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Kingston Eye Care Specialists watch over patients’ health

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For Luzerne County visitors bureau, home folks come first

Staci Miller was passing time in a Geisinger Health System waiting room two years ago when a woman with a clipboard approached her.Miller, a 47-year-old mother of four from Kingston, said she was asked whether she&#8217;d be interested in signing up for a genetic research project. She hadn&#8217;t heard of the project, MyCode, but was told all she needed to do was have two extra vials of blood drawn.Miller, who had blood work done regularly anyway, figured, &#8220;Why not?&#8221;Months fell off the calendar. She forgot about her extra blood work.Then, a few days before Christmas, she received a phone call. The results were in. Miller was at risk for breast cancer.Miller&#8217;s results came courtesy of one of the advances in local health care in 2017. Another organization, Wilkes-Barre-based Highmark Blue Cross Blue Shield, is making strides in two projects it says will change incentives for physicians and help patients who are dealing with complex diseases.Commonwealth Health, meanwhile, is touting the technology behind its robotic-assisted surgery program.Ideal placeMyCode got off to a slow start at Danville-based Geisinger Health (<a href="https://www.geisinger.org/" target="_blank">www.geisinger.org</a>).The project uses patients&#8217; DNA to provide clues about what diseases they have or might get. Geisinger researchers study the clues to learn how to improve health and possibly get out in front of diseases before they make people sick.&#8220;The ultimate goal is that we would use the genetic info to help prevent disease,&#8221; Geisinger genetic counselor W. Andrew Faucett said.Faucett, a former employee at the U.S. Centers for Disease Control and Prevention in Atlanta and a genetic counselor for more than three decades, said he joined Geisinger&#8217;s team because of the potential of projects such as MyCode.The project began in 2007 but started to take off only three years ago, Faucett said.&#8220;Before 2014, the project was funded internally and had a limited budget,&#8221; he said. &#8220;Two factors led to a ramp-up of the project. First, the technology improved and the cost of DNA sequencing dropped substantially and, second, our collaboration with Regeneron (Pharmaceuticals, in Eastview, N.Y.) provided additional financial support to enable us to scale up the program.&#8221;Northeastern Pennsylvania is an ideal place for the project because it has a stable population with larger families that tend to live for a long time, Faucett said. For genetics, he said, it&#8217;s important to study multiple generations &#8220;to see how things flow through the family.&#8221;MyCode is a unique project. Geisinger officials said other health care organizations might be using components of the program, but only Geisinger is doing &#8220;the whole package.&#8221;The project is open to all Geisinger patients. To date, more than 140,000 have consented to have their DNA samples taken, Faucett said. The exomes &#8212; the part of our DNA that contains disease-related information &#8212; have been sequenced from more than half. Results were returned to about 300 patients who showed risk for a specific disease, Faucett said.&#8220;We&#8217;re still developing the best ways to interpret genetic info and return it,&#8221; he said. &#8220;That will ramp up more in the future.&#8221;Miller&#8217;s results weren&#8217;t returned immediately because she was part of a research project and not the clinical program, Geisinger officials said.About two months after the results were returned, Miller had an MRI and a mammogram. Miller said the MRI cleared up &#8220;questions&#8221; raised by the mammogram. She next met with three doctors at Geisinger Medical Center in Danville who laid out her options. They ranged from having a double mastectomy to doing nothing at all.Miller said she opted to increase her health screenings. She now rotates getting mammograms and MRIs every six months.&#8220;The concern was always there,&#8221; Miller said, noting breast cancer runs in her family. &#8220;If it wasn&#8217;t for MyCode, I would have been going for just a mammogram but otherwise wouldn&#8217;t have done anything else. I wouldn&#8217;t have known to do anything else.&#8221;Finding meaningGeisinger genetic counselor Marci Schwartz saw Miller after Miller&#8217;s results were returned.&#8220;She is really lovely and super grateful for the information,&#8221; Schwartz said. &#8220;She&#8217;s willing to take action in preventing cancer in her own health care and sharing that with her family so they can use it as well.&#8221;While Miller realized she was at risk for cancer, most patients are caught off guard by the news, Schwartz said. They aren&#8217;t necessarily happy to learn they&#8217;re susceptible to a health problem, but they&#8217;re grateful to find out they can do something about it so that no consequences exist, she said.