From the Offices of Stuart Markowitz, MD and Stacy Nerenstone, MD


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In This Issue...

December 22, 2013 Edition

Wash In - Wash Out



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HH Facts and Firsts:

2001 - Mammotome stereotactic breast biopsies first became available at Hartford Hospital.

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A Message From the New President of the Medical Staff

A Message From the New President of the Medical StaffGreene

Dr. Stacy Nerenstone


I would like to extend a holiday greeting to all members of the Hartford Hospital Medical Staff.

We continue to practice in a time of tremendous change and challenge in medicine. We as physicians - no matter what the specialty - will need to stay on top of these changes and advocate for ourselves as a group as the system evolves from “volume to value.”

My immediate goals as medical staff president include:

1. Increasing outreach to the medical staff
We plan on having two additional medical staff meetings this year, in March and August, with an open format (i.e., Town Hall Meeting). This will augment our current semi-annual meetings, which have proved to be too short to allow much open discussion. We are hoping these will be in the evenings, so more physicians can attend. Please watch for the dates to be released in an upcoming issue of the Seymour Street Journal.

2. Increasing physician engagement
Our new Physician’s Task Force group has had its third meeting this past week. We discussed the role of this group to help improve the bidirectional communication between the physician community and both Hartford Hospital and Hartford HealthCare. We will be formulating a charter for the group, looking at metrics to define physician engagement, and prioritize a list of possible projects. We plan to continue monthly meetings.

3. Encouraging expanded participation in the election of the MEC and medical staff officers
The elections of medical staff officers and executive committee members continue to evolve into true elections. This year, every candidate submitted a personal statement so you would have a sound basis on which to select your representatives. For the next election cycle, we would like to have a “Meet the Candidates Night” to allow questions of the candidates from interested colleagues.

I feel privileged to work at our institution with outstanding colleagues who do extraordinary things to make such profound differences in the lives of our patients. Thank you all for your support.

Again, happy holidays to all of you, and a happy and healthy 2014 to you and your families.

Top News

$1.25M Grant To Fund Study Of Genetic Testing's Effect On Treating Depression

Hartford Courant, Dec. 10

Researchers at the Institute of Living at Hartford Hospital have received a $1.25 million grant to study how genetic testing could improve the treatment of depression.

Prescribing drugs for depression can often be a matter of trial and error. Gualberto Ruano, director of the Genetics Research Center at Hartford Hospital, said 40 percent of the time, patients don't respond to the first medication they are prescribed. That's because patients are genetically predisposed to respond to certain medications, he said. If you could know in advance their genetic make-up, Ruano said, prescribing the right medication the first time around becomes that much easier.

The grant comes from the Agency for Healthcare Research and Quality, an agency of the U.S. Department of Health and Human Services. Ruano said the funding is a sign that personalized medicine — that is, treatment tailored to a person's genetic makeup — is gaining acceptance within the medical establishment.

"It's one of the first times that pharmacogenetics is elevated to the same level of rigor as pharmaceutical studies," he said.

"An important aspect of this grant is that it is, I believe, the first grant from AHRQ (the Agency for Health Care Research and Quality) to an HHC entity - expanding the base for research support for our system," sad Dr. Hank Schwartz.


Hartford Hospital First in CT To Use New Technology To Assess Liver Disease

Hartford Courant, Dec. 18

The Comprehensive Liver Center at Hartford Hospital is the first in Connecticut to use Fibroscan technology, a painless alternative to liver biopsy for evaluating the stage of liver fibrosis in patients with hepatitis C, B and fatty liver diseases.

Fibroscan was approved by the FDA in April and is now available in the U.S. with Hartford Hospital among only a few health care facilities to have it. "We are proud to lead the way by introducing this minimally invasive technology to our patients," said Dr. Colin Swales, medical director, Transplant Hepatology at Hartford Hospital. "Our hope is to decrease the need for painful, invasive needle biopsies."

"Fibroscan is the perfect diagnostic tool for us to accurately identify patients with significant liver disease and its progression," adds Dr. Michael Einstein, director of hepatology, Hartford Hospital. "This truly revolutionizes how we manage patients with liver disease."

Dr. Jonathan Israel, hepatologist, Hartford Hospital touts the advanced technology and immediate results. "There are many benefits to the patient. The patient is spared the discomfort and risk of a needle biopsy, and the results are immediately available for us to evaluate and discuss with the patient."



