Arizona

PHOENIX — In what is a first for the Valley in more than two decades, a 17-year-old girl from Glendale, Ariz., became the recipient of a pediatric liver transplant on Dec. 6, the result of collaboration between Phoenix Children's Hospital and Mayo Clinic in Arizona. It is also the first living donor pediatric liver transplant in the Valley. The milestone surgery was all the more unique in that it was a living donor liver transplant, meaning that a donor offered to give up part of her liver to be transplanted into the recipient. Both the donor and the recipient livers will regenerate within a matter of weeks. The donor, a 35-year-old woman from Oklahoma, underwent comprehensive medical and psychological testing to be qualified as a match for the recipient. The donor is the godmother of the recipient, and has known her since she was born. The first surgery began at Mayo Clinic Hospital at 7:30 a.m. when part of the donor's liver was removed in a 3½ hour procedure led by David Mulligan, M.D., Director, Transplant Center, Mayo Clinic in Arizona. The partial liver was put on ice and transported to Phoenix Children's Hospital, where it was transplanted into the recipient. Pediatric liver transplants are primarily done when the child has primary liver disease that may progress to death, with the risk of death that outweighs the risk of transplantation. The recipient's surgery was led by Winston Hewitt, M.D., liver transplant surgeon at Mayo Clinic and surgical director of the Phoenix Children's Hospital Pediatric Liver Transplant Program. Medical director of the program is Tamir Miloh, M.D., Phoenix Children's Hospital. Both patients were reported to be doing well following the combined 8½ hour surgeries. The program marks the only such pediatric program in the Phoenix area for pediatric patients. Previously, patients had to travel to Tucson or out-of-state for the surgery. Certification for the Phoenix Children's Hospital Pediatric Liver Transplant Program was granted by the United Network for Organ Sharing in March 2012, paving the way for the first such program in Arizona to provide an integrated, child-centered liver transplant program that takes place within a dedicated pediatric hospital.

PHOENIX — Researchers have found that using telemedicine to deliver stroke care, also known as telestroke, appears to be cost-effective for rural hospitals that do not have an around-the-clock neurologist, or stroke expert, on staff. The research, published today in Circulation: Cardiovascular Quality and Outcomes, is intended to help hospital administrators evaluate telestroke. In telestroke care, the use of a telestroke robot allows a patient with stroke to be examined in real time by a neurology specialist elsewhere who consults via computer with an emergency room physician in the rural site. "Previous studies have demonstrated that a hub-and-spoke telestroke network is cost-effective from the societal perspective — we can assess medical services, like telemedicine, in terms of the net costs to society for each year of life gained," says neurologist Bart Demaerschalk, M.D., director of Mayo Clinic Telestroke Program, and co-author of the telestroke cost effectiveness study. "However, to date the costs and benefits from the perspectives of network hospitals have not been formally estimated." Contrary to a common perception that a telestroke referral network poses a substantial financial burden on hospitals, the study revealed that it is likely to save hospitals money and also improve patient outcomes by enabling patients to be discharged sooner. "The health economic results from an earlier study conducted from the societal perspective convincingly demonstrated that telestroke was cost effective compared to the usual model of care," says Dr. Demaerschalk. "It's a relatively small amount of money, comparatively, telestroke costs a couple thousand dollars more to save quality years of life — so it's a bargain really." The Circulation study estimates that compared with no network, a telestroke system of a single hub and seven spoke hospitals may result in the use of more clot-busting drugs, procedures and other stroke therapies, more stroke patients discharged home independently, and despite upfront and maintenance expenses, a greater total cost savings for the entire network of hospitals. Using data from Mayo Clinic and the Georgia Health Sciences University telestroke networks, the research model estimated that every year, compared to no telemedicine network, 45 more patients would be treated with intravenous thrombolysis and 20 more with endovascular stroke therapies — leading to 6.11 more independent patients discharged home. This represents more than $100,000 in cost savings for each of the participating rural hospitals each year, according to the study. "If the costs associated with the technology are reduced or if reimbursement opportunities increase we will recognize that this treatment method may, in fact, save even more money," Dr. Demaerschalk says. "The upfront costs associated with setting up the telestroke technology and managing the network organization are quickly offset by the financial gains that result from a higher proportion of patients receiving clot busting drugs and the reduced stroke-related disability and subsequent reduced need for rehabilitation, nursing home care and assistance at home."

