Investing in the Future of Health Care

It’s been about two years since the launch of OSF Ventures, the corporate venture arm of OSF HealthCare. Since that time, we have made eight investments in medical devices, therapeutics, health services and health IT technologies.

Our health IT portfolio includes precision medicine technology as well as data management and predictive analytics solutions. We are also excited to be a limited partner investor in Ascension Ventures Fund IV.

Why Venture Investing at OSF?

Investing in the Future of Health CareWe are often asked why a health care system like OSF would choose to get into the venture investment business. It’s really about financially supporting new technologies that can improve the health outcomes of those we serve.

It’s about engaging with health care entrepreneurs to provide them meaningful input from the perspective of a health care provider as they bring their product or service to market. It’s about assisting them with resolving the inevitable challenges that disruptive technologies encounter as they migrate from a Research & Development phase and attempt to get traction with customers. This is all done with the spirit of supporting new ways to improve the outcomes of those we serve and the experiences they encounter in their health journey.

We believe we can bring real value to these entrepreneurs as they discover new and exciting ways to assist us in serving patients. Our venture focus is on financially supporting companies that see value in collaborating with OSF clinicians and other professionals. This can include informal mentoring, pilot testing of new technologies in a health care environment and participation in formal clinical trials.

Another focus of our venture program is in identifying new technologies that can reduce costs to health care systems. As has been said by many, the current trajectory of health care costs is simply not sustainable. We believe that in the migration to value-based care, it is imperative to find ways to reduce costs to health care systems and other providers. In our venture diligence process, we are very careful to evaluate not only the ability of the new technology to improve care but also the financial impact to providers. Can it reduce costs compared with the way things are done today?

Recent Investments

We are excited to financially support and partner with InsightRx, a company founded in San Francisco that has developed software to individualize treatment based on a patient’s underlying biological and pharmacological characteristics.

This is particularly important when administering a drug with a narrow therapeutic index where adjustments to the dosage are difficult but very important to achieve the desired outcomes. According to Jerry Storm, Senior Vice President of Pharmacy Services at OSF, “InsightRx will allow pharmacists to efficiently and safely dose patients prescribed high-risk drugs, leading to shortened hospitalizations stays and improved outcomes.”

The Company’s initial work has mostly focused on chemotherapy drugs for children and certain complex antibiotics. OSF will be partnering with InsightRx to expand and improve their offerings.

Our most recent investment is in Regroup Therapy, a Chicago-based provider of behavioral health services using video conferencing technology. According to Cheryl Crowe, Director of Behavioral Health Services for OSF, “Our collaboration with Regroup Therapy will allow our patients significantly greater and timelier access to the professional care they need.”

The investment from OSF Ventures and others has provided the company the capital necessary to expand its offerings and attract new customers.

What’s Next for OSF Ventures

We intend to continue our work of identifying new technologies and services that can improve the outcomes of those we serve and the experiences they encounter in seeking care from OSF.

If you’re interested in learning more about OSF Ventures, please visit www.osfventures.org  Stay tuned for future announcements about new investments by OSF Ventures in companies with new and exciting technologies and how we intend to partner with them to bring value to our patients and their families!

Scoliosis has many faces and just as many treatment options

Scoliosis is one of the most common types of spinal deformity. It’s an abnormal curvature of the spine either front-to-back or side-to-side. Although it sounds scary, a scoliosis diagnosis is not a guaranteed ticket to the operating room for spinal surgery. There are multiple types of scoliosis and a wide range in how they affect people.

For some, scoliosis won’t progress beyond a slight painless curve of the spine, and it won’t ever progress. For others, scoliosis can become so extreme it interferes with lung capacity, or causes extreme pain in the back or legs. Each scoliosis case is unique, so there is no one-size-fits-all treatment.

“Surgery is a last resort”

Because the needs of scoliosis patients can vary widely, OSF HealthCare Illinois Neurological Institute provides a wide range of services. This includes physical therapy, epidurals for pain management, nonsurgical spine specialists and world-class neurosurgeons who specialize in spinal conditions, when all other options are exhausted.

“Surgery is a last resort,” said Daniel Fassett, MD, MBA, a neurosurgeon who specializes in spinal conditions for Illinois Neurological Institute. “In general, staying in as good of shape as possible is the best thing you can do to keep the scoliosis from getting worse and prevent symptoms. However, a lot of spinal conditions are genetic, so even athletes can suffer from scoliosis.”

