Tag Archives: patients

Health Insurance

The CORE Institute Selects SmartPager

To more quickly and efficiently share images, voice, and text between physicians and patients, The CORE Institute® announced it has selected SmartPager™, a HIPAA compliant secure messaging service that overcomes traditional limitations of one-way pagers and privacy issues associated with text messaging.  The service is easy to use with many different types of smart phones.

“We have seen a positive impact with the new platform” says Cassie Caliendo, Vice President of Contact Center with The CORE Institute.  “The time taken to reach a provider has been reduced to seconds.  The system automatically sends the message to the on-call provider and tracks the delivery, escalating if required.  The dashboard gives the entire team a clear view of our communications as they unfold in real-time.”

Dr. Jason Scalise, Orthopedic Shoulder Surgeon with The CORE Institute, speaks to some of the advantages of using their new platform.  “We’re able to share images, voice, and text, reducing the time required to effectively communicate.   If I am busy or in surgery, the message is automatically escalated to my backup.  We can spend more time focused on what really matters, which is providing best-in-class orthopedic care to our patients. ”

SmartPager was selected after an extensive 12-month market search; an evaluation a beta testing period proved the technology service could deliver on The CORE Institute’s demanding communication requirements in sending real-time, critical, HIPPA compliant communications to nearly 100 providers in 16 locations from Arizona and Michigan.

healthcare

ZocDoc will bring 600 jobs to Valley

A New York company that helps patients connect with doctors through an online service is opening a Scottsdale office and will hire more than 600 workers in the next three years.

ZocDoc is a free service for patients that also lets them book appointments online. Gov. Jan Brewer and Scottsdale Mayor Jim Lane announced the office opening on Tuesday.

Brewer has made three other major jobs announcements in recent weeks, including a new General Motors information technology innovation center in Chandler that will have 1,000 high-tech employees.

All three are benefiting from incentives from the Arizona Commerce Authority.

The Commerce Authority also was involved in Tuesday’s announcement.

The company says it will hire nearly 70 people to staff the office by year’s end.

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TGen, Scottsdale Healthcare study may help pancreatic cancer patients

A multi-center Phase III clinical trial demonstrates that Abraxane (nab-paclitaxel) plus gemcitabine is the first combination of cancer drugs to extend survival of late-stage pancreatic cancer patients compared to standard treatment.
The MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study was led by physicians from Scottsdale Healthcare’s Virginia G. Piper Cancer Center Clinical Trials, a partnership between Scottsdale Healthcare and the Translational Genomics Research Institute (TGen).

Their findings show that Abraxane plus gemcitabine was well tolerated and resulted in clinically meaningful outcomes compared to gemcitabine alone, the current standard of care. The study abstract was released today and the data will be presented at the American Society of Clinical Oncology (ASCO) 2013 Gastrointestinal Cancers annual meeting Jan. 25 in San Francisco.

“We are ecstatic that this clinical trial of Abraxane plus gemcitabine improves survival for patients with advanced stage IV pancreatic cancer,” said Dr. Daniel Von Hoff, international lead investigator for MPACT, chief scientific officer for Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare, and TGen’s Physician-In-Chief. “It once again demonstrates that laboratory science based medicine can make a difference for patients.”

MPACT is the largest phase III clinical trial completed in advanced pancreatic cancer with more than 800 patients. Findings from the study showed a 59 percent increase in one-year median survival rates from less than a quarter of the patients (22 percent) to more than a third (35 percent). The two-year survival rate for this cancer is negligible, less than 4 percent, but that more than doubles (9 percent) with the nab-paclitaxel/gemcitabine combination.

One of those patients was Lynne Jacoby, 48, of Phoenix, who works as a director of compliance for a healthcare company. Jacoby was given only weeks to live when her Stage 4 pancreatic adenocarcinoma, a tumor the size of a golf ball, was first diagnosed in April 2012 — nine months ago.

“If you had to live your life in a year, and that is all the time you have, wouldn’t you do everything you could to experience this time,” said Jacoby, who for nearly a year before her diagnosis had experienced night sweats, indigestion, stomach pains, neck and back pain, and an elevated white-blood count.