$119,000 DPH Smoking Cessation Grant Awarded to Cancer Center

Hartford Hospital’s Helen & Harry Gray Cancer Center has been awarded a $119,000 CT Department of Public Health (DPH) grant to provide evidence-based smoking cessation services to residents of the Greater Hartford area. Priority will be given to low income clients who attend our cancer screening programs and meet the DPH guidelines for free cancer screening, those who have no health insurance or have high insurance deductible of $1,000 or more and have annual income less than $22,340.

We will solicit referrals from Hartford Hospital’s patient population (both outpatient and inpatient), from the Helen & Harry Gray Cancer Center and through all of our many community outreach cancer screening activities. The program will provide five individual counseling sessions or six group counseling sessions. In these sessions, the counselor will discuss smoking cessation products, their appropriateness for the client and use this information to identify a culturally appropriate personally tailored cessation/reduction plan. The smoking cessation products and program will be provided to the client free of charge.

The program represents an expansion of our free smoking cessation program for cancer patients and their family members, which had been originally funded through a grant from the National Cancer Institute. That program also involved research which investigated the effectiveness of a smoking cessation intervention for cancer patients. Dr. Ellen Dornelas is the principal investigator of this research and several other tobacco cessation research projects including a study that provides treatment for pregnant smokers.

This program is scheduled to start this month. For more information or registration into the program, please contact Carol Barrett at 860-545-LUNG (5864) or atcarol.barrett@hhchealth.orgor for Spanish-speaking clients contact Dorely Roldan at 860-545-1582 or at


Hartford HealthCare Wellness Lounge Opens At Westfarms Mall

The Hartford Courant, Dec. 7

Hartford HealthCare launched a health and wellness lounge on Dec. 4 on the first floor of the Nordstrom wing at Westfarms Mall.

The wellness lounge is a place where shoppers can take a break from shopping, rest, and recharge their electrical devices.


Hospital Staff and CESI Develop Three Simulation Education Program For National OB-GYN Curriculum

Staff of Hartford Hospital and the University of Connecticut Health Center have developed three education programs for the national Simulation Curriculum in Obstetrics and Gynecology (SCOG curriculum) sponsored by the Committee on Education in Obstetrics and Gynecology (CREOG). This was accomplished with assistance from the Center for Education, Simulation, and Innovation (CESI) at Hartford Hospital.

These will be the national curriculum for training residents in obstetrics and gynecology.

The three programs are:

1) Surgical Instrumentation and Surgical Technique

2) Total Abdominal Hysterectomy

3) Opening and Closing the Abdomen

These three simulation programs are the combined work of the Society of Gynecologic Oncology (SGO), Society of Gynecologic Surgeons (SGS), and the Society of Academic Specialties General Obstetrics and Gynecology (SASGOG.)

Society of Gynecologic Oncology members are: Dr. Aaron Shafer, Dr. Joel Sorosky, and Dr. Angela Kueck (John Dempsey Hospital).

Society of Gynecologic Surgeons members are Dr. Adam Steinberg and Dr. Paul Tulikangas.

Society of Academic Specialties General Obstetrics and Gynecology members are Dr. Elizabeth Deckers, Dr. Amy Johnson, and Dr. Christopher Morosky.

Dr. Amy Johnson is the residency program director for the University of Connecticut program in Obstetrics and Gynecology.


CESI Awarded Three-year Reaccreditation

The Center for Education, Simulation, and Innovation (CESI) at Hartford Hospital has been awarded reaccreditation as a Comprehensive Education Institute for three years by the Accreditation Review Committee of the American College of Surgeons.


Finances for November: Inpatient Below Budget, Outpatient Above Budget

Inpatient volumes based on discharges for the month of November were 2.2% below budget. The comparison to the prior year shows November, 2013 discharges approximately 2.5% below the prior year. Outpatient revenues exceeded budget by approximately 5.8% for the month. The favorable outpatient revenue variance was driven by Perioperative services, Radiology, Cardiology and Laboratory services.

Through two months of fiscal year 2014, inpatient discharges are 0.2% higher than budget and 1.1% greater than the first two months of the prior fiscal year. Outpatient revenues are 11.0% above the budget for the two months ending November 2013. Year to date, the favorable outpatient revenue variances are in Radiology, Perioperative services, Cardiology and Emergency services.


Drs. Edmond Cronin Speaks on Heart Rhythm Disorders to HOCC Women's Group

Electrophysiologist Edmond Cronin, M.D., of Hartford Hospital discussed Heart Rhythm Disorders: Causes and Treatment at The Hospital of Central Connecticut's WomenHeart of Central Connecticut support network meeting on Dec. 18.


