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Education & Health Care: Powerhouses for the Greater Good

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ChristianaCare’s Virtual Education and Simulation Training Center helps doctors gain a firm foundation in surgical techniques, hand-to-eye coordination and repetitive skills exercises before they pick up a scalpel to operate on a real patient. It is outfitted to function like a real hospital, complete with a trauma bay, intensive care unit, operating room and standardized patient rooms. | PHOTO COURTESY OF ERIC CROSSAN

Delaware may be small in size, but it’s a giant in the fields of education and health care.

The University of Delaware (UD) is categorized as an R1institution by the Carnegie Classification of Institutions in Higher Education, indicating a very high level of research activity.

In health care especially, UD shines. The university’s STAR Campus hosts a major health sciences hub, where research into wearable technology happens alongside community clinics, combining academic excellence with local engagement. A professor at UD’s School of Marine Science and Policy in Lewes has started up a company that works on diagnostic solutions to achieve earlier discovery and treatment of degenerative diseases like Parkinson’s.

The state’s other major research institution, Delaware State University, recently announced the establishment of a new DNA Core Center, which will give researchers the capability to analyze an entire genome sample.

Meanwhile, Delaware’s health systems are innovators in their own right. ChristianaCare’s Gene Editing Institute, founded in 2015, uses CRISPR gene-editing technology to accelerate cures for disease and improve treatments. With a grant from the National Science Foundation, the institute has exposed community college teachers to gene editing, and outreach is now targeting younger students. Also, a recently published study authored by the institute’s scientists shows promising results regarding the application of CRISPR to treating lung cancer. Meanwhile, ChristianaCare’s Hospital Care at Home program is a national leader in the use of technology and home-based care to improve patient outcomes.

Other systems, such as Nemours Children’s Health and downstate providers Bayhealth and Beebe Healthcare, regularly earn accolades for the quality of their care. The Human Rights Campaign Foundation has repeatedly named Beebe Health care an LGBTQ+ Healthcare Equality Leader for its respectful, accepting care and community engagement.

Another hub of health care innovation: startups that work to solve treatment and diagnostic issues — many of them, such as TheraV, originated at UD. TheraV also benefited from a state-funded Encouraging Growth, Development and Expansion (EDGE) Grant. These young companies work alongside established medical-device innovators like Siemens Healthineers and Hologic.

In the pages that follow, learn more about the researchers and entrepreneurs that make our small state a major player in health care education and research.

TheraV: Finding a Solution for Phantom Pain
It seems implausible that a missing limb could cause discomfort, and in the past, doctors thought such “phantom pain” was a psychological issue. But, according to the Mayo Clinic, the pain is genuine, and it stems from the spinal cord and brain.

As a college intern in a prosthetic clinic, Amira Idris Radovic witnessed a patient’s pain firsthand and wanted to help. Today, Radovic is the founder of TheraV, which developed and markets a non-invasive wearable device that delivers vibration therapy to ease phantom pain.

Amira Idris Radovic

A native of Nigeria, Radovic is a University of Delaware success story. She came to Delaware on an academic and track-and-field scholarship and became an intern while taking a clinical immersion class. She immediately began researching phantom pain and learned that many patients used a vibrator as a home remedy.

The athlete came up with the idea for a device, Elix, when she spotted a vibrating platform used to massage athletes in the gym. It’s not an unusual approach — vibration therapy can treat pain in patients with cerebral palsy and other conditions that create muscle spasms.

Radovic and her team designed a comfortable wrap device that users put on the residual limb. They control the vibration using the TheraV mobile app.

After earning a bachelor’s degree in biomedical engineering in 2015, the budding entrepreneur won $2,500 in the 2016 Swim with the Sharks Pitch Competition. That year, she received a master’s in entrepreneurship and design through UD’s Horn Entrepreneurship program.

“Horn really helped me get the ball rolling, get funding and get my idea off the ground,” says Radovic, who has raised a total of about $450,000. Last year, TheraV received a cash prize at “pitch: A Competition for Black Student Founders,” sponsored by The Center for Entrepreneurship & Innovation at Duke’s Fuqua School of Business and the North Carolina Central University School of Business.

