Spring/Summer 2016

Helping Seniors Remain at Home

Breaking the CHF Cycle: Reducing Readmissions

Transforming the Patient Experience

A Publication ofGreenville Health System

A Healthy Start for International Adoptees

A Change of Epic Proportion in Your Health Care!

ghs.org

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Manage Your Own Care with a Few Clicks Epic, GHS new electronic medical record and billing system, offers an innovative tool called MyChart. With MyChart, you can see key parts of your medical record, communicate with your care team and participate in your careall online or through your mobile device. In the time it takes to order a movie, you can

Access your and your family members health information View test results and immunizations Ask for prescription refills Schedule and cancel office appointments Pay bills online

Ask for MyChart at your GHS doctors office or request an account online at mychart.ghs.org (your secure online portal to your GHS medical record).

Sign up for MyChart and start enjoying benefits now!

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C O N T E N T S

GHS Senior Care: Setting a Good PACE 2

With help from an innovative program, elders are living longerat home.

Parents Adopt Well to Clinic 6

When parents adopt children from other countries, the first call theyll want to make is to GHS International Adoption Clinic.

New Success with Congestive Heart Failure 10

A tiny device shows giant potential in keeping patients with CHF out of the hospital.

Where the Patient Is Number One 14

GHS is the regions leading provider of health care. Now were making sure that our patient experience is reaching the samehigh standards.

Departments

Message from the President and CEO 1

Spotlight 2

Whats Right in Health Care 3

Clinical Trials 16

Q & A 17

Practice Profile 18

Provider Directory 19

We welcome your comments, suggestions and ideas. Call (864) 797-7541or email nparker@ghs.org.

P R E S I D E N T S M E S S A G E

In August, Ill celebrate my 10th anniversary with Greenville Health System (GHS). When we relocated here, my youngest child was still in diapers; now hes active in school, church and community activities. Then, my hair was more dark than gray; today, not so much. Back then, I welcomed mild winters but wasnt keen on the dog days of August: Some things dont change.

The changes and events that have occurred at GHS in the last decade are nothing short of amazing. We have established the University of South Carolina School of Medicine Greenville, which has graduated the first class of medical students trained to work in the new healthcare environment; celebrated our centennial and GHS role as the Upstates leading healthcare provider; updated our name and logo to more accurately reflect our work in keeping people healthy; grown the number of providers employed at GHS from around 250 to more than 1,700; begun our journey to be a multi-regional health system with the addition of Baptist Easley Hospital and Laurens County and Oconee medical campuses; been recognized for promoting diversity; led the way in transitioning from a volume-driven to a value-based healthcare environment through initiatives such as the MyHealth First Network; implemented Epic, a computer system that enhances both the delivery of health care and the patient experience; and expanded the care we provide throughout the region with our Accountable Communities programs.

And thats just what we have room to highlight in this space! Im excited to have been part of GHS growth and

advancement in the last decade and am eager to continue our progress in years ahead as we seek to transform health care for the benefit of the people and communities we serve. The stories in this issue of Inside Health demonstrate some of the ways we are advancing health care. First, youll meet three children from Russia and Thailand, pictured on the cover, whose transition to their new life in South Carolina was eased by the special services of the International Adoption Clinic, part of GHS Childrens Hospital.

Well also introduce you to a retired chef who no longer faces repeated hospitalizations because of uncontrolled congestive heart failure, thanks to a groundbreaking device. And were pleased to report on our pioneering approach to primary care that promises to transform the patient experience. Of special note also is the Q&A, which answers questions about our new governance structure approved by the GHS Board of Trustees.

Just as my family and I are happy to call Greenville home, the GHS family is happy to offer you a medical home. Winter, spring, summer or fall, were here to partner with you to keep you in the best health possible.

Michael C. RiordanPresident and CEO

Work in Progress

1 Inside Health

S P O T L I G H T

GHS Senior Care: Setting a Good PACE

A new program helps individuals live in their communities as independently as possible for as long as possible.

Greenville Health System (GHS) now offers Senior Care, a Medicare and Medicaid program providing community-based care and services to people age 55 or older who would otherwise need nursing home-level care. It is the first such program in the Upstate.

GHS Senior Care, based on the PACE (Program of All-inclusive Care for the Elderly) model, is centered on the belief that the best outcomes for seniors with chronic care conditions happen when they are served in their communityand that taking preventive measures can help avoid some problems. Our goal, said Kim Martin, director of GHS Senior Care, is to provide the support seniors need to remain in their own homes, rather than live in a nursing home or long-term care facility. We want to help them sustain the best quality of life possible and receive excellent medical care at an affordable price.

We offer comprehensive services, added Brad Torrence, manager of PACE Operations.And we serve as traffic control in coordinating carean important factor as participants typically have several health conditions. This approach minimizes the possibility that something will fall through the cracks.

The comprehensive services include primary care (including doctor and nursing services); hospital care as needed; medical specialty services; prescription drugs; nursing home care as needed; emergency services; home care; physical, occupational and recreational therapy; adult day care and meals; dental care; nutrition counseling; social services; laboratory/X-ray services and transportation.

The PACE model also supports family members and other caregivers with a resource library, training, support groups and respite care. Its as important to help the caregivers as the participant, observed Martin.

