February 2020, Volume XXXIII, No 11
Cannabis use during pregnancy may harm infants
New research published in the Journal of Perinatology states that cannabis exposure during pregnancy could affect infants’ growth and development.
Researchers at HealthPartners Institute, the University of Iowa, and the University of Minnesota analyzed data on 3,435 women receiving prenatal care in the HealthPartners care system over a 21-month period. Urine testing showed that 283 of these women had cannabis in their systems while pregnant.
According to the study, babies born to women who had cannabis in their system during pregnancy were more likely to have their birth weight for age at or below the 10th percentile. Additionally, 9.1% of the babies exposed to cannabis during pregnancy had an abnormal developmental screening at 12 months of age, compared to 3.6% of babies who were not exposed to cannabis during pregnancy.
Although nationwide data show that about 5% of women self-report using marijuana during pregnancy, over 8% of women the researchers studied had a positive urine screen for cannabis during a prenatal visit.
According to the researchers, this could indicate that self-reported figures fail to capture the full scope of fetal cannabis exposure. With the increasing access to cannabis across the nation, some reports suggest that some women are using the drug to self-medicate pregnancy-related nausea.
Elyse Kharbanda, MD, senior investigator at HealthPartners Institute and lead author of the study, says that it’s possible that women may use cannabis when they don’t realize they’re pregnant, they don’t realize how long cannabis can stay in their system, or they may use and don’t report this on surveys due to fear of stigma.
Providers, Helmsley Trust partner to improve cardiac survival rate
The University of Minnesota, The Leona M. and Harry B. Helmsley Charitable Trust, and health care systems across the Twin Cities recently announced the creation of the Minnesota Mobile Resuscitation Consortium (MMRC) and its mobile extracorporeal membrane oxygenation (ECMO) vehicles, a collaborative initiative to treat cardiac arrest as quickly as possible.
The MMRC, made possible by an $18.6 million grant from the Helmsley Charitable Trust, aims to save the lives of cardiac arrest patients in scenarios under which traditional resuscitation efforts have failed.
In December, specially trained teams began serving people across the Twin Cities by using SUVs equipped with the critical life-support equipment. The vehicles meet the patient at participating emergency departments to be placed on ECMO, which eliminates the need for ongoing CPR.
Since the program’s launch, 20 cardiac arrest patients have been served by MMRC SUV response teams across the Twin Cities. The MMRC health care system partners include Fairview Health Services, Regions Hospital (HealthPartners), and North Memorial Health Care System, with contractual partnerships for physician services with Hennepin Healthcare and Lifelink III for clinicians. MMRC is the first program of its kind in the U.S. to serve multiple health care systems.
The MMRC is an extension of the University’s ECMO resuscitation program that started in 2015 under the leadership of Demetri Yannopoulos, director of the Center of Resuscitation Medicine and a professor in the Medical School.
The next phase of the MMRC’s program will include larger mobile ECMO trucks equipped with medical equipment and virtual reality technology to help experts attend to patients remotely. This will allow experts to administer treatment on-site in the vehicle, shortening the time to treatment and broadening the area served by the program.
Other donors are Zoll Medical, Stryker Emergency Care, Getinge Incorporated, and General Electric.
Health system gets top prize in Healthcare Innovation awards
Hennepin Health and Hennepin Healthcare earned first place in the 2020 Innovator Awards Program presented by Healthcare Innovation. The award recognized the team’s work to integrate health care and social services by expanding access to housing navigation, and to reduce the readmission rate for Hennepin Health members who use HCMC for hospital services.
An analysis of 2018 Hennepin Healthcare readmissions data showed higher group readmission rates for Hennepin Health members receiving hospital services at HCMC. It also showed that homelessness was a leading risk factor. In response, the systems collaborated to build a comprehensive, multilayered initiative to address this leading contributor to high health care use. The two organizations:
Participating patients engaged in care management through the first 37 weeks, and no patients were readmitted within 30 days. In addition, social workers helped to house 16% of participants and connect many more to other services.
The program reduced medical costs and improved health outcomes for underserved members. It now also includes Hennepin Health members admitted to Hennepin Healthcare for substance use disorder.
