Three Common Misconceptions about Melanoma

Former President Jimmy Carter shared recently that he is being treated for four spots of melanoma on his brain, sparking a national conversation and revealing some misconceptions that persist about melanoma.

In light of this conversation, we asked renowned melanoma researcher Dr. Sancy Leachman to dispel some of the most common myths she hears about this disease.

Myth #1: Brain cancer starts in the brain.

Fact: Often, people think that cancers that are in the brain start in the brain, but many cancers, especially melanoma, start on the skin but spread to the brain or the liver or other organs. The way that cancer kills you is through the metastasis that keeps vital organs from performing life-critical functions.

Myth #2: Men are diagnosed with melanoma more frequently than women.

Fact: Because melanoma rates are highest in men over 55, like Jimmy Carter, many people don’t realize that the rates of melanoma are increasing in young women and that melanoma is the leading cancer in women aged 26-29.

Myth #3: Sun exposure from my past doesn’t put me at risk for melanoma.

Fact: Just because sun exposure happened many years ago doesn’t mean your overall risk of developing melanoma is less, your cumulative sun damage and genetic risk (red hair, light skin, family history, etc) hasn’t changed.

Interested in helping researchers figure out how to best prevent, treat and detect melanoma? Join the new Melanoma Community Registry.

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CHErFRCUYAAXaYmSancy Leachman, M.D., Ph.D., is a physician-scientist who chairs the Department of Dermatology and is the director of the Melanoma Research Program at the Knight Cancer Institute. She is a dermatologist using basic science research and state-of-the-art technology to combat skin cancer.

 

 

Intel & OHSU Announce Collaborative Cancer Cloud at Intel Developer Forum

Each year millions of people all over the world, including more than 1 million patients in the United States, learn that they have a cancer diagnosis. Instead of going through painful chemotherapy that can kill healthy cells along with cancerous cells, what would happen if those patients were able to be treated as individuals based on their specific genome sequencing, and a precision treatment plan could be tailored specifically for their disease? And what if it could happen within 24 hours?

Today, I announced at the Intel Developer Forum that we are setting our sights on making this scenario a reality through an ambitious, open Platform-as-a-Service solution called the Collaborative Cancer Cloud.

The Collaborative Cancer Cloud is a precision medicine analytics platform that allows institutions to securely share patient genomic, imaging and clinical data for potentially lifesaving discoveries. It will enable large amounts of data from sites all around the world to be analyzed in a distributed way, while preserving the privacy and security of that patient data at each site.

The end goal is to empower researchers and doctors to help patients receive a diagnosis based on their genome and potentially arm clinicians with the data needed for a targeted treatment plan. By 2020, we envision this happening in 24 hours — All in One Day. The focus is to help cancer centers worldwide—and eventually centers for other diseases—securely share their private clinical and research data with one another to generate larger datasets to benefit research and inform the specific treatment of their individual patients.

The Rise of Precision Medicine                        

Precision medicine – taking into account individual differences in people’s genes, environments, and lifestyles – is one of the biggest of the big data problems and is on the cusp of a remarkable transformation in medicine. We view genomics as the first wave of precision medicine, and we’re working with our partners to drive adoption of genomic sequencers, genomic appliances, and cloud-based genomic analytics. With the Collaborative Cancer Cloud, we are combining next generation Intel technologies and bio-science advancements to enable solutions that make it easier, faster, and more affordable for developers, researchers, and clinicians to understand any disease that has a genetic component, starting with Cancer.

Initially, Intel and the Knight Cancer Institute at Oregon Health & Science University (OHSU) will launch the Collaborative Cancer Cloud. We expect two new institutions will be on board by 2016, addressing the critical need for larger patient pools and practitioner awareness. And from there, we can open up this federated, secure Collaborative Cancer Cloud network to dozens of others institutions—or let them create their own–to accelerate the science and the precision treatment options for clinicians to share with their patients. They can also apply it to advance personalized research in other diseases that are known to have a genetic component, including Alzheimer’s, diabetes, autism, and more.

In the same timeframe, we also intend to deliver open source code contributions to ensure the broadest developer base possible is working on delivering interoperable solutions. Open sourcing this code will drive both interoperability across different clouds, and allow analytics across a broader set of data – resulting in better insights for personalized care.

