Northwest Arkansas Democrat-Gazette
Patients connecting with special services
New technology and closer testing services saving lives at Northwest Arkansas medical facilities
Thomas Duncan considered himself lucky when he was diagnosed with lung cancer. A screening caught it early.
Medical Associates of Northwest Arkansas and The Center for Chest Care offer the free screening to people over age 50 with a long history of smoking and a family history of lung cancer. MANA Imaging is the only American College of Radiology accredited lung cancer screening center in Arkansas.
Duncan is just one example of local residents connecting with a growing number of specialized services available close to home. The advanced care options stretch across all levels of care from screenings to treatment.
Mike Malone, president and CEO of the Northwest Arkansas Council, said regional health care providers offer a variety of specialty services that are helping make the area a health care destination, and more can be added.
“It will be great to draw and keep more people here rather than see them go to some other markets,” he said.
The Northwest Arkansas Council named expanding the region’s health care offerings as a growth opportunity in its three-year strategic plan, the Greater Northwest Arkansas Development Strategy for 2015-17, unveiled last year. The group is a private, nonprofit organization collaborating with business and civic leaders to work on regional economic development, community vitality, educational excellence and infrastructure.
LUNG CANCER SCREENING
Duncan said the spot on the top of his lung was the size of a pencil eraser when a radiologist found it during a lung cancer screening in 2014.
The spot was cancerous and surgeons removed the upper part of his right lung. Today he is cancer free.
Duncan said he didn’t have any symptoms and only had the screening at urging of his sister. He lost both his wife and brother to lung cancer.
“If I hadn’t had the scan, they wouldn’t have caught it until it was in my bones,” the 70-year-old Fayetteville man said. “And if my sister hadn’t told me about the screening, I would not have ever known about it.”
Dr. Edward Jackson, a pulmonologist at MANA’s Fayetteville Diagnostic Clinic, said their screening program started in 2012 and was the first accredited program in the country that was not part of a university.
Initially only a handful of people were screened, even though it was offered at a reduced price of $25, he said. The clinic offered the screening free to veterans on Veterans Day and about 35 people were screened. Jackson said the screening is now offered free to high-risk patients and the clinic does 40-70 screenings weekly.
To be eligible for a free screening, a patient must be 55 and a heavy smoker for more than 30 years or age 50 and a heavy smoker for more than 20 years.
Dr. Allen Moseley, a MANA pulmonologist, said it’s important to catch lung cancer quickly because it tends to grow at a much faster rate than other cancers. The American Cancer Society estimates 158,040 people nationwide died from lung cancer last year, the highest number of all cancers. Lung cancer killed 2,620 Arkansans last year.
“I think five years from now this screening will be the standard for care,” Moseley said.
ROBOTIC SURGERY
Northwest Health System recently added a second robot to its minimally invasive surgery options, said Sharif Omar, the system’s CEO.
“It goes in through a single incision, and that technology was not in this market at all,” he said.
Drs. Michael Wilson and Chad Brekelbaum of Northwest Arkansas Urology Associates created the Northwest Robotic Surgery Institute 10 years ago. It was Northwest Arkansas’ first robotic surgery program and it added a second machine a few months ago.
Wilson said the process was predominately used for prostate surgery in the early days, but has since expanded across other areas, including colorectal, gynecology and bariatrics.
Dr. Nirmal K. Kilambi of Northwest Arkansas Urology Associates said the advanced technology provides the best patient outcomes in several procedures such as removing only a cancerous mass while sparing the rest of the kidney.
The benefits of using minimally invasive surgery include shorter recovery time and less cosmetic impact, said Dr. Jason Hurt. He uses the robotic surgery room weekly for gynecological procedures. He said the minimally invasive surgery cuts patients’ recovery time in half and incisions can be as small as 8 millimeters, often hidden in the belly button.
“The robot is a tool that a surgeon can use. The word robot is a bit of a misnomer,” he said.
The surgeon sits at a computer and use hand controls to manipulate the robot in the minimally invasive procedures. The computer-assisted technology allows surgeons to have a better range of motion and high-definition cameras let surgeons see the operating site better. Hurt said the machine also allows surgeons to get into tighter spaces.
Dr. Hollis Rogers III said robotics took a while to enter the colorectal field, but he now uses the procedure for nearly 90 percent of his colon resections. He said he did about 120 resections last year.
He said people were initially intimated by the term robotics, but it is the natural evolution of certain surgical procedures.
“In the early days of laparoscopy, people were terrified of that,” Rogers said.