She began the treatment of Abraxane plus gemcitabine in May 2012 and continues on the medications, saying now that she “feels awesome, wonderful.” She is scheduled to remain on the drug combination through May 2013.

“Life is priceless. No amount of money can be placed on life. I know I would be gone already if it was not for Dr. Von Hoff,” said Jacoby, who also refers to him as “Dr. Von Hope.”

The study showed significant improvement among some of the sickest patients including those with increased metastases. Significantly there was no increase in life-threatening toxicity. Other drug combinations that have demonstrated benefit have been limited by increased toxicities.

“This is a major improvement in a cancer with the lowest survival rates among all cancer types,” said Dr. Ramesh Ramanathan, medical director of Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare and principal investigator for the clinical trial in the United States. “Advanced pancreatic cancer is fourth most common cause of cancer death in the United States and throughout the world. It is difficult to diagnose with a majority of the cases diagnosed at a late stage after the disease has already advanced.”

Abraxane wraps traditional chemotherapy, paclitaxel, in near-nano sized shells of albumin, a protein that the tumor sees as food. The tumor uses various mechanisms to preferentially attract the albumin, which then acts like a “Trojan Horse” to release its package of chemotherapy inside the tumor. It is approved in the U.S. for metastatic breast cancer and non-small cell lung cancer.

The pancreas is a gland behind the stomach that secretes enzymes into the upper part of the small intestine to help digestion. It also produces hormones, including insulin, which helps regulate the metabolism of sugars.

The incidence of pancreatic cancer is increasing worldwide with an estimated 279,000 cases per year, including nearly 44,000 in the U.S. in 2012, and resulting in more than 37,000 American deaths last year.

Individuals seeking information about eligibility to participate in clinical trials at the Virginia G. Piper Cancer Center at Scottsdale Healthcare may contact the cancer care coordinator at: 480-323-1339; toll free at 1-877-273-3713; or via email at clinicaltrials@shc.org.

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TGen-US Oncology data helps triple-negative breast cancer patients

Genomic sequencing has revealed therapeutic drug targets for difficult-to-treat, metastatic triple-negative breast cancer (TNBC), according to an unprecedented study by the Translational Genomic Research Institute (TGen) and US Oncology Research.

The study is published by the journal Molecular Cancer Therapeutics and is currently available online.

By sequencing, or spelling out, the billions of letters contained in the genomes of 14 tumors from ethnically diverse metastatic TNBC patients, TGen and US Oncology Research investigators found recurring significant mutations and other changes in more than a dozen genes. In addition, the investigators identified mutations previously unseen in metastatic TNBC and took the sequencing data into account in selection of therapeutic protocols specific to each patient’s genetic profile.

“This study stands as a one-of-a-kind effort that has already led to potentially beneficial clinical trials, and sets the stage for future investigations,” said Dr. John Carpten, Ph.D., TGen’s Deputy Director of Basic Science and Director of TGen’s Integrated Cancer Genomics Division, and the study’s senior author.

The most frequently mutated gene among the tumors (seven of 14) was the TP53 tumor suppressor, and aberrations were observed in additional tumor suppressor genes including CTNNA1, which was detected in two of six African American patients (who typically have more aggressive and treatment-resistant disease). Alterations were also seen in the ERBB4 gene, known to be involved in mammary-gland maturation during pregnancy and lactation, but not previously linked to metastatic TNBC.

The study included an “outlier analysis,” which assessed expression patterns for each tumor when compared against the other tumors examined in the study. Specific cancer genes overexpressed among tumors in the study’s cohort included: ALK, AR, ARAF, BRAF, FGFR2, GLI1, GLI2, HRAS, HSP90AA1, KRAS, MET, NOTCH2, NOTCH3, and SHH. Significantly underexpressed cancer genes included: BRCA1, BRCA2, CDKN2A, CTNNA1, DKK1, FBXW7, NF1, PTEN, and SFN.