YUMA, Ariz. — November 26, 2012.  Mayo Clinic officials today announced Yuma Regional Medical Center (YRMC) as a member of the Mayo Clinic Care Network. The collaboration between YRMC and Mayo Clinic physicians will be rolled out initially through Yuma Regional Cancer Center, with opportunities for physicians from both organizations to work together in additional specialties in the future. The Mayo Clinic Care Network extends Mayo Clinic's knowledge and expertise to physicians and providers interested in working together in the best interest of their patients. YRMC physicians now will be able to connect with Mayo Clinic specialists on questions of patient care using an electronic consulting technique called eConsults. YRMC physicians also will have access to Mayo-vetted medical information through the AskMayoExpert database. These tools, in addition to health care consulting, will help YRMC provide the best care for its patients as well as improve its systems and the health of the community. "We're proud to welcome the Yuma Regional Medical Center care team to the Mayo Clinic Care Network," says Wyatt Decker, M.D., vice president and CEO of Mayo Clinic in Arizona. "Building a closer relationship with Yuma Regional Medical Center through the Care Network provides an opportunity for our two organizations to work together in new ways to provide specialized care, which ultimately enhances the lives of patients throughout Southwestern Arizona." "YRMC and Mayo Clinic both believe that health care should be delivered as close to home as possible," says Pat Walz, President and CEO of YRMC. "By working together, physicians can improve the delivery of health care so patients need to travel outside the region for care only when absolutely necessary. Mayo Clinic and Mayo Clinic Care Network members share a common philosophy, commitment and mission to improve the delivery of health care. And the primary goal of the network is to help people gain the benefits of Mayo Clinic knowledge and expertise close to home, ensuring that patients need to travel for care only when necessary. The Mayo Clinic Care Network represents non-ownership relationships. Network members are like-minded organizations committed to the delivery of high-quality, collaborative medical care for their communities.

YUMA, Ariz. — Mayo Clinic officials today announced Yuma Regional Medical Center (YRMC) as a member of the Mayo Clinic Care Network. The collaboration between YRMC and Mayo Clinic physicians will be rolled out initially through Yuma Regional Cancer Center, with opportunities for physicians from both organizations to work together in additional specialties in the future. The Mayo Clinic Care Network extends Mayo Clinic's knowledge and expertise to physicians and providers interested in working together in the best interest of their patients. YRMC physicians now will be able to connect with Mayo Clinic specialists on questions of patient care using an electronic consulting technique called eConsults. YRMC physicians also will have access to Mayo-vetted medical information through the AskMayoExpert database. These tools, in addition to health care consulting, will help YRMC provide the best care for its patients as well as improve its systems and the health of the community. "We're proud to welcome the Yuma Regional Medical Center care team to the Mayo Clinic Care Network," says Wyatt Decker, M.D., vice president and CEO of Mayo Clinic in Arizona. "Building a closer relationship with Yuma Regional Medical Center through the Care Network provides an opportunity for our two organizations to work together in new ways to provide specialized care, which ultimately enhances the lives of patients throughout Southwestern Arizona." "YRMC and Mayo Clinic both believe that health care should be delivered as close to home as possible," says Pat Walz, President and CEO of YRMC. "By working together, physicians can improve the delivery of health care so patients need to travel outside the region for care only when absolutely necessary. Mayo Clinic and Mayo Clinic Care Network members share a common philosophy, commitment and mission to improve the delivery of health care. And the primary goal of the network is to help people gain the benefits of Mayo Clinic knowledge and expertise close to home, ensuring that patients need to travel for care only when necessary.

