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....February 18, 1:33 AM |
| Key To The Future: New Science Merges With Medicine In Queens
By Brian M. Rafferty A network of hospitals that can share patient data, that can know in an instant any complications a trauma patient may have, that can use 21st Century technology to improve a patient’s chances of beating a fatal disease - that is the future.
And Al Aviles, who just learned last week that he has been placed in charge of New York City’s public health network, the Health & Hospitals Corporation, is the man who will take Queens into that bold, new world. Aviles, who joined HHC in 1997 as associate executive director of managed care for Elmhurst Hospital Center, was selected last week to fill the shoes of Benjamin Chu, who told HHC’s board of directors at an emergency meeting last Tuesday that he is leaving for a job in California. This was a fast promotion, considering that just three months ago Aviles was promoted to senior vice president of the Queens Health Network, in charge of Elmhurst Hospital and the Queens Hospital Center in Jamaica. This may be a giant step forward for a person who started his career in public service as a civil rights attorney for the New York City Commission on Human Rights, but his career has followed a path that has led him to the position he now holds. “There is a logical thread to where I am now,” he said during a private interview Friday in the executive offices atop Elmhurst Hospital. “I wanted to practice law as a tool for social change - a way to address social inequity. If you look at health care in the United States, we are the only industrialized country in the world that doesn’t have universal health coverage. That does not mean that we have an inferior healthcare system, but we need to start looking at basic health care as a civil right.” Leveling The Field The disparity between whites and minorities in terms of healthcare coverage shows that minorities don’t have access to quality healthcare, and they don’t get optimum care. “The data holds true even when you correct for circumstances such as insurance and income,” Aviles said. “Embedded in the whole healthcare policy debate is the question of how you level the playing field. This comes down to basic civil rights issues, and the Queens Hospital Network is the perfect platform to advocate for this idea and make a focus of ultimately providing the opportunity to prove that balance.” As the head of public healthcare in Queens, Aviles has sought to remediate the problem. The only change between his role in Queens and his new position as president is “a higher rank with a broader scope,” he said. Aviles is not alone. “Fundamentally, everyone who works in the public hospital system is with me,” he said. “People are drawn to it for all the right reasons. This is not an easy area to work in. It is difficult - the volume is tremendous the activity is frantic and very demanding. “What we do is address the issue of disparities,” Aviles said. “We have more than doubled our screening for colon cancer, which has astronomical numbers within the African American community. We are performing two times the number of colonoscopies and removing a lot more polyps. I welcome the opportunity to make that kind of difference.” Swapping Art For Science “One of the problems is we still view medicine as more of an art than a science,” Aviles said. “The individual physician should be able to do his best job possible, but the reality is medicine has become so complex, with so many options in terms of treatment, that we need to become more evidence-based. We need to test the suppositions of practitioners that this is the best care we can give.” In 1997, Aviles bolstered Elmhurst Hospital’s electronic patient record keeping. In 2005, the result is that orders are entered by doctors electronically, reducing errors from bad handwriting; all x-rays are digital, without cumbersome films to track down; and a patient’s digital record includes consultation reports, EKGs and all the medications they are currently prescribed so that doctors don’t overmedicate patients or prescribe conflicting drugs. “We take all the information that people think is in a doctor’s head, and now we don’t have to rely on going to a chart or a doctor’s recollection when a quick decision must be made. Aviles describes the process as a “major step forward,” not just because of the day-to-day use of the system, but for the ability to track information on specific ailments and mine the data to learn how best to handle a patient’s progress with a killer disease, such as diabetes. “Diabetes is increasing at an alarming rate, and it costs a tremendous amount of money in direct and indirect costs,” Aviles said. “The Centers for Disease Control estimate that diabetes costs this country $130 billion a year.” This serious health concern is now mitigated by years of data on what works and what doesn’t in treating the disease, which affects some 7,000 repeat patients at Elmhurst Hospital alone and 70,000 throughout the city. “We can bring up on a screen diabetics and look at their blood test, their hemoglobin, their A1C. We know if a patient has their diabetes under control. This allows us to pinpoint who is doing well and why others are not. As a result, in the course of a year we have seen the percentage of diabetes that is well-controlled double.” The Next Step With all of the data and a means by which to share it within the hospital, the logical next step would be to make that data accessible throughout a network of healthcare facilities. |
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