Each tumor was genomically unique, but nine of the 14 contained alterations in one or both of two particular cellular pathways: RAS/RAF/MEK/ERK and PI3K/AKT/MTOR.  Targeted therapeutic intervention aimed at these pathways achieved impressive responses in several cases.

“Importantly, the analysis provided insights into the potential unique therapeutic vulnerabilities of each cancer,” said Dr. Joyce O’Shaughnessy, M.D., the study’s other co-lead author. Dr. O’Shaughnessy is a practicing oncologist with Texas Oncology — an affiliate of The US Oncology Network — and is the Celebrating Women Chair of Breast Cancer Research at Baylor Charles A. Sammons Cancer Center.

Metastatic TNBC is a highly aggressive form of breast cancer that disproportionately affects African-Americans. It is called triple-negative because tumors do not express the estrogen receptor, progesterone receptor or HER-2, the biomarkers successfully targeted in most breast cancers.

Metastatic TNBC also has a poor prognosis once the cancer has spread to other organs, with a median survival rate among metastatic patients of only one year. While TNBC accounts for only about 15 percent of all breast cancers, its more aggressive biology makes it responsible for nearly one in four deaths related to this disease.

“The nature of this disease cries out for innovative research techniques such as whole genome sequencing coupled with new tools for data analysis,” said Dr. David Craig, Ph.D., TGen’s Deputy Director of Bioinformatics, and one of the study’s co-lead authors.

“We are aware that these results are preliminary and based on a small series of patients,” said Carpten. “However, our study will pave the way for new clinical trials and novel hypotheses for future testing in a very difficult to treat cancer.”

Whole-genome sequencing of tumors and normal tissue was performed on Life Technologies Corporation’s Applied Biosystems SOLiD™ 4.0 platform, and results were validated in a CLIA-certified laboratory.

The study, “Genome and transcriptome sequencing in prospective triple negative breast cancer uncovers therapeutic vulnerabilities,” is sponsored by the Translational Genomics Research Institute (TGen) and US Oncology Research with support from Life Technologies Corporation.

Molecular Cancer Therapeutics is one of several peer-reviewed scientific journals published by the 34,000-member American Association for Cancer Research (AACR), the oldest and largest scientific organization in the world focused on every aspect of high-quality, innovative cancer research. The programs and services of the AACR foster the exchange of knowledge and new ideas among scientists dedicated to cancer research, provide training opportunities for the next generation of cancer researchers, and increase public understanding of cancer.

 

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CTCA Creates Organic Farm To Help Serve Patients

Cancer Treatment Centers of America (CTCA) at Western Regional Medical Center (WRMC) and McClendon’s Select are partnering up to create the first and largest hospital organic farm in the United States that will provide patients, caregivers, employees and community members in the greater Phoenix area with organic produce grown right in their own backyard.

CTCA is proud to partner with Arizona’s own McClendon’s Select, one of the country’s top organic farm companies, providing a whole new level to its integrative care model. McClendon’s Select has been supplying CTCA with organic produce from their family owned farms since 2009 and now will be managing the 25-acre farm located on WRMC property between Fillmore and the I-10 in Goodyear. Construction started last Friday on what will be an expected six-week process. The first planting will occur in early November and the first harvest is scheduled for December 15, 2012.

CTCA is the first cancer hospital in the country to provide its patients with organic produce grown directly on its own land. Patients will have access to fresh produce that has been picked at its peak nutritional value and can feel good knowing exactly where their food is coming from – in fact, they’ll be able to see it from the main hospital, or when driving in, and can even get involved with the patient and community gardens. “At CTCA one of our goals is to get test results to patients in minutes to hours rather than days or weeks, so it makes sense then that we would do the same thing for the food they eat – it’s fresh, homegrown and delivered from the farm to their fork all in the same day,” says Sharon Day, Director of Nutrition. “We are happy to provide high quality food and nutrition to our patients, caregivers, and employees, taking our quality of care to a whole new level.”

In addition to bringing in fresh, organic produce to CTCA’s culinary department directed by Executive Chef Frank Caputo, the hospital plans to host farmer’s markets, cooking demonstrations and both patient and community gardens open to the public. Any surplus produce will be managed by McClendon’s Select and sold at various farmer’s markets throughout the greater Phoenix area.