“When you’re talking about a spinal deformity, you’re looking at a fairly large surgery and there are going to be long-term changes and sacrifices as a result. We’re talking about fusions in most cases, where screws and rods are placed into the spine to hold it in position. There’s loss of flexibility. There’s the possibility of needing more surgery as they age because they could develop arthritis. Or maybe the fusion may not take. A certain area may not heal. Screws and rods could fracture later and life and need revision surgery.”

Not every scoliosis patient with back pain or leg pain is a candidate for surgery. There are many patients for whom spinal surgery would probably not alleviate their pain. Spine surgeons like Dr. Fassett screen patients thoroughly before performing surgery, and they won’t perform a fusion if they think it won’t succeed. They won’t put somebody through a painful surgery and recovery if it won’t lead to a reduction in that person’s pain.

Success rates are higher for patients with sciatica, or nerve pain, than with back pain patients. Surgery to relieve the compression on nerves causes the pain to go away reliably, according to Dr. Fassett. “Whereas with back pain, we will help some patients with back pain but not everyone.”

Managing scoliosis

For people who have scoliosis but suffer from minimal or no symptoms, Dr. Fassett recommends staying in shape, doing posture exercises and working on core strengthening.

If somebody starts having symptoms like back pain or leg pain, treatment options can include physical therapy, like core strengthening and posture work to help with nerve compression, or pain management.

Epidural injections to help with inflammation are common, and so are over-the-counter pain killers for mild to moderate pain. In general, it’s good to catch issues early so a care plan can be developed to prevent or slow the worsening of the condition.

“One thing I see a lot is patients with one leg longer than the other leg,” Dr. Fassett said. “Because of that, their pelvis tilts and their body is forced to develop a curvature to compensate, which results in more arthritis, and it kind of snowballs. If they found the issue earlier in life and wore a shoe lift, it would keep their pelvis symmetric and reduce the risk for scoliosis down the road.”

Scoliosis types

Idiopathic Scoliosis

The scoliosis the public is most familiar with is commonly seen in teenagers. Dr. Fassett believes there are probably some genetic factors that result in it. Basically, as the spine is growing, it starts to develop a curvature, which can increase during the spine growth phase. So if someone is still growing and they have a scoliosis – that needs to be watched closely.

Appearance can be a big concern for idiopathic scoliosis patients. Scoliosis can affect posture, make shoulders uneven, or because the development of a rib hump, where a person’s ribs protrude further on one side of their back than the other.

Congenital Scoliosis

A birth defect can result in a single malformed triangular vertebrae that causes a curvature in the spine.

“You could have a mild curve, and you could just watch it,” Dr. Fassett said. “But if pain develops, then surgery might be an option down the road.”

Neuromuscular Scoliosis

If somebody has a neuromuscular disorder, like cerebral palsy, the muscles may not work the same on both sides of their spine, so they can develop a severe curvature relatively early in life.

“The worry is a lot of the neuromuscular curves can become so severe they contort the rib cage, affecting the chest cavity and resulting in pulmonary changes, like changes in lung capacity. That is one of the main indications that surgery is necessary,” Dr. Fassett said.

Degenerative Scoliosis 

“The one I most commonly see in my practice is called degenerative scoliosis,” Dr. Fassett said. “So as a person ages, arthritis can weaken their joints and result in curvature of the spine.”

Is Continuous Improvement Innovation?

Innovation may appear to be the newest topic for health care, but at OSF HealthCare, innovation has been grounded in our Mission to serve persons in the spirit of Christ, from the very beginning.  Our Sisters modeled innovation for us, from their utilization of a Peoria Journal Star newspaper helicopter for the first “Life-Flight” of a patient to the improvisation of Mission Partners in Escanaba warming a neonate by utilizing steam heat as an incubator.

continuous improvementHave you ever had an idea to improve something in your workplace, but didn’t know how to turn that idea into value for others?  At OSF HealthCare, we enable our Mission Partners to be “continuous innovators” by giving them the tools they need to bring about change for the betterment of our organization and the people we serve.

While innovation can be defined in many different ways, we at OSF define innovation as “The process of translating ideas that align with our vision of transforming health care into value for the benefit of the patients and communities we serve.”  Building a culture of innovation is about instilling a desire to create fundamental change which is becoming increasingly important as we navigate tremendous change in healthcare.

Our Performance Improvement Division, a part of OSF Innovation, leads efforts to nurture concepts that will improve existing products, processes or services. These are ideas we believe will eliminate unnecessary waste and ultimately improve the quality of care.