PHOENIX, Ariz. — A program at Mayo Clinic using telemedicine technology is showing promise for patients with concussions in rural Arizona. A case study published in the December 2012 issue of Telemedicine and e-Health validates "teleconcussion" as a useful means to assess concussed patients. In the case study, doctors at Mayo Clinic in Arizona conducted a live audio-video evaluation of a 15-year-old soccer player in Show Low, Ariz., who received a concussion during a game. The teleconcussion evaluation, believed to be the first in the state to use telemedicine for concussions, supports the use of this technology to bring concussion expertise to rural locations. Similar telestroke, teleneurology, and teleepilepsy programs have been operating at Mayo Clinic in Arizona for several years. More than one-third of rural Arizona lacks access to the kind of neurological expertise found in metropolitan areas. Mayo Clinic's program aims to address this disparity by providing support through these programs. With telemedicine technology, use of a specialized remote controlled camera system allows the patient in the rural setting to be "seen" by the neurology specialist — in real time. The Mayo Clinic neurologist, whose face appears on the screen of the monitor, consults with physicians at the rural sites and evaluates the patient via Internet-based computers. "When a community doesn't have ready access to providers trained in the recognition and management of concussion, concussed athletes sometimes go unrecognized or returned to play prematurely potentially subjecting them to more serious injuries," says Bert Vargas, M.D., neurologist and assistant professor of Neurology at Mayo Clinic in Arizona. "Teleconcussion can help triage patients and help identify which people are in need of additional workup or management. In the case of sport-related concussions, this technology can provide rural physicians with assistance in making decisions about when athletes can safely return to play." Click here to hear Dr. Vargas talk about teleconcussion and the case study. Dr. Vargas says that this technology is welcome news for doctors in rural areas, especially in light of the concussion law in Arizona. SB 1521, which was signed into law in 2011, mandates evaluation and clearance athletes with concussions by trained health care providers. "Despite the current culture of increased awareness and recognition of concussions, concussed athletes go unrecognized — even at the professional level," Dr. Vargas adds. "Many professional sports organizations have voiced the need for neurologists to be on the sideline to make rapid authoritative decisions regarding return to play for athletes suspected of having a concussion. Teleconcussion may eventually be a way to address the logistical issues associated with having a neurologist on the sideline of every professional and collegiate level sporting event."

PHOENIX — Mayo Clinic kidney transplant patients were entertained by "American Idol" finalist and Scottsdale resident Scott MacIntyre as they gathered for their annual transplant ...

PHOENIX – It's been said that marriage is good for your health — especially if you're a man. Research at Mayo Clinic in Arizona shows that's true when it comes to seeking care for stroke symptoms. VIDEO: Dr. Lee-Iannotti explains the study. A Mayo Clinic study, presented at the American Stroke Conference in New Orleans in early February, says that men experiencing a stroke call for emergency help quicker than women, especially if they are married. "Marriage has long been shown to offer health benefits and often more for men," said Joyce Lee-Iannotti, M.D., a neurology Fellow at Mayo Clinic in Arizona and author of the study. "The reasons are unclear, but it's been postulated that it can be societal roles, where women take on the roles of caregivers and advise their spouses to seek care, often putting their own health behind that of their children and husband." The study was a retrospective review of 209 patients with acute stroke symptoms brought by emergency medical services to Mayo Clinic in Phoenix over 15 months ending in November 2011. Researchers collected participants' age, gender, marital status, time of symptom awareness and time of emergency medical services dispatch. They compared the time from symptoms awareness to EMS dispatch between married and single participants and between men and women. Married men called within 28 minutes of symptoms compared to married women, who called an average of 67 minutes after their first stroke symptoms. Single men activated EMS earlier than single women, but the difference was not significant. The average age of the patients was 76 years; half were women, half were men. Approximately half were married and about half were single. The researchers found that, overall, the group of married patients called for emergency services more quickly than their single counterparts, but the difference wasn't significant. The researchers plan a future study of the reasons why married men with stroke symptoms seek medical attention earlier. Dr. Lee-Iannotti urges everyone, regardless of gender, to watch for signs and symptoms if you think you or someone else may be having a stroke. Note when signs and symptoms begin, because the length of time they have been present may guide treatment decisions. Signs and symptoms of stroke: Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination. Trouble speaking and understanding. You may experience confusion. You may slur your words or be unable to find the right words to explain what is happening to you (aphasia). Try to repeat a simple sentence. If you can't, you may be having a stroke.