A Complementary Effort

You may be asking, “Haven’t we seen efforts like this before?” There have been numerous multi-institution partnerships formed to utilize big data analytics to look for insights about cancer and its treatment. Our focus on the federation/distribution of private datasets is complementary to the exciting work that’s happening to make public data sets more accessible to research. In CCC, each partner will maintain control of its patients’ data, while the shareable cancer treatment knowledgebase grows in availability and in impact. We want to help harness the power of that data — in a way that benefits clinicians, researchers and patients with a better knowledgebase and preserves security and privacy. By securely sharing clinical and research data amongst many institutions while maintaining patient privacy, the entire research community can benefit from insights revealed in large data cohorts.

In the end, precision medicine will only be as precise as available data allows. To better understand complex diseases like cancer, the medical and technology industries must collaborate to make the growing wealth of insights resulting from secure analysis of public and private genetic datasets accessible for the patient’s benefit. And if we do, we can turn an agonizing and uncertain process for the patient into a personalized process that occurs all in one day.

We encourage you to view the links below to learn more about our work with OHSU:

OHSU’s Exacloud

Collaborative Analytics for Personalized Cancer Care

Learn more about precision medicine and genomic code research at these resources:

www.intel.com/healthcare/optimizecode

https://www.whitehouse.gov/precision-medicine

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profile-image-display.jspaEric Dishman is the Director of Proactive Health Research at Intel Corporation. This post originally appeared on Intel’s Health & Life Sciences blog.

Three Questions for OHSU’s Dr. Karen Oh

Meet Karen Oh, M.D., associate professor of diagnostic radiology in the OHSU School of Medicine and Director of Breast KarenOh_IMG_9296-webImaging at OHSU.

Dr. Oh functions as part of a multidisciplinary breast team that includes subspecialized breast surgeons, radiation oncologists, hematologic oncologists, genetic counselors and breast health nurses.

Dr. Oh recently spoke with the OHSU School of Medicine about developments in diagnostic radiology – including the passage of new legislation that aims to educate patients on how breast tissue density may impact cancer detection – and advancements she hopes to see in the future.

What’s been the most interesting development in your area in the last two years?

The Oregon Breast Density Rule was passed and has been in effect since January 2014. This state-specific rule was first passed in Connecticut, and in the Oregon legislature was sponsored by one of our own faculty members, Senator Elizabeth Steiner Hayward. Senate Bill 420 mandates that mammogram facilities must provide specific lay person verbiage to patients with dense breast tissue, in an attempt to educate patients on how breast tissue density may impact mammographic cancer detection.

This paragraph of information opens discussions between patients and their providers about whether additional breast screening tests are warranted. More information can be found on this State of Oregon website.

What is the most important aspect of support that OHSU provides to you currently and how would you like this or other support to grow in the future?

The most important aspect of support that OHSU provides is the dedication to excellent patient care. OHSU encourages the multidisciplinary approach, and our patients can only benefit from this.

Within the areas where I work, including the Breast Center, Center for Women’s Health and Perinatal Center, I am lucky to work with providers and staff from many different specialties. We come together on a daily basis as peers to collaborate on patient care. Allowing providers the time and resources to continue this type of collaboration is important for the future of health care at OHSU, and I would like to see increasing support toward this goal.

A hypothetical: If you could have one tool that would solve a seemingly impenetrable problem in your work, what would it do? You have unlimited resources to design this tool, so think big.

Much of my clinical time and efforts are spent in the Breast Center. There, I interpret breast imaging studies and perform biopsies of breast lesions in an attempt to diagnose breast cancer at an early stage. The difficulty with breast cancer is that most instances occur in women who have no known genetic predisposition. Unlike smoking and lung cancer, there is no known direct cause for breast cancer. We just don’t know why women get breast cancer, which is why screening mammography was implemented.

However, there is controversy about screening mammography and much discussion about over-diagnosis, or the diagnosis of a cancer that would not ultimately be apparent to a patient if we hadn’t found it on a screening exam. While this may be true for some breast cancers, we don’t know which cancers will eventually be fatal. If there were a way to know which cancers at diagnosis would be fatal, this key information would significantly mitigate the effects of over-diagnosis and over-treatment.

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This blog post originally appeared on OHSU’s internal “Inside the SOM” blog, authored by Jennifer Smith, Senior Communications Specialist in the OHSU School of Medicine.