We refer to this work as core innovation and it’s the bedrock of our vision to transform health care. Our competency in Performance Improvement is an integral part of building the culture of innovation at OSF.

Rapid Improvement Model

OSF Performance Improvement offers Rapid Improvement Model (RIM) training to support the pursuit of continuously improving the organization. RIM projects are strategically selected work initiatives that are capable of being accomplished in a 90-day time frame.

Value of RIM Training:

  • Builds improvement into culture as a core competency
  • Enables breakthrough performance and efficiency in targeted areas
  • Enables operational improvement in department/division metrics
  • Fosters development of leadership competency in performance improvement

Training is offered annually three times a year. Each training session is three days. Content Includes:

  • Leading teams
  • Communicating with Mission Partners
  • Identifying focused problems
  • Evaluating and implementing the right solutions
  • Sustaining the change

Tools and Methodologies include:

  • Change Management (mitigating resistance)
  • Project Management (managing project work to a timeline)
  • Lean
    • Eliminating waste as defined by those we serve by evaluating value and non-value added steps of our processes. This includes evaluating the layout of the work and identifying the standard work processes to ensure consistent value to those we serve.

Employing the RIM to Improve Care: Streamlining the Pre-Operative Testing Process

OSF Saint Anthony Health Center identified that in its current state, patients coming for pre-operative testing had to walk to several areas of the hospital to complete the testing and wait at each step. After an analysis of the initial data, it was determined that the duration of a patient’s appointment actually took 45 minutes, but their current average time at the Medical Center was 2 hours.

Patients were expressing displeasure in the process as tracked by Cardiology Mission Partners. With patient satisfaction as one of our Key Results, they identified an opportunity to impact their scores by streamlining the pre-op testing process and improving the patient experience. Sarah, the Performance Improvement Lead identified through walking this process, it was taking patients 135 minutes and 675 number of steps to complete their pre-operative testing. She and her Team of Mission Partners involved in the process were able to reduce the time it takes to do pre-operative testing to 35 minutes and 346 number of steps!

Achieving Continuous Improvement in 90-days

FOCUS PDCA is:

  • Find an opportunity to improve determined by variation in data collection on key indicators, measures or outcomes
  • Organize a team that is directly involved in and understands the process
  • Clarify team needs to understand the current process so they can analyze it and differentiate the way it actually works and the way it was meant to work
  • Understand the cause of process variation
  • Select the most appropriate solution keeping in mind cost and degree of difficulty to implement
  • Plan by outlining and documenting improvements to be tested
  • Do the small tests of change
  • Check the results of the small test of change (re-work as needed)
  • Act by analyzing improvements made, determining where to apply changes and ensuring continuous monitoring to sustain improvement
    • Utilizing small tests of change we can identify “quick fixes” to accelerate improvements. With incremental and continuous process improvements, it allows us to define and validate the improvement opportunity we have identified.

Improving Quality of Life for Oncology Patients

OSF Saint Anthony Medical Center identified that palliative care services were only offered to inpatients.  Many clinical trials have demonstrated the multitude of benefits that palliative care services can provide for oncology patients, including better symptom management, less depression and anxiety, better communication with care teams, better advance care planning and better quality of life. It can also help ensure that patients are aware of and appropriately referred to hospice care if/when needed. An opportunity was identified to improve the care of Center for Cancer Care (CFCC) patients by providing palliative care in the outpatient oncology setting.

Peggy, the Performance Improvement Lead worked with a team of Mission Partners and developed an implementation plan to ensure patients with breast cancer, head and neck cancer, lung cancer, pancreatic or colon cancer being treated with chemotherapy will be assessed weekly using the ESAS scale tool (a tool used to measure the severity of nine of the most common symptoms of cancer patients on a scale of one to ten)).

The results will be tabulated by the oncology nurse navigators who will report any symptoms over a seven to the attending oncologist. Referral to palliative care will be initiated if the symptoms cannot be resolved by the oncologist. The initial target was 50% of patients meeting the criteria are referred to palliative care and the actual results for Fiscal Year 16 – 1st Quarter 2017 went beyond that target!

Continuous Improvement Leads to Real Change

Is OSF HealthCare including continuous improvement in our culture of innovation?  Most certainly we are by following in the footsteps of our founding Sisters and continuing to improve upon what we’re doing today. Innovation requires courage, competency and culture. Continuous improvement builds the competency to support the culture to lead with courage.