Morrison's Invention Gives ICU Patients Mobility

Hartford Business Journal, Dec. 9

It may seem surprising to find a critically ill patient up and moving within a hospital's intensive care unit, but at Hartford Hospital that's exactly what you will find, thanks to Earl … and EARL. Earl Morrison is a mechanical assistant at Hartford Hospital, and EARL is the specialized cart he designed for the ICU medical staff there in an effort to enable patients more mobility during recovery.

"In the ICU, mobility has been found to be important in terms of recovery," said LuAnn Mahoney, a nurse manager at Hartford Hospital. "The effects are long term as well; mobile patients are found to be in better shape even one year post-recovery than those who aren't mobile."

What holds most ICU patients back, however, is the amount of critical equipment they need to have with them at all times, including monitors, oxygen tanks, IV poles and pumps, and portable mechanical ventilators. The sheer weight alone requires several people to help get one patient up and moving.


Our Physicians Are Great Sources For Local Media

Dr. Len Jacobs was interviewed on WNPR and WTNH on Dec. 10 about Hartford Consensus II.

Dr. Laura Saunders was interviewed on NBC CT on Dec. 13 about the one-year anniversary of Sandy Hook.

Dr. David Tolin was quoted in a Real Estate column in the New York Times on Dec. 5 about hoarders.

Dr. Gualberto Ruano was interviewed on WNPR on Dec. 17 about the $1.25 million grant to the Genetics Research Center and the IOL.

Dr. Kelly Johnson-Arborwas featured in a story on WFSB about hangovers.

Research and Academics

Dr. Richard Cartun Gives Five Invited Presentations in 2013

Richard W. Cartun, MS, PhD, director of Histology and Immunopathology, director of Biospecimen Collection Programs, and assistant director of Anatomic Pathology at Hartford Hospital, gave five invited presentations at national and international meetings during 2013:

“Technical Session on Diagnostic Immunohistochemistry,” delivered at The Seventh Annual International Retreat on Applied Immunohistochemistry and Molecular Pathology in Coral Gables, FL on February 3.

“The Use of Positive and Negative Controls in Diagnostic Immunohistochemistry,” and “Best Practices for the Immunohistochemical Detection of ER, PR, and HER2 Protein Overexpression in Breast Cancer,” delivered at the National Society for Histotechnology (NSH) IHC/Molecular Forum in Bethesda, MD on July 19-20.

“Best Practices for the Immunohistochemical Detection and Interpretation of ER, PR, and HER2 Protein Overexpression in Breast Cancer,” delivered at the American Society for Clinical Pathology (ASCP) Annual Meeting in Chicago on September 19.

“Best Practices for the Immunohistochemical Detection and Interpretation of ER, PR, and HER2 Protein Overexpression in Breast Cancer,” delivered at the National Society for Histotechnology (NSH) Annual Meeting in Providence, RI on September 22.


Dr. Ajay Kumar Presents Quest Webinar: "Strategies to Improve Blood Utilization"

Dr. Ajay Kumar,chief of the Department of Medicine, spoke at a Quest webinar on Dec. 18 called "Strategies to Improve Blood Utilization."

Avoidable complications and over-utilization of resources are drivers of needless costs in healthcare. The focus of this QUEST sprint is on techniques and tools available to identify and reduce inappropriate use of blood products. A more conservative approach to the utilization of blood products not only saves resources but improves patient outcomes. Dr. Kumar will share successful strategies to improve blood management and related outcomes.

A sprint is a 90-day rapid cycle improvement webinar series to help drive improvement in specific indicators. Enrollment is open to any QUEST member hospital.

Chief's Corner

GreeneWelcome To "Chief's Corner"

We recognize the need for sharing information about activities throughout the hospital more widely with our Medical Staff.

Chief's Corner will bring you highlights of activities of interest, which will be authored by our Department Chiefs. Should you have any comments or suggestions along the way, please share them with us.

- Dr. Jack Greene, Hartford HealthCare regional vice president of Medical Affairs for the Hartford Region and Hartford Hospital


MarkowitzImproving Care in the ED: The New ED qTrack

Dr. Jeff Finkelstein, Chief of Emergency Medicine

In FY 13, the Hartford Hospital Emergency Department provided care to over 100,000 patients. In an effort to speed up care, improve the patient experience and decrease the walk-out rate, the ED needed to make some changes.

The rate limiting steps for any ED to see patients are usually divided into three areas: staff, rooms and/or tests.