Memories of a White Coat

white coat ceremonyLast Friday, it was my pleasure to serve as the emcee for the M.D. Class of 2019 White Coat Ceremony and the J.S. Reinschmidt Lecture.

The white coat is a time honored tradition in the medical field, marking an important step in each future physician’s journey.

I remember when I was sitting in that seat, during my own White Coat Ceremony at the University of Utah Medical School. I was filled with plenty of emotions – happiness, excitement, nervousness, fear of the unknown, but above all, hope about the future. While that was 19 years ago, it really doesn’t seem that long ago!

In my address to students, I asked them to visualize their future selves: as seasoned physicians and lifelong learners, as public servants who provide comfort, as collaborators who work seamlessly with other health care professionals, as leaders in their future fields.

In the first days and weeks of one’s medical school experience, it may be hard to see that future self. But just as countless physicians have done before, it is important that today’s students trust that the process will lead them to a crisp, clear and obvious end.

Last week, 146 students made their first step in a journey that I remember like it was yesterday. At the time of my White Coat, I had followed my dream of going to medical school, and I quickly realized that caring for children as a pediatrician was my calling.

My path through medical school and pediatrics residency training at OHSU culminated when I was fortunate to join the faculty as one of three members of a new group of pediatric hospitalists at Doernbecher Children’s Hospital. As a medical student and resident, I had not heard of nor worked with anyone called a “hospitalist” and yet now the field is the fastest growing pediatric specialty in the U.S.

Today, as an educator, I’m looking forward to seeing where the road leads for the Class of 2019.

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Tracy Bumsted

Tracy Bumsted, M.D., MPH, FAAP, has been the Associate Dean for Undergraduate Medical Education at the OHSU School of Medicine since 2013. Dr. Bumsted is a practicing board certified pediatrician on the inpatient unit at Doernbecher Children’s Hospital, where she is a member of the Division of Pediatric Hospital Medicine in the Department of Pediatrics. 

Childhood hearing loss inspires OHSU researcher’s breakthrough

As a child, Peter Steyger, was cured of meningitis. Unfortunately, the same drug that saved him caused significant and long-lasting hearing loss.

Now a neuroscience researcher at OHSU, Dr. Steyger and his team have found patients stricken with dangerous bacterial infections are at greater risk of hearing loss than previously recognized.

We sat down with Dr. Steyger to learn some more about his research.

That’s a great photo of you with your speech therapist. Can you tell us how your personal experiences have shaped your research?

Peter Steyger underwent speech therapy in 1968 at the University of Manchester with Gordon Campbell and his mother, Peggy Steyger.

Peter Steyger underwent speech therapy in 1968 at the University of Manchester.

The photo was taken of me with my mother and Gordon Campbell, a speech therapist and coach for my mother, who was to teach me how to listen and talk. Gordon Campbell was at the University of Manchester (UK) at the time, where my mother and I would attend sessions with him to improve our own daily speech therapy sessions.

At the time of the photo, I was about six years old, and had been receiving speech therapy for close to three years.  This speech training allowed me to be mainstreamed and obtain a regular grammar school education.

I was in speech therapy because I had lost my hearing though meningitis, streptomycin treatment, and as the recent manuscript showed, the combination of infection-induced inflammation likely potentiated the ototoxic effect of these aminoglycosides.

My own experience has informed my research, primarily through the realization that most ototoxicity experiments are done in healthy pre-clinical models, and yet aminoglycosides are only given to very sick patients to save their lives.

What’s been the most interesting development in your area in the last two years?

One of the most interesting developments in auditory neuroscience that has affected our research in ototoxicity is the realization that the cochlea is not an immunologically-privileged site, and that in fact the cochlea and inner ear does in fact respond to vascular and immunological activation.

Lower power image of the cochlear coils, containing hair cells

Lower power image of the cochlear coils, containing hair cells

This has been characterized by our colleague, Dennis Trune, who established that the cochlea is immunologically activated by middle ear infections, and this could alter auditory function. More importantly, these inner ear changes may alter auditory function.

What’s next for you? What projects are you currently working on/looking forward to?

To follow up on our existing data and establish whether it is inflammation in general that potentiates drug-induced hearing loss, or if there is something specific about bacterial-induced inflammation that potentiates drug-induced hearing loss.

