For Release April 17, 2013
KANSAS CITY, Mo. – Four distinct research programs that could improve patient health care and reduce health-care costs are the recipients of the 2013 Health Outcomes Research grants, awarded by Blue Cross and Blue Shield of Kansas City.
The four $50,000 grants were presented to physicians and staff members at Children’s Mercy Hospital and Clinics and the University of Kansas Medical Center.
“The proposals received represented a broad array of outstanding, cutting-edge research being conducted at area hospitals,” said David Gentile, president and chief executive officer of Blue KC. “Although the selection of proposals to receive funding is always challenging, the proposals selected represent some of the most innovative and potentially impactful research efforts underway that have the ability to quickly and materially improve quality, reduce cost and enhance well-being of patients.”
For the second year, the Kansas City Area Life Sciences Institute (KCALSI) managed the grants program for Blue KC. “We are really excited to partner with Blue KC in this program. The proposals are reviewed by skilled scientists and medical researchers to assess their potential to improve patient care and medical outcomes,” said Dr. Wayne Carter, president and chief executive officer of KCALSI.
“We’re proud to promote local research in our healthcare community,” said Dr. Ravi Govila, vice president and chief medical officer of Blue KC. “These proposals address national healthcare priorities – reducing healthcare disparity, improving access and coordinating care – which will lead to improved health outcomes in Kansas City.”
This year’s grant recipients and a brief description of their research programs follow.
Recognizing a Deadly Infection
Dr. Steven Simpson describes severe sepsis as “the worst possible outcome of infection.” Unfortunately, severe sepsis is a growing problem in the United States, with the number of cases doubling about every 8.5 years. Simpson, professor of medicine and director of fellowship training, division of pulmonary and critical care at KU Medical Center, believes his program can greatly reduce this trend.
“Severe sepsis is very common, and it isn’t difficult to treat if you catch it early, but it’s not always recognized by physicians and nurses,” Simpson said. A key reason for this is that diagnostic criteria for identifying severe sepsis were not published until 1992. That means many doctors trained prior to ’92 may not be familiar with the diagnostic guidelines.
Also impacting the situation is the aging “baby boomer” generation. People age 65 and older are more susceptible to the infection, and approximately 10,000 baby boomers are turning 65 each day through 2029.
Simpson’s research program will work with four area hospitals and, with the help of a web-based tool, teach physicians, nurses and other hospital staff to recognize, diagnose and treat severe sepsis. The tool’s easy-to-use checklist will simplify identifying the symptoms, while the users’ data entries will enable each hospital to track its progress in managing the deadly infection.
“At least half the people who are dying of severe sepsis could be saved,” Simpson said. “At KU, we reduced our sepsis mortality rate from 49 percent to 18 percent. We believe we can help other hospitals achieve similar results.”
Treating Asthma Patients Long Distance
Rural areas are relatively underserved by asthma specialists – not comforting news for asthma patients living in Kansas and Missouri, which are largely rural states. Can quality asthma care be provided by a doctor located in one city to a patient hundreds of miles away in a rural area?
A research program developed by Dr. Jay Portnoy, section chief – allergy, asthma and immunology at Children’s Mercy Hospitals and Clinics, will utilize computer technology – or “telemedicine” – to enable Kansas City asthma specialists to diagnose and treat children in Wichita and St. Joseph to test the theory.
“Basically everything that can be done at a face-to-face visit, we can do at a distance,” Portnoy said. “Using a digital stethoscope, I can listen to a child’s heartbeat and lungs. A digital camera allows me to see their ears, nose and throat. I can do a complete physical exam from a distance, but that’s not the most critical part of the allergy evaluation. It’s talking to parents and patients to discover how their environment is interacting with their symptoms. Using telemedicine, I’m able to talk to them, and very quickly it feels just like they’re in the same room.”
The project’s goal is to demonstrate that young patients seen via telemedicine do just as well as patients who drive several hours to Kansas City to receive face-to-face care. The outcomes will help his team identify how telemedicine can be delivered more effectively.
“If we can demonstrate that outcomes are just as good using telemedicine, health plans and others will be more willing to cover the cost of providing care in this way,” Portnoy said.
Managing Heart Failure Patients at Home
African Americans experience heart failure at young ages, compared with other ethnic groups, which often results in early and repetitive hospitalizations. And notably, African Americans also have a strong family legacy, being especially close and helping other family members.
What if this legacy could be used to improve heart failure patients’ health care and reduce repeat hospitalizations? That’s the focus of the research program from Ubolrat Piamjariyakul, RN PhD, a research associate professor at the University of Kansas Medical Center.
Her team has developed an innovative healthcare delivery practice model that will train family members in heart failure home care management. Family caregivers will learn to recognize heart failure symptoms, control fluids, maintain a low sodium diet, and ensure adherence to prescribed medications. All are key factors in dramatically decreasing return hospitalizations.
“Family members are very willing to help, but they might not know how to help,” Piamjariyakul said. “Equipping them with the knowledge, confidence and home care skills would be very helpful to the patient.”
The four-week, nurse-led training pilot program will be conducted via telephone with all family caregivers and patients.
Developing Better Patient Handoffs
Phone calls, pages, interruptions and background noise can all cause communication breakdowns, which can adversely affect patient handoffs – the transfer of responsibility for a patient’s care from one healthcare worker to another.
Developing a tool that could greatly minimize miscommunications is the focus of the research program underway by Dr. Robert Riss, associate director of medical student education and a Pediatric Hospitalist at Children’s Mercy Hospitals and Clinics. Riss and his team are working to not only create a tool that would ensure the most important patient information is passed on correctly, but also that physicians and other hospital staff actually use the tool.
“Without a tool, it’s possible to give too much patient information, so the care provider doesn’t know what to synthesize as being important or not. At the same time, you can also give too little information,” Riss said. “The amount and kind of information that’s important for an attending may be different than for an intern. Our goal is to identify the information that is important to have whether you’ve been practicing medicine for one year or 20 years.”
The benefits of improved patient handoffs include maintaining a consistent patient care plan and potentially shortening hospital stays and reducing medical costs. “We could reduce redundancies in tests or medications,” Riss said. “If we’re not making mistakes, we won’t have to do extra things to correct them.“
Information about the Blue KC Health Outcomes Research Grants, including eligibility, review criteria and application procedures, can be found on the Kansas City Area Life Sciences Institute’s website at www.kclifesciences.org.
Through its Research Development Grants program, KCALSI manages a variety of individual grants for area corporations and trusts, helping them identify proposals with the best scientific, medical and technical merit. Research grants are awarded to generate initial results and stimulate the submission of major multidisciplinary research proposals to government or private agencies. From 2006 to 2011, KCALSI’s program managed 47 grants totaling $1,820,902 million, which enabled area researchers to successfully compete for $10,976,000 million in additional funding. Importantly, grants totaling an additional $9,003,343 million are waiting for final funding decisions. KCALSI’s Research Development Grants program includes proposal review, evaluation by subject matter experts, written reviews for all applicants, and post-award management.
For More Information, Contact: Dr. Keith Gary, KCALSI Director of Program Development, (816) 753-7700.
About Blue Cross and Blue Shield of Kansas City:
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in the state and the only not-for-profit health insurer in Kansas City, has been part of the Kansas City community since 1938. It provides health coverage services to nearly 1 million residents in the greater Kansas City area and Northwest Missouri. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on the company, visit the website at www.BlueKC.com.