The new ED qTrack works by creating increased capacity for traditional ED beds. This is accomplished by recognizing that this is a service environment in which there is more demand for traditional ED beds than there are beds available at the predictable peak times of each day.

qTrack’s unique workflow design then increases traditional ED bed availability by implementing a “dynamic” solution that moves patients into and through “Care” areas rather than having patients spend their entire emergency department visit in a traditional ED bed.

Second, with traditional ED bed capacity freed up, qTrack provides a workflow and staffing model that is able to evaluate and treat patients on arrival and rapidly thereafter using predetermined stages and well defined patient care streams. We use intake rooms, treatment rooms, and a results waiting area instead of a traditional ED room.

The early results have been dramatic. Left without being seen rates have been cut in half, patient satisfaction is up, door to doctor time has been reduced by 25% for similar type patients, staff and physician engagement has been tremendous and the patients appear to like getting seen quickly and do not mind moving through the care areas.

Our goal is to expand qTrack hours, hard wire the work flow and build a permanent area for qTrack treatment rooms.


MarkowitzTransforming Our Culture, One Leon At a Time

Dr. Stuart Markowitz, Hartford Hospital President

From time to time I have begun to walk various areas of the hospital and touch base with staff.  This week I was walking on North 12.  As I exited the elevator I encountered Leon, one of our members of the Environmental Services team. 

As I approached him he stopped me, clearly not knowing who I was.  He noticed my name tag signaling I was a doctor.  He introduced himself and I did the same.  He told me what his responsibilities were on the floor and showed me the length of flooring he was responsible for.  I told him how good it looked and how well kept it was and that I was proud, as he was, for its appearance. 

We talked a bit longer, never “disclosing” my true identity.   As we separated I wished him the best for the holidays and the coming New Year.  As I turned to walk down the hall he said to me “Hey doc, remember to wash in and wash out.”

This was a great moment for me.  I realized that we have come a very long way in transforming our culture.  We have created a culture of ownership amongst so many of our staff. 

Not only was Leon proud of the work and the results produced and eager to share them with me, a physician.  But he took ownership for something even bigger – he reminded me of one of our core values, of our focus on taking care of our patients and our commitment to our goals.  If we had 7,500 Leons, we would be handwashing at 100%.

I believe we have many Leons and can cultivate many more. 

Thank you Leon, for your caring and commitment.  Thank you for being a watchful eye and always putting our patients' wellbeing first.


Enhancing The Patient Experience

Voices of Our Patients: Kudos To Dr. Sugunaraj

I wanted to take a moment to share some feedback with you about the hospitalists who admitted and are caring for my mother (Matilda ‘Tillie’ Malchiodi) while she is a patient here at Hartford Hospital.

My mother was in the hospital at Lawrence and Memorial Hospital in New London for over 2 weeks prior to coming here- during both a nursing and technician union strike. As you can imagine things were a little stressful trying to ensure she was receiving the care she needed.

I have worked as a nurse at HH for 18 years, and many of those years in medicine. I eventually convinced her to transfer to Hartford Hospital last Thursday so she would receive better, less fragmented care. I headed to meet her on B5E as soon as I heard she was here. When I arrived Mark Russell, APRN was with her making a plan for her care on admission. Mark had done so much work prior to my mother’s arrival to get necessary physicians consulted- nephrology and transplant surgery. They were in her room within an hour and a half of her arriving to B5E. Mark’s plan was comprehensive to say the least, optimistic (which she needed) and he was extremely open to information and input from both my mother and myself while making this plan.

Dr. Jay Sugunaraj came to visit her soon after and was equally comprehensive and optimistic in his planning and communicating with us.

My mother was kept very well informed all along the way, even when she required transfer to a higher level of care, Edmund (and forgive me for only remembering his first name) called me at 5 a.m. to notify me and did not hang up the phone until I understood everything that was happening to provide care for her.

She is doing well now, and the plan is to discharge her to home tomorrow.

In this day in age in health care, as you all know so well, communication skills and partnering with patients and their families is so important for positive outcomes. I wanted to be sure to share this feedback regarding all who cared for her as part of CMG as they each clearly exhibited to us these wonderful qualities in a medical provider. She and I are both so pleased with the care she has received.

Please convey to these individuals- as well as any others who cared for her during her stay that I did not get to meet- our sincerest gratitude for doing what they do so very well.

We greatly appreciate each of them and the hard work they do every day.

