At Tampa General Hospital, USF faculty physicians play leadership roles in the six medical specialties that made the Top 50 list.

 U.S. News & World Report (U.S. News) has ranked Tampa General Hospital, USF Health’s primary teaching hospital, as one of one of the top 50 hospitals nationally in six medical specialties and the number one hospital in the Tampa Metro area for 2016-17.   The Tampa Metro area includes Hillsborough, Pinellas, Pasco, and Hernando counties.

Dr. Charles Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine is a member of TGH’s senior executive team, and TGH President and CEO Jim Burkhart, DSc, is a member of USF Health’s senior leadership team.  USF faculty physicians often hold leadership positions as division chiefs or medical directors in the nationally ranked TGH medical specialties.  Five of those six medical specialties received higher U.S. News spots this year:

• Cardiology and Heart Surgery ranked #30, climbing five spots from last year.  TGH is USF’s primary cardiology practice site for inpatient and outpatient services.
• Diabetes and Endocrinology jumped from not ranked (NR) last year to #27 this year.
• Gastroenterology and GI Surgery ranked #26, up 13 spots from last year.
• Urology ranked #18, up 11 spots from last year.
• Nephrology ranked  #18, rising 6 spots from last year.
• Pulmonology ranked # 48, remains in the top 50.

In addition, Moffitt Cancer Center, where USF continues to have a longstanding relationship and strong scholarly presence, was ranked the sixth best hospital for cancer in the nation — up from its 18th place spot last year.

Johns Hopkins All Children’s Hospital in St. Petersburg, USF’s primary pediatric hospital partner for training of medical students and residents, was ranked nationally by U.S. News in six pediatric specialties:  cancer, cardiology and heart surgery, neonatology, orthopedics, pulmonology, and urology.

The annual U.S. News Best Hospitals ranking,  now in its 27th year, recognizes hospitals that excel in treating the most challenging patients.

U.S News sifts through data from nearly 5,000 medical centers and survey responses from more than 30,000 physicians to rank hospitals in 16 adult specialties. Death rates, patient safety and hospital reputation were among the factors weighed. Only 153 hospitals were nationally ranked in a specialty in 2016-17.

The full rankings are available at http://health.usnews.com/best-hospitals.

Dr Kapil Patel was recruited from Stanford University known for its preeminent center

Pulmonologist Kapil Patel, MD, arrived at USF Health full-time Sept. 1 with one overarching goal in mind: to help lead and strengthen the Lung Transplant Program at Tampa General Hospital while strategically working to create a Center of Excellence for Advanced Lung Disease.

He came from Stanford University Medical Center, home to one the few such specialty pulmonology centers in the United States, which is known for its exceptional patient outcomes and consistently ranked by U.S. News & World Report as one of the best in the nation.

Pulmonologist Dr. Kapil Patel was recruited to the USF Health Morsani College of Medicine from Stanford University Medical Center.

“Dr. Patel’s recruitment is significant for USF Internal Medicine, the patients of USF Health and Tampa General Hospital and the community at large. His move from Stanford University to head the lung transplantation program is a landmark, making this the first solid organ transplant program to be part of USF in 35 years,” said John Sinnott, MD, chair of the Department of Internal Medicine, USF Health Morsani College of Medicine. “Dr. Patel’s vision for a center for advanced lung disease will place USF and Tampa General at the forefront of caring for patients with lung diseases in the United States.”

A center like the one at Stanford promotes continuity of care, allowing patients to be conveniently treated in one place by physicians who subspecialize in complex lung disorders, while cohesively providing the latest advances in medical and surgical care, said Dr. Patel, assistant professor of medicine in the Morsani College of Medicine’s Division of Pulmonary, Critical Care and Sleep Medicine and medical director for lung transplant, interstitial lung disease and adult cystic fibrosis.

“As you bring academic research to the forefront, it also opens opportunities for patients to participate in clinical trials that can afford alternatives to treatment they may not otherwise receive elsewhere,” he said.

Dr. Patel most recently directed the Stanford’s Interstitial Lung Disease (ILD) Program, one of the arms of the medical school’s Center for Advanced Lung Disease. He helped build physician referrals to Stanford’s ILD program from 100 to more than 200 in just over two years.

Providing integrated subspecialty care for complex lung diseases

Dr. Patel says he was attracted to USF Health by the opportunity to serve as medical director of an academic-affiliated lung transplant program and to build upon the solid foundation laid by Tampa General’s transplant team to create what could be Florida’s first center for advanced lung disease.

He plans to work with colleagues in USF Health Internal Medicine and Tampa General over the next several years to develop a center of excellence serving as the umbrella for four interconnected programs:

• Lung Transplantation: Tampa General already has an active program accredited by the United Network of Organ Sharing – one of five in Florida – and has performed more than 480 total adult lung transplants (single and double) since 2002. The program’s one-year patient survival rate of more than 91 percent and three-year survival rate of more than 71 percent both exceed national survival rate statistics. Dr. Patel plans to selectively grow a larger program.

“Selective is the way to go to do the right thing for patients. It is critical to identify appropriate candidates in need of transplant and to understand the limitations to transplant, so you do not push the limits too far,” he said. “We want to be confident that the surgery will go well, so the patient leaves the hospital with a new life.”

Since arriving here, Dr. Patel has worked closely with USF Health-affiliated cardiothoracic surgeon Christiano Caldeira, MD, of Florida Advanced Cardiothoracic Surgery, who serves as surgical director of the heart and lung transplant programs at TGH. They take donor calls together, jointly decide which donor organs are the healthiest for recipients, and co-manage lung transplant patients in the intensive care unit (ICU).

Dr. Patel with Nicole Davis, RN, a lung transplant coordinator at Tampa General Hospital.

• Interstitial Lung Disease, or ILD (also known as pulmonary fibrosis): This new program would manage the care of patients with a group of lung disorders causing tissue deep in the lungs to progressively stiffen and scar, which affects the ability to get enough oxygen into the bloodstream. Currently, Dr. Patel said, Florida has no ILD program certified by the Pulmonary Fibrosis Foundation (PFF) Care Center Network. Dr. Patel will lead an initiative by USF and TGH to establish the first.

• Cystic Fibrosis: Cystic fibrosis is an inherited disease that causes thick mucus to build up in the lungs, leading to repeated, serious lung infections. The Cystic Fibrosis Program at TGH is the largest adult program in the state certified and supported by the Cystic Fibrosis Foundation.

• Pulmonary Hypertension: USF Health pulmonologist Ricardo Restrepo-Jaramillo,MD, assistant professor of medicine, specializes in pulmonary hypertension – high blood pressure that occurs in the arteries that go from the heart to the lungs and may eventually lead to heart failure. He will become director of the new USF pulmonary hypertension program at TGH, Dr. Patel said.

Lung transplants are typically performed for people likely to die from lung disease within one to two years, when other treatments like medications or breathing devices no longer work, according to the National Heart, Lung and Blood Institute. ILD and cystic fibrosis are both conditions accounting for the most lung transplants nationwide, Dr. Patel said, with pulmonary hypertension affecting a smaller population of patients needing transplants.

Collaborating with community physicians

To create an integrated center, Dr. Patel plans to bring several pulmonologists with research as well as clinical expertise into the lung transplant program he directs, as well as recruit subspecialty directors for the ILD and cystic fibrosis programs. He will also add nurse practitioners to a team already supported by TGH nurse coordinators, respiratory therapists, social workers, dietitians and a pharmacist.

“When you manage patients with advanced lung disease, it takes a multidisciplinary team of professionals skilled in pre and post-transplant,” he said. “These are patients with complex conditions who need a lot of support and coordination,”

Dr. Patel sees patients at the Cardiac and Lung Transplant Clinic based at Harbourside Medical Tower.

More immediately, though, he is focusing on selectively increasing the referral base of patients by meeting with community physicians across the Tampa Bay region and seeing established pre-transplant patients in the clinic at Harbourside Medical Tower, Tampa General campus.

“I want doctors in the community to know that we are here to collaborate in the care of patients with advanced lung diseases,” Dr. Patel said. “Our availability is a priority, and ensuring the shortening of turn-around times for initial clinic visits is crucial, so that patients referred to the USF-TGH program are evaluated for medical care or transplant within weeks, not months. When someone needs a transplant, they need to be seen yesterday, and we work to intervene early.”

Advances in pulmonary transplant treatment

Over the last decade, advances in surgical techniques and significant improvements in post-operative care have contributed to improved survival of pulmonary transplant patients.

“We’ve gotten better at understanding what it takes to get these patients through transplants with fewer complications,” Dr. Patel said. “Once you get patients through the ICU following transplant, their chances of recovery and surviving a year or more out are much better.”

Medical therapy has also improved. For example, in 2014 the FDA approved the first medications (pirfenidone and nintedanib) to treat the most common type of pulmonary fibrosis, known as idiopathic pulmonary fibrosis (IPF). Until then, lung transplant was the only option for these patients, said Dr. Patel, who at Stanford led several site clinical trials testing the effectiveness of drugs for IPF.

Dr. Patel received his MD degree from the Medical University of Lublin in Poland. He completed a fellowship in pulmonary and critical care medicine at the University of Vermont and a dual heart-lung and lung fellowship at Stanford University Medical Center. He worked in private practice in Baltimore as well as holding faculty positions at the University of Vermont College of Medicine, the University of Maryland Medical Center, and Stanford.

Dr. Patel is a member of the American College of Chest Physicians and the International Society for Heart and Lung Transplantation.

A USF-TGH Center for Advanced Lung Disease won’t happen overnight. But Dr. Patel is confident that the vision can become a reality one purposeful step at a time.

“That’s why I came here,” he said. “We have a strong foundation and the pieces to grow.”

Photos by Eric Younghans, USF Health Communications and Marketing

The new department will be home to USF’s growing biomedical engineering program

TAMPA, Fla. (Jan. 4, 2017) —  The University of South Florida College of Engineering and the USF Health Morsani College of Medicine have established the Department of Medical Engineering, a unique transdisciplinary concept that will combine the related aspects of engineering and medicine while providing access to real-world health care environments for education and research.

The faculty will consist of both physicians and engineers specializing in chemical and mechanical engineering, biomedicine and nanotechnology with initial concentrations in a broad range of biomedical engineering areas such as nanotechnology for drug delivery, orthopedics, and cardiology, neurology and cancer.

“The new program will focus on how best to help patients and improve medical care,” said Robert H. Bishop, dean of the USF College of Engineering.  “We are creating an environment where intellectual collisions can readily occur between engineering professors, medical doctors, researchers, and students leading to innovative solutions that save lives and improve the quality of health care. In addition, occupations in biomedical engineering are typically high paying and are showing above average growth in the United States.”

Robert H. Bishop, PhD (left), dean of the USF College of Engineering, and Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine.

While most biomedical engineering programs are based only within engineering, medical engineering at USF will offer a unique concept that pairs engineers with doctors and medical residents in a clinical setting.  Graduate students will spend time at Tampa General Hospital meeting with surgeons and going into the operating room as observers.  In addition to completing a thesis, graduate students will be encouraged to obtain a patent and publish an article in a peer-reviewed journal.

“This medical engineering department will enhance opportunities for doctors and engineers to learn from one another in real-world clinical environments,” said Dr. Charles J. Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine. “It will facilitate joint work on applied research, including drug discovery and delivery and the development of medical devices and imaging to solve health care problems and improve patient care.”

The success of the USF biomedical engineering (BME) graduate program, which has grown more than 50 percent over the last five years and is currently the largest BME graduate program in Florida, is expected to lead to the launch of a bachelor’s degree program in biomedical engineering at USF in the near future.

Robert Frisina, director of the biomedical engineering program, will serve as interim chair of the Department of Medical Engineering.  An advisory group of National Academy members is being formed to help attract world class faculty to the new program.

