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 Dear Colleagues:
As I compose this note, I am watching the snow fall on our campus. I had never lived in the Midwest before and our most recent home before moving here was Seattle, a place that rarely sees a white winter. Now, as my wife Jeannie and I begin our fifth year in Madison, we have both come to embrace Wisconsin’s four wonderful seasons. With the snows also come the holidays and a new year, providing opportunities for us all to reflect on our past and look toward the future.
As I look back on the last twelve months, I am tremendously proud of the achievements of the many and diverse members of our Department of Medicine. The individual accomplishments are too many to mention here, but I am thankful that this year, through Vital Signs, we have been “getting the word out” about our efforts and our triumphs in clinical care, education and research. As many of you will recall, Vital Signs was a direct result of our strategic plan. We are making progress in each of the priorities that we established in forming this plan, and there is exciting work still to be done. We face unique challenges and opportunities in 2014, and I’m confident that we are up to the tasks at hand.
As the year draws to a close, I want to thank every member of the Department of Medicine for all you have done over the last year. Our patients and our department have seen the benefits of your care and your accomplishments in education and research. Best wishes to you and your families for the Holiday Season and for a Happy New Year.
Warm regards,
Rick
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Emergency Medicine: From Division to Department
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The Department of Medicine wishes Emergency Medicine well on its transition to a department. The following news release was issued Wednesday, December 18.
MADISON - The University of Wisconsin School of Medicine and Public Health (SMPH) Division of Emergency Medicine will evolve into an independent academic department on July 1, 2014. Emergency medicine is currently a division in the Department of Medicine. University of Wisconsin-Madison Provost and Vice Chancellor for Academic Affairs Paul DeLuca approved the SMPH proposal.
Departmental status acknowledges the great transformation the emergency medicine faculty has spearheaded in transitioning the program from a clinical service to one that incorporates teaching, research, and other community service activities.
“One of the many benefits of creating a department is the positive impact on the recruitment and retention of the very best faculty and residents,” said Dr. Robert Golden, dean of the School of Medicine and Public Health. “This in turn will benefit our state, since so many of the graduates of the residency training program will continue to practice in Wisconsin.” (MORE)
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Park Street Campus Nuclear Cardiology Lab Receives Accreditation
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Heart and Vascular Care’s Nuclear Cardiology Lab located on UW Health’s Park Street Campus (202 S. Park Street) has been granted a three-year term of accreditation in nuclear cardiology by the Intersocietal Accreditation Commission (IAC).
Accreditation by the IAC means that the lab has undergone a thorough review of its operational and technical components by a panel of experts. The IAC grants accreditation only to those facilities that are found to provide quality patient care in compliance with national standards through a comprehensive application process including detailed case study review.
IAC accreditation is a “seal of approval” that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of nuclear cardiology.
IAC accreditation is widely respected within the medical community, as illustrated by the support of the national medical societies related to nuclear cardiology, which includes physicians, technologists, and medical physicists. Nuclear/PET accreditation is required by the Centers for Medicare and Medicaid Services (CMS) and in some cases private insurers.
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For those residents going after fellowships, it was a great match day for our Department of Medicine graduates as they move into top fellowship slots across the country.
Class of 2014:
Paulina Czapiga - Gastroenterology and Hepatology, University of Wisconsin
Sverrir Gunnarsson - Cardiovascular Medicine, University of Wisconsin
Nick Kim - Gastroenterology and Hepatology, University of Kansas
David Kosoff - Hematology/Oncology, University of Wisconsin
Matt Louie - Hospice Palliative Care, University of Wisconsin
Noreen Murphy - Pulmonary Critical Care, University Illinois-Chicago
Bhavisha Patel - Allergy, Mayo Clinic
Nicole Reilly - Cardiovascular Medicine, University of Wisconsin
Chris Saddler - Infectious Disease, University of Wisconsin
April Zehm - Hospice Palliative Care, Massachusetts General Hospital
Class of 2013 (matching this year):
Elizabeth Duke - Infectious Disease, University of Washington
Jacky Kehler - Pulmonary Critical Care, Northwestern University
Ravi Patel - Gastroenterology and Hepatology, University of Wisconsin
Janet Retseck - Hematology and Medical Oncology, University of Pittsburgh Medical Center
Lyndsey Runaas - Hematology and Medical Oncology, University of Michigan
In addition, the accredited fellowship programs across the Department of Medicine recently matched all fellowship spots open for 2014. The divisions are very pleased with the match results this year and have excellent sub-speciality programs.
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Electrocardiograms Go Electronic
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University of Wisconsin Hospital and Clinics’ and American Family Children’s Hospital electrocardiograms (ECGs or EKGs) went electronic this December with the activation of the new GE-Marquette ECG system. “We do well over 50,000 ECGs per year so this is a major step forward. We are not quite completely paperless but this is a goal.” said Craig January, MD, PhD, Professor, Cardiovascular Medicine and Director of the Heart Station.
