As the original and largest teaching hospital of Harvard Medical School, as well as home to a host of interns, residents, and fellows from around the world, Boston’s own Massachusetts General Hospital has always been in the forefront of technology and innovation. Founded in 1811, and recognized in 1846 as the first hospital in America to perform a successful surgery using ether as an anesthetic, Mass General is known for an impressive series of firsts. Now, Mass General has launched the Institute for Heart, Vascular and Stroke Care, one of the first institutes in the world to integrate cerebrovascular and cardiovascular care.
The Institute is founded on four key pillars, including a fully integrated, personalized clinical care model, extensive educational initiatives, quality and public policy advocacy leadership and supporting programs for both clinical and translational research. By matching patients with a multidisciplinary team of specialists, the Institute concentrates on a patient- and disease-focused care model, which allows for the best possible quality of care while researching and discovering the medicine of the future.
Michael R. Jaff, DO, who serves as Chair for the Institute as well as Medical Director for Mass General’s Vascular Center, explains, “Unlike others before us, the Institute integrates leading cerebrovascular and cardiovascular care today, with the goal of discovering the medicine of tomorrow and improving patient outcomes. Through the Institute we will continue to advance and improve the field of medicine with a cross-disciplinary team and an integrated approach to research and quality patient care. We intend to arm medical practitioners from around the world with the latest research and tools to make positive changes in the diagnosis, treatment and care of patients.”
On September 9, the Institute for Heart, Vascular and Stroke Care invited more than 130 visiting international physicians and their guests, in Boston for the 2013 UIP World Congress, to visit and tour their newest facilities. Upon arrival, the guests were invited to peruse the Paul S. Russell, MD Museum of Medical History and Innovation, partake in a reception, and enjoy some international mingling.
What would be the reaction upon showing off their innovative digs? “I think it’s going to blow their minds!” exclaimed Dr. Jaff, who, along with his colleagues, allowed a sneak peek into the inner workings of their collaborative setup. Hosting the event along with Dr. Jaff were his partners in change—Drs. Julianne Stoughton, Nancy Cantelmo, and Sherry Scovell—experts in vein care, who believe that the integrated approach to patient care is the new standard in diagnosis and treatment of venous disease. “I think that what we have here is a rare opportunity to show the world what we are capable of if we work together to discover the best patient outcomes. It just makes sense,” says Dr. Scovell.
There are no territorial wars here. “This setup allows for what we believe to be the best possible care. We work together with our team every step of the way,” explains Dr. Cantelmo as she takes the first touring group through the nurses’ station and past the ergonomically positioned threesided rooms and data collection desks. She continues, “The focus is on what is best for the patient and that makes us rather unique.”
Although the majority of my experience inside of operating rooms comes from the viewpoint of a patient (and usually in a twilight state), I know enough to say that this truly is the OR of the future. But they don’t call it that mainly because the hospital houses an actual “OR of the Future” (which one can be sure was at least a small part of the inspiration for the new Institute), but also because it is clear they don’t expect to rest upon that which they’ve just completed. They’ve only just begun.
The facility, located in the hospital’s Lunder Building, houses an impressive collection of equipment and technology to better serve the staff, while providing up-to-the-minute data and visuals on the four large screens covering virtually every bit of wall space in each of the procedure rooms. “Almost all of our equipment is mounted on booms from the ceiling, providing ease of use, as well as accessibility from just about every angle,” explains Dr. Stoughton. Custom tables can be positioned and moved to accommodate almost any necessity. They’re still working with the table vendor to better accommodate fewer table transfers and increased uses, such as transport, imaging, procedures, etc., but this is just part of the evolution. Encoded supplies are stored right there in the rooms with identifiers for each and every purpose imaginable, linking directly into the Institute’s main computer system, which records and documents each piece. It seems as though they have thought of everything.
But I wanted to know just how did the idea and subsequent decisions come about to set up the Institute? What is some of the history behind developing a designated multidisciplinary center at Mass General? Dr. Jaff explains, “We had two centers—the Corrigan/Minehan Heart Center and the Vascular Center. It was clear that there were many similarities between patients in both centers, with opportunities to use the power of collaboration to improve the care of our patients with heart, vascular and cerebrovascular disease.”
So, what is the process that allows for the best caregivers to come together in the room? “Healthcare in the United States is shifting from volume-to value, and in our opinion, the only way we can do this is by breaking down the competitive silos of specialists to streamline care, improve the consistency of care, and improve the quality. An institute allows all of this to happen. We have a novel access office that ensures that patients are referred to physicians who are skilled, experienced, and credentialed to care for the specific patient,” says Dr. Jaff. “In addition, we utilize systems to bring specialists together to review cases of complex patients and provide an integrated approach to management.”
Massachusetts General Hospital conducts the largest hospital-based research program in the US. Some of the advances in recent years include the invention of a new optical imaging technique that can provide 3D microscopic views of the inner surfaces of blood vessels and gastrointestinal organs (2006), early prototypes of microchip-based devices to isolate a single cancer cell from a blood sample (2010), and a collaborative effort in developing a brain-computer interface allowing a tetraplegic to control a robot arm through just his thoughts (2012).
Okay, we get it—groundbreaking research and innovation are the cornerstones of Mass General’s legacy, but how do they stay ahead of the pack? “One of our greatest initiatives has been the development of the SPARK Awards,” says Dr. Jaff. “Funded by a generous philanthropic gift from Dr. Jerry Corrigan and Kathy Minehan, we developed a competitive application process based on three basic rules:
1. All applications must represent a multidisciplinary effort.
2. The research, if funded and positive, must be of enough importance that it would be eligible for future funding by NIH/foundations/etc.
3. The research must be original and the application cannot be used to support ongoing projects.
We have now had two rounds of applications and have more than 15 ongoing projects, all of which stand to make real impact on the care of patients with vascular diseases.”
A Working Model
Massachusetts General Hospital clearly takes pride in its new Institute for Vascular, Heart and Stroke Care, and it is certain that this team of vein specialists is positioned to advance venous care well into the next generation, regardless of which discipline they come from. By collaborating from start to finish, this innovative approach to patient care will set the standard for years to come. We can chalk this up as another first for one of the nation’s great institutions.