About USF
The University of South Florida is a high-impact, global research university dedicated to student success. USF is a Top 25 research university among public institutions nationwide in total research expenditures, according to the National Science Foundation. Serving over 48,000 students, the USF System has an annual budget of $1.6 billion and an annual economic impact of $4.4 billion. USF is a member of the American Athletic Conference.

About USF Health
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and the USF Physicians Group. USF Health is an integral part of the University of South Florida, a high-impact, global research university dedicated to student success. For more information, visit www.health.usf.edu.

News release by Janet Gillis, Communications and Marketing Officer, USF College of Engineering

Media contact:
Anne DeLotto Baier, USF Health Communications
abaier@health.usf.edu, or (813) 974-3303

There were tears of joy from 65-year-old Jeanette Ebaugh, who recently received the 500^th lung transplant from Tampa General Hospital (TGH).

Ebaugh celebrated the successful procedure, alongside her husband and the team of health professionals who saved her life, during a press conference March 8 at TGH.

“I have my life back,” Ebaugh said. “This is the best I’ve felt in more than three years. Now I can breathe on my own without the help of oxygen. I feel very lucky.”

USF Health pulmonologist Dr. Kapil Patel, assistant professor of medicine and director of Lung Transplantation and Interstitial Lung Disease at the USF Health Morsani College of Medicine, with Jeanette Ebaugh, who received the 500th lung transplant at Tampa General Hospital.

The team that prepared Ebaugh for the lung transplant, provided surgical and post-surgical care and continues to carefully monitor her progress is led by Kapilkumar N. Patel, MD, assistant professor and director of the Lung Transplantation and Interstitial Lung Disease, Division of Pulmonary and Critical Care Medicine in the Department of Internal Medicine at the USF Health Morsani College of Medicine, and Christiano Caldeira, MD, associate professor and division chief of Division of Cardiothoracic Surgery in the Department of Surgery at the USF Health Morsani College of Medicine.

Tampa General is the 26th hospital in the nation to perform 500 or more lung transplants.

Dr. Patel and Dr. Caldeira were at the press event to share the TGH’s milestone and the success of the Lung Transplant Program – now the 26^th hospital in the nation to perform 500 or more lung transplants.

“We started the transplant program at TGH in 2002,” said Dr. Patel, the USF Health pulmonologist who is medical director for the lung transplant program at TGH. “Since then, we’ve completed 35 to 40 transplants every year. Lung transplants are the longest and some of the most complex surgeries, but we’ve been able to complete them successfully.”

Ebaugh, from Port St. Lucie, Florida, was diagnosed five years ago with idiopathic pulmonary fibrosis, an incurable lung disease, at another hospital, and was told she had five years to live. But, in 2015, doctors at TGH gave her hope and placed her into the TGH’s lung transplant program waiting list for a single lung transplant. After 22 months, TGH found Ebaugh’s organ donor match. Her surgery took six hours.

“Thank you to the donor and their family,” said Ebaugh, as she got emotional. “Without their generosity I would not be here. Thank you to my doctors and the wonderful staff at TGH. Thank you for giving me a new life.”

TGH partnered with LifeLink Foundation to find the organ donor. The non-profit organization is a locally federally designated agency that handles the recovery of organs for transplantation in 15 counties in west Florida.

“Ebaugh is one of the success stories,” said Betsy Edward, senior public affairs coordinator for LifeLink Foundation. “But we still have 120,000 patients on the national organ transplant waiting list hoping for their own successful outcomes. We want to reiterate that without the generosity of another family’s organ donor, Ebaugh would not be here today. So, I encourage others to help make a similar donation to save lives.”

From left: Dr. Christiano Caldeira, associate professor and chief of the Division of Cardiothoracic Surgery at the USF Health Morsani College of Medicine, Dr. Patel and patient Jeanette Ebaugh answer media questions at the press conference.

Dr. Caldeira, who performed the lung transplant on Ebaugh, said TGH has reached this milestone because of an effective interprofessional collaboration between various health professionals and organizations. “It takes a lot of people to make this a success, and we wouldn’t have been able to achieve this accomplishment without the excellent coordination of the surgical team, TGH’s lung transplant program, Dr. Patel, LifeLink and others,” he said.

TGH has one of the busiest transplant centers in the country, performing transplants in adult lung, heart, kidney, pancreas, liver and pediatric kidney.

Dr. Patel joined USF Health and TGH in 2016 to help lead and strengthen the Lung Transplant Program at Tampa General Hospital while strategically working to create a Center of Excellence for Advanced Lung Disease.

“I wouldn’t have come here if the recipe wasn’t right for success,” Dr. Patel said. who was recruited from Stanford University Medical Center. “The program has such a strong foundation, and it will only get better from here.”

Story and photos by Vjollca Hysenlika

For generations, nurses tending to newborns have been able to tell the subtle difference between a baby’s cry of hunger and that of pain.

That ability to distinguish those differences is now being combined with continuous facial expression recognition software in hopes of offering a new way to help health care providers more precisely gauge whether a baby is experiencing pain or simply needing a diaper change.

Neonatal experts in the USF Health Morsani College of Medicine are partnering with facial expression recognition experts in the USF College of Engineering to build data that combines known information collected through facial expression recognition capabilities and the known information from nurses who have years of training and on-the-job experience using the neonatal infant pain scale (NIPS).

“Our intent is to develop a methodology and technology to allow us to better detect when the patients we are caring for experience pain,” said Terri Ashmeade, MD, professor of pediatrics in the USF Health Morsani College of Medicine and chief quality officer for USF Health.

“Babies hospitalized in the NICU experience many painful procedures and research has shown that these painful experiences are associated with altered development of the infants brains and can impact them long term. Babies cannot tell us when they are experiencing pain, or how intense their pain might be. So the most important thing about this research is that, by coupling computer vision technology with vocal responses, we can have a fuller understanding for what our patients are experiencing and know when we should intervene. And that precision in knowing when they are feeling pain would prevent us from exposing babies to medications they don’t need.”

Dr. Terri Ashmeade at Tampa General Hospital’s NICU.

The preliminary study looked at 53 infants in the NICU at Tampa General Hospital. Using small video cameras attached to infant incubators, the researchers collected footage of the young patients before, during and after scheduled procedures and interventions. The footage was examined later through facial expression analysis software and was also coupled with vital signs that were measured in sync with the footage, with audio that was also collected, and with near-infrared spectroscopy (NIRS), which measures oxygen levels in the brain.

All of those datasets – facial expressions, body movements, sounds of crying and vital signs – were combined and then matched with the nurses’ own professional expertise of what particular cries and facial expressions mean, the NIPS score. The resulting overlay could provide a tool in a NICU that would constantly monitor a baby and then alert the health care team when there is evidence the baby is feeling any distress from pain. Currently, these NICU-skilled nurses build in typically hourly assessments of the infants to gauge a NIPS score – the new technology would offer round-the-clock monitoring.

Cameras continually monitor the newborns.

This new use of computer vision and pattern recognition adds a new dimension to existing software, said Rangachar Kasturi, PhD, the Douglas W. Hood Professor in the Department of Computer Science and Engineering, USF College of Engineering.

“USF’s expertise in computer vision and pattern recognition is well known, so naturally we have a strong interest in using it to help this population,” Dr. Kasturi said.

“The key difference here is that we’re not trying to recognize or identify a face, we are measuring the baby’s muscle movement and how their creases and lines move, to determine if they are experiencing pain. We are comparing the nurses’ scores with those we get from the technology to determine how accurate our scores are. We want to replicate what these talented nurses do so the babies can be constantly monitored.”

USF engineering professor Dr. Rangachar Kasturi and USF doctoral student Ghada Zamzmi. Photo by Ryan Noone.

In gauging facial expression, capturing known meanings in babies can be difficult, said Ghada Zamzmi, a doctoral student in the USF Department of Computer Science and Engineering.

“There are common expressions such as happy, sad, angry etc. that we know about adults, but those cannot be applied to newborns,” Zamzmi said. “In this study, we are capturing the facial muscle movements in video, or optical flow, and classifying them as relating to pain or no pain. In addition to facial expression, we are automatically analyzing other signals such as sounds, body movement, and heart rate to increase the reliability of detecting pain in case of missing data. We believe developing an automated multimodal system can provide a continuous and quantitative assessment of infants’ pain and lead to improved outcomes. ”

This type of technology and assessment could be used beyond the NICU, including for any patient who is not able to communicate directly with their health care team about whether or not they’re experiencing pain, such as elderly patients with dementia, Dr. Ashmeade said.

NICU babies are some of the most vulnerable and require multiple medical procedures – even surgeries – that are painful, Dr. Ashmeade said.

Babies may require multiple medical procedures while in the neonatal intensive care unit.

“These newborns, many of them born prematurely, cannot communicate their feelings, which is why and how the nursing staff has become the go-to experts for gauging the babies’ needs,” she said. “While we have had many successes in neonatal care and improving survival of our babies, what we really want to focus on is a great outcome. Anything we can do to foster appropriate development, especially of the brain, is what we want for these babies.”

In addition to Drs. Ashmeade and Kasturi, and Zamzmi, researchers on the study included: Chih-Yun Pai, Dr. Dmitry Goldgof, and Dr. Yu Sun. This preliminary research was supported, in part, by a 2016 USF Women’s Health Collaborative Seed Grant. The team has applied for further funding with the National Institutes of Health and expects to hear if an expanded study is approved by next Fall. In June, the research will be presented in Norway at the Scandinavian Conference on Image Analysis, which is sponsored by the International Association for Pattern Recognition.

Story by Sarah Worth, photos by Eric Younghans, USF Health Communications

USF Health faculty, students, staff and local and state leaders celebrated the extraordinary work and legacy of John S. Curran, MD, professor of pediatrics, associate vice president of USF Health, and senior executive associate dean for faculty and academic affairs at the USF Health Morsani College of Medicine, during a special ceremony on June 29 at USF.

Children help Dr. Curran unveil the new name of Children’s Medical Services, John S. Curran, MD, Children’s Health Center.

During the event, USF Health honored Dr. Curran for his outstanding contributions as a pediatrician and leader, by naming the Children’s Medical Services building, the John S. Curran, MD, Children’s Health Center. The special recognition was authorized by USF Board of Trustees at their June 8 meeting.

(L to R). Edmund Funai, MD, chief operating officer at USF Health, vice dean for administration at Morsani College of Medicine and senior vice president for strategic development at the USF System, and Dr. Curran listen to Roberta K. Burford, JD, associate vice president for Strategic Health Operations at USF Health, read the USF BOT Resolution before unveiling the new name of the Children’s Medical Services.

“Consider this special token of our appreciation for the many years of passionate service as a developer of innovative programs, exemplar as a physician educator, and, most of all, as an advocate for Florida’s children,” said Edmund Funai, MD, chief operating officer at USF Health, vice dean for administrational at the Morsani College of Medicine and senior vice president for strategic development at the USF System, after unveiling the new sign of the Children’s Medical Center. “Because of your guiding hand, we are all better positioned for the future, and we have all benefitted from your hard work, activism, leadership and friendship.”

Dr. Curran greets USF Health faculty, staff, leaders and friends outside John S. Curran, MD, Children’s Health Center.

Celeste Philip, MD, surgeon general and secretary of the Florida Department of Health, also honored Dr. Curran for his impact on health outcomes across the state of Florida.

“We’re grateful to Dr. Curran for his contributions to children’s medical services and the state’s department of health,” said Dr. Philip during the celebration. “I’m impressed by his desire and motivation to continue to help improve health outcomes in our state until the very end. He may be leaving for a short period, but we’re certain he will be back in some capacity. That speaks to how much he means to our state and all of his contributions. That is who he is and that is what he stands for.”

Gene Earley, deputy director of the Hillsborough County Healthcare Services, honored Dr. Curran for his tremendous impact on the Hillsborough County Health Care Plan, which he helped develop more than 20 years ago.

