The mean score of a traditional fistulotomy was the same as the mean score of a sphincter-preserving technique with a 50% success rate but no risk of diminished continence. CONCLUSIONS: These data suggest that the majority of patients with an anal fistula will select a sphincterpreserving technique to manage their fistula. This finding may indicate that, within limits, it is of greater importance for most patients to minimize their risk of diminished continence than to have a highly successful treatment strategy for their fistula. © The ASCRS 2010.