TheraV also received an EDGE Grant from the Delaware Division of Small Business. “Delaware is business and founder-friendly,” says Radovic, now headquartered in NextFab, a maker collaborative in Wilmington. “It made sense for us to stay here. We live here, and we know the community here.”

The busy mother of two, who has experienced supply chain issues, is currently producing products for pre-orders, which have been steady since she began marketing Elix. Then she’ll restock the inventory.

Elix is not a medical device, which requires FDA approval, but that is some-thing Radovic would like to pursue in the future. She has ideas for other products, but she’s focused on Elix right now.

“You have to be very focused on one thing first and get it off the ground before you can venture into something else,” she notes. 

Genpro: Where Academia and Health Care Happily Collide
Prof. Adam Marsh
never imagined that his research might benefit humans. Before joining the University of Delaware’s School of Marine Science and Policy in Lewes, he studied how animals in Antarctica adapt to extreme environments.

Prof. Adam Marsh

In Lewes, he became interested in epigenetic imprinting, which happens when the environment stimulates signals in a genome (an organism’s genetic information) so the organism can adapt to the conditions.“We always respond to stress, and part of that stress involves chemical changes to DNA that allow certain genes to be turned on which are likely to be beneficial,” he explains. Those that are not beneficial are “turned off.”

His findings are the basis for Genome Profiling, a UD spinout whose EpiMarker platform helps detect signs of disease “stress.” The earlier the detection, the sooner treatment can begin. The goal is to slow the progression of these conditions with effective early medications. And because the test only requires bloodwork, it’s far more affordable than minimally invasive or invasive procedures.

Currently, the company focuses on diagnosing Parkinson’s disease and endometriosis. Parkinson’s symptoms often mimic several neurodegenerative conditions. “Patients are often diagnosed at a point at which the neurodegeneration — the damage – has been going on for six to eight years,” Marsh says. Endometriosis is another disease with a slow progression.Unfortunately, many women aren’t diagnosed until six years after the onset, and the confirmation usually involves laparoscopic surgery.

GenPro’s technology does not provide therapy; it is designed to diagnose. “We just want to find those signals,” Marsh explains.

The company became a spinout in 2014, and commercial activity started in 2018. Currently, GenPro is in clinical trials for the Parkinson’s and endometriosis diagnostic. “It’s a long road to get these kinds of assays to FDA approval,” Marsh notes. Since UD is an owner but not an investor, GenPro has gone through the typical funding process, including three rounds with seed investors. Next up is the series A phase for the “big infusion of cash to grow the company,” he says. “Now we need to scale. We need staff, location — we need everything a company needs, and that takes money.”UD might not provide funding, but Marsh can access the school’s resources when he’s not teaching.The networking, however, has been invaluable. Marsh met GenPro’s CEO-to-be, Jeb Connor, through his academic contacts. A Hewlett-Packard veteran, Connor was helping startups through the university. To be sure, UD has a unique entrepreneurial environment, Marsh maintains. Partly, that’s due to the number of enterprising people with doctorate degrees —medical or academic — in the state.

“There are a lot of experts in a small area,” he says. “In those early stages of development, it was easy to find extremely knowledgeable people who could answer very specific discipline questions. You could call them up and arrange a face-to-face meeting in two or three days.”

Once GenPro successfully hits the series A stage, new hires will handleMarsh’s responsibilities as chief science officer. “Then I’ll segue back into my marine science-focused research.”But if history is any indication, he may find more discoveries to benefit humans.

Hologic: Focusing on Women’s Health
Every day, women across the country schedule mammograms to screen for breast cancer. The test can save lives, especially if tumors are not discernible to the touch. Many of the patients will step up to cutting-edge machines made by Hologic, a medical technology company with an emphasis on women’s health.

Jennifer Meade

Hologic, which has a Newark site, develops, manufactures and supplies medical imaging systems and diagnostic and surgical solutions. The company has operated in the Newark area since 1999, but the facility has a long history. The DuPont Co. opened the site in 1966, and Sterling purchased it in 1996.