We also want to determine if individuals with bacterial infection and inflammation have a greater prevalence of hearing loss.

What is the most important aspect of support that OHSU provides to you currently and how would you like this or other support to grow in the future?

Peter Steyger

Peter Steyger, Ph.D.

OHSU has a vast array of research expertise in a wide variety of areas that are surprisingly integrated when it comes to translating bench science into bedside practice.

I have found our basic and clinical colleagues to be very collegial, collaborative and supportive. This is further enhanced by the seed-funding of newly-innovative ideas (acorns) into thriving translational and clinical research projects that support our communities statewide and globally.

Click here to learn more about Dr. Steyger’s work with the Oregon Hearing Research Center.

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This blog post originally appeared on OHSU’s “On the Brain” blog.

Thank you to OHSU’s “Godmother of Midwifery”

By Ariane Le Chevallier, OHSU Communications 

How lucky I am to have known someone who was so hard to say goodbye to! This month, we celebrate the retirement of Dr. Carol Howe, Associate Dean for Practice at OHSU’s School of Nursing and Director of the Nurse-Midwifery Education Program.

Dr. Howe has served OHSU for over 35 years and her remarkable contributions to midwifery and women’s health, not only at OHSU, but all across Oregon are truly inspiring.

I had a chance to sit down with Dr. Howe to talk about how she came to midwifery, to OHSU and to reflect on some of the highlights of her career.

Q: How long have you been at OHSU?

Carol Howe Retirement Party_2A: I first came to OHSU in 1974. I was here for three years and started the midwifery practice during that time. Then I moved to San Francisco while my husband was completing his residency, and I earned my doctoral degree. We came back in 1980 and I’ve been here ever since.

Q: How did you decide to pursue midwifery?

A: Well, it turned out to be sort of an accident more than anything else. I got a catalogue from Yale, which had a master’s in maternal/newborn nursing, with a note saying that graduates are eligible to be nurse-midwives. I had never heard of a nurse-midwife at that time. I applied and got in.

Q: How have you seen midwifery change over the years?

A: The biggest change has just been in name recognition. People now understand what a midwife is. When I moved to Oregon, there was one other nurse-midwife practicing and she was in Eugene. Now we have about 300 nurse-midwives statewide, and we deliver just shy of 20 percent of the babies in the state.

Q: What has your career been like?

A: My biggest accomplishment was starting the nurse-midwifery practice at OHSU, which has turned into a wonderful and robust part of the services we offer here. Also, starting the educational program and having it be so successful.

The biggest challenge is the sheer workload. The hours of a midwife are hard. It’s intense. When you’re with a patient, you are actually there. Midwife means “with woman” so you are really there. It’s a very intense time. When you are finished with a birth, you are used up emotionally and physically. It’s a hard balance to keep up.

Q: What are the benefits of having a nurse-midwife as part of your birth plan, as opposed to perhaps a physician?

A: We like to say that we are a team and there are some things that midwives are better at, some things physicians are better at. Patients benefit from having access to both. Midwives spend a great deal of time on patient education and paying attention to the whole of what’s happening to the woman, including her family and life in general, and her psychosocial needs.

The most important thing for a woman in pregnancy is to trust her provider, whether it’s a direct-entry midwife, physician, or a nurse-midwife. If she trusts her provider, a woman can just relax and let her body do the work it needs to do. 

Q: Looking back on your career, what have been some of the highlights?Carol Howe Retirement Party_1

A: Every year is a highlight. On the education side, every year when we graduate our students, it’s such an emotional time for them, but also for the faculty. I am really proud of the graduates of this program. There have been some incredible births. There have been some real challenges.

Q: How many babies you’ve delivered?
A: I don’t know! I never counted. I wish I had! It’s got to be over 1,000….I was too busy!

Q: What are you looking forward to in retirement?

A: Sleeping late. Visiting my grandchildren, maybe traveling with my husband. Beyond that, I haven’t got a whole lot of plans…I have some incredibly good friends and faculty colleagues and I’ve been watching to see how they are doing and how they are making that transition!

Q: How would you like your staff, students and faculty to remember you?

A: As a good midwife. It’s just been a great journey, one I didn’t expect. I’ve had a great time and people have had my back all the time. Everybody has somehow made this possible for me.

Thank you Dr. Howe and best wishes for a wonderful retirement. For more information (and some great photos of Dr. Howe over the years), check out her story on OHSU’s Historical Notes blog.

