UConn Health

ConnectiCare Passage Plan Patients Now Accepted at UConn Health


Physicians at UConn Health recently began accepting ConnectiCare passage plan patients. “Passage” plans are referral plans offered by ConnectiCare to commercial and Medicare Advantage members. Members of passage plans are required to get primary care provider (PCP) referrals to see any specialist in the ConnectiCare network. For assistance on referrals and general information, contact practicerelations@uchc.edu.

 

When do doctors need to submit a referral?

When a patient needs specialist care, a referral must be submitted before the patient goes to see that specialist. One referral is required for office visits for each different specialty. However, a referral isn’t needed for each visit to the same specialist.

For example:

  1. If the patient needs to see a dermatologist and a cardiologist, a separate referral must be entered for each specialist.
  2. If the patient’s dermatologist refers the patient to a surgeon, the patient will need another PCP referral for the surgeon.
  3. If the patient needs to see a dermatologist six times, only one referral is needed. Referrals should be submitted with start and end dates that allow the patient enough time to see the dermatologist six times.

Better Ways to Heal Bones

Julie Bartucca

illustration of engineers going over blueprint of human skeleton with engineering notes on the hip bones

UConn Health is engineering innovative solutions for bone and joint problems, promoting faster recovery and less trauma to the body.


We’ve all signed a child’s colorful cast on their broken arm, gotten a call to inform us an elderly relative fell and broke a hip, or been laid up with back spasms ourselves. Maybe you’ve had a knee replacement or dealt with joint pain from years of athletic activity. It’s practically inescapable — 1 in 2 American adults suffers from a musculoskeletal disorder or injury such as arthritis, chronic back pain, fractures, or osteoporosis, according to 2016 data from the United States Bone and Joint Initiative (USBJI).

This is compounded by the fact that the U.S. has a rapidly aging population and, as people age, they lose bone density and the risks increase. Experts say the incidence of and costs to treat such issues are in danger of spiraling out of control.

But researchers at UConn and UConn Health are using a host of materials and technologies — from stem cells to spider-spun silk fibers to hydrogel to ultrasound waves — to strengthen bones and joints and accelerate recovery from musculoskeletal diseases and injuries.

“Musculoskeletal injuries are among the most common reasons to see a doctor. If we can take care of those faster and more effectively, patients can get back to their activities and work faster.”

“Musculoskeletal injuries are among the most common reasons to see a doctor. If we can take care of those faster and more effectively, patients can get back to their activities and work faster, which helps everybody,” says Dr. Augustus D. Mazzocca, director of the UConn Musculoskeletal Institute (MSI) and chair of the Department of Orthopaedic Surgery at UConn Health.

“There’s the economic impact of having people out of work, and the emotional problems of people who lose mobility and are isolated,” he says. “We’re trying to bring you back into society and get you back to what you like to do.”

To that end, UConn Health doctors also are developing ways to get you home faster after any musculoskeletal procedure, including spearheading same-day joint replacements.

Faster, Safer Recovery

UConn Health hip and knee replacement patients don’t have to wait for our clinical innovations to come to market. They can benefit from new approaches to the surgeries right now — and “right now” might also describe when they can go home post-op.

“Nearly 100 percent of my patients go home within 24 hours, and some now the same day,” says Dr. Mo Halawi, a new UConn Health orthopaedic surgeon who specializes in joint reconstruction and is spearheading an effort to minimize the time these patients spend in the hospital recuperating.

“The criteria for discharge are identical whether a patient leaves on the day of surgery or several days later. But with minimally invasive techniques, regional anesthesia, blood-conserving strategies, opioid-sparing analgesia, and immediate mobilization, patients are now achieving recovery milestones a lot quicker than before,” he says.

According to Halawi, the ideal candidate for same-day total joint replacement is one who is independent, motivated, has a good support system, and has no major risk factors for surgical complications. Much of the work is done in advance to optimize patients’ health and prepare them for surgery, allowing for the
speedy discharge.

After surgery, Halawi takes a less-is-more approach. Patients get on their feet right away and have no IV medications, drains, catheters, dressing changes, braces, or laboratory tests. Very rarely do his patients get discharged to nursing homes or rehabilitation facilities. Studies have shown that “patients recover better and have fewer complications in the comfort
of their homes,” he says.

