All Children's Hospital Physicians' eNewsletter

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When All Children's Hospital joined Johns Hopkins Medicine in April 2011, expansion of the hospital's education and research missions were among the key goals for the integration.

Just in time to mark the third anniversary of this collaboration, the ACH community celebrated Match Day on March 21st and highlighted the innovative new All Children's Hospital Johns Hopkins Medicine (ACH JHM) pediatric residency program.

"This Match Day is the beginning of a new era and marks the first significant academic milestone for All Children's since integrating with Johns Hopkins Medicine," said Dr. Jonathan Ellen, president and physician in chief at All Children's Hospital and professor of pediatrics and vice dean, All Children's Hospital for the Johns Hopkins University School of Medicine.

"As home to two unique residency programs, All Children's Hospital will further its commitment to patient safety and quality by training top health care leaders, clinicians and researchers of the future," he noted.

"Match Day is always an exciting time for our pediatrics program," said Dr. Patricia Emmanuel, chair of pediatrics at the USF Health Morsani College of Medicine. "We look forward to having a new group of students from across the country, and we're delighted that they will be learning and caring for children at All Children's Hospital. Our strong partnership with All Children's creates a great learning environment for our residents in a variety of programs to learn more about caring for children across a broad range of specialties."

As the director and associate director of medical education at ACH JHM, Dr. Chad Brands and Dr. Raquel Hernandez were excited by the opportunity to design a new approach to pediatric resident training in keeping with the rapidly changing landscape of health care. They developed the ACH JHM residency program, which builds on the Hopkins foundation for residency training and also emphasizes opportunities for individualized education, early opportunities for research, and participation in learning communities of peers and faculty mentors, all focused on patient safety and quality. The curriculum includes the ethics of care, leadership, research methodology and translational research, cultural competence and the business of medicine. The new program also features continuous quality improvement training and tools developed by the Armstrong Institute for Patient Safety and Quality at Hopkins.

Approximately 40 physicians at ACH have received faculty appointments with the Johns Hopkins University School of Medicine and will be actively engaged in teaching and mentoring the new residents.

"Our program was created from the ground up and designed to train outstanding pediatricians and create leaders in pediatric health care focused on patient safety and value," said Dr. Brands. "Nothing like this has been done in academic medicine in the past 50 years."

Here are the names of the ACH JHM residents revealed on Match Day along with their academic affliations:

�		Stacey Cole: University of Utah

�		Brianna Conforti: The Chicago Medical School

�		Paul Gilbert: Johns Hopkins University School of Medicine

�		Mirinda Gillespie: Johns Hopkins University School of Medicine

�		Katherine Hurley: Texas Tech University

�		Nicholas Jabre: University of Cincinnati

�		Racha Khalaf: University of Central Florida College of Medicine

�		Alexander Kim: University of Virginia

�		John Morrison: University of Nebraska

�		Nina Replete: Ross University School of Medicine

�		Elena Rueda-de-Leon: Florida International University

�		Jacquelyn Selbst: University of South Florida

Angela Sanborn was a normal, healthy 15-year-old attending East Lake High School when she began experiencing pain in her groin area.

Because she worked out frequently at the gym, doctors at a local hospital thought the pain was merely a muscle strain. "But it got worse," she said. "Within a week, I went back to the hospital and they transferred me here to All Children's."

Angela became a patient in ACH's cutting-edge Pediatric Thrombosis Program, overseen by Dr. Neil Goldenberg, who also serves as Director of Research at All Children's Hospital Johns Hopkins Medicine. A battery of "CAT" scans and ultrasounds followed. And that's when it was discovered that Angela was suffering from a blood clot ("deep vein thrombosis" or "DVT") that was extensive throughout the lower venous system of her body - from the level of her ankle to above her kidneys. By now, her leg was purple and swollen and the pain was excruciating.

Yet the news that stunned the Sanborns was this: The clot was provoked by an oral contraceptive Angela had taken for six weeks, though she was more susceptible to DVT due to certain preexisting anatomical conditions she hadn't even been aware of until arriving at ACH JHM.