Gene Earley, deputy director of the Hillsborough County Healthcare Services, presents Dr. Curran a plaque for his contribution to Hillsborough County Health Care Plan.

“Hillsborough County Healthcare Services Department is thankful to Dr. Curran for his many years of outstanding services to Hillsborough County,” said Earley. “Your professionalism, leadership, commitment, dedication and passion has significantly improved the Hillsborough County Health Care Plan and health provided in Tampa and nearby counties. Your dedication to duty has improved the quality of health care services provided to the residents of Hillsborough County.”

The Board of County Commissioners of Hillsborough County also recognized Dr. Curran’s tremendous career by declaring Thursday, June 29, 2017 as Dr. John S. Curran Day.

Hillsborough County Commissioner Sandra Murman presents the county’s proclamation to Dr. Curran. 

“I am overwhelmed at the great outpouring of love and affection that you have given me for a fairly long career here at USF Health Morsani College of Medicine,” Dr. Curran said.  “I’ve been overwhelmed by your support, but I’ve always had great interest in helping those who couldn’t help themselves. I’m not the wizard. I just have been blessed with the opportunity to bring people to work together to help people in our community. And I am not going to rest. I will continue to be an advocate for those in need.”

Dr. Curran with his wife Christine, and daughters Heidi, far right, and Heather.

William Sappenfield, MD, professor and chair of the Department of Community and Family Health at the USF College of Public Health, signs guest book for Dr. Curran.

*****

John Curran, MD — an influential pediatrician and inspirational leader and pioneering child health advocate who advanced public policy to benefit some of Florida’s most vulnerable patients – is retiring after 45 years of service at the University of South Florida.

Dr. Curran, who is a professor of pediatrics, associate vice president of USF Health, and senior executive associate dean for faculty and academic affairs at the USF Health Morsani College of Medicine, has helped transform health care through his long-term dedication and commitment to children’s health.

John Curran, MD, professor of pediatrics, associate vice president of USF Health, and senior executive associate dean for faculty and academic affairs at the USF Health Morsani College of Medicine.

“Dr. Curran has been an invaluable member of our faculty and has offered his expertise and service well beyond our university to include local, regional and national health care efforts,” said USF System President Judy Genshaft. “His passion for putting the children of this state first and assuring their access to quality health care is truly impressive. As a founding faculty member of our medical school, an accomplished pediatrician, and a tireless advocate for child health, Dr. Curran will forever have a prominent place in this university’s history.”

“We’re forever grateful to Dr. Curran’s exemplary service to the Morsani College of Medicine, USF, Tampa Bay, Florida and beyond,” said Charles J. Lockwood, MD, MHCM, senior vice president for USF Health and dean of the Morsani College of Medicine. “Dr. Curran’s incredible efforts to improve perinatal health have contributed to saving the lives of thousands of babies. His distinguished career has been vital to the Morsani College of Medicine’s rise to prominence. We’re blessed to have such an outstanding physician, teacher, servant leader and child advocate on our faculty.”

Dr. Curran reads to children at the USF Health’s Children’s Medical Services in 2008.

Dr. Curran began his career at USF in 1967. Since then, he’s made a tremendous impact on faculty, students and staff in various positions and capacities. Dr. Curran is one of the founding faculty members of the Morsani College of Medicine. In 1972, he helped establish the USF Division of Neonatology and the USF neonatology fellowship program.

As a faculty member and leader, Dr. Curran made significant contributions to the Department of Pediatrics at the Morsani College of Medicine. As a result, he was named the acting chairman of the department from 1987 to 1990. Under his leadership, the department became one of the largest and most innovative departments at USF.

“In his four decades of service to USF, Dr. Curran has held many roles and influenced the medical community throughout Tampa Bay, but no contribution is greater than his work with children,” said Patricia Emmanuel, MD, professor and chair of the Department of Pediatrics at the Morsani College of Medicine. “He has impacted the lives of thousands of children across the state. There is no child born with a chronic condition that is not touched by his legacy. The department of pediatrics is honored and thankful for his leadership and service.”

Following his role at the Department of Pediatrics, Dr. Curran joined the Dean’s office in various positions as the executive associate dean and associate dean for academic affairs overseeing all education programs. During that time, Dr. Curran also started the general pediatrics program in downtown Tampa and integrated Children’s Medical Services (CMS) case management with pediatric subspecialty services. He also helped develop innovative ideas for faculty development and promotion.

“Dr. Curran was notable for consistently giving sage advice,” said Steven C. Specter, PhD, associate dean for Alumni Relations and director of MD Career Advising. “He was always direct and honest, and I always knew he could be counted on if asked for help. USF loses one of the brightest, most influential faculty members in its 46-year history.”

Dr. Curran also held various positions at Tampa General Hospital (TGH) serving as the founding director of the neonatal intensive care unit from 1972 to 1987, and the chief of pediatrics at TGH from 1992 to 2001.

During his outstanding career, Dr. Curran expanded his service beyond the university and into the community locally, regionally and nationally. He was one of the core architects and passionate advocates for the Children’s Medical Services program in Florida — creating an exceptional network of pediatric medical specialists across the state to provide care and services for children with chronic conditions.

He was also one of the founders of the nationally award-winning Hillsborough County Health Plan for families that can’t afford traditional insurance coverage. His commitment towards the project for more than 20 years has been critical to the long-term success of the program. To this day, that program continues to provide primary and specialty care to thousands of uninsured individuals every year.

More recently, Dr. Curran co-founded and co-directed the Florida Perinatal Collaborative (FPQC) with William Sappenfield, MD, professor and chair of the Department of Community and Family Health at the USF College of Public Health.  FPQC’s evidence-based statewide initiatives are helping to transform the quality of care for pregnant women and newborns.

L to R: USF leaders of the Florida Perinatal Quality Collaborative include Linda Detman PhD, Department of Community and Family Health at the Chiles Center for Healthy Mothers and Babies; William Sappenfield, MD, MPH, director of the Chiles Center; and Dr. Curran, executive director of the FPQC.

“Dr. Curran’s leadership was instrumental in convening stakeholders in 2010 to agree to the establishment of FPQC — facilitating cooperation across maternal and infant health disciplines with a history of working in silos,” said Dr. Sappenfield. “Under his direction, the FPQC has worked with hospitals and health care providers across the state to reduce early elective deliveries, respond to obstetric hemorrhage and severe new-onset hypertension, reduce neonatal catheter associated blood stream infections, improve teamwork and delivery room processes during the first hour of life for very low birth weight and premature infants and increase the feeding of mother’s own milk to very low birth weight infants. Dr. Curran is passionate about improving the quality and safety of health care and he really set the course for the FPQC.  Simply put, the FPQC, and its success in improving the quality of health care for Florida’s mothers and infants, would not exist without him.”

Dr. Curran received numerous awards during his career. He was awarded the Distinguished Service Award from USF for his service and devotion to USF and the entire Tampa Bay community. He also received the Abraham Jacobi Award from the American Medical Association, the Lifetime Healthcare Hero Award, the Lawton Chiles Perinatal Award from the March of Dimes, and the Frederick A. Reddy, M.D. Memorial Award from the Hillsborough County Medical Association.

“Dr. Curran’s enthusiastic service has directly benefited our nation’s children by facilitating the development of legislation and programs that have improved pediatric health care delivery,” Dr. Lockwood said. “I am immensely grateful to Dr. Curran and his service. His legacy will be carried on by many USF medical students, residents and faculty who have benefitted from his compassionate leadership, wisdom and encouragement.”

Prior to joining USF, Dr. Curran served in the U.S. Air Force as a physician and chief of newborn services at the USAF hospital in Wiesbaden, West Germany. He entered the military reserves in 1972, but rejoined active duty during the Gulf War in the early 1990s. Dr. Curran achieved emeritus status from the Society of Air Force Flight Surgeons — receiving two Air Force Outstanding Medical Mobilization Augmentee awards. He retired as a full colonel in 1992 after 26 years of service.

Dr. Curran speaks after receiving recognition from Florida legislature for his work in 2007.

There is no doubt, Dr. Curran is a trailblazer and a champion of USF and USF Health. His legacy has impacted generations and will continue to transcend for many years and decades to come.

To celebrate his outstanding career and thank him for his tireless service, USF Health will hold a Dr. John S. Curran building designation ceremony with faculty, staff, leaders and friends at 3 p.m., Thursday, June 29 in the Children’s Medical Services (CMS) lobby, followed by a reception in the USF Health rotunda. In case of rain, the festivities will be held in the USF Health rotunda.

Tampa, FL (July 5, 2017) – Tampa General Hospital and the USF Health Morsani College of Medicine are creating a new model for advanced organ transplantation. Noted transplant physician Dr. David Weill has been named director of the new Institute for Advanced Organ Disease and Transplantation, which will bring together the four organ transplant programs under singular leadership.

Dr. David Weill leads the new Institute for Advanced Organ Disease and Transplantation, which will bring together the four organ transplant programs: heart and lung, kidney, liver and pancreas.

The institute will serve patients in need of organ transplants or who suffer complex medical conditions as a result of advanced organ disease of the heart, lungs, liver, pancreas, and kidneys at Tampa General, already one of the nation’s busiest transplant centers, and at USF Health’s South Tampa Center for Advanced Medical Care.

“Dr. Weill’s clinical expertise and his vision for how to improve outcomes and enhance quality of care are aligned with what we’re already doing here at TGH,” said Dr. Sally Houston, chief medical officer at Tampa General. “Dr. Weill is working with our seasoned team of physicians to create a new model that will better coordinate clinical care and enhance the patient experience at all stages of organ failure.”

Dr. Charles J. Lockwood, senior vice president for USF Health and dean of the USF Health Morsani College of Medicine, says the institute will offer high-quality, integrated care with cutting-edge research designed to benefit a wide range of patients.

“In each of our transplant areas, this academic-affiliated institute will enable us to create pathways of subspecialty care to help patients with complex disorders delay or even avoid a transplant; to seamlessly transition to a transplant when needed, while minimizing postsurgical complications; and to maximize quality of life,” Dr. Lockwood said.

Tampa General is one of nation’s busiest transplant centers.

Dr. Weill has ambitious plans for the institute. “No matter how good our current outcomes are, we can always do better. We’re going after the most experienced physicians and we will ​dig deep with our research. This is critical, because it gives you better ways to improve patient outcomes, and reduce health care costs.”

​Dr. Weill says the new Institute in Tampa will also work to increase clinical trials, publish more research results, and compete for more research grants. Patients will have the opportunity to participate in these trials and know that they have access to the latest advances in medical treatment. The Institute will also offer specialized fellowships, offering some of the nation’s top young doctors the opportunity to get top-level training in the complex care that patients with advanced organ disease need.

“With the vision and leadership of Dr. Weill, our partnership will dramatically advance the national visibility of the already outstanding transplant service at Tampa General Hospital by increasing academic research productivity,” Lockwood said.

“Dr. Weill will support efforts to enhance the national reputation of Tampa General Hospital’s transplant program by increasing our research efforts and continuing to recruit top notch talent,” Houston said.

Dr. Weill, a professor of medicine and cardiothoracic surgery at USF Health Morsani College of Medicine, says the new Institute will work to increase clinical trials, publish more research results, and compete for more research grants.

Dr. Weill is the former director of the Center for Advanced Lung Disease and the Lung and Heart-Lung Transplant Program at Stanford University Medical Center. He is also past chair of the Pulmonary Transplantation Council of the International Society of Heart and Lung Transplantation. He served 10 years on the editorial board of the Journal of Heart and Lung Transplantation and in several capacities for the United Network for Organ Sharing, including as a member of the Thoracic Committee, a member of the National Lung Review Board, and a member of the Membership and Professional Standards Committee.