“Hip- and knee-replacement surgery is constantly evolving, and we need to always deliver safe, effective, efficient, and evidence-based medicine to our patients. Soon, more surgeons and patients will realize that long hospital stays and recovery times are outdated,” Halawi says.

Engineering Cartilage

Though it is in the very early stages of development, UConn Health tissue engineer Syam Nukavarapu and his team have created a hybrid hydrogel system that they hope is the first step toward forming a hypertrophic cartilage template with all the right ingredients to initiate bone tissue formation, vascularization, remodeling, and ultimately the establishment of functional bone marrow to repair long bone defects.

How the more than 200 bones in an adult human skeleton form and how they are repaired if injured varies and has posed a challenge for many researchers in the field of regenerative medicine.

The cartilage template Nukavarapu and his team created appears to overcome hurdles that make it difficult for regenerative scientists to help the body’s long bones regenerate.

Two processes involved with human skeletal development help all the bones in our body form and grow. These processes are called intramembranous and endochondral ossification: IO and EO respectively.

While they are both critical, IO is the process responsible for the formation of flat bones, and EO is the process that forms long bones like femurs and humeri.

For both processes, generic mesenchymal stem cells (MSCs) are needed to trigger the growth of new bone. Despite this similarity, IO is significantly easier to re-create in the lab since MSCs can directly differentiate, or become specialized, into bone-forming cells without any additional steps.

However, this relative simplicity comes with limitations. To circumvent the issues associated with IO, Nukavarapu’s team set out to develop an engineered extracellular matrix that uses hydrogels to guide and support the formation of bone through EO.

“Thus far, very few studies have been focused on matrix designs for endochondral ossification to regenerate and repair long bone,” says Nukavarapu, who holds joint appointments in the departments of Biomedical Engineering and Materials Science and Engineering. “By developing a hybrid hydrogel combination, we were able to form an engineered extracellular matrix that could support cartilage-template formation.”

Nukavarapu’s team’s findings could be the first step to initiating the proper healing of long bones with biomedical help.

Using the Wisdom of Spider Webs

When someone breaks a load-bearing bone — the femur, for instance — doctors might install a metal plate to support the bone as it fuses and heals. But the metal can cause inflammation and irritation, and since metals are very stiff, the new bone may grow back weaker and more vulnerable to fracture.

UConn materials scientist and biomedical engineer Mei Wei and her team have developed an alternative to metal: a composite made with silk fibroin, a protein found in the silk fibers spun by spiders and moths and a common component in medical sutures and tissue engineering because of its strength and biodegradability.

Wei’s study found that the high-performance biodegradable composite showed strength and flexibility characteristics that are among the highest ever recorded for similar bioresorbable materials.

Working with UConn mechanical engineer Dianyun Zhang, Wei’s lab created a mix of silk and polylactic acid fibers coated in bioceramic particles. The new composite lasts about a year — large, adult leg bones can take many months to heal — and then starts to degrade. No surgery is required for removal.


Tissue engineer Syam Nukavarapu (left) examines a specimen of his hybrid hydrogel in his UConn Health lab.


Capturing the Power of Ultrasound

In the Department of Orthopaedic Surgery and the Institute for Regenerative Engineering at the UConn School of Medicine, researchers Yusuf Khan, Bryan Huey, and Lakshmi Nair are studying the combined power of gel-encapsulated bone cells and ultrasound waves to help fractured bones heal.

Physical force has been shown to stimulate bone cell regeneration for full healing, but immobilizing the fracture with a cast doesn’t allow for any movement. Khan believes that adding cells to the fracture site early on, and then directing a transdermal physical force toward the cells via low-intensity ultrasound, could accelerate fracture repair. In cases where a fracture can’t heal on its own, the therapy could provide the necessary stimulus to complete the healing process.

The team’s lab has already demonstrated the successful placement of bone cell hydrogels in mice and is working with the Department of Materials Science and Engineering to optimize the gel capsules for human use.

Harnessing Stem and Amniotic Cell Strength

Dr. Cato T. Laurencin, the Albert and Wilda Van Dusen Distinguished Professor of Orthopaedic Surgery and the director of the Institute for Regenerative Engineering at UConn Health, is developing clinical therapies to treat — and potentially reverse the effects of — osteoarthritis using human amniotic tissue, stem cells, and new combinations of the two.