SCOTTSDALE, Ariz. – A new study from Mayo Clinic supports the idea that "what's good for your heart is good for your brain." The study, ...

SCOTTSDALE, Ariz. — Mayo Clinic in Arizona is the first and only clinical center in the Southwest to offer a new treatment that disrupts the ...

PHOENIX — October 22, 2012.  Mayo Clinic in Arizona has received the American Heart Association/American Stroke Association's Get With The Guidelines-Stroke Gold Plus Quality Achievement Award. The award recognizes Mayo Clinic's commitment and success in implementing excellent care for stroke patients, according to evidence-based guidelines. To receive the award, Mayo Clinic achieved of 85 percent or higher adherence to all Get With The Guidelines-Stroke Quality Achievement indicators for two or more consecutive 12-month intervals and achieved 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures, which are reporting initiatives to measure quality of care. These measures include aggressive use of medications, such as antithrombotics, anticoagulation therapy, deep vein thrombosis prophylaxis, cholesterol reducing drugs and smoking cessation, all aimed at reducing death and disability and improving the lives of stroke patients. In addition to the Get With The Guideline-Stroke award Mayo Clinic has also been recognized as a recipient of the association's Target: Stroke Honor Roll, for improving stroke care. Over the past quarter, at least 50 percent of the hospital's eligible ischemic stroke patients have received tissue plasminogen activator, or tPA, within 60 minutes of arriving at the hospital (known as 'door-to-needle' time). A thrombolytic, or clot-busting agent, tPA is the only drug approved by the U.S. Food and Drug Administration for the urgent treatment of ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reverse the effects of stroke and reduce permanent disability. "Mayo Clinic is to be commended for its commitment to implementing standards of care and protocols for treating stroke patients," said Lee H. Schwamm, M.D., chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston. "The full implementation of acute care and secondary prevention recommendations and guidelines is a critical step in saving the lives and improving outcomes of stroke patients." Get With The Guidelines-Stroke uses the "teachable moment," the time soon after a patient has had a stroke, when they are most likely to listen to and follow their healthcare professionals' guidance. Studies demonstrate that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second heart attack or stroke.

PHOENIX — October 1, 2012.  A new Mayo Clinic study confirms the use of smartphones medical images to evaluate stroke patients in remote locations through telemedicine. The study, the first to test the effectiveness of smartphone teleradiology applications in a real-world telestroke network, was recently published in Stroke, a journal of the American Heart Association. "Essentially what this means is that telemedicine can fit in our pockets," says Bart Demaerschalk, M.D., professor of Neurology, and medical director of Mayo Clinic Telestroke. "For patients this means access to expertise in a timely fashion when they need it most, no matter what emergency room they may find themselves." Click here for a video of Dr. Demaerschalk talking about the study. Mayo Clinic was the first medical center in Arizona to do pioneering clinical research to study telemedicine to serve patients with stroke in non-urban settings. Today, Mayo Clinic is the hub in a network of 12 other spoke centers, all but one in Arizona. In telestroke care, the use of telemedicine platforms or robots located in a rural hospital lets a stroke patient be seen in real time by a neurology specialist who typically is working from a desktop or laptop computer in Phoenix. The Mayo Clinic stroke neurologist, whose face appears on a computer screen, consults with emergency room physicians at the rural sites and evaluates the patient. Patients showing signs of stroke can be examined by the neurologist who can also view scans of the patient's brain to detect possible damage from a hemorrhage or blocked artery. If necessary patients can be administered clot-busting medications within the narrow window of time necessary to minimize permanent injury to the brain.The study compared the quality of medical images using a particular smartphone application to the same types of information and images typically viewed via desktop computers. Mayo Clinic neurologists worked with emergency physicians and radiologists at Yuma Regional Medical Center to compare brain scan images from 53 patients who came to that medical center with stroke. The scans were reviewed by radiologists in Yuma and a separate adjudication panel of stroke neurologists to determine the level of agreement between these traditional interpretation routes and new images and scans on smartphones interpreted by telestroke doctors. The study shows there was a high level of agreement (92 to 100 percent) among all the reviewers over the most important radiological features. "Smartphones are ubiquitous, they are everywhere," Dr. Demaerschalk says. "If we can transmit health information securely and simultaneously use the video conferencing capabilities for clinical assessments, we can have telemedicine anywhere, which is essential in a state like Arizona where more than 40 percent of the population doesn't have access to immediate neurologic care."