Laparoscopic and robotic surgery are both minimally invasive procedures, but laparoscopy has a limited range of motion and video images are two dimensional. Robotic procedures are seen in three dimensions.
The robotic surgery suite also sees numerous bariatric surgeries by Dr. Joshua Roller of Roller Weight Loss & Advanced Surgery. Bariatric, or weight loss, surgeries at Northwest increased from 288 in 2014 to 500 last year.
“We should be offering a minimally invasive option to open surgery,” said Dr. Joseph Ivy, a gynecologic oncologist. “It’s the standard of care in Northwest Arkansas.”
CARDIAC
Mercy Northwest Arkansas is focusing on cardiac care, said Eric Pianalto, president of Mercy Hospital Northwest Arkansas.
The system added two new cardiologists and installed a new catheterization lab, he said.
“Nationally cardio is a growing area, and we are following that trend,” he said, pointing to an aging population.
Mercy made a big investment in heart and vascular care after it completed a $5.5 million expansion project that included an 11-bed pre- and post-procedure cardiac unit, added a fourth catheterization lab and new cardiac imaging suites and equipment.
The expansion also included a covered walkway that linked the Mercy Heart and Vascular clinic at Mercy Physicians Plaza to the hospital’s heart and vascular center.
Mercy Fort Smith opened a $10 million heart and vascular center in 2013 on the third floor of the Mercy Centers of Excellence. The $10 million center includes prevention, detection and treatment of heart and vascular diseases.
The 16,000-square-foot facility includes four cardiac catheterization labs, a vascular lab with three exam rooms, a cardiac imaging suite and a pre-op and recovery unit.
BREAST CARE
Dr. Steven Harms said the whole breast ultrasound, breast MRI and risk assessment makes The Breast Center stand apart from the competition.
The center is Medical Associates of Northwest Arkansas clinic with locations in Fayetteville and Bentonville. The Breast Center opened in 2004 and Harms said it is the only independent breast center in Arkansas.
Harms helped develop the use of magnetic resonance imaging for patients at highrisk of breast cancer. He uses that knowledge on local patients and travels the world to teach about breast imaging.
Dr. Stacy Smith-Foley said the addition of breast tomosynthesis, or 3D mammography, helps patients with dense breasts by reducing false positive results.
“The single item that really sets us apart is we care for the whole patient,” she said. “Most of our patients have the opportunity to talk to both the radiologist and the doctor.”
Smith-Foley said risk assessments help determine who needs additional screening.
It’s as easy as a patient using an iPad to answer about a half-dozen questions, Harms said.
“No one else is doing this,” he said. “Patients are like snowflakes, every one is different and they need individualized care.”
STROKE PROGRAM
Washington Regional Medical Center’s stroke program treated more than 725 patients last year, including 190 who transferred from other hospitals, said Gina Maddox, Washington Regional spokeswoman.
Stroke patients benefit from the 2014 opening of the Northwest Arkansas Neuroscience Institute located in the hospital.
“We get stroke patients from all over,” said Bill Bradley, Washington Regional president and chief executive officer. “A lot of them are coming from south of Fort Smith, from Russellville, even a few from out of state.”
Bradley said he is surprised at how young some stroke patients are.
Three neurosurgeons run the program. They specialized in endovascular neurosurgery, a process that uses catheter technology and radiological imaging to provide minimally invasive treatment for illness including stroke and cerebral aneurysm.
The hospital last year earned the Joint Commission’s Gold Seal of Approval and the American Heart Association/ American Stroke Association’s Heart-Check mark for Advanced Certification for Primary Stroke Centers.
The Joint Commission’s on-site review examined the hospital’s stroke program management, delivery of clinical care and performance improvement. The commission is a standards-setting and accrediting organization.
MOTHER AND CHILD
Willow Creek Women’s Hospital in Johnson is a Level III Neonatal Intensive Care Unit and can serve mothers and babies as early as 23 weeks gestation to term. It has the highest level of any Northwest Arkansas units.
The hospital also provides a neonatal ICU transport team that will pick up NICU babies at hospitals that do not have a NICU.
Willow Creek practices family-centered care that includes private rooms for mothers and babies to stay together.
Babies leaving the NICU enter Northwest Health System’s NICU Graduate Care Clinic. The two-year program has neonatologists, pediatricians, social services, speech therapists, nutritionists and occupational therapists following a baby’s development.
The hospital also has “The Golden Hour” where physicians and staff encourage mother and family to spend the first hour with the baby without interruption to facilitate bonding.
“Patients are like snowflakes, every one is different and they need individualized care.” — Dr. Steven Harms, The Breast Center