“It’s an honor to partner with CTCA in this capacity and my team and I at McClendon’s are excited to see how this will transform culinary services in health care across the country. We think this is a huge step for our industry and the value organic farms can bring to facilities like CTCA,” says Bob McClendon, owner and farmer at McClendon’s Select.

“We’ve always provided our patients with the highest quality of certified organic produce and meats since we opened in 2008. We will now be able to grow our own food onsite and deliver delicious, highly nutritional meals to our patients and employees on the same day we’ve gone out and picked it from the vine or pulled it out of the ground. It’s just incredible,” says Executive Chef Frank Caputo. “Our culinary team is excited to be able to offer this service to our patients and employees.”

CTCA offers a comprehensive and integrative approach to fighting cancer—all under one roof. Its integrative cancer treatment expands the boundaries of conventional care by bringing together traditional tools for fighting cancer, such as surgery, radiation, chemotherapy, and immunotherapy, with supportive therapies, including nutritional support, naturopathic medicine, mind-body medicine, oncology rehabilitation, pain management, and spiritual support. Being able to offer patients home-grown, organic produce that is fresh from the “backyard” is just another way CTCA continues to provide patients with the very best options while fighting cancer.

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Blue Cross Blue Shield of Arizona, Banner Health create joint venture

Blue Cross Blue Shield of Arizona and Banner Health announced today that they will enter into a new joint venture, to be known as Blue Cross Blue Shield of Arizona Advantage (BCBSAZ Advantage), in which both companies will participate equally to bring enhanced Medicare services to Arizonans. The venture brings two premier organizations together with a common goal of improving the quality of patient care, enhancing wellness management and affordability for people enrolled in Medicare.
BCBSAZ Advantage will include Medicare Advantage plans for seniors in Maricopa County and portions of Pinal County, currently known as Banner MediSun Medicare Health Plan, including their MediSunONE Classic, MediSunONE Plus and MediSunONE Premier plans.

By aligning their shared interests and capabilities, Blue Cross Blue Shield of Arizona and Banner Health will deliver value to Arizonans enrolled in Medicare programs by offering them the stability of two premier organizations that share a vision for the future delivery of healthcare that inspires people to live healthy and productive lives, and provides highly coordinated care when it’s needed.

“This is an opportunity to capitalize on the strengths of the Blue Cross Blue Shield brand to position our company to more efficiently and effectively serve expanding markets in the government sector,” said Richard L. Boals, president and chief executive officer of Blue Cross Blue Shield of Arizona. “By joining with Banner to offer Medicare products, we’re now able to offer a broader range of services that furthers our position to compete as an industry leader during a transformative time in the healthcare industry.”

Blue Cross Blue Shield of Arizona currently offers Medicare supplement and prescription drug plans (Part D) to more than 23,000 Arizonans. Through the joint venture with Banner Health, it’s estimated the companies will be serving 25,000 Medicare Advantage enrollees. Current Banner MediSun members will be able to keep their coverage intact as both companies are committed to focusing their efforts on making this a smooth and positive transition for members and employees alike. All terms are subject to final regulatory approval.

“This new collaboration with a proven community partner like Blue Cross Blue Shield of Arizona clearly shows that when two leading organizations are so closely aligned, the whole is even greater than the sum of its parts,” said Peter S. Fine, president and chief executive officer of Banner Health. “This is an ideal opportunity for Banner to leverage our comprehensive network of quality providers who are supported and linked by an electronic medical records system and other enabling technologies that are unmatched in Arizona.”

Blue Cross Blue Shield of Arizona also recently announced the launch of BlueAlliance, an innovative health insurance product offering lower premiums by using Banner Health Network’s local network of more than 2,500 healthcare providers in the Maricopa County area. BlueAlliance is the lowest-priced health plan available for small businesses in the entire Blue Cross Blue Shield of Arizona portfolio of health plans, which traditionally have focused on a broader network of more than 18,000 participating providers.

