A summary of news and clinical information for members of the Partners International Physician NetworkTM

What's New

• MGH and Partners Support Inauguration of CEDIMAT
  
  Realizing the vision of pioneering MGH physician, Dr. Juan Taveras, the Centro de Diagnóstico, Medicina Avanzada, Laboratorio y Telemedicina (CEDIMAT) was formally inaugurated March 17 in Santo Domingo, Dominican Republic. CEDIMAT is the technological centerpiece of the largest medical center in the Dominican Republic - Plaza de la Salud - a major medical campus championed by Dr. Taveras in an unprecedented endeavor to raise the quality of medical care on the island. Dr. Taveras was supported in his efforts to establish Plaza de la Salud and CEDIMAT by former President of the Dominican Republic Joaquín Balaguer. CEDIMAT is equipped with the latest diagnostic technology in imaging and nuclear medicine, and includes a separate telemedicine facility that will link Plaza de la Salud to the MGH for patient consultations, medical conferences and educational events.

  The inauguration was attended by current Dominican President Leonel Fernández Reyna, Cardinal Nicolás López Rodríguez, President of the Board of Directors of CEDIMAT, Ing. Heriberto De castro, President of the General, Maternity and Infants Hospital at Plaza de la Salud, and other dignitaries in government and industry. Mr. David Jones and Mr. Edwin McCarthy attended the event on behalf of MGH and Partners HealthCare System. The event included a teleconference in which Dr. Taveras led a discussion between President Fernández and other Dominican officials, and Dr. James Mongan, President of MGH, Dr. Robert Colvin, Chief of Pathology at MGH and Dr. James Thrall, Chief of Radiology at MGH.

  Cooperation between Plaza de la Salud, the MGH and eventually other Partners hospitals, will include weekly teleconference links to the Radiology-Pathology conference; patient consultations for complex diseases; patient referrals; and visiting faculty between Santo Domingo and Boston. Dr. Taveras, Professor Emeritus at Harvard Medical School and former Chief of Radiology at MGH, plans to devote an increasing amount of his time to helping the Plaza de la Salud institutions develop into first class medical facilities

• Operating room of the 21st Century Here Today
  
  Since 1994, BWH surgeons and interventional radiologists have been working inside the world's first Intra-operative Magnetic Resonance Imaging system to perform invasive procedures. The new system represents "a profound change in our ability to see during invasive procedures," according to Ferenc Jolesz, MD, its originator and director of the Image-Guided Therapy Program in the Department of Radiology at BWH. "For patients, therapies can be more accurately planned, less invasive, less painful - and as a result, more successful." The machine was developed in partnership with General Electric. To develop an open machine capable of generating a uniform magnetic field, GE developed two super-conducting magnets, using a new type of conducting material. Every piece of equipment had to be made from non-magnetic materials so they would not fly into the magnets or distort the imaging field. Doctors produce images using tools mounted with two tiny light sources. At the top of the machine is a sensor that follows the light source. Images displayed on the monitor show the orientation of the tool and its target, such as a tumor. "Wherever you put your tool," explains Jolesz, "the computer gives you the image of what's underneath."

  The Intra-operative MRI has been used in several hundred brain tumor surgeries. "Intra-operative MRI allows us to maneuver precisely within the brain," says Neurosurgeon-in-Chief Peter Black, MD, PhD

  Surgeons and interventional radiologists are also using the machine to perform biopsies; implant radioactive seeds for prostate cancer patients; non-surgically ablate breast, liver and other soft tissue malignancies; and conduct dynamic imaging of brain lesions.

• WorldCare Enters Venezuela
  
  WorldCare, the world's leading telemedicine company, continued its expansion into Latin America by launching WorldCare-Venezuela in March. The occasion was marked by a press teleconference between Caracas and members of the WorldCare consortium hospitals.

  Dr. James Thrall, Chief of Radiology at MGH, participated in the four-point telecast and lauded WorldCare's efforts to "make access to state-of-the-art medical care affordable and accessible to millions of persons in Venezuela and around the world."