Dr. Weill received his BA from Tulane University and his MD from Tulane University Medical School. He completed his residency at Parkland Hospital, University of Texas – Southwestern and a fellowship in Pulmonary and Critical Care Medicine and Lung Transplantation at the University of Colorado at Denver and Health Sciences Center.

  -USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and the USF Physicians Group. The University of South Florida, established in 1956 and located in Tampa, is a high-impact, global research university dedicated to student success. USF is ranked in the Top 30 nationally for research expenditures among public universities, according to the National Science Foundation. For more information, visit www.health.usf.edu

-Tampa General Hospital-
Tampa General is a 1011-bed Level 1 trauma center on the west coast of Florida that serves as the region’s only center for comprehensive burn care. It the primary teaching hospital for the USF Health Morsani College of Medicine, one of the nation’s busiest adult solid organ transplant centers, and a nationally designated magnet hospital for quality nursing care. TGH is the only nationally accredited comprehensive stroke center in Hillsborough County and is also a state-certified spinal cord and brain injury rehabilitation center. For more information, go to www.tgh.org.

-Photos by Eric Younghans, USF Health Communcations and Marketing

Dr. Paul Kuo joins Morsani College of Medicine Sept. 1 

TAMPA, Fla. (Aug. 1, 2017) — The USF Health Morsani College of Medicine has selected Paul C. Kuo, MD, as the new chair of the Department of Surgery.  He will also fill the university’s Richard G. Connar Endowed Chair in Surgery.

Dr. Kuo will join USF Sept. 1 from Loyola University Medical Center in Chicago where he served as the John P. Igini professor and chair of the Department of Surgery since 2010. He was also Loyola’s associate chief medical informatics officer and headed its clinical analytics group known as OnetoMAP, which mines large volumes of data to predict health outcomes. His clinical interests include hepatobiliary surgery, transplantation and minimally invasive surgery.

Paul Kuo, MD

“Dr. Kuo will work with our leadership and hospital partners to continue building a robust Department of Surgery to advance USF Health’s pursuit of academic excellence,” said Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine.  “I am confident that his proven leadership, depth and breadth of expertise, and commitment to value-based care will help us meet this goal.”

During his time at Loyola, Dr. Kuo joined the U.S. Army Reserve Medical Corps where he served in combat operations in Afghanistan treating wounded special operations soldiers.

From 2003 to 2010, Dr. Kuo was chief of the Division of General Surgery and vice chair of research in the Department of Surgery at Duke University Medical Center. He was also a NIH-funded investigator who headed the transplantation surgery team at Duke for eight years.

Before joining Duke, he led the kidney and pancreas transplantation and laparoscopic surgery section of the Division of Transplantation Surgery at Georgetown University Medical Center. He has also held faculty positions at Stanford University Medical Center and the University of Maryland Medical Center.

Dr. Kuo received his M.D. from The Johns Hopkins University School of Medicine, completed an internship and residency in general surgery at Brigham and Women’s Hospital, a fellowship in transplant/hepatobiliary surgery at Beth Israel-Deaconess Hospital and two research fellowships at Harvard Medical School. Dr. Kuo also holds a MBA from the Carey Business School of Johns Hopkins University and a M.S. in medical informatics from Northwestern University.

Dr. Kuo has consistently been named one of the “Best Doctors in America.” He is a fellow of the American College of Surgeons and a member of several surgical and medical societies and associations.

“I look forward to coming to USF Health to help build integrated, multidisciplinary programs that deliver cutting-edge clinical care to patients across the Tampa Bay region and beyond,” Dr. Kuo said.

In addition to leading USF’s surgery department, Dr. Kuo will assume the role of surgeon-in-chief at Tampa General Hospital, and later this year is expected to be named associate chief medical officer for surgical services at the Morsani College of Medicine.

Tampa General Hospital named one of top 50 hospitals nationally in six medical specialties by U.S. News & World Report

TAMPA, Fla. (Aug. 8, 2017) — U.S. News & World Report (U.S. News) has ranked Tampa General Hospital, USF Health’s primary teaching hospital, as one of one of the top 50 hospitals nationally in six medical specialties and second among hospitals in Florida for 2017-18.  For the second consecutive year, TGH was also named the top hospital in the Tampa Metro area, which includes Hillsborough, Pinellas, Pasco, and Hernando counties.

Morsani College of Medicine physicians hold leadership positions and/or serve as attendings in all six nationally recognized TGH medical specialties:

• Cardiology and Heart Surgery  (TGH is USF’s primary cardiology practice site for inpatient and outpatient services.)
• Diabetes and Endocrinology
• Gastroenterology and GI Surgery 
• Nephrology
• Pulmonology
• Urology

Two of the six specialties have rapidly climbed the ranks.  Diabetes and Endocrinology advanced 14 spots to No. 13 this year, while Pulmonology jumped 20 spots to No. 28.

“This winning recognition exemplifies our joint commitment to elevating the level of care in our region through excellence in academic medicine, and is a testament to the great pride our physicians take in providing high-quality, team and evidence-based care,” said Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine.

In addition, Moffitt Cancer Center, where USF continues to have a longstanding relationship and strong scholarly presence, continues to rank in the nation’s Top 10 Best Hospitals for Cancer.

Johns Hopkins All Children’s Hospital in St. Petersburg, USF’s primary pediatric hospital partner, was ranked nationally by U.S. News in three specialties for children:  cardiology and heart surgery, neurology and neurosurgery, and orthopedics.

The annual Best Hospitals rankings, now in its 28th year, are part of the U.S. News patient portal designed to help patients make informed decisions about where to receive care for life-threatening conditions or for common elective procedures.

Risk-adjusted survival and readmission rates, volume, patient experience and safety, quality of nursing care and other care-related indicators were among the factors weighed.  For the 2017-18 rankings, U.S. News evaluated more than 4,500 medical centers nationwide; only 152 were nationally ranked in at least one of 16 adult specialties.

The full rankings are available at health.usnews.com/best-hospitals.

Dr. Maureen Groer heads a group of USF Health researchers in a five-year study examining the relationship between pregnant Hispanic women, depression and the Toxoplasma parasite

Tampa, FL (August 31, 2017) – The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has awarded more than $2.6 million to the University of South Florida College of Nursing to study the correlation between pregnant Hispanic women, depression and a common parasite that affects the brain.

Maureen Groer, PhD, Gordon Keller professor at the USF College of Nursing, will lead a group of USF Health researchers in a five-year study examining whether Hispanic women, who carry the Toxoplasma gondii parasite, have a greater risk of the infection reactivating during pregnancy.

The project is significant because it is the largest study ever done on Hispanic women infected with the parasite. The Toxoplasma parasite is a common organism that can be transferred through eating undercooked meat or touching cat feces.

The study could help pinpoint the cause of prenatal and postpartum depression and lead to different treatments for chronic toxoplasmosis.

Maureen Groer, PhD

Pregnant women, who have a weaker immune system, are more susceptible to the infection, which can cause brain and eye damage and result in personality changes. Once infected, the parasite normally lives in the brain in a dormant state.

“It would be the first large study to measure the immune changes in pregnancy and its effects on chronically infected women,” Dr. Groer said. “So we’re looking at immunity in these women across pregnancy.”

Dr. Groer and her team will screen more than 800 women at Tampa General Hospital’s Genesis Women’s Center to find 480 pregnant Hispanic women — half of the women will have tested positive for the parasite, while the remaining 240 women will not.

Researchers will monitor the two groups during pregnancy and for six weeks after giving birth. The women will undergo blood tests to study chemicals related to depression and eye exams to see if the parasite has formed cysts in the retina.  Scientists will also test the infant’s cord blood to see if the parasite was transferred from the mother.

Dr. Groer believes the women who carry the organism will be more likely to experience prenatal and postpartum depression and have the latent parasite reactivate during pregnancy.

“They had it already, and now their immune system is very different. And some defenses they normally had against the organism might be less effective. So if the organism reactivates, it will reactivate likely in the eye,” she said.

The study, titled “Chronic Toxoplasma gondii, Pregnancy Reactivation, and Perinatal Depression,” focuses on Hispanic women, because a previous USF health study Dr. Groer conducted linking depression and the Toxoplasma gondii parasite noticed a high infection rate among Hispanic women.

Dr. Groer will work with a team of USF Health researchers who specialize in ophthalmology, biological chemistry, molecular medicine, psychiatry, neurosciences, and biostatistics.

The study’s co-investigators within the College of Nursing include Allyson Duffy, PhD, assistant professor; Amanda Elliott, PhD, assistant professor; and Ming Ji, PhD, professor.

Dr. Groer will also collaborate with researchers and physicians from USF Health Morsani College of Medicine, including Andreas Seyfang, PhD, associate professor; Jamie Fernandez, MD, associate professor; Steven Cohen, MD, professor; Karen Bruder, MD, associate professor; and Adetola Louis-Jacques, MD, assistant professor.

Teodor Postolache, MD, a psychiatry professor at the University of Maryland School of Medicine, will also be a co-investigator. Dietmar Fuchs, an associate professor of biological chemistry at Innsbruck Medical University in Austria, will consult on the project.

The study is supported by NICHD, part of the National Institutes of Health (NIH). NICHD strives to ensure that every child is born healthy and grows up free from disease and disability. For more information about NIH and NICHD visit www.nichd.nih.gov.

-Story by Elizabeth Brown,  USF College of Nursing Communications

Tampa General Hospital’s next president and chief executive officer, John Couris, officially started his new job earlier this week (Aug. 28).  Couris joins TGH from Jupiter Medical Center, a 327-bed not-for-profit hospital where he served as president and CEO since June 2010.

The TGH Board organized a CEO search committee in January 2017 and hired a consultant to conduct a nationwide search. Through an exhaustive and in-depth process, the committee interviewed numerous candidates from various backgrounds and finally decided to offer the position to John Couris because of his experience and passion in academic medicine, his knowledge of the Florida market, his executive experience and his high level of energy and enthusiasm.

John Couris, president and CEO of Tampa General Hospital

“Tampa General is at a critical juncture in its continuing evolution to become a world class medical center. As the teaching hospital for USF Health, the only Level I Trauma Center on the west coast of Florida and a leading safety net hospital in the state, it is critically important that we have the best possible leadership. I am confident we will have that in John Couris,” said John Brabson, chairman of the TGH governing board. “He’s a dynamic leader with a passion for quality, innovation and excellence.”

Dr. Charles Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine, was a member of the search committee and praised the selection.

“I am very much looking forward to working with Mr. Couris,” Dr. Lockwood said. “John has shown a deep understanding of TGH and its unique role as one of the top teaching hospitals in Florida.”

Couris launched his professional hospital career in 1990 at Massachusetts General Hospital in Boston, one of the premier academic medical centers in the country. During his nearly 10 years at Mass General, he served in various leadership positions.

He joined the BayCare system in August 2000 as a vice president at Morton Plant Mease Health Care in Clearwater. In September 2006, he was named Morton Plant Mease North Bay Hospital’s chief operating officer.

In 2010 he became the CEO and president of Jupiter Medical Center, where he forged partnerships with such notable providers as Mount Sinai Hospital in New York and Nicklaus Children’s Hospital in Miami.

Couris was involved in the formation of a clinically-integrated network with more than 300 physicians to provide high-quality, low-cost care to the community and regional businesses. He also led a $50 million expansion plan that included a $30 million investment in medical technology, a new pediatric unit, and a comprehensive cancer institute.

Couris also established a $300 million fundraising campaign for critically needed medical services, including advanced cardiac care, expanded pediatric services and comprehensive stroke care.

During his tenure at Jupiter Medical Center, the hospital earned an “A” rating from LeapFrog Group and a four star rating from the Centers for Medicare and Medicaid Services. Those performance rankings helped place Jupiter in the state’s top 10 percent of hospitals.