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All Children's Hospital patients and their parents now have electronic access to some of their key health information thanks to MyHealth, an online patient portal set to go live in mid-March through the hospital's website, bringing information to a family's fingertips.

The MyHealth personal health record will include: a list of health issues (illnesses and problems rather than a diagnosis), home medications, lab results, discharge documentation, known allergies and immunizations given at ACH.

"Providing families with easy access to this information can empower patients and parents to play an active role in their health care," says Dipti Amin, M.D., a pediatrician and Director of Medical Informatics at All Children's. "Making this information portable and easily accessible can enhance coordination of care."

"A growing number of healthcare systems and providers are offering online access to personal health information, thanks in part to funding from the Federal Stimulus Plan initiative to empower patients with information that can improve care," says Cal Popovich, Vice President for Information Technology.

During the roll-out of this new service, families will be invited to enroll in MyHealth when they register or consent for certain services at All Children's main campus in St Petersburg or any regional All Children's Outpatient Care location. The parent who signs the consent form on-site will have secure access to the child's personal health information. An email is sent to the parent within minutes of completing this enrollment during registration. Parents must respond to this email to set up an account that includes security questions. After that, they simply go to www.allkids.org/MyHealth to review the personal health record.

"We know that parents are very important members of their child's health care team," says Dr. Amin. "MyHealth provides information to help them manage the child's health care needs. Families will be able to refer back to their discharge instructions and health record if they have questions, and they will also be able to review their information and be ready to ask questions or provide feedback at upcoming appointments."

Keeping privacy and confidentiality in mind, All Children's has designed its patient portal so that it will not show information about certain health problems, lab results or prescribed medications. And for patients ages 11-18, the healthcare provider can mark some information "private" so that it is not available for a parent to view, in keeping with Florida privacy laws.

The MyHealth patient portal will add additional features over time, including additional clinical reports and discharge summaries, pre-visit screenings, and messaging with physicians employed by All Children's Hospital.

The ACH Office of Human Subjects Research (OHSR) has announced that the eIRB2 (electronic IRB2) system was launched in Baltimore on January 27, 2014 and is now available to ACH-based investigators. One of the benefits of eIRB2 is that it enables ACH investigators to expand the conduct of their research to include the JHM hospitals in Maryland or Washington, D.C.

"The ACH Office of Human Subjects Research (OHSR) staff is available to provide assistance during this time of transition," Dr. Jorgensen notes. The OHSR staff can be reached at 727-767-4275.

Here are key things to know about implementation of eIRB2 at ACH:

�		New protocol submissions: ACH is not requiring new protocol submissions in eIRB2 until June 2, 2014. All Institutional Review Board (IRB) applications can continue to be submitted via iRIS until that date. As a reminder, all new projects, whether in iRIS or eIRB2, must be submitted with consent forms on the JHM informed consent template.

�		Early Users: "Early user" ACH investigators are welcome to get started in eIRB2 prior to the required date in June. Please be aware that, as the site has just launched, there will continue to be some trouble-shooting by IT staff in Baltimore in the short term. Any investigators wishing to expand the conduct of their research from ACH to another of the JHM hospitals in Maryland or Washington, DC must do so in eIRB2. Contact our office if you have questions about being an early user.

�		Continuing reviews: All continuing reviews should be submitted in iRIS until further notice. Informed consents will need to be converted to the JHM informed consent templates starting with continuing reviews (i.e., annual renewals) submitted on June 2, 2014. These may be done at the time of continuing review and do not require a change in procedure application. If an investigator wishes to change consents to the JHM template prior to continuing review, a change in procedure application will need to be completed.

�		Training: On-site eIRB2 training will be provided at ACH prior to June 2, 2014. An announcement regarding training dates will be forthcoming.

�		Conversion of existing iRIS studies: The new timetable for conversion of existing studies from iRIS to eIRB2 has not been finalized and will be forthcoming.