  WorldCare's Venezuelan partner is General de Seguros, one of the largest and most prestigious health insurance companies in the Andean Region. Mr. Andres B. Capriles, President of WorldCare Venezuela, and a principal of General de Seguros, emphasized that "Venezuelans can now have the world's leading physicians provide expert medical advice, usually within 48 hours."

  The Massachusetts General Hospital is the leading provider of patient consultations for WorldCare. Brigham and Women's Hospital recently joined the WorldCare consortium and is now providing second opinion services to patients in WorldCare's markets.

• Partners "One Stop Shopping" For Clinical Research
  
  The Clinical Research Program at MGH and The Clinical Trials Program at BWH offer "one-stop shopping" for investigators, industrial sponsors, and patients interested in advanced clinical research, by providing access to:
  • clinical studies in varied therapeutic areas
  • top investigators and thought leaders
  • skilled study coordinators
  • state-of-the-art facilities
  • large and well-characterized patient populations

  For more information on the MGH program visit the CRnet website at http://www.massgeneral.org/crp/. Or contact the program by phone (617-726-5500) or by email: clinicalresearch@mgh.harvard.edu.

  For more information on the BWH program visit the website at http://research.bwh.harvard.edu/ctcpage.htm or contact the program by phone (617-732-8100).

• Harvard Medical Holds Alternative Medicine Conference in S. Korea
  
  On July 2nd and 3rd, the Second International Symposium, Scientific Integration of Western Medicine and Complementary/Alternative Medicine & Mind/Body Medicine will be held in Seoul, Korea. The symposium, sponsored by Harvard Medical International/Harvard Medical School and Asan Medical Center/University of Ulsan College in Seoul, will assess the standing of complementary and alternative medicine (CAM) within the US as well as examine the influence of CAM on western scientific medicine. Featured speakers will include: Joseph Martin, Dean of the Harvard Faculty of Medicine; William Harlan, Acting Director, Center for Alternative Medicine, National Institutes of Health; Kenneth Shine, President, Institute of Medicine, National Academy of Sciences; and Col. Brian Schuster, Assoc. Director, Walter Reed Army Institute of Research. Contact Ms. Byung Hee Min, Office for International Relations, Asan Medical Center by fax at 011-82-2-2224 5255 or email at bhmin@www.amc.seoul.kr.

Patient Services

• Airport Assistance for International Visitors
  
  At a press conference April 1st Peter Blute, Executive Director and CEO of Boston-Logan Airport, announced a new program to assist international patients arriving and departing from Logan Airport. MGH President James Mongan, MD and BWH Director of Access Services Chris Collins attended the event. The new program was created to accommodate the special needs of international patients, including:
  • Personal escorts to meet patients at their gate,
  • Help retrieving and carrying luggage,
  • Assistance getting through U.S. Customs and Immigration,
  • Assistance finding airport services and shops,
  • Interpreter services for 24 languages,
  • Transportation coordination to the hospital or hotel.

Patients interested in airport assistance should contact their International Coordinator (see back page for contact information).

 

• "Centers of Excellence" Reference Materials Now Available
  
  Partners has developed a reference notebook on selected clinical areas of excellence at BWH, MGH and Dana-Farber/Partners CancerCare. While the Partners hospitals offer world class medical care in every specialty of medicine and surgery, the notebook summarizes information on the services which international patients most frequently use. The first edition of the Partners Centers of Excellence notebook includes information on diagnosis, treatment approaches, innovative technologies, and referral information for adult oncology (12 disease areas), cardiology & cardiac surgery, general surgery (8 subspecialties), neurosurgery and telemedicine.

  To obtain a free copy of this resource, contact the Partners International Program (see back page).

Clinical Focus:

• Telemedicine
  
  Today, clinicians worldwide have immediate and continuous access to the most advanced medical support through the Partners Telemedicine Center. By broadening communication among clinicians, Partners Telemedicine fosters more uniform and effective approaches to health care delivery.