This model of care has been shown to reduce the number of days an individual spends in skilled nursing care or the hospital, said Torrence. We believe thats because of the services a PACE program offers and the level of communication and oversight we encourage.

To enroll in GHS Senior Care, an individual must be 55 years of age or older, have certification by the state that nursing home-level care is needed, the ability to live safely in the community with the help of PACE services, and live in Greenville County or specified ZIP codes in Anderson and Pickens counties.

To learn more about GHS Senior Care, including eligible locations and payment structure, please call (864) 522-1950 or visit ghs.org/seniorcare.

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GHS Senior Care is located in a custom-designed building, just a few minutes from Greenville Memorial Medical Campus. It is a safe and inviting place, with many windows to bring in light and views of nature.

2For the second time, GHS Patewood Memorial Hospital (PMH) received two-year certification from the Joint Commission for the program management of hip/knee/shoulder joint replacement surgery. The Joint Commission awarded PMH certificates of distinction based on compliance with national standards, clinical guidelines and outcomes of care.

W H A T S R I G H T I N H E A L T H C A R E

Heres a snapshot of whats going on at GHS as we live ourmission to heal compassionately, teach innovatively andimprove constantly.

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537Babies born last year at Oconee Memorial Hospital, which recently joined Greenville Memorial Hospital in earning the designation of Baby-Friendly Hospital. Baby-Friendly hospitals promote breastfeeding, skin-to-skin contact and rooming-in (keeping moms and babies together).

400Babies born last year at Laurens County Memorial Hospital. If they experience complications at birthsuch as pre-term deliverythey now can be assessed by GHS neonatologists via Delivery Buddy, a telehealth program. Delivery Buddy is the first telehealth program for neonatal patients in the Southeast.

15,000+GHS employees who can benefit from opportunities for physical activity during work hours. For its efforts in promoting physical activity, GHS recently received the Gold Medal Award from the S.C. Hospital Associations Working Well initiative and Prevention Partners.

900Wounds treated at Baptist Easley Wound Care and Hyperbaric Center last year. The center was recognized for excellent outcomes with a Center of Distinction Award from Healogics, the nations largest provider of advanced wound care services. (GHS is part owner of Baptist Easley Hospital.)

1Our first priority: taking care of patients and their families.

Inside Health 4

3 in 10The number of American adults who consume sugary drinks at least once per day as reported by the Centers for Disease Control and Prevention. Learn five steps you can take today to reduce sugar intake from GHS registered dietitian Jessica Menig, RDN, CSP. ghs.org/reduce

12U.S. healthcare supply chain management departmentsof which GHS is onenationally recognized by the ECRI Institute for demonstrating excellence in overall spend management and for adopting best practices in its processes. Organizations receiving the award were chosen out of nearly 3,000 hospitals and health systems for a high level of dedication to improving healthcare quality and reducing costs. GHS is the only health system in the Carolinas to receive the award.

$1 Million The gift from longtime GHS neonatal physician Jerry Ferlauto, MD, and wife Natalina for the Ferlauto Center for Complex Pediatric Care, which will help families cope with the complex needs of chronically ill children.

117Rooms that will be available in the remodeled intensive care unit at Greenville Memorial Hospital. The first phase recently was completed; the full renovation will conclude in 2017. In addition to more space, the renovation will bring updated technology.

Pam Jackson is thankful for the good health of her family additions (l-r) Siri (10), Narada (9) and Claire (8).

Parents Adopt Well to ClinicThe International Adoption Clinic at Childrens Hospital of Greenville Health System (GHS) helps parents address the medical needs of their newly adopted children.

By Lark Reynolds

Inside Health 6

Sue Jue, MD, gives Narada a clean bill of health.

W hen Jonathan and Pam Jackson adopted a baby girl from Russia in 2009, Pam thought it wouldnt be much different from having a child of her own. They already had four biological children (now ages 23, 21, 20, and 15), so she was well-versed in parenting. But when she took her new daughter to the pediatricians office for the first time, she began to rethink that idea.

Adopting a child from another country is completely different from having your own child because there are so many things you dont know, Jackson remarked. You show up at the pediatrician with this child who has this long, involved history, and the doctors trying to figure all of this out in a short time.

A special program at GHS Childrens Hospital offers a solution for piecing together the complex puzzle of an internationally

adopted childs medical needs. The International Adoption Clinic, part of Childrens Hospitals Division of Pediatric Infectious Disease, offers pre-adoption consultation along with post-adoption assessment.

Sue Jue, MD, along with division colleague Robin LaCroix, MD, and medical director Joshua Brownlee, MD, typically have their first contact with adopting parents before the child has even arrived in the U.S.

One of the things that parents are concerned about when they adopt a child is, is the child healthy? Dr. Jue said. In the pre-adoption consultation visit, we usually review the medical record that they receive from the childs home country and can let parents know if there are any red flags or issues that might need to be addressed fairly quickly.

7 Inside Health

Dr. Jue said they also can offer parents advice on immunizations they might need to get before traveling to pick up their child. This pre-adoption consultation often helps address parent concerns and reassure themor sometimes helps parents with the decision on whether to pursue the adoption.

First Stop on ArrivalWhen the parents return to the U.S. with their child, a clinic physician wants to see the child within the first two weeks.At this visit, the physician will review the childs immunization record as provided by the home country. Records and documents for some countries are more thorough and reliable than those from other countries, Dr. Jue noted.

