Fall 2019 Digestive Health Institute Update

A Message from John Dumot, DO

Innovations in Digestive Health | Fall 2019

Innovation comes in many forms. It can mean a new device or drug that targets an unmet need, a new process designed to improve patient care, or an idea that leads to increased productivity. University Hospitals Digestive Health Institute prioritizes medical innovation equally in technology, research and clinical care. 

We're thrilled that the Food and Drug Administration (FDA) recently granted 510(k) marketing clearance for EsoCheck, a noninvasive cell collection device that collects sample cells from a targeted area of the esophagus to screen for Barrett's esophagus. Amitabh Chak, MD, University Hospitals gastroenterologist and Professor of Medicine, Case Western Reserve University School of Medicine, and Sanford Markowitz, MD, Ph.D., co-invented the device (with Joseph E. Willis, MD) and served as principal investigators. FDA clearance is a major milestone; now, the challenge lies in market adoption. We expect EsoCheck to make the greatest impact in populations where endoscopy is either limited or not available.

In clinical areas, we practice high reliability medicine (HRM). That means we rely on fail-safe methods to ensure patients receive the highest quality care without unnecessary tests or procedures. HRM helps guide clinical decision making. For example, a substantial portion of Medicare beneficiaries undergo repeated upper endoscopies, many of which may not be required¹. Unnecessary procedures increase patient risk and burden healthcare resources.

To improve efficiency and address patients’ concerns about their condition and medication, we developed treatment algorithms to identify patients most at risk for esophageal and pancreatic cancer. These algorithms walk doctors through several steps to determine whether patients are candidates for an endoscopy and other esophageal function testing. Those patients with Barrett’s esophagus will be candidates for periodic endoscopy for cancer screening, while others may benefit from alternatives to chronic proton pump inhibitor medications.  

We are pleased to share our consensus on pancreatic cysts which are known to be associated with a subsequent risk of pancreatic cancer. Jordan Winter, MD, Chief, Surgical Oncology, UH Case Medical Center, led our own group of expert gastroenterologists, surgeons and radiologists to provide consensus on an algorithm to guide the management of pancreatic cysts found on imaging studies. These guidelines will help reduce unnecessary costs while ensuring we provide high quality care. 

We've developed an HRM to address gastrointestinal (GI) bleeding, which is a common reason for hospitalization, morbidity and mortality. To provide high quality care consistently, Brooke Glessing, MD, led a multidisciplinary team to create an algorithm to evaluate patients as soon as they arrive at the emergency room. These guidelines are for both doctors and patients to ensure they receive the right care no matter where they are. UH Digestive Health Institute is one of several institutes within University Hospitals to adopt HRM. The practice helps us improve safety, reduce inefficiencies and deliver consistently good care.

On a related note, our consistently excellent Division of Thoracic & Esophageal Surgery has received high marks for improving both outcomes and value. We're proud to report our surgical team ranks in the top 10 percent in the Society of Thoracic Surgeons (STS) database for quality improvement and patient safety.

With an ongoing emphasis on efficiency, consistency and quality, UH Digestive Health Institute offers a full spectrum of care. To correctly diagnose the digestive conditions we treat, we rely on our innovative processes and good old-fashioned consultations with experienced, caring providers.

To make an patient appointment or contact a Digestive Disease Institute specialist, call 216-553-1976.

¹Repeated Upper Endoscopy in the Medicare Population: A Retrospective Analysis, Annals of Internal Medicine.