“It is a true honor to be selected as the next leader of TGH,” said Couris. “It is a great institution with a long history of excellence. Working together as a team, I know in my heart that TGH’s best days lie ahead, and together with USF and all the members of our medical staff, we will achieve its full potential as a world class destination for healthcare excellence.”

-Photo by Daniel Wallace, Tampa General Hospital

This story is part of a series highlighting faculty who are shining examples of quality and compassionate patient care and patient safety. Every day, these health care providers put their patients first. In the process, they create successful models of advanced care focused on empathy, safety, technology and evidenced-based medicine, models that carry through everything they do – into their practice, their teaching, their research, their community outreach, and into the USF Physicians Group.

When Thomas Rutherford, MD, sees a patient, he really sees the patient’s entire family.

He is an ovarian cancer surgeon and many times the type of cancer his patient has is caused through genetic mutations that were passed to her by one of her parents. It also means she will pass it on to her children. For daughters, it might be the ovarian cancer itself, but maybe also breast cancer. For sons, new science is linking the genetic mutation to prostate and also breast cancers.

That makes Dr. Rutherford a physician for not only the whole patient, but also that patient’s whole family for generations to come. And for that insight, coupled with a demeanor of warmth and compassion, patients are giving him high marks on surveys for offering them a highly engaged patient experience.

Dr. Thomas Rutherford, Director of Gynecologic Oncology

***

Dr. Rutherford joined the USF Health Morsani College of Medicine in March. He leads the Gynecologic Oncology Division in Department of Obstetrics and Gynecology and directs the medical school’s gynecologic oncology fellowship program, as well as surgical quality at the Tampa General Hospital Cancer Center.

He is a nationally recognized expert for ovarian cancer treatment and research and, at USF, he is creating a new model of cancer care delivery that builds on strengths of existing programs to enhance accessible, integrated and high-quality care for patients and their families.

In less than six months on the job at USF Health, he has earned top scores in Press Ganey patient satisfaction surveys provided to Tampa General patients, earning scores that placed him in the 99^th percentile for communications with patients.

That level of scoring is significant and puts him among only 1 percent of physicians across the country and across all specialties.

While Dr. Rutherford said he can’t put his finger on exactly what he does to earn him these high marks, he boils it down to these key points: Do what you promise to do, ask to enter a room, apologize if they’ve had to wait, listen when they ask questions, and thank them for coming in.

“Knowledge alone doesn’t meet the expectations our patients have of us,” he said. “We have to add more to the conversation, listen to their concerns, and make our encounter be the best it can be. Our patients deserve this and it can greatly improve the care we provide them.”

Dr. Rutherford is the first to admit he does not accomplish this alone – his entire team of providers commits to these philosophies.

“Everyone knows what I expect and everyone pulls together as a team to get that kind of score,” he said.

Since arriving in Tampa, Dr. Rutherford has launched a community outreach program to connect the top USF-TGH gynecological cancer surgery teams with referring community obstetricians and gynecologists across the region. The aim is to coordinate treatment closer to home for their patients whenever possible and have surgeons provide the more routine surgeries in community hospitals closer to home for patients, while more complex cases requiring the multispecialty team approach and expertise for advanced patient support would be sent to TGH.

“The sooner they can be reunited with their families, the better their recovery can be,” he said. “Going to a local hospital for the more routine procedures and saving the highly specialized procedures for our multidisciplinary teams at TGH does exactly that.”

***

Dr. Rutherford grew up on a farm in rural Pennsylvania where his family grew their own food. He is one of five siblings and says his childhood gave him a realistic look at life.

“We all learned as kids that you work every day,” Dr. Rutherford said.

That’s likely why he insists a patient’s family be involved in the care plan: he realizes how connected she is with her home life and how everyone else should pick up the slack while she fights her disease.

“We actually have a sign-up sheet for handling the day-to-day things she likely does to maintain the household,” Dr. Rutherford said.

That all-encompassing approach carries into his teaching, as well.

“I tell every resident (physician) I teach to treat every patient like she is your own mother,” he said. “We look at the whole family. It’s about the disease process and the care process and that includes the home life. When you take care of patients, you’re caring for the entire family.”

***

At a recent patient follow-up appointment, Dr. Rutherford put his core philosophies to practice the moment he entered the exam room. The patient is already smiling when he says “Thank you for coming in today. You’re looking good, how do you feel?”

It’s likely that this patient’s survey answers helped push up Dr. Rutherford’s Press Ganey score, a point he shrugs off.

“That’s the thing with surveys: the problem with being on top is that there’s only one way to go,” he said.

He added that it takes more than common courtesy to succeed with patients. Total patient care encompasses prevention, high-risk genetic screening, education and research, individualized treatment, survivorship, and end-of-life care.

“We do a lot of outreach and bring what we know to families, especially about genetics,” he said. “In the end, they usually teach me more than I teach them.”

Story by Sarah Worth, photos by Eric Younghans, USF Health Communications.

Brigitte Jenkins has more living to do.

She is 80, has a full and loving family, and aims to reach her U.S. travel goal – she has visited 49 of our 50 states and has yet to see Hawaii.

That’s why when she was diagnosed with ovarian cancer earlier this year, she didn’t pause long when her USF surgeon recommended surgery to remove the cancerous mass before following up with chemotherapy.

“What I have to do, I have to do,” said Jenkins, describing her approach when she was told she needed surgery. It’s the same way she faces many other challenges in her life.

“I take everything I have to do that way, and I pray a lot,” she said.

USF Health physician Dr. Thomas Rutherford meets with his patient Brigitte Jenkins at Tampa General Hospital Cancer Center.

Jenkins is one of the first women to benefit from a new model of cancer care delivery now offered in the Tampa Bay region, a partnership between the USF Health Morsani College of Medicine (MCOM) and Tampa General Hospital. The effort builds on strengths of existing programs to enhance accessible, integrated and high-quality care for patients and their families.

Leading the program is Dr. Thomas Rutherford, a nationally recognized expert for ovarian cancer treatment and research who joined USF in March 2017. He leads the Gynecologic Oncology Division in MCOM’s Department of Obstetrics and Gynecology and directs the medical school’s gynecologic oncology fellowship program, as well as surgical quality at the Tampa General Hospital Cancer Center.

Rutherford performed the life-saving surgery on Jenkins and wants other older women facing cancer to remember that age alone should not preclude surgery as an option.

OVARIAN CANCER IS KNOWN as the silent killer because it is not usually diagnosed until it’s in advanced stages, when prognosis is poor. For women diagnosed when the disease is confined to the ovary, survival rates are much higher. Stage 1 is when cancer is only in the ovary. Stage 2, it has spread to the pelvis. Stage 3, it has spread to the abdomen and lymph glands. And Stage 4 is metastatic – cancer cells have spread to other parts of the body.

“With ovarian cancers that are found late, about 80 percent of the cases are at Stages 3 and 4,” Rutherford said.

It is more likely for women in mid-life and older to have ovarian cancer. In fact, it’s rare for women younger than 40 to have it. Most of these cancers develop after menopause and half of all cases are found in women age 63 or older.

Despite the high prevalence of ovarian cancer in the elderly, treatment of these patients is often less aggressive than that of younger women. As a result, many elderly cancer patients receive inadequate care.

Which is Dr. Rutherford’s point when counseling patients – age alone is not a negative prognostic factor.

“The majority of elderly patients are able to tolerate the standard of care for ovarian cancer,” he said. “There’s a lot to consider, but age by itself should not be a limitation to surgery.”

WHAT MAKES THE NEW USF/TGH INITIATIVE so unique is the concentration of specialists at the ready to treat the comorbidities of even the most complicated cases.

“With patients like Mrs. Jenkins, it must be well orchestrated and with no delays,” Rutherford said.

Jenkins is a kidney transplant recipient, so nephrologists were standing by while Dr. Rutherford performed surgery. Jenkins also has a heart condition, so cardiologists and pulmonologists were on hand, as well. That heart condition is also what made her first surgeon refuse to operate and offer only rounds of chemotherapy to fight the advanced cancer, giving Jenkins, in essence, a terminal prognosis.

“Most patients will respond to chemotherapy, but we know there can be residual cells – there’s no guarantee the chemo will get it all,” Rutherford said. “Chemotherapy alone without surgery makes no sense.”

Another key factor for the USF/TGH program is its use of a standard of care called Enhanced Recovery After Surgery, or ERAS, which follows a protocol that gets the patient in and out of surgery, up and out of bed, and discharged and home as soon as possible for recovery. ERAS limits narcotics, uses short-acting anesthesia, urges patients to eat nearly right after surgery, and has patients walking fairly soon after leaving the operating room. ERAS is helping reduce length of hospital stays by 35 to 40 percent and offering an earlier return to work and productivity. It has also been shown to reduce complications without a rise in re-admissions.

SIX MONTHS LATER – and about to have her last round of chemo – Jenkins said she is a survivor, ready to keep on living.

“Everything went well. I was in the hospital only one day,” she said. “Dr. Rutherford is a real gentleman. Just wonderful. I really like him.”

Jenkins said that Dr. Rutherford gave her the ‘allclear’ news.

“The pathology report came back and said no more cancer!”

Now she can begin thinking about Hawaii.

Photo by Eric Younghans, story by Sarah Worth, USF Communications.

Robby Wu, DO, assistant professor of medicine in the Morsani College of Medicine and advanced heart failure and transplant cardiologist for USF Health and Tampa General Hospital, joined the team in August of this year to help strengthen the growing heart failure program. “I did my advanced heart failure and transplant fellowship at USF Health and loved my experiences at TGH, so stayed on as faculty with USF Health,” Dr. Wu said.

Robby Wu, DO, advanced heart failure and transplant cardiologist for USF Health and Tampa General Hospital.

One of the procedures that Dr. Wu performs as an advanced heart failure and transplant cardiologist is the implantation of Abbott’s CardioMEMS HF System. This device is a remote monitoring platform that is FDA approved for wirelessly measuring and monitoring pulmonary artery pressure and heart rate in the New York Heart Association (NYHA) Class III heart failure patients who have been hospitalized for heart failure in the previous year. The catheter-based procedure through the right groin takes about 30-45 minutes and once the paper clip-sized, pressure-sensing device is implanted, the patient will use an at-home electronics unit to take daily pressure readings. This measurement process takes less than a minute and the hemodynamic data and real-time notifications sent to your physician can be used for heart failure management with the goal of reducing heart failure hospitalizations. Patients can also stay engaged with their care by using the myCardioMEMS app where they can keep track of their uploaded readings, set medication reminders, and talk directly with their care team.

The sensor, app and at-home electronics unit used to take the daily measurements. CardioMEMS is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2020. All rights reserved.

Normally, to measure pulmonary artery (PA) pressure, the patient would have to visit a clinic and have a “balloon catheter” inserted by a venous approach. Frequent visits would be time consuming and costly but monitoring the pressure of blood through the PA is critical for heart failure patients. “These hemodynamic changes occur earlier than clinical symptoms such as shortness of breath or leg swelling, so we can catch these changes and act on them before the patient gets into trouble,” Dr. Wu said.

When relying on a manual measuring system at a clinic, the patient is then left in the dark about their health when they’re not hooked up and so, with little ability to take preventative action, rehospitalization is more likely. According to a randomized controlled trial for wireless pulmonary artery haemodynamic monitoring in chronic heart failure referenced by Abbott, “each time you are hospitalized for heart failure, your heart is damaged, which may contribute to your heart failure getting worse.”¹

CardioMEMS is a trademark of Abbott or its related companies. Reproduced with permission of Abbott, © 2020. All rights reserved.

The CardioMEMS HF System was FDA approved in 2014 but was not commercially available to Florida until July of last year. Previously, Tampa General Hospital had been implanting the device on a research-only basis. “The system has been used in many other parts of the country with tremendous success,” Dr. Wu said. “The COVID pandemic has placed a larger emphasis on the critical need for remote monitoring devices and so clearance in Florida was expedited for this use.”