TUBA CITY, Ariz. — September 24, 2012.  Residents of the largest city in the Navajo Nation in need of emergency medical care for a stroke may benefit from a Mayo Clinic "telestroke" program that will now be available at Tuba City Regional Health Care. A recent agreement between Tuba City Regional Health Care and Mayo Clinic in Arizona means the service will start in Tuba City as early as November. Tuba City is located in north central Arizona within the Painted Desert. Most of the area's population belong to the Navajo and Hopi tribes. "This telestroke partnership between our physicians and Mayo Clinic means our Navajo and Hopi patients can now have immediate high-tech, state of the art stroke care," said Joseph Engelken, CEO of Tuba City Regional Health Care. Mayo Clinic was the first medical center in Arizona to do pioneering clinical research to study telemedicine as a means of serving patients with stroke in non-urban settings, and today serves as the "hub" in a network of 11 other "spoke" centers, all but one in Arizona. Tuba City Regional Health Care will become the 12th hospital to be part of the telestroke service from Mayo Clinic. When Mayo Clinic began its stroke telemedicine program in 2005, statistics revealed that 40 percent of residents in Arizona lived outside an area with immediate stroke expertise. In telestroke care, the use of a telestroke computers located in a rural hospital lets a stroke patient be seen in real time by a neurology specialist at Mayo Clinic located in Phoenix. The Mayo stroke neurologist, whose face appears on a computer screen, consults with emergency room physicians at the rural sites and evaluates the patient. Patients showing signs of stroke can be examined by the neurologist via computer, smart phone technology, portable tablets or laptops. In addition to assessment of the patient, the neurologist can view scans of the patient's brain to detect possible damage from a hemorrhage or blocked artery. A major benefit of the collaboration is that patients with stroke symptoms who meet the criteria can often be administered clot-busting medications within the narrow window of time necessary to minimize permanent injury to the brain. "Excellent, capable emergency physicians at Tuba City Regional Health Care can ring the telestroke hotline and be instantly connected with Mayo Clinic's stroke experts," said Bart Demaerschalk, M.D., Professor of Neurology, and medical director of Mayo Clinic Telestroke. "Urgent and immediate virtual care can be provided to patients — collaboration between stroke neurologists and physicians at the remote sites has resulted in 96 percent accuracy in diagnosing stroke." "Telestroke will enhance the quality of care we provide to our loved ones, by providing them with access to specialists without having to leave their family or home," said Joette Walters, Clinical Education Department Manager who oversees the Telemedicine Program at Tuba City Regional Health Care. "Stoke can be a devastating and life-altering diagnosis, where optimal treatment is contingent on a narrow timeframe, by providing this new service we have the potential to improve quality of life for our loved ones." To date, more than 1,000 emergency consultations for stroke between Mayo Clinic stroke neurologists and physicians at the spoke centers have taken place. Such comprehensive evaluation techniques, leading to appropriate life-saving treatment for stroke, have resulted in significant cost reductions in terms of ground and air ambulance transfer of the patient to another medical center. Dr. Demaerschalk explains that telestroke technology is not intended to replace face-to-face communication with patients. "But our research strongly suggests that the technology can enhance evaluation and treatment for patients in rural areas, as well as peer-to-peer collaboration among physicians," he says.