When an ECG is performed on a patient, the ECG cart provides a computer-generated analysis of the tracing and sends it to the GE MUSE Heart Station computer where it is accessed by cardiovascular medicine faculty through HealthLink. This preliminary ECG tracing can also be viewed electronically on the ECG cart and the ECG technician can print a copy for the ordering service. In HealthLink, faculty can edit and confirm the preliminary computer interpretation and electronically compare it to the previous ECG (or several previous ECGs).
What are the advantages of the new GE-Marquette ECG system?
- It is widely used in the U.S. and its ECG analysis software is considered to be more accurate than others.
- The new system has the potential to speed up the ECG analysis process. This is particularly valuable at UWHC where the vast majority of ECGs are abnormal, reflecting the patient populations for whom we provide care.
- Because there are fewer steps in the ECG interpretation process, including removal of hand written analyses, the error rate in transcribing the final confirmed ECG should be minimal, to also improve patient care.
- The amount of paper usage should decline by at least 80 percent.
- This GE-MUSE Heart Station computer system now handles both ECGs as well as the ECG component of stress tests. Future advances at UWHC are planned that will allow the GE-MUSE system to receive data from patient bedside monitors and from ambulatory monitoring devices to provide more unified ECG and arrhythmia monitoring services for our patients.
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The Weather Outside is Frightful—What to Do?
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At this time of year, employees, new and old, often wonder how to deal with inclement weather. The weather guidelines for SMPH employees of UW-Madison’s inclement weather guidelines are listed on the university’s website.
Some highlights of the guidelines include:
- Only the Chancellor has the authority to cancel classes, suspend services, and close the campus to the public and employees. Individual colleges and schools will not close unless the whole campus is closed.
- Employees should be advised to use discretion regarding their health and safety and that of family members, but they are required to use appropriate leave (i.e., vacation, personal holiday) or arrange to make up time to cover any absences. Unit practices for employee absences should be followed. Supervisors are advised to be flexible, if operationally possible, in their approval of employee-requested leave in inclement weather situations.
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Policy Change in HealthLink Access
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Effective January 1, 2014, UW School of Medicine and Public Health (UWSMPH), UW Medical Foundation (UWMF), and UW Hospital and Clinics (UWHC) will put in place a UW Health-wide policy which permits employees to use their HealthLink login ID only for work-related purposes and to access their own personal medical records. Employees WILL NOT be permitted to access the medical records of family members (including their children of any age) or other individuals through HealthLink, even if authorization for such access is provided by the family member or other individual. All patients, including employees, are encouraged to access medical records via MyChart and may also obtain electronic (DVD) or paper copies of their medical records by submitting appropriate authorizations to the Health Information Management Department.
Historically, SMPH, UWMF, and UWHC maintained inconsistent policies regarding personal access to medical records directly in HealthLink. This new policy is simple and applies uniformly across all of UW Health. Only those employees whose job duties require access to medical records have such access. Use of your HealthLink login ID to access any records other than those you need to access to perform your job, or to access your own records, will result in discipline and may also result in penalties under federal and state laws.
Remember: You must secure your workstation and HealthLink sessions when not in use, and you may not share your HealthLink login ID. You will be held responsible for access to records made using your login ID and password.
Ensuring the privacy of all patient medical records – including those of the many patients who also are our employees – is a high priority across UW Health. If you have any questions about this policy, please contact the appropriate privacy officer/coordinator, listed below:
- Rebecca Hutton, UW-Madison Privacy Officer, rchutton@wisc.edu, 890-3941
- Amanda K. Reese, UWMF Privacy Officer, amanda.reese@uwmf.wisc.edu, 821-4101
- Daniel J. Weissburg, UWHC Privacy Officer DWeissburg@uwhealth.org, 203-4631
If you have questions about using MyChart to access your own or others’ medical records (via a proxy process), please access the UW Health website.
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Silver Tsunami and Alzheimer’s resources
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 Kathleen Walsh, MD, assistant professor, Geriatrics, was recently quoted in a story that has had widespread appeal to many parts of Wisconsin. The story titled “Silver tsunami: Aging population sparks concern about Alzheimer’s resources” talks about a family’s struggles with the lack of information and resources available to children taking care of their elderly parents. The article was picked up by the Green Bay Press Gazette, Stevens Point Journal, Fond du Lac Reporter, Appleton Post Crescent, Wausau Daily Herald, and Wisconsin Rapids Tribune.
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Faint and Fall Clinic Helps Christmas Tree Farmer
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After a couple of fainting episodes, a Waunakee Christmas tree farmer was referred to the Faint and Fall Clinic at UW Hospital and Clinics. Mohamed Hamdan, MD, Chief of Cardiovascular Medicine, talks about the streamlined model of the Faint and Fall Clinic and how it brings the specialists to the patient. See the full story on WMSN Fox 47.
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A recent patient comment from Endocrinology: "Dr. Shenker has been exceptional not only in terms of his expert knowledge but certainly in his personal follow-up with the logistical details of my unique situation. I feel I am getting the best possible care available!"