According to Abbott, this remote monitoring platform is the only one on the market that is clinically proven to aid physicians in preventing worsening heart failure,⁴ lowering mortality rates³ and improving quality of life.²

• 33% overall reduction in heart failure hospitalizations over an average of 18 months²
• 50% reduction in heart failure hospitalization for HFpEF patients over an average of 18 months⁵
• Shorter length or stay when patients are hospitalized¹
• 6% freedom from device or system related complications¹
• No pressure sensor failures¹
• Better patient quality of life as shown by significant improvements in Minnesota Living with Heart Failure Questionnaire scores¹

Dr. Wu is passionate about patient-centered care, collaborative team management, and outcome driven protocols and USF Health is glad to have him on board and making life better for patients in the Tampa Bay community. “I am looking forward to the collaboration between USF and TGH and am excited to be a part of such a robust academic health system, Dr. Wu said. “I’m really proud to be working at the best cardiac hospital in Florida.”

Dr. Wu sees patients at USF Health Morsani Center for Advanced Healthcare and USF Health South Tampa Center for Advanced Healthcare (STC). To schedule an appointment, call 813-259-0600.

REFERENCES

1. Abraham, W. T., Adamson, P. B., Bourge, R. C., Aaron, M. F., Costanzo, M. R., Stevenson, L. W., … Yaday, J. S. (2011). Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: A randomized controlled trial. The Lancet, 377(9766), 658-666. n=550. http://dx.doi.org/10.1016/S0140-6736(11)60101-3
2. Abraham, W. T., Stevenson, L., Bourge, R. C., Lindenfled, J., Bauman, J., & Adamson, P. B. (2016). Sustained efficacy of pulmonary artery pressure to guide to adjustment of chronic heart failure therapy: Complete follow-up results from the CHAMPION randomized trial. The Lancet, 387(10017), 453-461. http://dx.doi.org/10.1016/S0140-6736(15)007233-0

1. Abraham J, et al. Association of Ambulatory Hemodynamic Monitoring with Clinical Outcomes in a Concurrent Matched Cohort Analysis. JAMA Cardiology. 2019; 4(6):556-563.
2. Adamson PB. Pathophysiology of the transition from chronic compensated and acute decompensated heart failure: new insights from continuous monitoring devices. Current Heart Failure Reports. 2009; 6:287-292.

5. Adamson, P. B., Abraham, W. T., Bourge, R. C., Costanzo, M. R., Hasan, A. H., Yadav, C., … Stevenson, L. W. (2014). Wireless pulmonary artery pressure monitoring guides management to reduce decompensation in heart failure with preserved ejection fraction. Circulation: Heart Failure, 7(6), 935-944.  http://dx.doi.org/10.1161/circheartfailure.113.001229

The device invented by USF Health doctors, teaming with Tampa General Hospital, Northwell Health and Formlabs, has been used worldwide to address critical shortages of test kit swabs

Tens of millions of the USF Health-invented 3D printed nasal swabs have been mass produced for use by health care providers worldwide. [Allison Long, USF Health Communications]

Now, a multisite clinical trial led by the University of South Florida Health (USF Health) Morsani College of Medicine provides the first evidence that 3D-printed alternative nasal swabs work as well, and safely, as the standard synthetic flocked nasal swabs.

The results were published online Sept. 10 in Clinical Infectious Diseases. A commentary accompanying the paper cites the authors’ timely, collaborative response to supply chain disruptions affecting testing capacity early in the pandemic.

Seeking a solution to an unprecedented demand for nasal swabs at their own institution and others, USF Health researchers in the Departments of Radiology and Infectious Diseases reached out to colleagues at Northwell Health, New York’s largest health care provider, and leading 3D-printer manufacturer Formlabs. Working around the clock, this multidisciplinary team rapidly designed, tested and produced a 3D printed nasal swab prototype as a replacement for commercially-made flocked nasal swabs. Bench testing (24-hour, 3-day, and leeching) using respiratory syncytial virus as a proxy for SARS-CoV-2, as well as local clinical validation of the final prototype (fabricated with FDA-approved nontoxic, surgical grade materials), was successfully completed in mid-March 2020.

The larger-scale clinical trial began in late March at three sites: Tampa General Hospital (TGH), Northwell Health, and Philadelphia-based Thomas Jefferson University Hospital.  (Other sites joined later.)

The paper’s first author Summer Decker, PhD, directs the USF Health Radiology-TGH Division of 3D Clinical Applications, which creates and prints 3D anatomical models for surgeons and other clinicians and designs medical devices. [Allison Long, USF Health Communications]

“In the midst of a pandemic, our team of experts representing academic medicine, health care delivery systems, and the medical device industry put aside boundaries to quickly work together toward a common purpose,” Dr. Decker said. “It’s rewarding that the novel design for a 3D swab we created has been adopted around the world, equipping more providers to diagnose COVID-19 and hopefully help prevent its spread.”

The gold standard for diagnosing respiratory infections is to look for viral genetic material found in mucosal fluid collected with a long, slender swab inserted into the patient’s nose and back of the throat. The nasal swab is put into a plastic tube with chemicals that stabilize the sample until the virus-specific genetic material can be extracted and amplified by polymerase chain reaction (PCR) in a diagnostics laboratory. Conventional swabs feature a bushy tip coated with nylon flock; the USF Health doctors designed a tip with a 3D printed textured pattern able to capture a sufficient sample for COVID testing while keeping patient safety and comfort in mind.

Kami Kim, MD, infectious diseases division director at USF Health Morsani College of Medicine, led the multisite clinical trial comparing the performance of commercial nasal swabs with the 3D-printed alternative.

The clinical trial fully tested the safety and effectiveness of this 3D printed swab in 291 symptomatic adults undergoing COVID-19 screening at the TGH, Northwell Health and Thomas Jefferson University Hospital sites. The 3D printed nasal swab was compared to the standard synthetic nasal swab across three SARS-CoV-2 testing platforms FDA-authorized for emergency use — a modified version of the Center for Disease Control and Prevention’s real-time reverse transcriptase PCR diagnostic panel, and two commercial molecular diagnostic tests.

“This trial provided the first rigorous head-to-head comparison to make sure that the 3D swab performed as well as the standard,” said principal investigator Kami Kim, MD, professor and division director for infectious disease at the USF Health Morsani College of Medicine. “Across all three platforms used in our study, we demonstrated that the commercial swab and the 3D printed swab were comparable for accurate detection of COVID-19 infection.”

For both swabs, the only adverse patient reaction documented during the trial was a few instances of slight nasal bleeding. The cost of materials per 3D printed nasal swab ranges from 26-to 46-cents, while commercial swabs cost about $1 each, the authors reported.

Given the ongoing need for widespread COVID-19 testing, the study authors concluded that 3D printing technology offers a viable, cost-efficient option to address swab supply shortages, particularly when local hospitals or other clinical sites already have 3D printing labs equipped to print and process the devices.

The 3D printed nasal swabs were specifically designed for patients using FDA-approved surgical grade material. [Allison Long, USF Health Communications]

“Among all parts 3D printed during COVID-19, nasopharyngeal swabs have received the most attention, with participants ranging from humanitarians to charlatans,” Dr. Rybicki wrote in his summary. “The authors should be congratulated for staying on the right side of the curve, and for their perseverance, leadership, scientific rigor, and good will.”

USF Health patients have access to most of their clinical data through MyChart. A federal rule called the 21st Century Cures Act, which went into effect in November 2020, is designed to give patients more control over their personal health information.

USF Health provides nearly all physician-generated clinical documentation related to your visits with USF Health providers and releases them to you via MyChart.

Once your physician completes the notes and documentation associated with your USF Health appointment, those details will automatically be sent to your MyChart account.

This more complete documentation includes lab results, imaging results, and pathology results, along with completed notes and orders related to your visits with USF Health providers.

• What is the Cures Act? Why is it happening now?
  The rule change, known as the ONC Cures Act Final Rule, is part of the 21st Century Cures Act. It is designed to give patients more control over their health information. This part of the regulation (Information blocking) is designed to help provide patients access to their electronic medical record information. The final rule was published in May 2020 with an effective date of April 5, 2021.

• Why am I seeing prior medical results in MyChart now?
  It is important to us that we share the most information that we can regarding your medical results. Based on feedback from our patient advisors, we found that most patient are in favor of seeing all results. You may not see all your results starting November 2, 2020 but we are working on getting them all viewable in the near future.

• What if I have questions/concerns about the meaning of some of the information I see?
  If you have questions/concerns regarding your health information, please reach out to your provider via a MyChart message.

• What can I do if I feel a provider has made an error in one of my notes or if I feel there is an error with one of the results?
  If you feel like there is an error in your record, please fill out the amendment request form via the MyChart portal. The form can be found under the Resources or Health tabs in MyChart. You will need to print and submit per instructions provided on the form.

• If I receive a test result that does not make sense to me, what options will I have for reaching my provider or someone who can help explain it to me, especially if it looks to be a scary diagnosis?
  Because we release results to you immediately, you may see results before your healthcare provider has seen them. Some results may be difficult to interpret, so you may wish to wait until your provider’s office contacts you. Please allow your provider time to review the result and follow up with you within 3 business days. If you have an immediate concern, please contact your provider.

• If I have an immediate concern that requires me to speak to a provider after-hours, will I have someone I can speak to?
  If you have a concern that cannot wait, you can call the clinic number after hours to reach the on-call provider for your clinic. It is of course better if you can wait to discuss this with the provider who ordered the test since they would know you the best.

• Where on MyChart will I find all this newly added information?
  Results will still be found under the Test Results section of MyChart. Notes and other clinical documented information will be found under the Visits> Appointments and Visits section. Click on each encounter to see the specific documentation associated with it.

• Will there be a MyChart message/notification when the upload of all past results are now available?
  There will NOT be a notification. Once turned on, you will see past results when you login to MyChart and navigate to the Test results section.

• What records will be available to me in MyChart?
  Most clinical data after November 2nd will be available to you via MyChart. We will not be releasing notes that were written before Nov. 2nd, 2020 to MyChart. To obtain copies of any notes before this date, please contact medical records via the release of information (ROI) department. When we turn the setting on, all your previous medical results will be in MyChart at once.

• What is included in “clinical data” that will start to be released to me immediately as of Nov. 2nd?
  The data set includes these categories:
• • Allergies
  • Assessment and Plan of Treatment
  • Care Team
  • Clinical Notes
  • Demographics
  • Goals
  • Health Concerns
  • Immunizations
  • Labs
  • Medication
  • Problems
  • Procedures
  • Provenance (metadata)
  • Smoking Status
  • Unique device identifiers for implants
  • Vitals

*Notes include: Consultation Notes, Discharge Summary Notes, History & Physical, Procedure Notes, Progress Notes
**Labs include: Imaging Results, Laboratory Results, Pathology Results

• What is included or meant by “clinical notes” that will be instantly released?
  Clinical notes are notes written by a variety of physician and clinical staff that are pertinent to your care either in an outpatient or inpatient setting. Example of these notes are progress notes, consultation notes, procedure notes, history and physicals, and discharge summaries.

• If I am hospitalized, will all notes, tests, etc. also be automatically uploaded into MyChart throughout my stay or is this only for outpatient services?
  Yes, as soon as a provider signs a note or after a test is resulted, it will be automatically uploaded into MyChart without delay even when you are admitted to the hospital as an inpatient.

• What sort and search tools will I have when looking through years of records in MyChart?
  For Notes, there is the ability to filter by past and/or future appointments/visits and the ability to filter by provider(s).
  For Test Results, there is the ability to sort by test, ordering provider, and date. Also, there is the ability to free text search.