By the time Hologic moved into the space, film-screen mammography was the gold standard for cancer detection. “It emerged in the 1960s and became widely accepted as a breast cancer screening method in the late1980s,” explains Jennifer Meade, division president of Hologic’s breast and skeletal solutions.

Hologic continued to push the envelope by manufacturing detectors for digital mammography. This “2D” technology involves two x-rays: one from the top and another from the side. Then, in 2011, Hologic became the first manufacturer to bring 3D technology to the market.

The Genius 3D Digital Mammography System takes multiple images of each breast from different angles. “Unlike a 2D exam, 3D mammography allows the doctor to examine breast tissue one layer at a time,” Meade says. Consequently, theGenius can detect 20% to 65% more invasive breast cancers than 2D mammography. The result: earlier diagnosis and treatment.

The system is also FDA-approved as “superior” for dense breasts, Meade adds. All breasts have glandular, connective and fat tissue. However, dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and low amounts of fatty tissue, making a mammogram more challenging to read.

Hologic’s Newark site, which has 160 employees, also produces the FDA-approved Affirm Prone Biopsy System. “This biopsy system delivers faster, more comfortable breast biopsy procedures,” Meade says. In addition, an increase in automation, superior imaging, and 360-degree breast access improve the experience for patients and providers.

Meanwhile, the TruNode System’s single-use sterile and wireless gamma probe has enhanced radio-guided surgical procedures, such as sentinel lymph node biopsy, which determines whether cancer cells are present.

The Brevera Breast Biopsy System is one of the newer products made in Newark. The technology is the first to combine tissue acquisition, real-time imaging, sample verification and advanced post-biopsy handling into one system. Clinicians can perform quick, efficient procedures that save time and money.

These products require custom software, and engineers in Newark are kept busy working on new products. The core artificial intelligence platform, Genius AI, will continue to advance cancer detection, improve operational efficiency, and support clinical decisions across the breast cancer-care continuum, Meade says.

“The innovation starts right here in Newark with the employees of the R&D department,” she says. “They work tirelessly to provide physicians with the cutting-edge tools to help fight breast cancer.”

ChristianaCare: Building a Digital Bridge Between Patient and Provider
In America, the typical standard of care is a series of episodes. For instance, patients see their primary care doctors a few times a year — or less — and specialist visits are sporadic. After a hospital stay, they go home. “What’s happening in between is this huge whitespace,” says Dr. Tim Shiuh, chief health information officer and vice president for digital clinical transformation at ChristianaCare.

Dr. Tim Shiuh

Delaware’s largest health system is using technology to fill in the gaps. “We want to take care of patients continuously to address their needs proactively and not just wait for episodes of care,” Shiuh continues.

To that end, ChristianaCare has launched two new programs. The first involves a familiar technology: the Apple Health app. Now patients can share the app’s health-and-well-ness information with providers.

ChristianaCare also introduced ChristianaCare Hospital Care at Home, which provides high-level hospital care — both in person and virtually — in qualifying patients’ homes. The initiatives demonstrate how technology is revolutionizing the delivery of services.

The health system is one of the first to offer the new Apple feature, available through iOS 15. The app pulls together the fitness information that the user selects, such as heart rate, blood pressure, activity measurements and sleep monitoring. When patients elect to share data with providers, it’s viewable in their electronic health records.

“The technology helps empower patients to take control of their own health and wellness and partner with us,” Shiuh says. “That’s the sweet spot.”

Technology is also a necessary “tool in the toolbox” for Hospital Care at Home, says, Dr. Sarah Schenck, program medical director. “There was a dire need to provide services in our community and expand the hospital’s capacity during the pandemic,” she says, “So, we moved quickly.”

Dr. Sarah Schenck

ChristianaCare received assistance from Medically Home, a Boston-based company that helps health systems provide in-home hospital-level care. The Centers for Medicare & MedicaidServices provided a waiver for a cute care-level Medicare patients. Patients requiring a 24-hour hospital stay do not qualify, nor do those who need observation or ICU care. Qualifying patients must also live within 25 miles of the Christiana and Wilmington hospitals.