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 December 27, 2013
No Grand Rounds due to the Holiday.
 January 3, 2014
"Quality Care in Inflammatory Bowel Disease"
Freddy Caldera, DO
Assistant Professor (CHS)
Division of Gastroenterology & Hepatology
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Nephrology Awards Excellence
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Nephrology presented several awards during their holiday party on December 8, 2013. Each year they give an award for excellence in the areas of: Teaching, Clinical, Research and Fellowship.
The winners for the Nephrology Excellence Awards for 2013 are:
Teaching Excellence Award - Jesse Roach, MD
Clinical Excellence Award - Maha Mohamed, MD
Research Excellence Award - Nancy Wilson Schlei, PhD
Fellowship Excellence Award - Muhammad Chaudhry, MD
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Chan on CJASN Editorial Board
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 Micah Chan, MD, MPH, assistant professor, Nephrology, has been accepted to the editorial board of the Clinical Journal of the American Society of Nephrology (CJASN).
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Last Vital Signs I announced the publication of Dr. Peter Rahko’s new book, Heart Failure: A Case-Based Approach, and listed several Department of Medicine authors included in the book. However, I missed three authors. Those include:
David Murray, MD, Associate Professor of Medicine in Cardiovascular Medicine
Maryl Johnson, MD, Professor of Medicine in CVM
Walter Kao, MD, Associate Professor of Medicine in CVM
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Hughes-Hallett T, Murray S, Cleary J, Grant L, Harding R, Jadad A, Steedman M, Taylor K. Dying healed: transforming end-of-life care through innovation. World Innovation Summit for Health End-of-Life Care Report 2013.
Paul Olson TJ, Hadac JN, Sievers C, Leystra AA, Deming DA, Zahm CD, Albrecht DM, Nomura A, Nettekoven LA, Plesh LK, Clipson L, Sullivan R, Newton MA, Schelman WR, Halberg RB. Dynamic Tumor Growth Patterns in a Novel Murine Model of Colorectal Cancer. Cancer Prev Res (Phila). 2013 Nov 6. [Epub ahead of print]
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New Department of Medicine Emeritus Faculty
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 John Schilling, MD, clinical professor, Pulmonary and Critical Care, will retire from the Department of Medicine, on December 31, 2013. Dr. Schilling leaves his position after a remarkable career of service to patients, medical learners, and the field of pulmonary and critical care medicine. He earned his medical degree from Washington University, St. Louis, Missouri in 1976, then trained at the University of Iowa Hospital and Clinics in Internal Medicine (1976-79) and Pulmonary (1979-81). In 1981, he joined the University of Wisconsin faculty and established a thriving clinical practice at Meriter Hospital. (MORE)
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New Department of Medicine Faculty
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New faculty will be listed after their photos are available.
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 Kraig Kumfer, MD, PhD
Hospital Medicine
Clinical Instructor
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Antibiotic resistance is a rising public health challenge that is gaining momentum in the popular press. We asked an expert in Infectious Diesase, Alex Lepak, MD, to comment on a recent NY Times article on this topic.
The New York Times article “Antibiotic-resistant infections lead to 23,000 deaths a year, CDC finds” provides worthy coverage of the recently released CDC Threat Report 2013. The headline-grabbing statistic is only one of many embedded in the CDC report, which provides a rather conservative but important examination of antibiotic resistance and its consequences. Over two million Americans are infected yearly with a drug-resistant pathogen. These infections result in 20 billion dollars of direct, additional healthcare costs and another 25 billion dollars in lost productivity. The report also includes chilling statistics on C. difficile infection, which they acknowledge is not a drug-resistant pathogen but a consequence of inappropriate antibiotic use. C. difficile accounts for 250,000 illnesses and at least 14,000 deaths annually.
The Times article reflects a shift in the lay press coverage from MRSA to CRE (carbapenem resistant Enterobacteriacea). It highlights the fact that CREs are relatively rare, resulting in 600 deaths annually, but that they are a looming and more serious threat than MRSA due to broader antimicrobial resistance, continued rise in infection rates (unlike MRSA which has decreased recently), and most importantly more severe outcomes. Outcome data are discouraging with reports of mortality exceeding 50 percent in patients with blood stream infection. Unfortunately, we cannot expect novel therapies to eradicate these infections any time soon. There was only a single new drug application for an antibiotic submitted to the FDA between 2010 and 2012, and the pipeline does not hold any novel therapeutic targets in the near future.
The good news for UW Health is that only one confirmed case of CRE has occurred here. Our relatively low rates compared with other large Midwest referral centers is likely due to aggressive infection control practices and the maintenance of an active, real-time antimicrobial stewardship program including antibiotic restriction. These systems will continue to play a vital role in limiting the spread of antibiotic resistance.
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We want to hear from you!
Please email us at marketing@medicine.wisc.edu and share information about your community service/outreach efforts, grants awarded, papers published, accomplishments in education and clinical work, or anything else which you are proud or think would be of interest to your colleagues.
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