MediSun members with questions can call Member Services at 800-446-8331. For more information on BCBSAZ Advantage, call 888-288-0019.

At your service 2008

At Your Service

By Kerry Duff

When Margret Thomas of Tucson was suffering from an agonizing headache in the middle of the night, her husband, Harold, called their primary care physician on his cell phone. The doctor met them at the hospital and an hour later she was in surgery having a brain aneurysm removed. Without the surgery, Margret would have died.

The Thomases were able to reach their doctor after hours because they contract directly with Dr. Steven D. Knope, an internist and sports medicine expert in Tucson, for concierge medical care. The couple pays him an annual out-of-pocket fee in exchange for personalized medical services such as 24/7 accessibility by beeper or cell phone and house calls.

“My wife and I can’t live without Dr. Knope,” says 76-year-old Harold. “Whether we’re at home in Tucson, Cincinnati or somewhere else, we can call him day or night and he gets back to us in 10 minutes or less. That’s worth a lot to us. A concierge doctor is like having insurance.”

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Knope has been a concierge physician in the Tucson area for eight years. He has 125 patients that pay $6,000, or $10,000 per couple for concierge care. The fee includes a two-hour comprehensive physical, stress test, full cancer screening, health and fitness consultation and a personalized exercise and nutrition program. The doctor also accompanies patients to see specialists, and if they are hospitalized, he is the attending physician at the hospital — not a hospitalist who is unfamiliar with their health care, he says.

“Concierge medicine is very much patient driven,” Knope says. “Patients want a different model of care today and they’re willing to pay for it. The difference between concierge medicine and fast-food medicine is that the concierge doctor has time to perform correctly. If a doctor only has seven minutes to deal with a complex patient, he can only do so much. Doctors need time with their patients to do a good job.”

Scottsdale internist and geriatric physician, Scott Bernstein, converted his 2,000-patient practice to concierge medicine in July. What pushed him in that direction, he says, were Medicare constraints and the rising costs of running his practice.

“I was being squeezed from both ends,” Bernstein admits. “Now my patients and I contract directly without the constraints of the Medicare program. I can see patients the same day they call and I have time to provide the type of care they need and I want to provide. I can also do house calls and telephone appointments, which are not covered by Medicare.”

Bernstein sent a letter to his patients in April to let them know he was converting to concierge medicine. Since then, more than 200 people have joined the practice and agreed to pay his $2,000 annual fee.

“It was very bold to make this kind of change after working so hard for 12 years to build my practice,” he says. “I had to say goodbye to 80 percent of my patients and that was scary. But now I couldn’t be more thrilled. I give my patients the time and care they need, and most nights I have dinner with my family, which never happened before.”

Douglas Liebman of Scottsdale, a longtime patient of Dr. Bernstein’s, says he fully supports this type of care, but had to carefully weigh the costs before making a decision.

“I had to think about this carefully because I already have a $2,500 annual payout to Blue Cross Blue Shield,” Liebman says. “But then I realized that staying with Dr. Bernstein was a quality decision at any cost because it concerns my health care. He is genuinely concerned about my well-being and that’s really important to me. I also like being able to reach him after hours and weekends. But what I like most is the house calls. In the world of medicine today, it’s amazing that a doctor will come to your house if you can’t make it to the office.”

Bernstein transitioned to concierge care with the help of Dr. Helene Wechsler, a family physician in Scottsdale, who after 15 years of being in private practice with four other doctors started her own concierge practice in 2004. Wechsler’s practice is limited to 300 patients who pay $2,000 ayear.Patients with children under 18 pay $1,000 annually per child.

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“When I first started practicing 19 years ago, I scheduled patients for 30-minute appointments,” Wechsler says. “But when the healthcare system moved to managed care, I could only see each person 15 minutes or less. In that amount of time you can only treat part of a person and I like to treat the whole person. As a traditional family physician, I also had mountains of paperwork and stress. But I eliminated both when I reduced my patient load and stopped accepting insurance and Medicare. “My concierge practice is peaceful and happy, and when patients walk in the door it’s a pleasant experience,” she adds.