If the children are infants, many times well start over with immunizations, Dr. Jue said. If theyre older, Ill do blood work or antibody titers to see if they have a protective antibody based on the vaccines their records indicate they were given. Then I develop a catch-up immunization schedule for the children going forward.

At this same visit, Dr. Jue screens the child for acquired congenital conditions such as HIV, syphilis, hepatitis B and tuberculosis, along with other conditions such as lead poisoning and parasitic infections such as giardia. Sometimes, medical records may indicate that the child already has been tested for some of these conditions, but Dr. Jue always repeats them.

As a parent, I would want to be sure, Dr. Jue emphasized.

Knowledge from ExperienceDr. Jue can relateshe adopted a daughter from Chinanearly a decade ago, and she did all of those things for her own daughter.

All of the clinics doctors possess the extensive

knowledge base to address parent concerns

and dig into the appropriate research to

find answers.

When Jackson visited after bringing her daughter, Claire, home from Russia, it was because she already had been to her pediatricians office, where Claire tested positive for tuberculosis. Like any parent, Jackson panicked. But Dr. LaCroix offered some insight.

Apparently, the vaccine for tuberculosis used in Russia leaves a mark on the skin, Jackson said. So when Dr. LaCroix did her physical assessment of Claire, she saw that and said the reason her TB test returned positive was probably because she had received that immunization.

After a chest X-ray confirmed that Claire did not have tuberculosis, Jacksons fears were calmed.

She kind of talked me off the cliff, because I was really stressed about it, Jackson recalled.

After Jacksons initial, almost accidental, visit to the clinic, she made sure it was her first stop the next time she adoptedthis time from Thailand in 2013and again when she adopted a second girl from Thailand in 2015. Both girls appeared to be underweight on U.S. growth charts. But at the adoption clinic, they did some digging into the numbers.

Jackson said, They put in the time to get the Thailand growth charts, and then they brought them to me and showed me, and said, This is actually OK, you dont need to worry that theyre so small. Theyre actually normal for that country.

Dr. Jue said they also can help the parent connect to other services or specialties if neededfor instance, if the child shows developmental delays or has a birth defect such as cleft palate.

Once the post-adoption visit is complete, Dr. Jue said they often will see the family one more time to go over blood work and test results. Then, armed with a customized vaccination schedule, the family returns to their chosen pediatrician.

(l-r) The Jackson Nine (plus one)Keagan, friend Halee Bryant, Claire, Narada, Siri, parents Pam and Jonathan, Jakeget Goofy on a Disney trip. (Siblings Hannah and James are not pictured.)

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Jackson was thrilled to have discovered such a valuable resource in the International Adoption Clinic.

If youre going to adopt internationally, that

is the first place you should go, she stated.

They really put a lot of time into that clinic.

I believe its their passion. I know that theyre

spending far more time than they can bill for,

because they care so much about these kids.

Tracey Butcher, MD, a pediatrician with GHS Carolina Pediatrics of Greenville, said the clinic also is a valuable resource for physicians.

The needs of internationally adopted children are so much greater than those of a typical pediatric patient, Dr. Butcher pointed out. Each case is complex and unique, and depends on a number of factors, from the home country to the age and any present medical conditions. That amount of complexity and the time involved to gather that information is overwhelming for a general pediatrician.

The clinic sees internationally adopted children of any agealthough Dr. Jue said most tend to be toddlersfrom any country. Currently, the majority of the children come from China, Thailand, Russia, Ethiopia and Ghana.

To schedule an appointment for an international adoption evaluation, call (864) 454-5130.

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Before the CardioMEMS, I was pretty lethargic. The device has helped me so much to get back to some sense of normalcy. Having Dr. Vaz see where I am on a daily basis and adjust my medications based on that has made a major improvement in my life. Charles Simandl

Click the photo for moreof Charles Simandls story.

Inside Health 10

New Success with Congestive Heart FailureAn innovative technology is helping patients with congestive heart failureavoid hospital readmission.By Robin Halcomb

A ccording to the American Hospital Association, congestive heart failure (CHF) leads all causes of hospitalizations among U.S. adults more than 65 years old. Unfortunately, 50 percent or more of those patients will be readmitted within six months of discharge, and multiple readmissions are not uncommon. Greenville Health System (GHS) is tackling the problem with a new device that alerts doctors of symptoms that could lead to readmissions.

The CardioMEMS HF System uses a tiny implanted sensor to monitor the chronic level of filling pressures in the pulmonary artery. For patients with CHF, filling pressures are the most accurate determinant of developing problems that may cause a hospital readmission.

Cardiologist Dev Vaz, MD, medical director of GHS Congestive Heart Failure Program, is using the system to monitor a group of patients with CHF and is encouraged by the results.

CardioMEMS allows us to catch things in the early stages, approximately a week or two before a patient would otherwise end up in the hospital, Dr. Vaz explained. If a patient is becoming congested, we will very quickly adjust to that as needed to bring pressures down before they escalate and result in a hospitalization.

The sensor is about the size of a paper clip with a thin, curved wire at each end. It is permanently placed in the pulmonary artery through a catheter, which releases the sensor in the far end of the artery. The sensors small, remarkably complex power source is outside of the body, which means there are no concerns about changing a battery or developing an infection of the device.