An estimated 20 percent of Americans suffer from osteoarthritis, the most common degenerative joint disease and the leading cause of disability worldwide. Although current surgical and non-surgical therapies can provide some relief, none treat the root cause of the disease.

Stem cells have been proven to reduce pain and improve function in osteoarthritis patients. New studies suggest that the use of stem cells may heal cartilage, but results vary. Thanks to the host of powerful cytokines contained in amniotic tissue, many of which have been shown to decrease inflammation, Laurencin believes human amniotic tissue may overcome the limitations of current stem cell therapies, providing an ideal delivery system with added benefits.

“Soon, more surgeons and patients will realize that long hospital stays and recovery times are outdated.”

In its initial studies, Laurencin’s team has found its amnion-based delivery system can support stem cell survival, growth, and proliferation, and that the combination of amnion matrices and stem cells have immunosuppressive and anti-inflammatory effects on knee tissue cells.

“We believe amniotic tissue growth factors help drive human development and regeneration,” says Laurencin. “We are hopeful that harnessing this powerful new cell combination will help us further advance regenerative engineering for patients, especially those with arthritis or sports injuries, who want to avoid steroid treatments or are interested in next-generation therapies.”

Although it is not yet covered by insurance, amnion tissue treatment is available now to Laurencin’s patients. Laurencin’s team hopes to make the combination amnion¬stem cell therapy available within the next three years.

From the advanced research that’s changing the care of the future to the clinical changes happening now, Musculoskeletal Institute head Mazzocca says the Institute is uniquely positioned to provide the best possible care to patients.

“We try to take all the clinical people that treat musculoskeletal disease — rheumatology, osteoporosis, comprehensive spine, orthopaedics — and put it in one place, and combine them with all the researchers so they can cross-pollinate and make care better for the people of the state of Connecticut,” he says. “And there’s nobody else in the state of Connecticut that does what we do.”

Jessica McBride, Colin Poitras, and Lauren Woods contributed to this story.

To Our Readers

UConn Health Journal magazines


Two years ago, we published the first UConn Health Journal with the goal of giving physicians, dentists, and the public insight into the groundbreaking research and life-changing clinical care happening at UConn Health. As an academic medical center, UConn Health makes the discoveries that shape the future of health care. Our scientists work to understand medicine’s biggest mysteries, design new therapies and treatments, and turn laboratory breakthroughs into advances in patient care.

As our team collaborates to produce each issue, I constantly find myself in awe of everything that drives UConn Health’s innovations. Our stories can be heavy on science or heavy on heart, sometimes in the same issue. This spring, the story “Aches, Age, and Influenza” told of how UConn scientists’ findings in mice may help us prevent influenza-related muscle deterioration in the elderly. In the same edition, we got to know 11-year-old Alyssa Temkin, who since birth has struggled with an unforgiving, deadly disease for which a new UConn doctor is closing in on a cure.

Most of the time, though, our stories walk the line between the two. Because when it comes down to it, these advancements are based on science. But by definition, medical discoveries always impact real people. The mission of UConn Health Journal, like that of the UConn Health enterprise, is to translate that research: What does it mean for you? For your patients? For your loved ones?

In this issue, we’re exploring one topic from several angles. The brain has for centuries fascinated and perplexed. The more we learn about it, the more we find there is left to discover. At UConn, those who work with the brain range from a neurologist with a ringside seat to the evolution of concussion treatment to a radiologist and medical physicist who harnessed 3-D printing technology to give surgeons a practice brain for complicated procedures.

And please, let us know what you think and what else you’d like to read about. Email me anytime at julie.bartucca@uconn.edu.

Thanks for reading,
Julie Bartucca
Editor, UConn Health Journal

Event Spotlight: Global Genomics Conference

Genomics and Society: expanding the ELSI universe


UConn Health and The Jackson Laboratory Host Global Genomics Conference

Good genomics research requires healthy curiosity, powerful data analysis, rigorous scientific methodology — and a strong ethical grounding. UConn Health and the Jackson Laboratory for Genomic Medicine co-hosted the Ethical, Legal, and Social Implications Research Program’s (ELSI) fourth-annual conference June 5 through 7 to explore how ethical decisions surrounding genomic discoveries are informed by the legal and social context of our society.