• Will absolutely everything be auto released into MyChart, or will some things be held back from me? And if so, for what reasons will the information be held?
  While almost everything is auto released, there are a few exceptions. Certain federal or state laws prohibit us from releasing notes or results automatically. One such example is HIV tests, for which there is a state statute. This result can only be released after the provider has spoken directly with the patient.
  Notes can also not be shared per the provider’s discretion if there is a warranted reason such as preventing harm to a patient (i.e. active investigation).

• Is there a MyChart technical support line/email I can contact if I need help navigating the system and these new changes?
  Please send email to mycharthelp@usf.edu

• How can I share this information to another provider (non-TGH/TGMG/MyChart)?
  You can share your record in multiple ways by going to the Health>Medical tools section and by selecting ‘Share My Record’ topic.

• Is the information in MyChart easily downloadable/copyable?
  You can download your information by going to the Document Center under Health>Medical tools section and then clicking on visit records.

The USF Health Tampa Bay Street Medicine, Hillsborough County and Pioneer Foundation Needle Exchange Program is ready to hit the road as Florida’s second needle exchange or syringe service program (SSP). In conjunction with Tampa General Hospital, the Health, Equality and Linkage Project (HELP) Medical Van will offer to persons who inject drugs (PWID), a safe place to turn in used syringes for clean ones to avoid sharing blood-borne diseases like HIV and Hepatitis C, get anonymously tested for those diseases and be linked to free primary care, wound care, or drug treatment programs among other social services. Targeted locations in Hillsborough County will be those with the highest rates of HIV and opioid overdoses such as around the University Square Mall and downtown Tampa.

Representatives for the USF Health Tampa Bay Street Medicine, Hillsborough County and Pioneer Foundation Needle Exchange Program during a mock run through outside the University Square Mall.

Formed in 2014, Tampa Bay Street Medicine (TBSM) is a USF Health Morsani College of Medicine (MCOM) student-run service organization supervised by faculty that provides medical care to underserved populations. It was initially started to meet the needs of Tampa’s homeless community but continues to evolve as student leaders recognize opportunities to help elsewhere. TBSM students conduct biweekly street runs in unsheltered settings near the I-275 bypass, operate continuity clinics at First Presbyterian Church, and staff a medical van at a variety of clinic sites in partnership with Pioneer Medical Foundation.

USF Health Tampa Bay Street Medicine students talk with a homeless man during a night of biweekly street runs in unsheltered settings near the I-275 bypass. Pre-COVID photo.

“We’re going to the same locations where we’ve built that relationship, where they know that we have providers for primary care and they can trust us already,” said Asa Oxner, MD, FACP, faculty advisor for the USF Health TBSM and vice chair of the USF Health MCOM Department of Internal Medicine. “We have around 800 reoccurring customers in these locations, so we can first start by serving the people we already know well and work on marketing and growth.”

At a PWID’s first visit to the program, they can receive up to 10 clean hypodermic needles and every visit after that, it’s a 1:1 exchange. SSP volunteers will also distribute condoms, alcohol swabs, portable sharps containers and Naloxone (or Narcan), an emergency treatment for narcotic overdose. Pioneer also staffs the Lily Pharmacy free medical clinic inside the University Square Mall, adding another layer of resources along with the other community agencies partnering to offer downstream care for clients who engage in the SSP’s services. Enrollees in the program are tracked with a nickname and an ID number associated with a laminated card they’re asked to carry that identifies them as part of the SSP. If the card holder is arrested for drug paraphernalia, USF providers are working with the local police authorities to have our clients placed in drug rehabilitation instead of jail. At the same time, when PWID carry clean needles and a portable sharps container, it protects the law enforcement and first responders in return.

From inside of the medical van, Jerren Creak, MPH, patient care services research associate for Tampa General Hospital, explains the disease testing options to a mock patient, a member of the community in remission from a substance use disorder, during a mock run through of the needle exchange program.

“In communities where drug users are invited to swap out used needles without retribution, hospitals have reported major declines in the spread of blood-borne infections like hepatitis C and HIV, increased enrollment in drug treatment programs and fewer opioid-related overdose deaths,” said Khary Rigg, PhD, associate professor at the University of South Florida’s Department of Mental Health Law & Policy, in a report from the Tampa Bay Times. “As for the cost, research has shown that every $1 spent on needle exchange programs yields an average $7 savings in avoided costs for HIV-related medical treatment.”

According to the Centers for Disease Control and Prevention, more than 140 Americans die from drug overdoses every day. The U.S. Opioid Epidemic was declared a public health emergency by the United States Department of Health and Human Services (HHS) in 2017. SSPs are a key part of harm reduction strategy, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself. SSPs have been legal in many other states for decades, but it was not legal in Florida until recently. Thanks to the relentless fight for legislative approval and the resulting success of the University of Miami’s IDEA Exchange, a pilot program that was approved in a 2016 exception policy, Governor Ron DeSantis signed into law the Infectious Disease Elimination Act (IDEA) on June 27, 2019.  IDEA allows county commissions to authorize sterile needle and syringe exchange programs for PWID. The law states that disease prevention must be the goal of every exchange program, they cannot use state, county or municipal funds to operate, and they are required to be funded through grants and donations from private resources and funds.

A grant already pays for prescription medications for patients of existing programs operating through partnerships with the University of South Florida, Tampa General Hospital, the Drug Abuse Comprehensive Coordinating Office and Gracepoint, and the SPP will be allowed to use that money to buy the county’s first batch of hypodermic needles and syringes.

With this green light, TBSM and USF faculty began advocating for an SSP in Hillsborough County with the Hillsborough County Commissioner’s Office Opioid Task Force Behavioral Health subcommittee. They used the robust data from Miami’s IDEA Exchange and their program was approved. The needle exchange was supposed to kick off in April but was delayed due to COVID-19.

During a mock run through of the SSP, Heather Henderson, MA, CAS (second from left), USF Applied Medical Anthropology PhD Candidate and director of social medicine programs for Tampa General Hospital, hands a prop to mock patients, members of the community in remission from a substance use disorder, to represent the needle exchange.

In preparation for the official start of the program in December, the USF Health and Pioneer team met in the University Square Mall parking lot with two members of the community in remission from a substance use disorder serving on the SSP advisory board, to do a mock run through and receive their feedback. “This was really great,” said one of the mock patients. “You guys came across that you care and you’re nonjudgmental.”

TBSM will be joined at the needle exchange by USF Health College of Public Health and USF Applied Medical Anthropology students to create a true interprofessional effort to make life better for people in the community. “Preventing acquisition of HIV/HCV requires a complex understanding of the interconnection between biomedical and social dimensions of infectious disease,” said Bernice McCoy, MPH, USF PhD Candidate in Applied Anthropology. “These students will apply both epidemiological and ethnographic methods to contextually assess our SSP’s potential impact and further explore the drug-using habits of PWID. Through this assessment that we can and identify facilitators and barriers towards HIV/HCV risk-reduction within the Tampa Bay community.”

The Opioid Crisis in Florida          

According to the National Institute on Drug Abuse, nearly 68% of the 4,698 reported drug overdose deaths in Florida involved opioids in 2018—a total of 3,189 fatalities (Figure 1).

Figure 1. Number of drug and opioid-involved overdose deaths in Florida. Deaths may have involved more than one substance. Source: CDC WONDER

The increase in substance use has resulted in consequent increases in injection drug use across the country. This has caused not only large increases in overdose deaths, but also the transmission of blood-borne diseases. According to the CDC, the majority of new acute hepatitis C virus (HCV) infections are due to injection drug use and Florida is in the top 10 states with the highest rates of infection. According to the Florida Department of Health HIV/AIDS Surveillance Program, about 7% of the new diagnoses of HIV in Florida in 2018 were from injection drug use (IDU) (Figure 2) and 11% of persons living with an HIV diagnosis were persons who inject drugs (PWID) (Figure 3).

Figure 2. HIV modes of exposure in 2018. Source: National HIV Behavioral Surveillance System (NHBS).

Figure 3. The number of persons who inject drugs (PWID) living with an HIV diagnosis in Florida in 2018. Source: NHBS.

According to the CDC, the HIV burden in Florida is the highest in Broward, Duval, Hillsborough (Figure 4), Miami-Dade, Orange, Palm Beach, and Pinellas. It was announced in the February 2019 State of the Union Address that these counties are a part of 57 jurisdictions that are the focus of the Trump administration’s, “Ending the HIV Epidemic: A Plan for America” or EHE initiative, which aims to end the HIV epidemic in the United States by 2030.

Figure 4. Hillsborough County is one of Florida’s HIV hotspots. Source: NHBS.

The IDEA Exchange

On July 1, 2016, after years of struggling to win legislative approval, Miami-Dade became the first county in Florida with a legal hypodermic needle exchange program and on December 1, 2016, World AIDS Day, the IDEA Exchange opened its doors as a pilot program. The IDEA Exchange in Miami was started by Hansel Tookes, MD, MPH, an assistant professor at the University of Miami’s Miller School of Medicine and principle director of its harm reduction research group. NBC Miami reported in June 2019 that the Miami program has disposed of more than 317,000 used needles since it received temporary authorization from lawmakers in 2016. The program also distributes naloxone and Tookes told the Miami Herald in November 2019 that since March 2017, “the IDEA Exchange has handed out 2,871 boxes of the drug and those who have taken naloxone from the clinic to carry with them have reported 1,529 overdose reversals in that time.” Miami is the only place in Florida seeing a decrease in opioid-related mortality while death tolls spike across the state.

Video by Torie Doll, USF Health Communications & Marketing, with interview footage assistance provided by Ian Vancattenburch, Movie Magic Productions.

The new office will allow the previously separate offices to combine resources and elevate their research efforts to improve health care for all Floridians

TAMPA, Fla (Nov. 30, 2020) — Tampa General Hospital and USF Health today announced the creation of a joint TGH-USF Health Office of Clinical Research to strengthen and expand current jointly conducted clinical trials, including translational studies that bridge laboratory discoveries and benefit patient care.

Both organizations are working to create Florida’s leading academic medical center dedicated to outstanding patient care, education and research. The restructuring will allow TGH and USF Health to combine resources and work together more seamlessly to initiate, operate and coordinate clinical trials looking at new ways to prevent, detect and treat disease.

“We already have established and invested in a strong foundation for clinical research,” said Tampa General President and CEO John Couris. “Combining the efforts of TGH and USF Health is the next step to elevate the world-class research we do to push forward to the edge of scientific discovery.”

“The joint office will allow for expansion of that portion of our clinical research portfolio occurring at TGH and to conduct that research with greater efficiency,” said Charles J. Lockwood, MD, MHCM, senior vice president of USF Health and dean of the USF Health Morsani College of Medicine.  “A robust research portfolio is a core component of all academic medical centers – and clinical trials are an essential part of what we do to advance the science leading to evidence-based health care. We expect this joint office to streamline the clinical trial process, thereby providing greater opportunities for both hospitalized patients and outpatients to participate in leading studies investigating new treatments.”

The joint TGH-USF Health Clinical Research Office will build upon the success over the last seven months of researchers and research staff at both institutions working to collaboratively launch about 35  COVID-19 clinical trials investigating a range of diagnostics, antiviral and anti-inflammatory medications, treatment protocols, vaccines and surveillance registries. Several, such as the joint studies testing Regeneron’s combination monoclonal antibody therapy in sick people or those exposed to the virus, are part of larger national clinical trials.

Including those COVID trials, TGH and USF Health now are working together on about 350 research studies. In July, TGH and the University of South Florida signed a new clinical affiliation to further solidify one of the largest academic medical centers in Florida and build upon their longstanding relationship and commitment to improving health care in Tampa Bay.

Clifton Gooch, MD, professor and chair of neurology at USF Health, was appointed co-vice president of Clinical Trials and Translational Research, and Rachel Karlnoski, PhD, was named executive director of the joint TGH-USF Health Office of Clinical Research.