Patients use a portable electric unit and a special pillow containing an antenna to take daily sensor readings, which are transmitted to a secure websitea simple process that takes only a few minutes. Each day, Dr. Vaz reviews the data for red flags and communicates directly with the patient to make appropriate adjustments.

Patients with CHF traditionally are monitored through intermittent physical exams, where doctors look at changes in weight and blood tests for signs of problems. While CardioMEMS will not replace those exams, the system does provide a more robust way to look for signals that a patient may be headed for trouble.Dev Vaz, MD, exhibits the tiny sensor that does a big job.

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Getting Back to LifeCharles Simandl is one of the first seven GHS patients to receive the CardioMEMS. A retired chef, Simandl was diagnosed with CHF three years ago and was being treated with medications. Last summer, he suffered a heart attack related to an earlier heart stent and has been followed up by Dr. Vaz.

Simandls CHF continued to cause problems, including four hospitalizations over a four-month period. During that time, Dr. Vaz discussed the CardioMEMS option with Simandl, and the device was implanted September 17, 2015, at Greenville Memorial Hospital, GHS flagship facility. Since the implant, Dr. Vaz has been able to avoid readmission for Simandl by adjusting his medications based on arterial pressure readings from the device.

Before the CardioMEMS, I was pretty lethargic, said Simandl. The device has helped me so much to get back to some sense of normalcy. Having Dr. Vaz see where I am on a daily basis and adjust my medications based on that has made a major improvement in my life.

Simandl is participating for the third time in HeartLife, GHS comprehensive cardiac rehabilitation program that is considered one of the best in the country. He also walks daily, describing his walking routine based on the aisles in a grocery store. I can do a full grocery store now! he remarked.

Congestive Heart FailureCongestive heart failure is a condition where a persons heart does not pump enough blood to meet the bodys needs. The most commonly used classification system for CHF is the New York Heart Association Functional Classification. Class III heart failure is characterized by patients who may be comfortable at rest, but anything less than ordinary activity causes fatigue, palpitation or dyspnea (difficult or labored breathing).

A critical factor affecting outcomes of this serious and progressive disease is patient compliance with diet, medications and follow-up. To avoid developing heart failure,

Dr. Vaz recommends that everyone maintain a healthy diet and body weight and participate in active aerobic exerciseas appropriate.

Trial and SuccessGHS uses patient selection and treatment standards from a trial first published in 2011 in the British medical journal The Lancet. In that trial, 550 Class III patients were selected randomly into treatment or control groups. Both groups received the wireless implantable monitoring system, but only implants in the treatment group were activated. The trial concluded there was a 37 percent reduction in hospitalizations in the treatment versus the control group. The benefit seemed to increase over time, with a 45 percent reduction in hospitalizations after six months of randomization.

Dr. Vaz sees CardioMEMS as a good reflection of GHS commitment to stay on the leading edge of technology and provide patient-centered care.

We were the first health system in the Upstate to implant a CardioMEMS device, he commented. That fits well with the values, mission and goals of GHS.

The Congestive Heart Failure Program at GHS includes a well-organized, multidisciplinary team with doctors, nurses, pharmacists, social workers and others with special training in working with patients with cardiac conditions.

The results of the program speak for themselves, Dr. Vaz observed. Greenville Memorial Hospital historically has had 30-day readmission rates between 14% and 19%, which is far below the national averageof 24% to 27% and ranks among the top 10 hospitals in the country for low readmission rates.

Coming Soon to a Smartphone Near YouWith the success of the CardioMEMS system, Dr. Vaz is excited about related developments.

Developers are working on apps for mobile devices for patients and providers, he said. Apps and other iterations will further increase patient engagement and reduce response times. Furthermore, there is a proliferation of new devices for remote hemodynamic monitoring. This is a game changer for CHF.

To learn more about the CardioMEMS device or GHSCongestive Heart Failure Program, call (864) 455-2431or visit ghs.org/heart.(Medical device images provided courtesy of St. Jude Medical, Inc.)

Simandls new normal includes enjoying old hobbies.

Inside Health 12

Each day, Dr. Vaz reviews patients transmitted data and adjusts medication accordingly.

We were the first health system in the Upstate to implant a CardioMEMS device. That fits well with the values, mission and goals of GHS.Dev Vaz, MD

Where the Patient Is Number OneGHS vision is to transform health care for the benefit of the patients and communities we serve. One way were doingthat is by transforming the patient experience in our primary care offices. By Lark Reynolds

With the help of GHS, Simon Kizito plans to stay healthy for wife Kimberly and daughters Tess (9) and Sasha (2).

Greeter Britney Adams stands by to assist patients, as needed, asthey check in.

Inside Health 14

S ometimes a patient walking into a doctors office can feel like the least significant person in the room. But the physicians and staff at Greenville Health System (GHS) Pediatrics & Internal MedicineWade Hampton (GPIM), strive for the opposite effect, and theyve made significant changes to their practice to achieve it.

A lot of times when you enter a traditional office, you go to a glass window, and behind it are nurses scurrying in and out and somebody making copiesjust a lot of activity, said Pam Evans, a patient at GPIM. But here, there was none of that. It was a very crisp and clean first impression. I felt comfortable.