If you are interested in seeing this culture of innovation at work, I invite you to visit our website to learn more about all the ways we are investing in our communities.

No more hobbling around for Pontiac man

Dick Riley hobbled around on a “bad knee” for a couple years before finally deciding to do something about it.

“I just kept putting it off,” the 85-year-old Pontiac man said.

On November 1, 2016, Dick went to see orthopedic surgeon Dr. Jeffrey Lowe with OSF HealthCare Medical Group – Orthopedics in Pontiac.

According to Dr. Lowe, Dick’s initial diagnosis was osteoarthritis of the left knee. He began therapy with a home exercise program, pain medication, over-the-counter anti-inflammatories and intra-articular steroid injections.

“Dick was getting minimal relief from the injections and an MRI of his knee was ordered,” Dr. Lowe said. “The MRI revealed a meniscal tear and it was thought to be contributing to the pain.”

Meniscus tears can happen during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. Tears can be minor (with the meniscus staying connected to the knee) or major (with the meniscus barely attached to the knee by a cartilage thread).

Dr. Lowe recommended Dick undergo a procedure called a knee arthroscopy with partial medial and lateral menisectomy and chondroplasty. That outpatient procedure took place March 1, 2017.

Knee arthroscopy is a minimally-invasive procedure used for conditions of a joint. It uses a small, lighted, optic tube (arthroscope) that is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen. The doctor then removes the damaged tissue, allowing healthy cartilage to grow in its place.

Treated “like a king”

Dick said Dr. Lowe “is about the best doctor I’ve ever seen.”

“He has a good bedside manner. He’s always smiling,” he said. “He just makes you feel at ease. He’s a very good doctor. I recommend him to anybody.”

Having retired from the Army following a 22 1/2-year career, Dick said he and Dr. Lowe connected about the places where he served during his tenure.

“I spent my entire career in the Far East – time in Okinawa and Korea. Dr. Lowe had been to Okinawa, so we got to talking about that,” Dick said.

Dick also appreciated the care he received at OSF HealthCare Saint James – John W. Albrecht Medical Center in Pontiac.

“The nurses and staff in recovery are very good. While I was over at the hospital they treated me just like a king,” he said. “I’ve never ever been treated like that anywhere else. I felt like something special.”

Timing was everything for Irma Barton

Irma Barton has dealt with colitis for about 30 years. She knows when she’s having an episode, due to the type and location of the pain.

Last fall, the 68-year-old Pontiac woman began experiencing severe pain and thought she was having a bout with the colitis.

“It just kept getting worse,” she said.

She finally called her gastroenterologist, who ordered a CT scan of her abdomen in addition to a colonoscopy. Irma’s colon received a clean bill of health, but the CT of her abdomen revealed a large cyst on her right ovary. She was told to contact her gynecologist for follow-up care.

Irma underwent a vaginal ultrasound and it was decided they would just keep a watch on the cyst.

“While we were watching it, I had so much pain I couldn’t stand up some days,” she said.

Because of bleeding ulcers, all Irma could take for the pain was acetaminophen.

“I would be in bed some days from the pain. I couldn’t eat,” she said.

Irma was referred to a specialist in Peoria, but the wait for an appointment was going to be at least a month because it had been determined the cyst was not cancerous.

Immediate care

Irma’s daughter-in-law stepped in and arranged for her to see Dr. Jared Zotz with OSF HealthCare Medical Group – Obstetrics & Gynecology in Pontiac.

“They got me an appointment that next day. I went in to see him and he realized I was in a lot of pain,” Irma said. “He said, ‘You have a pretty good-sized cyst there.’”

She was scheduled for surgery the very next day – November 18, 2016 – due to an opening in Dr. Zotz’s calendar.

“It doesn’t always work out that way, but we just happened to have an opening,” Dr. Zotz said. “Especially if someone is in so much pain, I don’t want to put them off that long.”

Following the surgery at OSF HealthCare Saint James – John W. Albrecht Medical Center in Pontiac, Dr. Zotz told Irma’s husband, Gene, and their kids that he removed her right ovary. The cyst was 6 centimeters and had wrapped around Irma’s colon.

“That’s why I was having so much pain,” she said.

Within two weeks, Irma was back to her normal activities, and she can’t express enough appreciation for Dr. Zotz and his staff.

“He was so kind and so sweet – like I’d known him forever. And all the nurses there were wonderful,” she said. “I can’t say enough good things about my experience there.”