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• On Sound Medicine: Trauma surgeons in Boston, vein filters, and advances in health informatics

On Sound Medicine: Trauma surgeons in Boston, vein filters, and advances in health informatics

• April 25, 2013

INDIANAPOLIS -- The award-winning “Sound Medicine” announces its program for April 28, featuring segments about advancements in health care informatics, vein filters, and why smoking before surgery is hazardous to your health. Please check local listings for broadcast dates, times and stations.

How did trauma surgeons minimize injuries at the Boston Marathon? Three people were killed in the Boston Marathon bombings and more than 200 were injured; 50 people remain hospitalized. Michael Collins, M.D., speaks with "Sound Medicine" about recent developments in trauma surgery that helped in Boston. From the horrific injuries caused by improvised explosive devices in the Afghanistan and Iraq wars, trauma surgeons learned how to better treat lower-extremity wounds like the ones seen in Boston. According to Dr. Collins, having first responders at the scene allowed for faster transportation to medical facilities, which helped save more limbs and lives. He notes that disaster training helps surgeons overcome the shock of injuries caused by tragedies. Dr. Collins is an orthopedic surgeon at Hinsdale Orthopedics and author of “Cold Steel, Hot Lights.”

Why is it important for patients to quit smoking before surgery? Smokers having elective surgery face a slew of potential health problems including wound infection, respiratory failure, prolonged hospital stay and multiple complications after surgery. John Maa, M.D., said surgeons should use the five A’s: Ask patients if they smoke; advise them to quit; assess previous attempts to quit; assist them with nicotine replacement; and arrange a follow-up meeting. The National Health Service policy in Great Britain requires smokers awaiting elective surgery to complete a weeklong smoking cessation program. Most surgeons in the United States do not require patients to attend smoking cessation courses because of competing interests; if smokers don’t want to attend a cessation course, they will simply find another surgeon. Dr. Maa also said mandatory smoking cessation courses could lead to discrimination against smokers and a fear that surgeons would be stigmatizing smokers. Dr. Maa is an assistant adjunct professor of surgery and director of the Surgical Hospitalist Program at the University of California San Francisco.

Do vein filters help or harm? In 2010, the Food and Drug Administration issued a medical alert warning consumers that inferior vena cava vein filters could potentially move or break, causing medical emergencies. Matt Johnson, M.D., is co-chairing a study to measure the safety and efficacy of vein filters over a five-year period. Dr. Johnson spoke with "Sound Medicine" host Barbara Lewis about what vein filters do, how they work and what he hopes to learn throughout his study. The IVC is the biggest vein in the body and transports the blood supply from the legs and abdomen back to the heart. Sometimes blood clots in the legs will break off and travel through the inferior vena cava to the heart, which then filters into the lungs. When the blood clot reaches the lungs, it can block the blood supply and cause a pulmonary embolism. More than 100,000 people die from pulmonary embolisms each year. The study Dr. Johnson is co-chairing follows patients from the first doctor’s visit, to placement of the vein filter, and up to three years post-op. The FDA, the Society of Interventional Radiology and physicians are collaborating to study the effects of vein filters. Dr. Johnson is a professor of radiology and surgery at the Indiana University School of Medicine.

Are hospitals preventing the spread of infectious diseases effectively? Hospital-based infection prevention specialists try to stop the spread of infectious diseases through careful observation of patients' medical records. Brian Dixon, Ph.D., recently conducted a study of the awareness, adoption and use of electronic medical records and health information exchanges among prevention specialists. Dr. Dixon’s study that found many prevention specialists have no say in which system their hospital uses. Although over 80 percent of Indiana’s hospitals have electronic medical records, only 10 percent of hospitals reported being a part of a health information exchange program. According to Dr. Dixon, grants and incentive dollars from the government may be enough to cover the hard costs like machinery, but soft costs such as workflow redesign and training time are simply too expensive. Dr. Dixon is a Regenstrief Institute investigator and an assistant professor of health informatics at the IUPUI School of Informatics.

What is Indiana doing to prevent prescription drug abuse? According to John Finnell, M.D., car accidents used to be the No. 1 cause of death in 18- to 40-year-olds; now it’s prescription drug abuse. To help monitor prescription drug abuse, Indiana is using health information technology to monitor prescriptions. The INSPECT program requires a physician to log in and enter a patient's full name, date of birth and address, and within 10 to 15 minutes the program generates results. A majority of hospital emergency rooms in Indiana now require INSPECT checks for all patients. Wishard Memorial Hospital in Indianapolis is also using a program called Narc Check, which uses algorithms to generate a score physicians can use to predict whether a patient may be abusing prescription drugs. Dr. Finnell is the director and an associate professor of health informatics at the Indiana University School of Informatics.

“Sound Medicine” covers controversial ethics topics, breakthrough research studies and the day-to-day application of recent advancements in medicine. It’s also available via podcast and Stitcher Radio for mobile phones and iPads and posts updates on Facebook and Twitter.

“Sound Medicine,” co-produced by the IU School of Medicine and WFYI Public Radio (90.1 FM) and underwritten in part by Indiana University-Purdue University Indianapolis, is aired on the following Indiana public radio stations: WBSB (Anderson, 89.5 FM), WFIU (Bloomington, 103.7 FM; Columbus, 100.7 FM; Kokomo, 106.1 FM; Terre Haute, 95.1 FM), WNDY (Crawfordsville, 91.3 FM), WVPE (Elkhart/South Bend, 88.1 FM), WNIN (Evansville, 88.3 FM), WBOI (Fort Wayne, 89.1 FM), WFCI (Franklin, 89.5 FM), WBSH (Hagerstown/New Castle, 91.1 FM), WFYI (Indianapolis), WBSW (Marion, 90.9 FM), WBST (Muncie, 92.1 FM), WBSJ (Portland, 91.7 FM), WLPR (Lake County, 89.1 FM) and WBAA (West Lafayette, 101.3 FM).

“Sound Medicine” is also broadcast on these public radio stations across the country: KSKA (Anchorage, Alaska), KTNA (Talkeetna, Alaska), KUHB (Pribilof Islands, Alaska), KUAF (Fayetteville and Fort Smith, Ark.), KIDE (Hoopa Valley, Calif.), KRCC (Colorado Springs, Colo.), KEDM (Monroe, La.), WCMU (Mount Pleasant, Mich.), WCNY and WRVO-1 (Syracuse, N.Y.), KMHA (Four Bears, N.D.), WYSU (Youngstown, Ohio), KPOV (Bend, Ore.) and KEOS (College Station, Texas).