Liza Nowicki, RN, MSN, Simulation Nurse Educator at CESI

Operational Update

Nominate a Connecticut Hero By Dec. 31

The Red Cross is looking for people who have performed extraordinary acts of courage to save someone's life or who commits countless hours to a special cause to honor as Connecticut Heroes. Each year, the Red Cross accepts nominations for recognition of people who go above and beyond in service to others, exemplifying the spirit of the Red Cross mission. These heroes are honored in recognition of their good works at the Community Heroes Breakfast Celebrations, on March 7, 2014, in Hartford.

Nominate your Community Hero for deeds that occurred in the last 15 months. Nominations must be received by December 31, 2013 to be considered for this year’s event. The nominee must live or work in, or the event must occur in, Connecticut. Nominations may be made for both living and posthumous Heroes. Details about the Heroes Celebration and an online nomination form are available at the Red Cross website,

For more information about the Red Cross Community Heroes Celebration and sponsorship opportunities, contact Devin Cleary at (860) 678-4310 or email him at


State Mandated CME Renewal Available Free To HH Doctors on Jubilant Learning Portal

State mandated CME for physician license renewal is available free on the Hartford Hospital Jubilant Learning Platform. You will need your Novell sign on information to access the portal. If you have forgotten your sign on, please call the HELP desk 55699 (outside: 860-545-5699).

To access Jubilant from the web, go to the Hartford Hospital page and click on the gold tab “Medical Professionals.” Click on “Learning Portal” from the drop down menu, and then click on the green tab “Learning Portal Login.”

From the home page of the intranet (inside HH), click on the Learning Portal for Medical Education and Training link. Once you’ve clicked on the link, use your Novell sign in, and the CME is under Physician License renewal CME.

Once you have passed the post-test, you will be awarded a printable CME certificate. Your CME will also be maintained and easily self-service accessed on the Learning Portal site, should you need a copy in the future.

Please note that your Risk Management required activities through MRM will provide your Risk Management CME.


December Scrubs Tour Gives Donors An Up-Close Look

The fourth and final Scrubs Tour of the year took place on December 6. It was a great opportunity for our donors to get an up-close look at the hospital at work.

Presenters who gave their time and effort were:

  • Dr. Fran Kiernan, Cardiac Catheterization Lab
  • Dr. Courtland Lewis, physician-in-chief, Hartford HealthCare Bone & Joint Institute and chief, Department of Orthopedics
  • Dr. Frederick Rau, Obstetrics and Gynecology
  • Dr. Hank Schwartz, Hartford HealthCare psychiatrist-in-chief and vice president of Behavioral Health
  • Dr. Barry Stein, radiology, section director, cardiovascular MRI and CT
  • Dr. Adam Steinberg, Obstetrics and Gynecology \Urogynecology, Women’s Specialty Service
  • Dr. Kenneth Robinson, program manager, LIFE STAR
  • Dr. Ted Steger, radiation oncology physicist, Helen & Harry Gray Cancer Center
  • Kathy Burns, RN, medical oncology nurse manager, Helen & Harry Gray Cancer Center
  • Jeanne Bodett, RN, manager, Cardiac Catheterization Lab
  • Dawn Filippa, RN, surgical simulation coordinator, CESI
  • Becky Gleason, RRT, CESI
  • Kim Hayes, RN, Operating Room

Thanks to all the presenters who welcomed the donors who took part in the tour.


Luncheon Focuses on HHC's Alliance with MSK

Nearly 100 guests attended the "Focus on Health" Luncheon on December 18, which focused on HHC's alliance with Memorial Sloan Kettering.

Dr. Andrew Salner, director of the Helen & Harry Gray Cancer Center, provided a terrific overview of what it means for Hartford HealthCare to be the first member of the alliance, including more clinical research and greater access to the latest surgical treatments and therapies for cancer care.

We hold "Focus on Health" Luncheons three to four times a year. Members of our exceptional medical staff are a wealth of knowledge. We thank you for accepting our invitation to make these presentations on topics of relevance to our donors.


Remind a Colleague: Wash In, Wash Out

All health care workers and patients should feel comfortable reminding any other health care worker to sanitize regardless of their role. This should always be done in a courteous and constructive manner. All health care workers should respond courteously and gratefully when reminded.

If you remind another health care worker to sanitize, and he or she responds with irritation or hostility, please notify their department chief, Dr. Jamie Roche or Dr. Jack Ross, who will communicate with them to prevent recurrences.

Did You Know?

Supply Cost Stats

In FY2013, the Hartford Hospital Laundry purchased more than $1.9 million worth of linen, scrub wear and textiles.