For one thing, theres no glass window at this practice. In fact, theres not even a front office.

The elimination of the office area has had significant impact for patients. First, and most easily noticeable, when patients walk in, they see a single concierge desk and a smiling staff member standing at it. No distractions in the background, no other voices interrupting the greeter as she welcomes them. If help is needed, she guides them through checking in on an iPad at one of two kiosks in the waiting area.

It was very apparent that the greeter was solely focused on welcoming me and making sure that check-in went smoothly and quickly, said Evans.

Changes for the BetterNot only has technology made it possible for patients to check themselves in, but it also has significantly reduced the physical space needed to store patient records, enabling the repurposing of space previously used for that function. Inthe renovation of the practices space, physicians officesalso disappeared.

We wanted the new space to support our team approach, said Joanne Skaggs, MD, a GPIM physician. Now we have a landing room where the providers have work spaces, and we huddle there to discuss cases.

Another benefit at GPIM has been the addition of more patient rooms. Office hours also have expanded to 7 a.m.-7 p.m., and the team plans to add more providers along with four recently hired nurse practitioners. Three doctors will join the practice in coming months.

This growth and expansion of hours has improved access both for new patients who need a medical home and for current patients, particularly when they need same-day care. Dr. Skaggs shared the story of one patient who called the office at 3:30 p.m. about a medical ailment that had nagged her all day. Although the patient expected to be instructed to go to the emergency room, instead she was told to come in.

She arrived at the office at 4 p.m. and was seen right away, Dr. Skaggs relayed. She was so thankful that her issue was taken care ofand that she avoided the emergency room and instead saw people who knew her.

Clearly, then, patients are noticing the difference at GPIM, not only in terms of the physical changes to the setup and dcor in the waiting area, but also in the enhanced quality of the service they are receiving. And thats the goal.

If we dont create an experience for you

that just overwhelms younot just a good

experience but an extraordinary experience

then I believe we havent done our jobs, said

George Lesmes, chief administrative officer

for GHS physician practices.

Back to BasicsPeter Tilkemeier, MD, chair of GHS Department of Medicine, and his team shared their vision for transforming the delivery of care with GHS leadership, who embraced the proposal.

Now, pilot practices are employing the new model, although Dr. Tilkemeier said it would take some time to implement it smoothly and efficiently. The behind-the-scenes work is well underway, though, and that is where the clinical staffs at these practices have shone, he said.

The key to making the patient feel valued, welcomed and well cared for has been an emphasis on customer service training. All staff members, including the doctors, at each practice participate in the new training, which Lesmes developed.

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All the concepts are geared toward engaging people, Lesmes said. Its not sophisticated stuff, but for our people to create an experience thats extraordinary, theyve got to embrace it, and every person has to be on board.

Dr. Skaggs said the doctors at her practice learned a lot from the training.

It helped us remember why were doing what were doing and showed us how we can do it better, she said. It reminded us that each person is a person, not just a condition or an illness. Sometimes, we can lose sight of that because of stress or fatigue.

She said the training also focused on team building and encouragement, which has had an immense positive impact on the atmosphere at GPIM.

Although Epic technology is not unique to GPIM, it is also a big player in creating this new experience for the patient. From streamlining check-in and information gathering to opening up patients access to their own medical records on MyChart and offering a channel for communicating directly with their doctor, Epic is helping usher in this enhanced patient experience.

The messaging component of MyChart, particularly withDr. Skaggs, has been amazing, said Evans, the patient. I feel like theres a direct communication line that can be usedwhen needed.

Currently, pilot practices GPIM and GHS Internal MedicineMaxwell Pointe have integrated the new model of enhancing the patient experience, with plans to roll it out to all GHS primary care practices over the next few years.

The biggest benefits for our patients, noted Dr. Tilkemeier, are engagement, leaving the office informed and understanding of the plan, and feeling safe and truly cared for.

Our ultimate goal is to create the environment and experience that the patient wants, Lesmes added. Every visit, every site, every time.

If you are a GHS patient, we encourage you to register for MyChart. Visit mychart.ghs.org or ask about it at your next visit. If you are not a patient and would like to access transformed primary care at GHS, call 1-844-GHS-DOCS(447-3627) or see the directory on page 19.

C L I N I C A L T R I A L S

Cancer Survivors for RegistryGHS Cancer Institutes Cancer Survivor Registry is a database of demographics, contact information, and tumor and treatment information. Survivors can receive helpful information about moving forward. Contact Katie,(864) 455-5889 or kdaniels@ghs.org.

Breast Cancer Survivors with Neuropathy The purpose of this study is to evaluate the effectiveness of acupuncture in the treatment of peripheral neuropathy caused by chemotherapy in breast cancer survivors.Symptoms include pain, tingling, and/or numbness in fingertips or toes.Participants will undergo 18 acupuncture treatments over 12 weeks and complete questionnaires.Contact Armand,(864) 455-6251 or adesollar@ghs.org.

Women with Ovarian CancerThe purpose of this research study is to test an investigational agent called Vigil to determine when cancer may recur after receiving Vigil or a placebo and to compare your ability to carry out everyday activities. Vigil is a way of delivering a cancer protein in which the immune system recognizes the protein as foreign and rejects or destroys any cells that have it. Participants must be willing to receive a monthly injectionfor four-12 months. Call Anna,(864) 522-2063.