Nearly 300 people attended the three-day “Genomics and Society: Expanding the ELSI Universe” conference, which brought experts from around the world to UConn Health in Farmington, Connecticut, to discuss both what we can do with our genomic knowledge and the responsibilities that come with that power.

“The increase in genomic testing and technology are fueling breakthrough discoveries here in Connecticut and around the globe for heart disease, cancer, and a host of rare diseases,” said Dr. Bruce T. Liang, dean of UConn School of Medicine. “However, these promising personalized medicine therapies and our greater genetic knowledge may also come with a steep societal price if we don’t address the associated concerns in a timely fashion.”

Keynote speakers from the National Institutes of Health (NIH) and universities across the country spoke about the ethics of genomics in the clinical setting; the relationship between genes, ancestry, and identity; and the NIH’s All of Us initiative. All of Us seeks to broaden the genetic database used for research in the United States so that it more accurately reflects the citizenry and the differences in lifestyle, environment, and biology encountered in different populations across the country.

Much of the funding for ELSI comes from the National Human Genome Research Institute, with the goal of supporting research that anticipates and addresses the societal impact of genomic science. The institute has four broad priorities: genomic research; tracking how that research influences health care; exploring how social norms and beliefs affect how we understand genetic advances and how we use them; and legal, regulatory, and public policy issues. Workshops at the conference covered specific topics from those areas, including the implications of genetic testing in the criminal justice system; the uses and misuses of the gene editing technique known as CRISPR; and the controversies over the appropriate use of genetics in psychiatric, neurologic, and behavioral fields.

More information about the ELSI project.

A New Era

The New Uconn Health Patient Care Tower


During the early morning hours of May 13, 300 UConn Health doctors, nurses, staff, leaders, and volunteers mobilized to begin the carefully planned move of 70 inpatients, one by one, to UConn John Dempsey Hospital’s new patient care tower.

The new tower, which along with the original hospital building comprises the hospital, was designed with the latest, most advanced technology and patient safety, comfort, and privacy at the forefront. The aesthetic is made to be peaceful and healing, with soothing colors, earth-toned wood and tile, noise reduction features, and tons of natural light thanks to floor-to-ceiling windows throughout.

The tower is the biggest project of Bioscience Connecticut, the initiative launched by Gov. Dannel Malloy in 2011 to make Connecticut a leader in bioscience research and create new jobs. In addition to staff jobs at UConn Health, the project created more than 5,000 construction jobs.

“I am extremely impressed,” said patient Dr. Michael P. Kruger, who graduated from UConn School of Medicine’s orthopaedic residency program in the 1980s, after he was moved to the new facility. The private rooms are the biggest perk for any patient, Kruger said.

“Having a facility where you get the privacy — when doctors come in to talk to me, I don’t have to share the information with the guy next door — it makes a big difference, I think, in how you recover and what the outcome’s going to be,” he said.

We are great at what we do, but we are going to do it even better in the new tower.

Not to mention the state-of-the-art technology in the 11-floor, over 381,000-square-foot “hospital of the future.”

The Operating Suite is home to the da Vinci robot and the Mazor Robotics Renaissance Guidance System, the only one of its kind in New England for robotic-guided spine surgery. The suite includes 10 operating rooms, each with LED boom lighting, special rubber floors and air filtration systems for infection control, high-definition Black Diamond Video systems for enhanced surgical vision, live-broadcasting for medical education and physician training, and real-time communication with the Department of Pathology.

A 1,200-square-foot hybrid operating room will open this fall, equipped with advanced imaging capabilities for minimally invasive and complex procedures.

Four high-tech smart robots called TUGS will deliver pharmacy medications to nursing units across the hospital, along with high-speed, wall-based tube systems.

Other safety measures include a centralized monitoring system, allowing patients to be observed remotely 24 hours a day by technicians, in addition to traditional bedside monitoring by their nurses. And those nurses will be able to reach patients even faster if anything happens, thanks to Rauland Responder bedside call systems.

“The technology that we are now able to use for our patients is going to enhance the care that we deliver,” said Anne Sakitis, nurse manager of the orthopaedic surgery floor. “We are great at what we do, but we are going to do it even better in the new tower.”