Countdown To The Upgrade: 282 Days To ICD-10

ICD-10: Minimizing the Financial Hit

Health Leaders Media, Dec. 16

With the go-live date of Oct. 1, 2014 rapidly approaching, hospitals and health systems need to make ICD-10 a priority if they want to avoid costly surprises and setbacks.

HH In the News

In Mass Attacks, New Advice Lets Medics Rush In

The New York Times, Dec. 7

Seven minutes after the authorities in Sparks, Nev., received a call one day in October that a gunman was on the loose at a local middle school, a paramedic wearing a bulletproof vest and a helmet arrived at the scene. Instead of following long-established protocols that call for medical personnel to take cover in ambulances until a threat is over, the paramedic took a far riskier approach: He ran inside to join law enforcement officers scouring the school for the gunman and his victims.

“These events like the shootings are usually over in 10 to 15 minutes, but it often takes over an hour for everyone to get there,” said Dr. Lenworth Jacobs, a trauma surgeon who created the Hartford Consensus, which brought together experts in emergency medicine and officials from the military and law enforcement after the Newtown shooting to determine better ways to respond to mass casualties.

“We’re seeing these events in increasing frequency, and unfortunately we have to change how we approach them to keep death tolls down,” Dr. Jacobs said.


Father is Living Proof That Organ Donations Save Lives

Hartford Courant, Dec. 9

Paul Kaika had two young kids when he was diagnosed, unexpectedly, with an enlarged heart, called cardiomyopathy. He got a pace maker and modified his active lifestyle. But, within a decade, he received the shocking news that he needed a new heart. But, now, five years after a transplant, Paul is thriving. And, his journey culminated last July when he walked his daughter Melissa down the aisle.

"I value everything that happens in my life more. Seeing my children grow up is just so great," says Paul, who waited four months in Hartford Hospital for the organ. "It was a bumpy ride." Recovery was slow and steady, the biggest challenge being the "disconnect" between the heart and brain, a result of the loss of nerve endings, making warm-ups a vital component to physical activity.

"Heart transplant is an amazing process," says Dr. James Dougherty, a clinical cardiologist at Hartford Hospital, noting that only 2,200 Americans per year have the surgery, yet the need is great. "I think the limiting factor is organ donation." The number of donors remains static while waiting times for patients are increasing nationwide. But, Dougherty says, despite significant risks, the medical strides are encouraging: "Paul is a living example of that."

The video from FOX CT featuring our heart transplant story and live interview.


Undocumented immigrants to strain Connecticut’s safety-net hospitals

The Middletown Press, Dec. 10

Undocumented immigrants are expected to make up a larger share of Connecticut’s uninsured population next year, putting “new financial pressures on safety-net hospitals” that provide emergency care to everyone, state and national health experts predict.

The Affordable Care Act provides coverage options for legal immigrants, but those in the U.S. illegally cannot apply for Medicaid, even if they are poor, or buy coverage at Access Health CT (the new insurance marketplace), even if they have cash. That means undocumented residents without coverage will continue turning to local emergency departments for care at a time when Connecticut hospitals face the loss of millions of dollars in federal and state subsidies to help defray the cost of uncompensated care.

“All of our five hospitals function as safety-net hospitals. So sadly, we look at the elimination of DSH payments as another cut from the federal government because the additional revenues from some incremental bump in Medicaid enrollment will in no way” close the budget gap, said Dr. Rocco Orlando III,senior vice president and chief medical officer of Hartford HealthCare, which includes Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, Windham Hospital and Backus Hospital.

Despite the cuts, Hartford HealthCare “will continue to honor our mission” of serving the poor and uninsured as “we look for other ways to make things more efficient.” But overcoming deep federal and state funding cuts will be challenging, he said, leaving some Connecticut hospitals “with no alternative but to make tough choices.”


What Do We Want to Know About Adam Lanza and Why Do We Want To Know It?

Huffpost Healthy Living, Dec. 12

By Dr. Harold Schwartz, Psychiatrist-in-chief and vice president, Behavioral Health, Hartford Hospital/Institute of Living

As we approach the anniversary of Adam Lanza's attack at Sandy Hook Elementary School in Newtown, Connecticut, we cannot help but ask if we have discovered anything that helps us understand why -- and how -- this horrible tragedy could have happened.

We know one part with certainty. Lanza grew up in a "gun family," with ready access to multiple, high powered weapons. Shooting was a family activity. He locked himself away in a black plastic garbage bag-shrouded room watching "shoot 'em up" video games and left us pictures of himself holding a gun to his head. America is obsessed with guns and Lanza more than shared that obsession.