Edwin Bryson Sr., 71, was an ideal candidate. The Wilmington resident has diabetes, and his left foot was in excruciating pain. Instead of a hospital stay, he was admitted into the new home program. Daily, caregivers visited him to take his vital signs, dispense medication and recommend changes to his environment to make it safe.

The virtual hospital has a dedicated staff of physicians, nurse practitioners and registered nurses. “Just like any hospital, they work around the clock,” Schenck says. Some caregivers work from home; others come to the command center in north Wilmington.

The team monitors patients virtually and in person, and participants receive all the equipment necessary, such as scales, blood pressure cuffs and pulse oximeters. They also get a technology kit that links them 24-7 with the command center, powered by the ChristianaCare Center for Virtual Health.

Bryson was in the program for 20 days. Hospital-at-home programs cost up to 30% less, Schenck says, but cost is not the only benefit. Being at home reduces the risk of hospital delirium, which is common in older patients.Because seniors are in a familiar environment, they’re less likely to fall. Plus, caregivers can view the patient’s home to see how it impacts their condition. “You really learn a lot about a patient when you meet them where they are,” Schenck says.

She hopes to open the program to non-Medicare patients, which will require working with individual insurance companies. It’s a given that patients will need the internet and other tools to benefit. “Equity is at our core,” Shiuh says. “We don’t want to create a digital divide.”

Schenck agrees. “We believe that the future of health care is virtual; anything that can be done virtually will be done virtually. And as we build this digital front door, we better make sure everyone has access to it — that is our responsibility as a health system, and we take it very seriously.

Beebe Healthcare: Closing the Health Care Gap for LGBTQ+ Individuals
LGBTQ+ Americans are more likely than the general population to lack access to adequate medical care. Many LGBTQ+ individuals are hesitant to seek care at all because they fear being discriminated against by providers.

In Southern Delaware, Beebe Healthcare is working to address those disparities. For a few years now, the health system has focused on building bridges with the local LGBTQ+ community and providing care that respects diverse gender and sexual identities. Beebe has been named an LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation several times, most recently in 2022.

The transition to becoming a safe haven forLGBTQ+ individuals “started out as the awareness that we have a lot to offer here at Beebe to all parts of our local community,” says Angela Scott, RN, clinical programs manager at Beebe Medical Group. “Now, as part of our onboarding, inclusivity training occurs with all new hires.”

In addition, all existing staff at Beebe —whether they provide care or not — are required to take an annual sensitivity training that includes an LGBTQ+-focused module.While Beebe provides standard medical care to members of the LGBTQ+ community, it also offers specialized services, such as hormone therapy and OBGYN care that affirms the identity of transgender or gender-non-conforming patients, Scott says.

Another important piece of the puzzle is Beebe’s work beyond the walls of Beebe Medical Center in Lewes and its various physician offices. For example, the health system works closely with CAMP Rehoboth, a community organization in Rehoboth Beach that seeks to promote acceptance of diverse sexual and gender identities. “We partner with them for screenings and a lot of other activities,” Scott says.

Beebe has also participated in AIDS Walk Delaware for the past three years and partnered with local organizations for World AIDS Day activities. “There are so many ways we get our feelers out into the community to help support independent organizations,” Scott says. “We can’t do it all on our own. We have to be out there, supporting the work.”

For other healthcare organizations and providers interested in becoming a safe space for LGBTQ+ individuals, Scott has the following advice: “Start by making connections in the community. Talk to community members. You can’t serve somebody if you don’t have a close relationship with them.”

Regular staff training is important, as are small marks of respect, such as including a “preferred name” field in your electronic medical record, she notes. “Some patients may not want to be called by their legal name. We also ask about preferred pronouns.”

For Beebe, as for any organization, promoting diversity and inclusion is an ongoing process. The health system’s Diversity, Equity and Belonging Committee, for example, works continually to find ways to make Beebe an inclusive, welcoming workplace for individuals of all backgrounds.

As Scott puts it, “We are always thinking of new things we can do to reach out.”

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