Simple steps to maximize heart health

By now, we’ve all heard the recommendations for a heart-healthy diet – reduce your saturated fat intake, avoid trans fats, cut back on salt. But did you know there are specific foods you can eat that can help lower your LDL (“bad”) cholesterol even further?

Researchers have created a “portfolio” of cholesterol-lowering foods, that, when eaten together along with a heart-healthy diet, are even more effective at reducing LDL cholesterol than a low-saturated fat diet alone.

Follow these four simple steps to maximize your heart health.

1. Soluble fiber
The two types of fiber, soluble and insoluble, are beneficial for a host of health issues, but getting 10 grams of soluble fiber every day is useful for reducing LDL cholesterol.

Fiber is found in all whole plant foods such as fruits, vegetables, legumes, nuts, and grains; foods highest in soluble fiber include oats, barley, beans, citrus fruits, apples, okra, eggplant, and ground flaxseeds. You can also take a fiber supplement made from psyllium husk (e.g., Metamucil).edamame

2. Soy
Aim for adding 25 grams a day of soy protein to help lower LDL cholesterol and reduce your risk of heart disease.

Choosing more plant proteins, such as soy, in place of animal proteins helps reduce intake of saturated fat and cholesterol while increasing fiber.

To get to 25 grams, aim for two servings of soy foods a day—examples of a serving include ½ cup shelled edamame, 1 cup soy milk, ½ cup tofu, 3 ounces tempeh, or a soy “burger” (such as Boca Burger).

3. Almonds
This study looked specifically at eating ¼ cup of almonds every day (plain, not salted or honey-roasted), but the heart benefits of all nuts are well-documented.

Sprinkle them on your oatmeal, salad, or stir-fry, or simply eat a small handful as a snack.

4. Plant sterols and stanols
Plant sterols and stanols are naturally found in plant foods such as fruits, vegetables, and grains, and are very effective at lowering LDL by blocking cholesterol from being absorbed into the bloodstream.

The problem is that it’s impossible to eat enough fruits and vegetables (even for this dietitian!) to get to the recommended dose of 2 grams a day.

Many foods have added plant sterols and stanols (such as Benecol and Take Control margarine or Minute Maid Heart Wise orange juice), but I prefer a capsule such as Nature Made CholestOff (taken with meals).

These supplements help to avoid the extra calories from fortified foods (it takes 4 tablespoons of Benecol spread to get to the recommended 2 grams of plant sterols – too much margarine, in my opinion!).

After years of hearing what we shouldn’t eat, I love being able to tell people that eating more of certain foods can improve their health.

Enjoy!

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Severson-Tracy_13_blog

 

Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.

 

Women’s health: 9 tips for better eye care

Recently, comedienne Roseanne Barr announced that she has macular degeneration and glaucoma, and is losing her vision.

Unfortunately, this is an all too common occurrence.

A recent study by Prevent Blindness America showed that women are at higher risk than men for most eye diseases that cause vision loss, including glaucoma, age-related macular degeneration, cataracts, and diabetic eye disease, among others.

Of the 20.6 million Americans 18 and older who experienced vision loss in 2014, 12.4 million (60.1 percent) were women, according to the American Foundation for the Blind. One reason for this is that diseases of the eye increase with age, and women tend to outlive men. Women are also more likely to suffer from dry eye and to have hormonal-related changes in vision.

I’d like to encourage women to consider the following eye health and safety tips. Ask any of my patients: vision loss is life-changing.