  Partners Telemedicine offers the following services:

  • Remote clinical consultations (48 hour turnaround, 24 hr. in emergencies)
  • Subscription access to Grand Rounds by videolink
  • Custom medical education programs by videolink
  • Consulting services to set up and launch tele- medicine networks.

   

• Remote Monitoring of Breast Cancer Patients
  
  Under the direction of Yvedt Matory, MD, a surgical oncologist at the BWH, patients who have breast cancer and who are scheduled for either mastectomy or breast conserving therapy (including axillary node dissection) will be asked to participate in this post-surgical monitoring study. They will participate in scheduled visits from home through a laptop computer with videoconferencing capability, and will have access to disease-specific information through the computer. The study will examine quality assurance, patient satisfaction, and cost savings due to shorter hospital stays. This study is being followed carefully by Partners affiliates as well as third party payers.

• Teledermatology
  
  A World-Wide-Web-based tool and database was developed by Partners Telemedicine for users to submit, archive, and retrieve digital dermatological images and patient information from remote locations.

  This tool enables primary care doctors and specialists to consult before initiating a referral, thereby saving time and money.

  Patients participating in a pilot study were comfortable with this new care delivery method and the teledermatologists were able to make a diagnosis for a high percentage of the patients who presented. Physicians found it convenient and provided more diagnostic certainty than conventional methods. Following this study, physician groups affiliated with Partners were offered teledermatologic services. To date, many groups representing Partners 200,000 insured lives have expressed interest in contracting for teledermatologic services on a sub-capitated basis. Use of a Web browser means teledermatology can be practiced any place on the globe. For example, Partners Telemedicine is consulting with a major oil company in the Middle East to offer teledermatology via an internal network to their 60,000 employees.

• Telemedicine Success Stories
  
  At its best, telemedicine can clarify an uncertain diagnosis, identify innovative treatments, avoid unnecessary treatment costs, and give patients and families peace of mind.

  A seven-year-old Turkish boy had broken his hip as a result of a minor playground fall. MGH orthopedic specialists reviewed X-rays transmitted over the Internet by doctors in Istanbul and diagnosed a tumor. A special surgery not available in Turkey was recommended. Two days later the child and his parents arrived in Boston and had the tumor successfully treated.

  A four-year-old girl in Argentina was born with severe hearing loss. Her parents wanted to know if there was an operation anywhere in the world that would cure her deafness. Through their physician in Buenos Aires, Dr. Ruben Zito, the family participated in a videoconference with Dr. Roland Eavey at the MGH. Dr. Eavey explained that no corrective surgery currently exists, but provided information on the latest hearing aids and special resources for hearing-impaired children. Despite learning there was no cure for their daughter, the parents were grateful and relieved to know they had exhausted all possibilities and could focus on helping their daughter adapt to her disability.

  A patient in Belgium was diagnosed with lung cancer and told nothing could be done for him. A friend of the patient suggested he contact the Partners Telemedicine program for a second opinion. The Telemedicine Center arranged a consultation with a leading specialist who recommended a viable course of treatment. The patient received chemotherapy, radiation therapy and surgery in Boston and has had three post-surgical evaluations that show no recurrence of cancer to date.

Appointments and financial arrangements for international patients can be made by contacting:

Brigham and Women’s Hospital: Ms. Kerin Howard 01 (617) 732-5777 Email: khoward@partners.org	Massachusetts General Hospital: Ms. Leila Carbunari 01 (617) 726-2787 Email: lcarbunari@partners.org
Dana-Farber/Partners CancerCare: Ms. Nancy Crehan 01 (617) 632-3513 Email: ncrehan@partners.org	To obtain a remote patient management consultation or second opinion please contact: Partners Telemedicine: Ms. Kathy Fiamma 01 (617) 726-1051 Email: kfiamma@partners.org

To receive copies of The International Bulletin by mail contact us at:

Phone: 01 (617) 724-6420; fax 01 (617) 724-3801
Email: partnersinternational@partners.org