As the suppressing drama of the coronavirus progresses, Northeast Pennsylvania’s health care system is still marching forward with targeted expansions to technology, facilities, treatments and the vital human touch.

Within the critical arena of workforce development, the Northeastern Pennsylvania Health Care Foundation is unveiling a $1.5 million initiative for Lackawanna, Luzerne and Wyoming counties. Known as Careers in Care, the effort seeks to fuel the regional health care workforce, particularly with support for the development and retention of nurses.

Laura Ducceschi, MBA, president and CEO of the Scranton Area Community Foundation, also serves as administrator for the associated Northeastern Pennsylvania Health Care Foundation. She explained that the new initiative launched with a community listening tour that included 30 health care partners within the three-county area.

The information garnered clearly indicated that all levels of the health care workforce are short in precious human capital. Related to this fact is the reality that the greatest clinical placement challenge is students for nursing schools.

The information sessions also identified that student interest in health care must start as early as the middle school years, that a shortage of nurse educators exists, and nurse burnout is a problem. In addition, future caregivers still in school often have genuine needs for a living expense stipend.

“Now, we’ve gone back to our health care partners and are asking them for practical ideas to solve these problems,” said Ducceschi. “The partners must provide the solutions through an inter-disciplinary approach.”

She added that the Careers in Care initiative joins a pre-existing program that has pumped $3.2 million into physicians’ scholarships to attend the Geisinger Commonwealth School of Medicine.

Opioid battle

Despite yielding to other headlines, the battle against opioid addiction rolls on, with organizations such as The Wright Center for Community Health utilizing Medication-Assisted Treatment (MAT). The organization has been named a Commonwealth of Pennsylvania Opioid Use Disorder Center of Excellence.

The MAT approach to care utilizes pharmaceutical help with a drug such as Suboxone to block the effects of the opioid and reduce withdrawal symptoms. The patient therefore has a better chance of being weaned off of the opioid and returning to an addiction-free life.

Scott Constantini, Wright’s director of behavioral health services, outlined how as an organization his medical practice employs hundreds of inter-professional providers, residents, students and staff who have been educated on the power of MAT. This includes 19 physicians, three of whom are board-certified in addiction medicine, five CRNPs and one physician assistant, all of whom are MAT-waivered.

According to Constantini, despite an absence from the headlines, opiate abuse has not disappeared. In reality, first responders are now carrying Narcan (naloxone), an opioid antagonist used for the complete or partial reversal of opioid overdose, including respiratory depression, and this has lowered the patient death rate.

Meanwhile, with MAT, the process for treatment often begins during a routine wellness visit where the provider detects potential opioid use. Constantini emphasized that opioid addiction can happen to anyone, and often starts with pain management through the use of pharma.

“Perhaps the patient needs the opioid after surgery for pain, and eventually the physician cuts off the meds,” said Constantini. “The patient, who has quietly developed an addiction, then begins to receive the meds from a friend or out on the street.”

An attempt by a patient to withdraw from opiates, according to Constantini, can be a horrible experience. They may suffer from debilitating cravings along with physical symptoms such as nausea and diarrhea, sweats, and severe flu symptoms.

“If you have to go to the street to buy these drugs to alleviate the symptoms, it becomes very expensive,” said Constantini. “Therefore, the user may turn to heroin. Unfortunately, we have no consistent data on how long it takes to become opioid-dependent.”

If the Wright Center patient is determined to be eligible for MAT, he or she is “wrapped” in a care program that includes physicians, a case manager, mental health therapist and special needs provider. Some patients are referred for higher level care, and because behavioral compulsion often plays a part in addiction, personality disorders are treated.

“Unfortunately, addiction is a chronic condition and 50% remission is a good number, which we are achieving with MAT,” said Constantini.

Practice expansion

An expansion and hiring boom is also taking place at The Wright Center for Community Health, according to information released by Patrice Wilding, marketing and communications content manager. According to Wilding, the Wright organization now employs more than 500 people and during 2019 hired 152 employees, with 64 of them for newly created positions.

The Wright Center is also finalizing management agreements for two new practices in NEPA that will be launched later in 2020. A considerable portion of its workforce is now staffing the organization’s recently opened flagship facility at 501 South Washington Ave. in South Scranton, which sprawls across more than 41,000 square feet and contains 37 exam rooms, with four of these being exclusively devoted to dentistry.

According to information from the Wright Center, Scranton as a locale has been designated as a Medically Underserved Area by the federal government, and more than 41% of Scranton residents qualify as low-income. Of this low-income populace, 87 percent do not regularly access primary care services.

This makes the existence of organizations such as the Wright Center vital, because the staff will treat patients regardless of their insured status or ability to pay. During May of 2019, the Wright Center was designated by the U.S. Health Resources and Services Administration as a Federally Qualified Health Center, and because of adjusted reimbursement rates, its “ideal” patient is someone using Medicaid instead of private or employer-provided insurance.

Battling cancer

Officials from the Geisinger Wyoming Valley Medical Center have unveiled plans for an $80 million investment to upgrade the Frank M. and Dorothea Henry Cancer Center. The project also includes reconstruction of the main hospital entrance that opened nearly 40 years ago.

The 92,150-square-foot, four-story expansion will include an 18-bed inpatient unit to serve bone marrow transplant recipients, consolidation of treatment services, and a redesigned reception and lounge area. The plan also includes a $6.5 million installation of CyberKnife radiation therapy at the hospital, bringing total investment of technology and services to more than $300 million.

Rajiv Panikkar, MD, chair of the Geisinger Cancer Institute, commented that the upgrade of buildings within a care system can only can make a tangible effort real. It is technology, plus the people caring for patients, that make health care real and effective as an interdisciplinary team of specialists toil together.

Services already housed in the Henry Cancer Center include chemotherapy, infusion therapy, sophisticated imaging, comprehensive lab services, pharmacy services and research and clinical trials. The addition of the globe’s newest version of CyberKnife, according to Dr. Panikkar, stands as an example of treatment that previously would have required an NEPA resident to travel to Philadelphia for.

“This technology delivers greater accuracy and precision than can be achieved with standard radiation equipment, because with CyberKnife the shape and the number of beams applied to the patient can be varied,” said Dr. Panikkar.

The hospital’s inpatient unit was also ºupdated to more easily serve patients being treated with chemotherapy for certain types of lymphoma and leukemia. This will eliminate the need to transfer the patient to Danville for 15 to 24 days of inpatient care, thereby alleviating a great deal of family stress.

“Much of the same patient convenience will also be possible with some bone marrow transplants,” said Dr. Panikkar. “Access and follow-up can be done in Wilkes-Barre, and our multidisciplinary on-site services are being expanded, which is the key to better hematology. We also are having expansion with research and clinical trials.”

In addition to expanding the hospital’s cancer services, the project will produce a new, modern façade and lobby at the hospital’s main entrance. Plus, added space and resources will be created for Geisinger’s retail pharmacy.

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