  • Get a comprehensive eye exam. For people who wear contacts or glasses, I recommend an eye exam every 1 to 2 years. If you don’t wear contacts or glasses, you should get an eye exam at age 40, and by age 50, you should be getting an eye exam every year as eye diseases are more common with age. Women with a family history of eye disease or who have certain diseases themselves, especially diabetes or autoimmune disease, should be going even earlier.
  • Take contact lens hygiene seriously. If you wear dailies, change them daily. If you wear bi-weekly contacts, change them bi-weekly. And use appropriate cleaning solutions. Wearing contacts too long, and especially sleeping in them, can cause blood vessels in the eyes to grow into the cornea and can also lead to an increased risk of infection. Both infections and contact lens over use may lead to permanent scarring in the eye. Don’t be afraid to wear eyeglasses. With so many styles to choose from these days, there’s no excuse for not giving your eyes a rest.
  • Protect your eyes when doing those DIY home projects. Women are as prone to eye injuries from DIY projects as men. Protect your eyes with safety goggles. One little slip-up could scratch your cornea or lacerate the entire surface of your eye, causing permanent damage. You may need surgery, could lose your vision, or, worst case, lose your eye entirely. If your kids are helping out, they should wear protective eyewear too.
  • Be aware of vision changes during pregnancy. Women experience hormonal changes during pregnancy, some of which can affect eyesight and your prescription. Also, if you are diabetic and planning to become pregnant or are pregnant, it’s a good idea to get a complete eye exam to check for diabetic eye disease, including diabetic retinopathy. You may need to be monitored more closely throughout your pregnancy.
  • Tell your eye doctor what medications you are taking. Medicines can affect your vision. Antidepressants, allergy medicines, immunosuppressives and a host of other medications can lead to changes in the eye. If you’ve started taking a new medication and your vision changes, make an appointment with your eye doctor.
  • Treat dry eye properly. If you have dry eye, try a humidifier at home, use preservative-free eye drops and don’t forget to blink, especially when reading or using the computer.If you have severe dry eye, talk to your eye doctor – you may need to get a prescription eye drop, or even plugs to block drainage.
  • Quit smoking. Smoking has been associated with cataracts, age-related macular degeneration and corneal diseases.
  • Wear sunglasses! This one goes without saying. Exposure to sunlight causes UV damage which can cause cataracts or tumors.
  • Eat a balanced diet and exercise. Eat green leafy veggies, oily fish and fruit. These contain vitamins, minerals and fatty acids that can slow down the progression of some eye diseases. But make sure to consult your doctor about any supplements.

If you have blurry vision, eye pain or loss of vision, make an appointment with an eye doctor ASAP.

Early detection is key with all eye diseases. The sooner we know what’s going on, the better we can diagnose and treat your eyes.

For more information on eye diseases and how to take better care of your eyes, go to CaseyEye.com.

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Afshan Nanji, M.D., M.P.H., is an Assistant Professor of Ophthalmology at Casey Eye Institute. 

 

A better way to document patient end-of-life treatment wishes

For decades, Oregon has led the country in systems change to assure the treatment wishes of those nearing the end of life are consistently honored. The last thing any patient wants is to have clearly documented their wishes through a delicate and thoughtful conversation with their health care professional and family members, and by filling out Physician Orders for Life-Sustaining Treatment (POLST) form, and then not have those wishes honored.

That’s why Oregon Health & Science University launched ePOLST, a fully integrated online version of POLST. ePOLST will assist OHSU, and other health systems across the country that use the Vynca software, in more accurately recording and accessing the wishes of patients who are nearing the end of life.

Harriet, the patient whose POLST form could not be found

A better system

Why do we need a new system? Because there are too many stories like those of Harriet, a 94-year-old Oregon woman, now deceased, who signed a POLST form with her doctor two years ago. She needed to go to the hospital because her broken hip caused so much pain, but being admitted to intensive care was against her wishes.

Health care providers weren’t able to find her POLST form. Harriet’s family hopes that OHSU’s new ePOLST system will make POLST orders available right away so that other families can avoid the anguish of having to stop unwanted treatments.

The POLST form was created in 1990 in an effort to ensure the wishes of those with advanced illness or frailty are followed. POLST programs have been adopted or are in development in 43 states across the country.

POLST forms are strongly associated with desired care received. A survey of patients showed that less than 10 percent of patients want to die in the hospital. Unfortunately, without a POLST form, four times that many still do.

Knowing we needed to continue evolving the POLST program, we connected with Ryan Van Wert, M.D., the co-founder of Vynca and a critical care physician who comes from Stanford Biodesign.

Having seen the end-of-life care wishes of patients ignored simply because they couldn’t find their POLST form, his team worked collaboratively with OHSU’s EPIC support team, the OHSU Center for Ethics in Health Care, Oregon POLST Registry and Oregon POLST to pilot ePOLST, which launched in April.

Phase One

In the first phase of the launch, ePOLST allows OHSU clinicians to electronically and more quickly and accurately submit a POLST form, drastically reducing the need for paper forms, which are error-prone. (The current statewide error rate for paper POLST forms submitted to the Oregon POLST Registry is 18 percent.)