Women with Heavy Menstrual Bleeding Related to FibroidsThis study evaluates the ability of a new investigational device, the Sonata System, to reduce heavy menstrual bleeding related to fibroids. The Sonata System is considered investigational in the U.S. This study device allows a physician to view fibroids with ultrasound and to treat them by heating with radiofrequency energy. The device is placed into the uterus through the vagina and cervix: No incisions are needed. Participants must be premenopausal, ages 25-50, have had heavy menstrual bleeding relatedto fibroids for at least three months, have no desire to become pregnant and have had no disruptive chronic pelvic painfor the last six months. Call Cheryl,(864) 455-5951.

Women with Stress Urinary IncontinenceThis study evaluates the safety and effectiveness of an investigational cell therapy in women with stress urinary incontinence (accidental leakage with exercise, laughing, sneezing). For information, go to ResearchMySUI.com or call toll free 1-855-344-1074.

Relatives of People withType 1 DiabetesThis study is searching for ways to prevent and quickly medically intervene in those newly diagnosed with diabetes. Researchers are seeking to test family

members of people with type 1 diabetes to determine if they show signs of developing the disease. Parents, brothers, sisters and children of those who have type 1 diabetes (ages 1-45), and cousins, nieces, nephews, aunts, uncles and grandchildren (ages 1-20) can be tested for their risk of developing type 1 diabetes free of charge. Benefits of participation include finding out your family members risk level for developing diabetes, possibly receiving an early diagnosis of diabetes that would allow for early treatment and contributing to the fight against type 1 diabetes. Adult patients or their relatives may call Shirley at (864) 455-3261. Relatives of pediatric patients may call Lisa at (864) 454-5168.

Children and Adolescents with NarcolepsyThe purpose of the trial is to learn more about the medication Xyrem as a safe and effective treatment alternative for treating children and adolescents who have narcolepsy with cataplexy. Eligible participants are diagnosed with this condition and are between ages 7-16. Participants must agree to keep all study appointments and be available for phone calls from study staff for the 52-week study period. Contact Amy,(864) 454-5591 or ahayes@ghs.org.

To learn more, visit ghs.org/research.

Participants Needed

Hundreds of clinical trials are conducted throughout Greenville Health System on a variety of drug therapies, surgical devices and other treatments in all areas of medicine.

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How does a new governance structure affect GHS governmental status? The intention is not to change GHS governmental status. The structure described in the first question allows GHS to remain in compliance with Act 432 of the Joint Acts and Resolutions of the General Assembly of the State of South Carolina, which states that GHS is authorized and empowered to do all things necessary or convenient for the establishment and maintenance of adequate hospital facilities for Greenville County. Decision rights on this matter rest solely with the Board of Trustees and permit the board to contract with or lease operations to private organizations.

H. Howell Clyborne Jr. is vice president, Community and Governmental Affairs, of Greenville Health System.

Q & A

The Future of Health Care in the Upstate

The Board of Trustees of Greenville Health System (GHS) has approved a new governance structure for the system. By taking these steps to position GHS for the future, the board is ensuring GHS is able to fulfill its mission and vision and continue providing care to all regardless of their ability to pay.

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What is the new governance structure? The governance structure approved by the Board of Trustees creates a multi-regional health system in which GHS and other healthcare entities could participate. In this structure, the multi-regional health system will be governed by a new private, not-for-profit entity that will provide strategic oversight for the multi-regional health system with services and operations rendered through affiliated entities.

A set of guiding principlessuch as remaining true to our history as an academic health center, understanding the need for flexibility in making key strategic decisions and embracing diversitywas established so the new structure will be capable of meeting community needs now and in the future.

Can you give an example of how it will work?GHS has leased its facilities to a Greenville-based Upstate affiliate organization that will be responsible for day-to-day operation and management of GHS. The Upstate affiliate organization is the same operationally as GHS is today; the system will continue to deliver patient care and

meet the healthcare needs of this community. The affiliate organization, along with other regional affiliates, will receive strategic direction from the private, not-for-profit entity that governs the multi-regional health system. Care in the Upstate will continue to be delivered under the GHS name and, over time, the role of the GHS Board of Trustees will transition to one of oversight of the lease agreement, assessing community need and ensuring the healthcare needs of the Upstate are met.

What are the benefits of the new governance structure? The board believes there are many benefits. One of the chief benefits is ensuring the flexibility to deliver care to more people across more communities while keeping healthcare decisions local. This flexibility is needed because our current structure restricts with whom we can partner.

The ability to manage the health of populations is the future of health care, and this proposed structure allows GHS to do so in partnership with others. These partnerships also bring value in terms of quality and cost savings to our community.

P R A C T I C E P R O F I L E

Inside Health 18

(l-r) Douglas Whitehead, MD; Sara Velky, PA-C; and Mark Zeigler, MD, practice patient-centered care.

Pediatric AssociatesGreer

Every child is an artist. The famous Picasso quote adorns a waiting room wall at Pediatric AssociatesGreer, a reminder that each child is a unique blend of personality, creativity, talents, interests, likes and dislikes.

We look for the child inside the patient and get to know him or her so that we can provide the best care, said Susan Shelley, MD, a pediatrician with the practice.