Docs Detail Dangers of Bitter Cold Temps

WTNH, Dec. 13

As the snow heads our way for the weekend, we're dealing with some freezing temperatures out there. News 8 got advice from some professionals on how to keep you safe.

"So the blood doesn't go to the ears, your nose, your fingers, and that's when you can get frostbite," said Dr. AJ Smally, Hartford Hospital. He recommends that you wear loose layers, and lots of them; the air between them keeps you warm. Put on a hat and scarf; you lose a lot of heat through your head and neck. And wear a waterproof jacket if it's snowy.

As dangerous as the bitter cold can be outside, there can be dangers inside your own home. Doctors say this is the time of year when they see people coming in with problems with carbon monoxide. "And we recommend that every home have at least one CO detector, and please do not use your oven or stove for heat," said Dr. Steve Finkelstein, Hartford Hospital.

And when that storm gets here and the streets are under a foot of snow, keep some snow removal safety tips in mind. People should never put a hand in a snow-blower. "They think it's stopped, but it's jammed," said Dr. Smally. "There's a torque buildup and the snow-blower spins and they lose fingers. It happens every year. People can not put their hands in a snow-blower, period."

"Shoveling snow is actually much more of an exertion than most people think and it is one of the activities that increases the risk of heart attack," said Dr. Finkelstein.


Genetic Test Aims To Take Guesswork Out of Drug Dosing

WNPR, Dec. 18

Researchers at Hartford Hospital are looking into a gene that determines how fast the liver clears medication from the body. The goal of the five-year study is to reduce the guesswork in psychiatric drug dosing.

It's a gene with a fancy name: CYP2D6.

"CYP2D6 is part of a family of 50 or so genes that detoxify substances," said Gualberto Ruano, director of the Genetics Research Center at Hartford Hospital. He said the gene is especially relevant for the field of psychiatric medicine because it produces enzymes in the liver responsible for clearing some depression medications from the body.

In the HHC System

HoCC Presents Good News at Annual Meeting

New Britain Herald, Dec. 11

The Hospital of Central Connecticut made about $7 million this year but has “put much of that back into our people, equipment and facilities,” hospital President Lucille Janatka said its annual meeting Wednesday night.

Janatka was one of several speakers at the hospital’s annual meeting of corporators. She said the theme of the meeting, attended by approximately 200 people, was that the hospital through its affiliation with Hartford HealthCare is well positioned to be a provider of health care services to the community.

In September, Hartford HealthCare reorganized into three regions: East, Central and Hartford. At the time, Jeff Flaks, Hartford HealthCare’s chief operating officer said the new structure would help the organization implement its strategies more quickly and in a more coordinated way, resulting in better patient care.


MidState Honors Physicians With Awards

My Record Journal, Dec. 13

MidState Medical Center gave out its annual Physician Recognition Awards Thursday night. Nominations are submitted by the whole hospital community, including doctors, staff, patients and their family members. Dr. Richard Smith presented the awards.

The Daniel Kahn, MD Clinical Quality Award was given to Dr. Mark Ludwig, a pathologist. Ludvig “goes above and beyond expectations in providing timely and high-quality pathology reporting and integration into cancer care planning,” Smith said.

The Joseph Goodman, MD Clinical Collaboration and Teamwork Award was given to Dr. Mark Schaner. Smith said a nominator had compared Schaner to the award’s namesake, Dr. Joseph Goodman, who he said was considered the “gold standard” for treating patients with compassion.

The David W. Parke, MD Leadership Award was given to Dr. Gary Dee, a radiologist. One of Dee’s nominators also hailed his ability to “guide, lead, and inspire people to want to participate” in efforts to help the hospital realize its organizational vision and goals.


Southington Robotics Team Meets MidState's da Vinci System

My Record Journal, Dec. 17

Twenty high school students pulled and stretched white hair nets over their heads and climbed into blue scrubs Monday afternoon as they prepared to enter the operating room at MidState Medical Center in Meriden.

The students, members of Southington High School’s robotics team, were on a field trip to learn about robotic surgery, use the da Vinci Surgical System and see it in action.

Before the students entered the operating room, they were briefed on the surgical robot by Dr. Joseph Peccerillo, a MidState surgeon, Andrew Degenhardt, a clinical sales representative at Intuitive Surgical, and Marcy DiPasquale, the head robotics nurse at MidState.