Vynca team that developed ePOLST

OHSU clinicians can also now easily view a patient’s POLST form, which is located at the top of their EPIC electronic health record, if they have one.

This is critical in crisis situations where care teams are making decisions about treatment options.

Phase Two

In the next phase, OHSU clinicians will be able to electronically search the Oregon POLST Registry through ePOLST, which will make it easier to find POLST forms from other health care systems.

In Oregon, more than 250,000 POLST forms have been submitted to the registry since its inception in 2009.

More than 5,000 health care professionals have called the registry seeking forms in a time of urgent need — 2,000 of those patients had POLST forms provided to guide their care.

What’s next?

After almost two years, we’re happy to report the system is working well and is on track for the next phase! The fewer errors we have with POLST forms, and the easier we can find forms, the better care we can give to our patients, while also respecting their wishes.

Learn more about OHSU’s POLST Paradigm Initiative, or get involved with POLST Oregon.

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Susan Tolle, M.D. is the Director of the OHSU Center for Ethics in Health Care and Chair of the Oregon POLST Task Force.

Skin care event brings together researchers, registry participants

Join us Saturday, May 30, at the OHSU Center for Health & Healing for our Skin Cancer Research Expo and Sun Safety Event!

The expo differs from many other health events in that it will give community members an opportunity to take part in ongoing research.

Sancy Leachman, M.D., Ph.D., the director of the Melanoma Research Program at the Knight Cancer Institute and chair of the OHSU Department of Dermatology

The research expo is our first major OHSU melanoma-related event since Sancy Leachman, M.D., Ph.D., director of the OHSU Knight Cancer Institute’s Melanoma Research Program and chair of the OHSU Department of Dermatology, launched the Melanoma Community Registry in May 2014.

The first event was a symposium in November that attracted about 125 patients, friends and family; the registry has grown to more than 3,330 participants since launching.

The registry’s aim is to develop a cohort of survivors, family members and others to help researchers understand how to best prevent, treat and detect melanoma, and the Skin Cancer Research Expo is a significant opportunity to be face-to-face with physicians, scientists, survivors and advocates to help expand those efforts. About 10 researchers, including nine from OHSU, will be on hand to connect with attendees about research opportunities.

Among the researchers participating in the expo:

  • Leachman, who will ask survivors and advocates to join the Melanoma Community Registry. She will also have three surveys on hand: one is for all registry members intended to ascertain what information and research projects they would be interested in participating; another asks survivors about their quality of life; and the third is about sunscreen use.
  • The OHSU Knight BioLibrary, which will invite all attendees to donate blood for research. Attendees will be invited to join the Personalized Cancer Medicine Registry to become a donor and help grow this vital research resource.
  • Paul Spellman, Ph.D., professor of molecular and medical genetics, OHSU School of Medicine, and a researcher in the OHSU Knight Cancer Institute, who will seek blood donations from a subset of melanoma survivors. Free-floating DNA in the blood will be sequenced to determine if researchers can measure tumor DNA in the blood stream with the intention of developing a simple, non-invasive way to detect recurrence of cancer at a much earlier point than is currently possible.
  • Andrew Trister, M.D., Ph.D., a senior physician with Sage Bionetworks in Seattle, Wash., and Dan Webster, Ph.D., developer of an iPhone application called Mole Mapper (which measures and tracks moles), who will solicit feedback about the app.

The expo will also include information on how attendees can monitor their skin health, the best sunscreens to use and games for attendees of all ages. OHSU and Portland dermatologists will be on hand to offer free skin checks in a private clinic room, as well.

You can join the registry here, and visit our site to learn more about the research expo. We’d also love for you to connect with the Knight Cancer Institute on Facebook and Twitter.

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Matt Wastradowski is a Communications Specialist for the Knight Cancer Institute.

Why 96,000 Square Miles?

OHSU Health Fair at Pioneer Square.

President Robertson is fond of saying that OHSU has a 96,000 square mile campus, serving Oregonians “from Enterprise to Coos Bay, from Portland to Klamath Falls.”

This blog aims to highlight that breadth. 96,000 Square Miles (96K for short) will focus on the people of OHSU, the Oregonians we serve and the ripple effect of our work in Oregon and beyond.

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Participation Guidelines

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