At Pediatric AssociatesGreer, best care is high-quality, compassionate and prompt, with a focus on developing healthy habits.

We believe that by promoting healthy emotional and physical development, Dr. Shelley explained, and by emphasizing the value of good nutrition, education and exercise, we can help children build a strong foundation for their future.

In its pleasant location, the practice offers well-child care, physicals, immunizations, treatment for chronic and acute conditions, and diagnostic testing.

Pediatric AssociatesGreer providers also place a priority on developing strong partnerships with parents. We make every effort to be an easily accessible, reliable medical resource for parents and to encourage them in their challenging role, Dr. Shelley noted.

That accessibility includes office hours six days a week, same-day sick appointments and after-hours help when parents may call the practice and speak with a triage nurse for guidance if a child becomes sick or injured.

Even as our practice grows with Greer, were fostering a friendly small-group feel, Dr. Shelley concluded. Families feel comfortable here.

ProvidersJeffrey N. Faust, MD, FAAPEdward H. Hausladen, MD, FAAPSusan C. Shelley, MD, FAAPRebecca W. Shoaf, MD, FAAPLynn M. Smith, MD, FAAPKristi Donlan, CPNP

Pediatric AssociatesGreer318 Memorial Drive Greer, SC 29650(864) 879-3883 ghschildrens.org/pag

HoursMonday-Friday, 8:30 a.m.-5:00 p.m. (extended hours weekdays as needed for sick children)Saturday, 8:30-11:30 a.m.

(l-r) Drs. Shelley, Faust, Hausladen and Shoaf are four of the providers who care for the kids of Greer.

Having a personal physician with whom you can establish a lifelong relationship is as important as getting your screenings. If you need assistance finding one, here is a list of GHS primary care practices or call GHS Physician Finder at 1-844-GHS-DOCS (447-3627). To find out more about these practices, go to ghs.org/mydoctor. For a complete list of primary and specialty physicians, go to ghs.org.

G H S P R I M A R Y C A R E P R A C T I C E S

19 Inside Health

CLEMSONClemson-Seneca Pediatrics208 Frontage Rd., Ste. 1, 29631654-6034

CLINTONAdvanced Family Medicine*210 S. Broad St., 29325833-0973

Carolina Womens Center102 Medical Park Ct., 29325938-0087

GHS Internal MedicineLaurens22725 Hwy. 76 E., Ste. A, 29325833-4545

DUNCANPalmetto Medical Associates*500 Squires Pte., 29334968-5123

Pediatric AssociatesSpartanburg*500 Squires Pte., 29334582-8135

EASLEYPediatric AssociatesEasley*800 N. A St., 29640855-0001

GRAY COURTLaurens Family Medicine*9100 Hwy. 14, 29645876-4888

GREENVILLECarolina Pediatrics of Greenville*200 Patewood Dr., Ste. A120, 29615454-2670

Center for Family Medicine*877 W. Faris Rd., Ste. A, 29605455-7800

The Childrens Clinic*890 S. Pleasantburg Dr., 29607271-1450415 Duncan Chapel Rd.,29617522-2600

Childrens Hospital After-hours Care (Urgent Care)890 S. Pleasantburg Dr., 29607271-3681

Christie Pediatric Group*9 Mills Ave., 29605242-48403911 S. Hwy. 14, 29615522-1340

Cross Creek Internal Medicine*50 Cross Park Ct., 29605797-7035

Cypress Internal MedicinePatewood*200 Patewood Dr., Ste. B460, 29615454-2226

GHS Internal MedicineMaxwell Pointe*3907 S. Hwy. 14, 29615522-1300

GHS Pediatrics & Internal MedicineWade Hampton*1809 Wade Hampton Blvd., Ste. 120, 29609522-5000

Greenville Family Medicine*2-A Cleveland Ct., 29607271-7761

Greenville Midwifery Care & Birth Center35 Medical Ridge Dr., 29605797-7350

Greenville Ob/Gyn Associates2 Memorial Medical Dr., 29605295-42101025 Verdae Blvd., Ste. F, 29607286-7500

Greenville Pediatric Health Center*1350 Cleveland St., 29607 263-3012

Gynecology Specialists890 W. Faris Rd., Ste. 510, 29605101 Halton Village Circle, 29607455-1600 (for both)

Internal Medicine Associates of Greenville1025 Verdae Blvd., Ste. A, 29607242-4683

MD360(Urgent Care)1025 Verdae Blvd., Ste. B, 29607286-7550

Piedmont OB/GYN890 W. Faris Rd., Ste. 330, 29605455-12703917 S. Hwy. 14, 29615522-1360

Riverside Family MedicineEastside*215 Halton Rd., 29607454-2700

Riverside Family MedicineMaxwell Pointe*3909 S. Hwy. 14, 29615522-1320

GREERThe Childrens Clinic*325 Medical Pkwy., Ste. 150, 29650797-9300

Cypress Internal MedicineGreer*325 Medical Pkwy., Ste. 200, 29650797-9550

Family MedicineMountain View*406 Memorial Dr. Ext., 29651877-9066

Greer Family Medicine*1107 W. Poinsett St., 29650879-8886

Greer OB/GYN325 Medical Pkwy., Ste. 100, 29650797-9200

MD360(Urgent Care)1305 S. Suber Rd., 29650989-4609

Pediatric AssociatesGreer*318 Memorial Dr., 29650879-3883

LAURENSLaurens Family Medicine*106 Parkview Dr., 29360984-0571

PIEDMONT/POWDERSVILLEHeritage Pediatrics & Internal MedicineWren*1115 Wren School Rd., 29673859-0740(in collaboration with Baptist Easley)

Inside Health is published by Greenville Health System as a community service. This information is for educational purposes solelyit should not take the place of medical advice or diagnoses made by healthcare professionals.