Nicotine treatment may improve outcomes for substance abuse patients
A pilot study conducted by the Minnesota Department of Human Services (DHS) has demonstrated the value of including nicotine treatment as part of treatment for substance use disorders (SUDs).
In 2018, 14% of the state’s adults smoked, compared with 77% of adults in SUD treatment. Nicotine treatment traditionally has not been included as part of SUD treatment, even though tobacco-related illnesses claim more than eight times as many lives as alcohol and drug use.
DHS conducted its nicotine treatment pilot study at three substance use disorder treatment programs. The goal was for the programs to treat their clients’ nicotine dependence as they would any other chemical addiction. The study found:
The treatment programs that participated in the pilot were CentraCare/Recovery Plus in St. Cloud, Park Avenue Center, and Wayside Recovery Center. The nicotine treatment they offered included counseling sessions and individual treatment plans. They also provided nicotine patches, gum, lozenges, and medications to help people stop smoking. The pilot ran from February 2018 through June 2019. All three sites continue to offer nicotine treatment as a part of their SUD treatment programming.
Hospital recognized for inpatient mental health services
CentraCare–St. Cloud Hospital recently was awarded Platinum designation by Optum for its care provided to mental health inpatients. The Platinum designation—the award’s highest level of achievement—recognizes that the hospital’s inpatient mental health units met or exceeded Optum’s effectiveness metrics and efficiency criteria. Platinum distinction demonstrates shorter stay (without compromising outcomes), lower cost, better care with less practice variability, and better follow-up rates that lessen the chance of relapse and readmissions.
St. Cloud Hospital has received this award annually since 2015.
The award is based on clinical data collected by Optum during the course of an entire year. Optum looked at specific criteria, such as readmission rates and average length of inpatient stay, comparing St. Cloud Hospital’s data to that of other regionally based facilities.
Rural breast cancer patients travel long distances for treatment
The closing of rural hospitals and specialty care units is causing many people, including breast cancer patients, to seek treatment far from home. A study from the University of Minnesota School of Public Health recently found that U.S. rural breast cancer patients typically travel three times farther than urban women for radiation therapy to treat their disease.
The study, led by PhD student Colleen Longacre, appeared in The Journal of Rural Health.
Longacre looked at Medicare data from more than 52,000 women diagnosed with breast cancer between 2004 and 2013. The data was used to determine where the women lived and the distance to the facility where they received radiation therapy.
The study found that patients living in rural areas traveled, on average, nearly three times as far as woman living in urban areas for radiation treatment, and that the nearest radiation facility for rural women was, on average, four times farther away than for urban women.
“Radiation treatment is not just a one-time thing,” said Longacre. “Conventional radiotherapy requires treatment five days per week for 5–7 weeks at a time. This means that the average rural woman logs more than 2,000 miles of travel over the course of treatment.”
The study also found that:
Diana Cutts, MD, has been appointed chair of pediatrics at Hennepin Healthcare. Dr. Cutts joined the Department of Pediatrics as a staff pediatrician and medical director of the Growth and Nutrition Clinic. She is the pediatric consultant to the Mother-Baby Program/Redleaf Center for Family Healing, and has served as the director of the department’s Office of Pediatric Research and Advocacy since 1998. She had been assistant chief of pediatrics for 11 years.
Patrick Courneya, MD, has rejoined HealthPartners in a new role as chief health plan medical officer. He had previously served as medical director and associate medical director for the organization’s health plan. His return to HealthPartners follows six years at Kaiser Permanente as executive vice president and chief medical officer for national health plan and hospital quality.
Rahul Koranne, MD, MBA, FACP, has been named president and CEO of the Minnesota Hospital Association (MHA). Dr. Koranne had served previously as senior vice president of medical affairs and chief medical officer at MHA, and was a vice president with HealthEast Care System. Since 2008, he has served on multiple committees and task forces at both the state and national levels.
Yan Dong, MD, has joined St. Luke’s Cardiology Associates. Dr. Dong completed a cardiovascular fellowship at Case Western Reserve University MetroHealth Medical Center in Cleveland, Ohio, as well as an electrophysiology fellowship at Stanford University in Stanford, California. She is board-certified in cardiology, internal medicine, and electrophysiology.
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