Participating in Clinical Trials

As a physician, I believe that I wear many hats. Among them are: healer, teacher and student. Since joining MacArthur OB/GYN in 2011, I found that one way to combine these hats into one was by becoming a clinical investigator on the research studies that our office participates in. The impetus for MacArthur OB/GYN to join in these studies came from my partner, Dr. Jeff Livingston, who has a passion for educating patients.

So how does being a clinical investigator in a research study help my patients? For one thing, it offers patients the chance to receive a new treatment or therapy that may help their condition. The study may also involve following patients for an extended period of time and this outcome data may result new knowledge that results in large-scale changes to doctors’ clinical practice. Also, we are able to attract patients who may have been outside our practice; and helping more people in the community is definitely a good thing.

So what clinical studies are we participating in at this time? We are participating in 5 clinical studies, and they are:

  1. A study of a medication to treat Interstitial Cystitis/Bladder Pain Syndrome
  2. A Post-market study looking at the long-term outcomes of two types of sling procedures for urinary incontinence
  3. A study of a medication to treat endometriosis
  4. A study of a medication to treat uterine fibroids
  5. A study of a medication to treat yeast infections.

Each study has specific inclusion and exclusion criteria. In addition, patients generally receive the study medications for free and are compensated for their time. In order to participate, a patient may be identified by one of our doctors as being potentially eligible, or a patient can contact our office and express an interest in participating; in which case they would be scheduled to see one of the doctors who is either the Principle Investigator or Sub-investigator for the particular study.

Hopefully reading this will encourage you if you have one of these conditions (IC/Bladder Pain, Urinary Incontinence, Endometriosis, Fibroids, or Chronic Yeast Infections) to contact Veronica Almanza at 214-223-5479. She can explain the study to you in more detail and arrange a visit with one of our physicians. We are here to help.

Snacking Made Easy

Snacks. I find it hard sometimes to come up with an easy, healthy, quick snack that is portable and can be munched on at my desk between patients. And at 6:30 in the morning, who is thinking about what will be happening at 10:00am anyway, right? Here as a great snack idea that can be made ahead and give you several servings to last you through the week. No extra brain energy exerted before the coffee kicks in!

The salsa can also be used to top your favorite beef, chicken or fish.

Corn Salsa

1 15 ounce can black beans, rinsed and drained
1 cup frozen corn, thawed
1 large tomato, chopped
1 jalapeno pepper, chopped
2 green onions, thinly sliced
2 tablespoons fresh cilantro
2 tablespoons lime juice
½ teaspoon ground cumin
Salt to taste

Combine all ingredients in a bowl and toss. Serve with fresh vegetables or homemade whole grain pita chips.

Serves about 16
Serving size: ¼ cup

Nutritional information:
Calories 32
Total fat 0 grams
Carbohydrates 7 grams
Fiber 2 grams

Remember to add the carbohydrates from the pita chips! If you use the celery sticks then you can enjoy ½ cup and count this as one of your servings of carbohydrates or starches.

The Daily Show and Health Information Exchanges

Recently on The Daily Show, a very interesting topic was covered — the lack of interoperability of electronic health records. This was a huge surprise to me as one would not expect the Comedy Central to cover a topic frequently discussed only by health information technology policy wonks.

During the satirical editorial, John Stewart lambasted the fact that the electronic health records from the VA system are unable to communicate with the electronic health records of the Department of Defense. He pointed out the illogic of having two large departments in the United States government having two different systems that cannot exchange information with each other.

While his editorial was hilarious and brilliant, it failed to recognize that the lack of EHR interoperability is one of the central problems in the entire U.S. health system. It is not just these two government agencies that cannot communicate; the problem is much bigger affecting virtually every doctor’s office and every hospital in the country. Health information technology experts have been shouting from the rooftops about the need to create a seamless way to share health data for a long time.

In fact, solving this problem is one of the primary aims of the Affordable Care Act through the creation of health information exchanges. Here is the basic problem. A patient goes to the doctor and has blood work done. That lab result will go from the lab back to the doctor. If the patient goes to another doctor or hospital, that lab result is not available for review by the new health provider. The new doctor is likely to simply repeat the test. Now multiply this situation thousands of times across the U.S. health system every day and add in radiologic studies, pathology reports, medication list and others and you can easily see the billions of dollars wasted because these independently operating systems cannot talk to each other. The Affordable Care Act created financial incentives to encourage physician adoption of electronic health records. It also created incentives to facilitate data sharing as part of a program called Meaningful Use.

Ironically, the technology needed to solve the problem of independently operating electronic medical record systems not communicating with each other already exists. This is accomplished through the creation of health information exchanges (HIE). Basically, a HIE allows medical information to be shared from one system to another. This means a patient’s health information can live in the cloud and follow them wherever they go. The seamless sharing of health information allows each health provider to have the most updated information to make the best healthcare decisions. This cuts cost, saves time, prevents medical errors and makes life easier for patients and doctors.

So, if the technology to solve this problem already exists why, has it not been done already? There is no easy answer to this question and in my opinion it is unfathomable why HIEs are not up and running everywhere. HIEs are not new.

They exist in some parts of the country with some success (Indiana). Most believe widespread adoption is on the horizon. Policy makers have mostly agreed now on the accepted standard for information sharing. This had been the central “choke point” to developers of this technology. Other issues are EHR vendors hesitate to provide access to proprietary information. Hospitals have concerns about sharing valuable demographic information with competitors. There are many other excuses and all are valid concerns. But while the execution of health information sharing is delayed real people suffer.

John Stewart drew attention to the health concerns veterans — those fighting for our country. He put a face on an important topic that needs to be solved now. He also brought a rather mundane and boring health IT topic to the forefront of pop culture.

One of the keynote addresses at the HIMSS13 this year was delivered by President Clinton. He acknowledged that healthcare costs are approximately 18 percent of GDP, and healthcare costs of other developed countries are in the range of 11 percent to 12 percent of GDP. Healthcare costs at this level are not sustainable especially as baby boomers reach an age that will place a higher level of demand on healthcare.

The emphasis of the keynote address was on the importance of using technology in reducing healthcare costs. Government, business, physicians, hospitals, insurance companies and patients all want to avoid unnecessary tests and have the information timely for patient care.

Technology is available. What is lacking is the will of key leaders to do it now. John Stewart brings an issue that is solvable to “main” street. It is good to laugh at ourselves, but this is not laughing matter.