Advances in Care

Monitoring patients with aneurysmal rupture for delayed cerebral ischemia was historically a numbers game. It was difficult for doctors to predict outcomes in the weeks that followed their rupture, so at-risk patients could find themselves under observation in the ICU anywhere from 7 to 21 days. Dr. Soojin Park, Medical Director of Critical Care Data Science and AI at NewYork-Presbyterian/Columbia, knew there had to be a better way to monitor patients and predict outcomes. So, relying on her background in machine learning and leveraging vast amounts of data, Dr. Park developed the potentially game-changing Continuous Monitoring Tool for Delayed Cerebral Ischemia (or COSMIC) score. The score uses machine learning, and basic patient data that can be collected with equipment available at any hospital, to detect signals that more accurately assess risk, allowing doctors to treat each neurocritical patient with targeted care - ultimately improving outcomes and patient experience.

As methods for early cancer detection improve and the number of cancer survivors rises, the innovative field of cardio-oncology has emerged to ensure that patients with chemotherapy or cancer-related cardiac dysfunction can be safely, and swiftly, treated for their cancer. Dr. Stephanie Feldman, a clinical cardiologist with focus on cardio-oncology at NewYork-Presbyterian/Weill Cornell Medicine, is one of a growing number of physicians advancing research and pushing care in this field forward with a multi-disciplinary, comprehensive approach to care. Dr. Feldman joins us to discuss the rare risks of immune checkpoint inhibitors, how genetic mutations could put patients at risk for arterial thromboembolism, and how the cardio-oncology field can optimize the course of cancer care for patients at risk for cardiovascular complications.

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Dr. Mario Gaudino is a cardiac surgeon at NewYork-Presbyterian/Weill Cornell Medicine and the Director of the Joint Clinical Trials Office at Weill Cornell Medicine. There he oversees ongoing improvement and enhancements to existing clinical infrastructure and is currently leading research on the effects of coronary artery bypass surgery on women and people of color. His work not only focuses on groups that have been historically underrepresented in research, it also takes a patient centric approach to outcomes focusing on how a patient feels in addition to clinical metrics. His research contributions have potential to change how doctors approach treating huge swaths of their patient population and how they analyze that data.

It has been widely reported over the past ten to fifteen years that maternal mortality and morbidity in the US is on the rise. Dr. Dena Goffman has made it her personal goal to improve those numbers across the entire NewYork-Presbyterian health system. But how can one begin to tackle such a large and challenging issue? Dr. Goffman focuses on systematic shifts. She worked to set obstetrics goals across the entire hospital system, created new guidelines and utilized simulations to train and improve the skills of healthcare workers to be prepared for any situation. And she wasn’t afraid to use every tool in her toolbox, even new ones like an ingenious anti-hemorrhage device that she helped gain FDA approval. In this episode, Dr. Goffman shares what real systemic change for maternal fetal care looks like and how she is hoping these standards can help reverse the trends in maternal mortality across the country.

As a doctor trained in both minimally invasive and open approach surgery, Dr. Chan is very familiar with comprehensive spinal care. But there are aspects of minimally invasive surgery that, when possible, position it as preferable for postoperative recovery, namely when it comes to pain. Open surgeries can have patients taking opioids for weeks or even months after their procedure. With minimally invasive spinal surgery, patients may only need opioid pain management for two days postoperatively–or none at all. Motivated by postoperative quality of life, Dr. Chan has fine-tuned several innovative surgical approaches, proving that a surgeon doesn’t necessarily have to perform large muscle dissections in order to correct spinal deformities like scoliosis. His techniques provide surgical opportunities for patients who otherwise would not be spinal surgery candidates due to age or illness. In this episode, Dr. Chan details how he customizes care for his various patients depending on their needs, and shares his hopes for the future of spinal surgery.

For more information visit nyp.org/Advances