This move to better align joint clinical research includes new leadership appointments:

• Clifton Gooch, MD, and Abraham Schwarzberg, MD, were named as co-vice presidents of Clinical Trials and Translational Research for the joint office. Dr. Gooch is professor and chair of the Department of Neurology at the USF Health Morsani College of Medicine and Tampa General Hospital Endowed Chair in Neurology. Schwarzberg is senior vice president of network development and chief of Oncology at TGH.

• Following a national search, Rachel Karlnoski, PhD, director of clinical research operations for USF Health, was selected to fill the new role of executive director of research. Karlnoski will report to Gooch and Schwarzberg for the oversight of all clinical studies involving both USF Health and Tampa General Hospital. She retains the position directing clinical research operations for USF Health, which she had held since 2018. For all USF Health trials except those based at TGH, Karlnoski continues reporting to Stephen Liggett, MD, vice dean for research at USF Health.

The administrative research changes will not affect USF Health’s participation in clinical studies with Moffitt Cancer Center, James A. Haley Veterans’ Hospital or other community and academic partners. Nor will the changes affect TGH’s partnership in clinical studies with Moffitt Cancer Center, TeamHealth, the Florida Orthopedic Institute, or other private practice physician partners.

Since the launch of the COVID Confirmed (COCO) Clinic in early April, over 4,700 patients with COVID-19 have been given virtual follow-up services after being discharged from the hospital. Not only has this virtual outpatient clinic helped patients on their road to full recovery and often kept them from being readmitted to the hospital, it also provided resident physicians and senior medical, nurse practitioner, physician assistant, PharmD, social work and behavioral health students, with a place to complete their clinical rotations. In mid-March, the Association of American Medical Colleges (AAMC) issued new guidance for medical student clinical rotations during the coronavirus which stated that it, “strongly supports medical schools pausing all student clinical rotations, effective immediately, until at least March 31,” due to concerns about the availability of personal protective equipment (PPE) and to give time for appropriate educational strategies and alternative clinical experiences to be developed and implemented.

Volunteers and trainees played vital roles within the clinic which included conducting regular welfare checks, offering support and discussing any symptoms that haven’t been resolved. Social work and behavioral health students were not originally part of the COCO Clinic when it first launched, but the team quickly realized that COVID-19 and quarantine could severely impact a patient’s mental health and so the interprofessional team expanded. The medical, social, and mental health assessments screened for depression, anxiety and substance abuse, and if a patient answered “yes” to any of the questions, they were offered resources or referrals to support. According to Asa Oxner, MD, FACP, COCO Clinic operations director, one patient agreed to being referred to the mental health team of COCO and a real suicide attempt was mitigated.

In addition to regular follow-up assessments, nurse practitioner students were in charge of monitoring the dashboard that displays the oxygen levels and heart rates of high-risk patients who were wearing a special device on their wrist.

A patient wearing one of the COCO Clinic’s monitors. Photo by CBS affiliate, 10 Tampa Bay, from their, “COVID-19 Telehealth Clinic Getting Overloaded with Tampa Bay Patients” video.

“Volunteering with the clinic has been a unique educational experience. The clinic administrators do a great job of turning every opportunity into a teaching moment,” said Joshua Mizels, Morsani College of Medicine fourth-year medical student and past clinic volunteer. “My classmates who all volunteer have had the opportunity to keep interacting with patients, giving us the opportunity to learn more about what they are going through during this pandemic.  The experience from this opportunity has been invaluable toward my medical education. ”

Lucy Guerra, MD, MPH, FACP, and Asa Oxner, MD, FACP, co-coordinators of the COCO Clinic, along with Elimarys Perez-Colon, MD, medical director, Christine Jennings, RN, nurse manager, and Rachelle Idziak, MD, data manager, led the effort to get the clinic up and running and play a pivotal role in helping the community. For their dedicated efforts, the doctors received a USF Health Culture Coin from Chief Medical Officer, Dr. Mark Mosely.

Dr. Asa Oxner (left) and Lucy Guerra (right), COCO Clinic co-coordinators, were presented with USF Health culture coins by Dr. Mark Moseley, USF Health chief medical officer, for leading efforts to get the virtual clinic up and running.

“We have been successful in offering close follow up to patients keeping them out of the hospital when able, monitor patient’s vital signs remotely to identify patients at higher risk, safely linking patients to care and offering education and reassurance to patients with COVID19 in the Hillsborough county,” said Dr. Elimarys Perez-Colon, assistant professor of medicine, vice chief of medicine at Tampa General Hospital, and medical director of the COVID-19 Confirmed Clinic. “The data collected will assist our department of health to better understand the distribution and epidemiology of COVID19 in our county. This effort wouldn’t have been successful without the assistance and compassionate care offered by our trainees.” In the first three months, over 150 trainees played a part in the care of patients.

The COCO Clinic has been the talk of the town, featured in news stories by ABC Action News, Baynews 9, 10 Tampa Bay, among others.

After the success of the virtual clinic for COVID-19 patients, clinic leaders began working with partners at Tampa General Hospital and the Florida Department of Health to make the clinic a permanent resource for the community. As of November 12th, the COCO Clinic transitioned management of the clinic to TGH and became the TGH Transitional Care Center. “This transition will allow the clinic to continue operating and provide excellent care to our patients impacted by COVID-19, while allowing USF Quality and Clinical Operations Department staff who have been assisting the COCO clinic to return to their normal non-COVID duties,” said Dr. Moseley. “The clinic will continue to provide hours to our medical, pharmacy, and nurse practitioner students and our teaching attendings will continue to support the clinic. TGH has also been able to hire several RNs and Mas, who have been training in the current clinic and will be able to facilitate a smooth transition.” An emphasis will be put on taking care of COVID-19 ‘long haulers,’ virus survivors who continue to have side effects weeks, or months, after surviving the coronavirus. Caring for these patients will also help conduct research into the little known long term effects of COVID-19. Beyond COVID-19, the clinic can continue to help patients using the same monitoring and staffing model, but for serious chronic diseases such as heart failure or chronic obstructive pulmonary disease (COPD).

A USF Health-Tampa General Hospital study suggests different management protocols may be needed for obese vs. nonobese patients to improve maternal outcomes

TAMPA, Fla (Dec. 21, 2020) — Postpartum hemorrhage, or excessive bleeding after delivery, is still one of the leading causes of severe maternal injury and death in the United States. And the rise in obesity among pregnant women has been linked to increased rates of this potentially serious, largely preventable obstetric complication.

As part of an academic medical center initiative to improve maternal health, researchers at the University of South Florida Health (USF Health) and Tampa General Hospital (TGH) examined how obesity affected the management and outcomes of postpartum hemorrhage at a tertiary care center. Their findings were published Oct. 14 in the American Journal of Perinatology.

“This study showed that we managed postpartum hemorrhage the same way for women who were obese and those who were not. That’s good overall – but the same medical treatment is not always equitable because the obese women still experienced worse outcomes,” said study senior author Judette Louis, MD, MPH, the James Ingram Endowed Professor and chair of Obstetrics and Gynecology at the USF Health Morsani College of Medicine and co-medical director of Women’s and Children’s Services at TGH. “It highlights that certain groups of high-risk obstetric patients, such as obese women, may need some additional support or a different treatment protocol for postpartum hemorrhage.”

The researchers conducted a retrospective analysis of all deliveries complicated by postpartum hemorrhage from February 2013 through January 2014 – about 2.6% of the hospital’s 9,890 deliveries during that period (a rate consistent with the national average). Controlling for confounding variables, they compared two groups of patients treated for postpartum hemorrhage: obese women (a body mass index of 30 or higher) and nonobese women (BMI characteristic of normal weight or overweight). Both groups were similar in age, race, insurance status, and alcohol and tobacco use.

Judette Louis, MD, MPH, is a USF Health maternal-fetal medicine specialist at Tampa General Hospital.

Among the study’s key findings:

• Obese patients were more likely to have had cesarean deliveries, a risk factor for hemorrhage complications, than nonobese patients.
• Both groups were equally likely to receive the same medications (carboprost, methylergonovine and misoprostol) to treat excessive blood loss, but obese women tended to receive more than one of these uterotonic agents. The medications are administered to induce contractions when the uterus does not contract enough to shrink to normal size after childbirth. This condition, known as uterine atony, is a primary cause of postpartum hemorrhage.
• Despite similar management, obese women experienced more of any severe hemorrhage-related complications (including shock, renal failure, transfusion-related lung injury, and cardiac arrest), and they were more apt to sustain more than one of the serious complications.
• While the need for blood transfusion was similar for both groups, obese women were more likely to have greater blood loss and require more units of transfused blood. “Hemorrhage-related complications are largely driven by blood loss and the number of units of blood transfused,” said Dr. Louis, a USF Health maternal-fetal medicine specialist at TGH.
• Although obese women were more often transferred to the operating room, the rates of intrauterine pressure balloon tamponade (a device used to promote uterine contraction), interventional radiology procedures, or hysterectomy were no different for obese and nonobese women.

Some basic science and clinical studies investigating uterine contractions during labor indicate obesity can impair uterine tone, so that the reproductive organ may not react as quickly or well to contraction-inducing medications. The underlying reasons for this are undefined, but a disruption of the hormonal balance in obese women may contribute to the impaired uterine response to control bleeding, Dr. Louis said. “Perhaps they need a higher dose of uterotonic agents, or the order in which the medications are administered should be changed to work more effectively for them.”

The USF Health-TGH study points to the need for larger, multisite studies to better understand the different responses to treatment protocols for postpartum hemorrhage in obese women, she added. That includes looking into the possible physiological connections between obesity, pharmacokinetics of the treatment (how the body processes medications) and the impact on uterine atony.

“With higher rates of obesity affecting higher numbers of pregnant women each year, it is important to evaluate how this is affecting the management of obstetric complications,” the study authors conclude. “This study shows that despite similar (postpartum hemorrhage) management, key differences do exist in outcomes based on obesity status. There are numerous directions for future research… many of which have the potential for significant clinical implications and improvement of maternal outcomes.”

ABOUT USF HEALTH
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the Taneja College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and USF Health’s multispecialty physicians group. The University of South Florida is a high-impact global research university dedicated to student success. Over the past 10 years, no other public university in the country has risen faster in U.S. News & World Report’s national university rankings than USF. For more information, visit health.usf.edu

ABOUT TAMPA GENERAL HOSPITAL
Tampa General Hospital, a 1006-bed non-profit academic medical center, is one of the largest hospitals in America and delivers world-class care as the region’s only center for Level l trauma and comprehensive burn care. It is one of the nation’s busiest adult solid organ transplant centers and is the primary teaching hospital for the USF Health Morsani College of Medicine. With five medical helicopters, Tampa General Hospital transports critically injured or ill patients from 23 surrounding counties to receive the advanced care they need. Tampa General houses a nationally accredited comprehensive stroke center and its 32-bed Neuroscience Intensive Care Unit is the largest on the West Coast of Florida. It also is home to the Jennifer Leigh Muma 82-bed Level IV neonatal intensive care unit, and a nationally accredited rehabilitation center. Tampa General Hospital’s footprint includes 17 Tampa General Medical Group Primary Care offices, TGH Family Care Center Kennedy, TGH Brandon Healthplex, TGH Virtual Health and 19 outpatient Radiology Centers. Tampa Bay residents also receive world-class care from the TGH Urgent Care powered by Fast Track network of clinics, and they can even receive home visits in select areas through TGH Urgent Care at Home, powered by Fast Track.  As one of the largest hospitals in Florida, Tampa General Hospital is first in the state to partner with GE Healthcare and open a clinical command center that uses artificial intelligence and predictive analytics to improve and better coordinate patient care at a lower cost.  For more information, go to www.tgh.org.