Health Care News In the Region

UnitedHealthcare Still Intends To Drop Doctors in Parts of Connecticut

Hartford Courant, Dec. 10

UnitedHealthcare says a federal judge's temporary injunction last week will not keep it from dropping doctors from its Medicare Advantage network in some parts of Connecticut.

The Fairfield County Medical Association and the Hartford County Medical Association won a temporary restraining order and a preliminary injunction on Dec. 5, which halted UnitedHealthcare from cutting the associations' doctors from its network on Feb. 1.

A spokesman for the insurer, however, said this week that the court ruling applies only to those doctors who are members of either of the two associations. UnitedHealthcare, the nation's largest health insurer, is combing through member lists provided by the two medical associations.

As of late 2012, 59 percent of doctors in the Connecticut State Medical Society were in one of the two groups, according to the Fairfield association. The state society said its members are about 60 percent of all medical practices in Connecticut. For other doctors who are scheduled to be dropped early next year, there's no reprieve.

"I never have seen any insurance company do what United has done. This was unprecedented for an insurance company to say, 'Come Feb. 1, we're going to drop 20 percent of our entire physician network, 2,250 doctors,'" said Mark Thompson, executive director of the Fairfield County Medical Association.


Quinnipiac Using Fake Patients To Test Medical Skills

Hartford Courant, Dec. 15

Quinnipiac University has hired 24 "standardized patients," people to play the role of patients for medical students' training exercises. They are the first crop of simulated patients at the Frank H. Netter M.D. School of Medicine, which opened in September. The part-time employees assume specific maladies and meet with medical students in mock examinations.

The exercise gives the students practice in asking questions to suss out the right diagnosis, and in honing their interpersonal skills.

Dr. Aaron Bernard, program director, said he wishes he had this kind of training when he was in medical school. He considers himself to be a pretty personable guy, but the kind of interaction between doctor and patient "is a whole other communication skill," and one that's hard to prepare for on your own.


Medicare Identifies 97 Best and 95 Worst Hospitals for Hip and Knee Replacements

Kaiser Health News, Dec. 17

Medicare has started publishing how well patients fared after hip and knee replacement surgeries. It evaluated how often a hospital’s patients ended up being readmitted within 30 days of discharge. It also looked at how often patients suffered a serious complication after the operation, such as a blood clot, infection, problem with the artificial joint or death.

Bridgeport and St. Vincent Hospitals were among 97 hospitals that fared "worse" than the national average when it comes to complications after hip/knee surgery, while Saint Francis fared "better" than the national average among 95 hospitals in the same category.


Lawrence & Memorial To Lift Lockout Thursday

Hartford Courant, Dec. 17

The lockout that has barred hundreds of striking employees from going to work at Lawrence + Memorial Hospital for more than two weeks will be lifted Thursday at 6:45 a.m.

The 790 nurses and health care technicians represented by the AFT union, who have been locked out since the evening of Nov. 30, will be able to return to work Thursday.

Hot Topics in Health Care

Leaders of more than 250 hospitals call on Congress to stop Medicaid cuts

Medical News Today, Dec. 5

Members of America's Essential Hospitals are among more than 250 hospitals and health systems that have called on Congress to halt "crippling" cuts to Medicaid funding for care of the uninsured and other vulnerable patients.

In a Dec. 2 letter to House and Senate lawmakers, hospital leaders said statutory cuts to Medicaid disproportionate share hospital (DSH) funding - more than $18 billion through 2019 - "simply cannot be justified," now that about half the states have rejected Medicaid coverage expansion.


Solving the Shortage in Primary Care Doctors

The New York Times, Dec. 14

Again and again, we hear that the country has too few doctors, particularly for primary care. And Obamacare is supposed to make the shortage much worse in the coming years as more Americans become insured and try to shoehorn themselves into already crowded medical offices.

But why, exactly, are doctors in such short supply?

I had always assumed the culprit was medical school enrollment. But when I looked into those numbers, I found that they are actually increasing noticeably. Thanks to the opening of new medical schools and expanded admissions at existing ones, enrollment is projected to rise by 30 percent between 2002 and 2017, according to the Association of American Medical Colleges. That’s in addition, mind you, to the swelling number of med students studying abroad, with the goal of eventually practicing in the United States.

It turns out that the real bottleneck is at the post-med-school step: residencies, those supervised, intensive, hazing-like, on-the-job training programs that doctors are required to go through before they can practice on their own.

Coming Events

January 25, 2014 (Saturday)

Black & Red

Bushnell Center for the Performing Arts, 6 p.m.

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