Greenville Health System is known for its comprehensive services and world-class physicians, in addition to being an academic health center and conducting leading-edge research. However, our compassion and strength come from our people15,000 dedicated professionals, your neighbors, who work together to care for you and your family.

Editor-in-chiefJerry R. Youkey, MDExecutive VP, Medical andAcademic Affairs, Greenville Health SystemFounding Dean, USC School of Medicine GreenvilleUSC Associate Provost for Health Sciences Greenville

Art DirectionGHS Creative Services

Contributing PhotographerGeorge Reynolds

For more information, contact Nancy Parker, Editor,Marketing CommunicationsGreenville Health System701 Grove RoadGreenville, SC 29605-5601(864) 797-7541nparker@ghs.org

2016 Greenville Health System16-03455/16*The National Committee for Quality Assurance (NCQA) Recognition Programs assess whether clinicians and practices support the

delivery of high-quality care and are built on evidence-based, nationally recognized clinical standards of care.Most insurances accepted, including S.C. Medicaid program and Medicaid Managed Care.The practices listed here are part of GHS Partners in Health, Inc.

MD360(Urgent Care)11402 Anderson Rd., Ste. A, 29611631-2799(in collaboration with Baptist Easley)

Pediatric AssociatesPowdersville*207 Three Bridges Rd., 29611220-1110

Premier Womens Care209 Three Bridges Rd., 29611220-4209

SENECABetween the Lakes Primary Care106 Ram Cat Alley, 29678888-4445

Blue Ridge Womens Center103 Carter Park Dr., 29678482-236010110 Clemson Blvd., 29678985-1799

Clemson-Seneca Pediatrics111 Omni Dr., 29672888-4222

Mountain Lakes Community Care(Urgent Care)100 Omni Dr., Ste. B, 29672885-7425

Mountain Lakes Family Medicine10110 Clemson Blvd., 29678482-3148

Dr. Timothy Sanders Family Medicine100 Omni Dr., Ste. A, 29672885-7520

Seneca Medical Associates11082 N. Radio Station Rd., 29672882-2314

Upstate Family Medicine12016 N. Radio Station Rd., 29678882-6141

SIMPSONVILLEThe Childrens Clinic*727 S.E. Main St., Ste. 100, 29681454-6520

Christie Pediatric Group*1409 W. Georgia Rd., Ste. A, 29680454-5062

Cypress Internal MedicineSimpsonville*1409 W. Georgia Rd., Ste. D, 29680454-6540

Family & Internal MedicineSimpsonville727 S.E. Main St., Ste. 300, 29681522-1170

Greenville Ob/Gyn Associates727 S.E. Main St., Ste. 120, 29681454-6500

Heritage Pediatrics & Internal MedicineSimpsonville*727 S.E. Main St., Ste. 320, 29681454-6440

Hillcrest Family Practice*717 S.E. Main St., 29681522-5400

Keystone Family Medicine*1409 W. Georgia Rd., Ste. B, 29680454-5000

MD360(Urgent Care)300 Scuffletown Rd., 29681329-0029

SPARTANBURGChildrens Hospital SpartanburgNight Clinic*201 E. Broad St., Suite 210, 29306 804-6998

Pediatric AssociatesSpartanburg*249 N. Grove Medical Park Drive, Ste. 100 582-8135

Skylyn Medical Associates1776 Skylyn Dr., 29307 577-9970

Spartanburg Pediatric Health Center*201 E. Broad St., Suite 210, 29306 707-2135

TRAVELERS RESTTravelers Rest Family Medicine*9 McElhaney Rd., 29690834-3192

701 Grove Road Greenville, SC 29605-5601

NONPROFIT ORG.U.S. POSTAGE

P A I DGREENVILLE SCPERMIT NO. 842

GHS VisionTransform health care for the benefit

of the people and communities we serve.

GHS MissionHeal compassionately. Teach Innovatively.

Improve constantly.

GHS ValuesTogether we serve with integrity, respect,

trust and openness.

Baptist Easley: New Look, Same Excellence in Health CareThe goal of Baptist Easley (BE) always has been to bring the best health care close to home. Six years ago, as part of that journey, Baptist Easley entered a partnership with Greenville Health System (GHS), with GHS becoming part owner (along with Palmetto Health). This partnership advances health care for BEs growing community in a cost-effective manner by increasing access, enhancing quality and facilitating the coordination of patient care. The result has been consistent care that meets GHS high standards.

Baptist Easley, an important part of the GHS family, recently unveiled a new logo that reflects its relationship with GHS and its ongoing commitment to enhance the health and lives of the people it serves.

We will continue to care for our local community with the same commitment and passion as always, said Baptist Easley CEO Michael Batchelor. In conjunction with GHS, we proudly continue to provide access to the best possible health care here in our own local community.

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