The tower has six inpatient floors dedicated to intensive care, intermediate care, medicine, oncology, orthopaedic surgery, and general surgery, and 169 private patient rooms, including 28 private rooms in the intensive care unit. Each room honors one of Connecticut’s towns with a scenic nature photograph taken in that town by a local photographer, and features a view of the Farmington Valley, a high-tech bed and monitoring equipment, a private bathroom, and a couch that turns into a bed for visitors. The hospital now has 24/7 visiting hours.

The Emergency Department includes more than 40 patient rooms and five patient care zones, ranging from fast-track care for minor emergencies to advanced trauma care. It has onsite CT scan and X-ray, decontamination and resuscitation rooms, and an emergency dental chair.

The new tower is also home to a dedicated Dialysis Care Center, a Bone Marrow Transplant Unit, a Respiratory Therapy Department, and a physical/occupational therapy and rehabilitation gym. There are more than 80 ceiling lifts located throughout the hospital for safe patient handling.

“This tower represents a new era at UConn Health and for health care in our state. The opening of the new hospital tower is a very special generational milestone,” said UConn John Dempsey Hospital CEO Anne Diamond. “We did it! We dreamed it, we built it, and now we’ve opened it.”


Gallery: Inside the New Tower

A patient and staff are seen inside the Emergency Department waiting area. A children’s play area is inside opaque glass walls.

A UConn Health nurse shows a patient how to adjust her bed in a room on the sixth floor of the UConn Health new tower. It's open and spacious and large windows
Dr. David McFadden, surgeon-in-chief, gives direction in one of 10 new operating rooms. The room is equipped with a Black Diamond video camera, near top left, which allows surgeons to view a close-up video of procedures. Additional screens allow doctors to compare video to radiology scans to enhance precision.

The Doctors Are In – Spring 2016

UConn Health welcomes the following new physicians:


Seth Brown, MD

Specialties: Ear, Nose, and Throat/Otolaryngology, Otolaryngology Surgery
Location: Farmington


Saira Cherian, DO

Specialties: Internal Medicine, Primary Care
Locations: Farmington


Alexis Cordiano, MD

Specialty: Emergency Medicine
Location: Farmington


Montgomery Douglas, MD

UConn School of Medicine Chair
of Family Medicine

Specialty: Family Medicine
Location: Farmington


Jeffrey Indes, MD

Chief of the Division of Vascular and Endovascular Surgery

Specialty: Vascular Surgery
Location: Farmington


Leah Kaye, MD

Specialty: Obstetrics and Gynecology
Location: Farmington


Glenn Konopaske, MD

Specialty: Psychiatry
Location: Farmington


Guoyang Luo, MD

Specialties: Obstetrics and Gynecology, Maternal-Fetal Medicine
Location: Farmington


Jose Montes-Rivera, MD

Specialties: Neurology, Epilepsy
Location: Farmington


Rafael Pacheco, MD

Specialty: Radiology
Location: Farmington


Mario Perez, MD, MPH

Specialties: Critical Care, Internal Medicine, Pulmonary Medicine
Location: Farmington


Edward Perry, MD

Specialty: Hematology/Oncology
Location: Farmington


Surita Rao, MD

Specialties: Addiction Psychiatry, Psychiatry
Location: Farmington


Belachew Tessema, MD

Specialties: Ear, Nose, and Throat/Otolaryngology, Otolaryngology Surgery
Location: Farmington


Cristina Sánchez-Torres, MD

Specialties: Child and Adolescent Psychiatry, Psychiatry
Locations: Farmington, West Hartford


Brian Schweinsburg, Ph.D.

Specialties: Child and Adolescent Psychiatry, Psychology
Locations: Farmington, West Hartford


Mona Shahriari, MD

Specialties: Dermatology, Pediatric Dermatology
Locations: Canton, Farmington


Kipp Van Meter, DO

Specialties: Family Medicine, Internal Medicine, Primary Care
Location: Canton

Lab Notes – Winter 2015

Cancer Cells Unreceptive to Vitamin D

Many human colon cancers may not express receptors for vitamin D, limiting vitamin D’s protective role against colon cancer to the early stages of the disease, report Charles Giardina and colleagues at UConn’s Department of Molecular and Cell Biology and Center for Molecular Medicine in the April 14 issue of Cancer Prevention Research. The researchers observed that adenomas in the colons of mice tended to repress vitamin D receptors, while having elevated Class I histone deacetylases (HDAC). However, HDAC inhibitors may reactivate the vitamin D receptors. They propose that vitamin D could still be protective against colon cancer, but how its receptors are expressed and inhibited in cancer cells needs more examination. Read the article at Cancer Prevention Research.

