Changes in medical technology occur so rapidly that healing professionals are compelled to update their knowledge and training just to stay current. Meanwhile, the rest of us amble on with a pedestrian vocabulary of medical procedures until something happens, like an illness or a physical breakdown. It might suddenly seem that amazing new diagnostic instruments are available, that outpatient services have been drastically expanded, and our basic understanding of medical terms is lagging. A brief survey of what’s new is in order.
Digital Imaging
Medical practitioners and facilities of the Hudson Valley region offer some of the best in medical technological advancements. Many area dentists are now using Diagnodent lasers and intraoral cameras to augment digital X-ray appliances, for example. Digital imaging not only minimizes radiation exposure due to the fewer number of images taken, but also offers the advantage of easily stored and retrieved patient images for reference and transfer purposes. Most medical facilities have converted to digital imaging as a regular practice in lieu of film radiographs. Certainly digital mammography is faster, safer, and more precise in terms of deciphering exactly what is seen on a patient’s image. When a radiologist can zoom in and enhance a picture—and do it almost instantly—a patient’s results can be determined immediately and with greater accuracy.
In Kingston, the consolidation of the Fern Feldman Anolick Breast Center at Benedictine Hospital and The Greenspan Center for Women’s Health at Kingston Hospital is culminating in a new, state-of-the-art Center for Breast Health, to be located in the Thomas A. Dee Cancer Center on the Benedictine Hospital campus. Lead mammographer Gail Muench says that when the new center opens in the fall, the comprehensive program will include not only mammography and ulstrasound, but also breast MRI and breast specific gamma imaging (BSGI). Ultrasonography is an imaging technique using high-frequency sound waves that are sent through body tissue to produce an image—a sonogram—on a viewing screen. BSGI, a technology not currently offered in the region, involves injecting a nuclear contrast medicine into tissue, and is particularly useful in detecting cancers smaller than one centimeter.
Mammography remains the first method of detection for breast cancers but doesn’t always relay complete and clear diagnostic information. Ultrasonography, BSGI, and breast MRI, which shoots cross-sectional pictures behind the breast and deep into the chest wall, are all used for more complete auxiliary diagnoses. Muench and her associates are very pleased about soon having BSGI in their array of options. “Patients won’t have to wait the typical six-months for doctors to watch questionable lesions when deciding to biopsy or not,” says Muench. “There will be a learning curve for us, but it’s very exciting. That six-month wait was always a problem for us, and it’s very stressful for the patient.”
Minimally Invasive Techniques
Minimally invasive techniques in surgery requiring only very small incisions have begun to reach science fiction levels of wonder. Dr. Elisa Burns of Mount Kisco Medical Group reports how robotically assisted, laparoscopic surgery has altered gynecological treatments, offering patients less pain, a lower risk of infection, minimal scarring, decreased blood loss, and faster recovery times. “Patients who have undergone minimally invasive hysterectomies are now going home the day of or the day after surgery, and generally go back to work within one to two weeks,” Dr. Burns says. “We are now also performing minimally invasive surgery for endometrial cancers. At Northern Westchester Hospital, we use their da Vinci robot, a sophisticated and precise tool.” It has a 3-D, high-resolution video feature that provides better visualization of the robotic surgical process. Burns says that some cancer patients can undergo surgery one day and be released the next.
Endovascular surgery is another minimally invasive technique performed by radiologists, neurologists, neurosurgeons, cardiologists, and vascular surgeons, accessing regions of the body via major blood vessels. Interventional radiology can be used to diagnose pathology by injecting a radio-opaque dye that can be seen on live X-ray or fluoroscopy, and to treat these with image-guided instruments like needles and catheters. Both are offered at MD Imaging/Valley Endovascular in Poughkeepsie, where trauma is minimized for patients of aortic aneurysms, atherosclerosis, vascular injury, and other coronary diseases, reducing both infection rates and recovery time, as well as shortening hospital stays. Dr. Gary Grossman, medical director at MD Imaging, describes how a catheter device inserted into a blood vessel that supplies an ailing or damaged organ can introduce chemotherapy or blood-blocking material directly. “For example, instead of undergoing major surgery for removal of a fibroid tumor, a patient has the option where we can actually put a catheter in the uterine artery and inject some material that will cause the fibroid to shrink, avoiding a traditional six-week recovery from hysterectomy. That can be done on an outpatient basis as well.”
Transforming the Patient Experience
Other kinds of technological advances are transforming patients’ experience of medical service in simple, but vastly improved, ways. As facilities are newly built or reconfigured, consideration for efficiency, safety, and patients’ emotional well-being are more often taken into consideration. At Benedictine Hospital, a member of Health Alliance of Hudson Valley, a new Pre-Surgical Testing Unit will provide all the tests required before surgery in one location, to accomplish health history reviews and physical exams in one visit. And the new Infusion Therapy Center, also located on the Benedictine campus, will provide chemotherapy, IV therapy, injections, blood product transfusions, and other outpatient therapeutic services, in 12 private and two semiprivate treatment areas, outfitted with flat screen TVs, comfortable recliners, free WiFi, and a patient nourishment station.
The conversion to electronic patient medical record keeping is another way hospitals are utilizing new technologies. Dr. John Horiszny, president of the medical staff and director of the hospitalist program at Northern Dutchess Hospital in Rhinebeck, talks about the multiphase project of digitizing patient information. “Before we went live with our current system, information about patients could be in many different places,” says Dr. Horiszny. “Their vital signs could be on a chart at bedside, their X-rays in the radiology department; reports from consultants, lab results, and microbiology results could all be on separate computer programs. This new system puts everything together, and physicians can look at a single page to access all the pertinent information for their patients.” Dr. Horiszny emphasizes that the system is internal to all Health Quest offices and is password protected, accessible only to doctors or others directly responsible for patients.
At Greater Hudson Valley Family Health Center in Newburgh, where electronic health records and patient information are also being implemented, the new building has more than three times as many exam rooms as the old one. Spokesman Ken Mackintosh reports that a wait-time study showed it used to take an average of 45 minutes for a patient to be put in direct contact with a nurse, primarily due to the dearth of exam rooms. By simply installing more rooms, patients receive faster attention in a more streamlined protocol.
“In this environment, a ‘patient-centered medical home,’ a comprehensive array of medical needs is coordinated all in one setting, from primary care to follow-ups, referrals testing, dental care, and behavioral health care,” says Mackintosh. “As well as chemical dependency and substance abuse treatment services, we also provide full pharmacy and limited radiology services.” Greater Hudson holds triple designation as a federally qualified health center, a community health center, and a NYS-licensed diagnostic and treatment center. Mackintosh reiterates, “Just because you’re providing care for people without choice doesn’t mean they don’t deserve the best.”
Innovations in medical technology seem to indicate a trend towards a more humane and empathetic experience. Compassionate, personalized care is seen to be a vital element in meeting individual needs, and, in fact, usually does so more efficiently.
RESOURCES
Benedictine Hospital Hahv.org/benedictinehospital
Greater Hudson Valley Family Health Center Ghvfhc.org
Health Alliance of the Hudson Valley Hahv.org
Health Quest Health-quest.org
Kingston Hospital Hahv.org/kingstonhospital
MD Imaging Mdimagingny.com
Mount Kisco Medical Group www.mkmg.com
Northern Dutchess Hospital Health-quest.org/home_nd.cfm?id=9
Northern Westchester Hospital Nwhc.net
Valley Endovascular Endovasculartherapy.com
This article appears in July 2011.