&#8220;Most patients I&#8217;ve seen find meaning for it in their own way,&#8221; Schwartz said. &#8220;Whether it gives them the opportunity to catch something early or for a child or grandchild to get a heads-up, overall they tend to be happy we told them this info, even if it isn&#8217;t necessarily the best of news. &#8220;Schwartz cautioned patients not to use MyCode as an alternative to clinical testing.She urged those who think they may be at an increased risk for cancer or other diseases to speak with their doctor, noting MyCode is a research project and not a clinical program. They can join MyCode, she said, but their doctor also might want to consider clinical genetic testing or other treatments.Additional information, including consent forms, <a href="https://www.geisinger.edu/en/research/departments-and-centers/genomic-medicine-institute/mycode-health-initiative" target="_blank">can be found on Geisinger&#8217;s website</a> (www.geisinger.org) under the &#8220;research&#8221; tab.Highmark projectsPatients dealing with complicated diseases that might warrant a closer look will get a boost from a new program, according to Dr. Quentin Novinger, Blue Cross&#8217; medical director.Earlier this month, the insurer partnered with benefits provider Best Doctors to provide virtual expert second opinions for Highmark members and their physicians dealing with rare or complex medical conditions, he said.Highmark case mangers collaborate with case managers from Best Doctors, then perform a comprehensive review of a patient&#8217;s medical record. The information is analyzed from multiple angles before the case managers prepare their report, which is shared with the Highmark member and their doctor. Highmark pays for the service, Novinger said.Highmark (<a href="https://www.highmarkblueshield.com/home/" target="_blank">www.highmarkblueshield.com/home</a>) also is making advances for its physicians.The True Performance program rewards physicians based on the value, not the volume of their patients, Novinger said. The program was implemented in January and consolidated seven incentive plans into one.Physicians are traditionally reimbursed by procedure or by visit, he said.&#8220;The more they do it, the more income they have,&#8221; he said. &#8220;We want physicians to take care of our members, but we&#8217;re getting rid of the productivity model and going toward a value model.&#8221;Highmark, Novinger said, is putting up to 30 percent of what a physician is paid into opportunities for them to achieve certain measures and goals, including spending more time with patients.&#8220;Not just Highmark measures, but national measures,&#8221; he said.Enhanced precisionAt Wilkes-Barre General Hospital &#8212; part of the Commonwealth Health network &#8212; robotic-assisted surgery is allowing doctors to tackle the most complex procedures with precision, according to hospital officials.The hospital&#8217;s robotic team includes 14 surgeons representing several specialties, including general, colorectal, urological, thoracic and gynecological surgery, officials said. They perform surgery on the bladder, kidneys, uterus, colon and stomach, for instance, and repair hernias and remove cysts and tumors.Surgeons utilizing robots as an extension of themselves operate through small incisions using a magnified, 3-D vision system and wrist instruments that bend and rotate with greater flexibility than the human hand can, officials said.Patients benefit from faster recovery time, minimal scarring, less pain, and a shorter hospital stay.&#8220;This is an amazing technology that enhances our ability to operate by improving our vision,&#8221; said Dr. Clark Gerhart, director of the General Surgery Epicenter. &#8220;It also allows us better control of the operation because we have four different arms we can control at one time.&#8221;The surgeon views the patient&#8217;s anatomy through a screen and operates hand pieces and foot pedals to control the robot&#8217;s &#8220;hands.&#8221;Because the robot&#8217;s instruments are so small, the system allows surgeons to better reach and navigate hard-to-reach areas of the body.<style>
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<div class="neCaption">Staci Miller, of Kingston, details her experience using Geisinger&#8217;s MyCode health initiative two years ago. MyCode revealed Miller is genetically predisposed to breast cancer. </div></div><div class="metaInfo"><photo0>https://www.timesleader.com/wp-content/uploads/2017/04/web1_TTL043017healthcare.jpg</photo0><caption0>Staci Miller, of Kingston, details her experience using Geisinger&#8217;s MyCode health initiative two years ago. MyCode revealed Miller is genetically predisposed to breast cancer. </caption0><photoCredit0>Sean McKeag | Times Leader </photoCredit0></div></div>
<div class="metaInfo"><subheadMeta></subheadMeta></div><div class="metaInfo"><bylineMeta>By Joe Dolinskyjdolinsky@www.timesleader.com</bylineMeta></div><div class="metaInfo"><shirttailMeta>Reach Joe Dolinsky at 570-991-6110 or on Twitter @JoeDolinskyTL</shirttailMeta></div>

Northeastern Pennsylvania health facilities making strides in key projects