a group of vitamin D suppliments


Rogue X Chromosomes Uncovered in Farmington

Humans only need the genes from one X chromosome to be healthy. The extra one gets trussed up and shut down in the earliest stages of development. But female human embryonic stem cells growing in the lab sometimes reactivate their second X. They express extra genes, fouling up experiments and scuttling potential therapies. Now, researchers including UConn’s Marc Lalande and a team from Paris Diderot University have found a marker, and potentially a mechanism, for how the extra X reactivates – and they have an idea on how to prevent it. They describe their findings in the May 7 issue of Cell Stem Cell.


Friends are Unreliable Sources for Drinking Studies

In recent years, researchers have turned to friends of people in alcohol studies to verify what the subjects report about their drinking habits. People in the same social situations are sought out, in part, because of the inherent impairment caused by alcohol. But according to a UConn study published in Addictive Behaviors, friends don’t seem to provide any new information. In fact, they typically underreport what their acquaintances consume. The finding supports the so-called “protective effect” of friends described in other research. A growing availability of other evidence – hair and fingernail samples, for example – may provide better strategy for corroborating the amount of alcohol study subjects consume, says author Michael Fendrich, associate dean of the School of Social Work.


She Smells Him, She Smells Him Not

Mice rely on their noses to help them navigate the world. But high levels of progesterone “blind” receptors in the noses of female mice to male pheromones, UConn Health’s John Peluso and other colleagues, led by Dr. Lisa Stowers of The Scripps Research Institute, report in the June 4 issue of Cell. Female mice have high levels of progesterone during the infertile phase of their reproductive cycles, and tend to be indifferent or even aggressive toward males. But during the fertile phase, progesterone levels drop and estrogen rises, and their nasal receptors again respond to male pheromones, the researchers found. Female mice in their fertile phase are friendly and sexually receptive towards males – perhaps because they can smell them.

mouse

Honor Roll – Winter 2015

For the second consecutive year, UConn Health has received a Gold Award from Get With The Guidelines, an American College of Cardiology and American Heart Association initiative that recognizes hospitals for providing exceptional care to heart-attack victims according to evidence-based guidelines.


UConn Health psychiatrist Dr. Kristina Zdanys was voted onto the Medical and Scientific Advisory Council for the Connecticut Alzheimers Association in June. She will join colleagues Rick Fortinsky and Dr. Lavern Wright, who also sit on the council.


Hartford Magazine’s 2015 list of Best Doctors in Connecticut includes 53 UConn Health faculty members. See the list of cited UConn docs at UConn Today.

The Doctors Are In – Winter 2015

UConn Health welcomes the following new physicians:


Ridhi Bansal, MD

Specialties: Internal Medicine, Primary Care
Location: Canton


Philip M. Blumenshine, MD, MAS., M.Sc.

Psychiatry Emergency Department Medical Director

Specialty: Psychiatry
Locations: Farmington


Ethan I. Bortniker, MD

Specialty: Colon Cancer Prevention, Gastroenterology
Location: Farmington


Tilahun Gemtessa, MD, M.Sc.

Specialty: Infectious Diseases
Location: Farmington


Matthew Imperioli, MD

Specialty: Neurology
Location: Farmington


Neha Jain, MD

Specialty: Psychiatry, Geriatric Psychiatry
Location: Farmington


David Karimeddini, MD

Specialty: Radiology
Location: Farmington


Hsung Lin, DMD

Specialty: Family Dentistry
Location: Storrs Center


Janice Oliveri, MD

Specialty: Internal Medicine
Location: Farmington


Houman Rezaizadeh, MD

Specialty: Gastroenterology
Location: Farmington


Bernardo Rodrigues, MD

Speciaty: Neurology
Location: Farmington


Lenora S. Williams, MD

Specialty: Obstetrics and Gynecology, Women’s Health
Location: Storrs Center


Visit UConn Health’s online physician directory for information about all our specialists.