San Diego Organization of Healthcare Leaders
In my 20+ years in healthcare, I would always look forward
to this time of year for two reasons. The first, and probably most obvious was
getting the kids back to school and restoring a sense of order after a summer
of beach visits, baseball tournaments, cook-outs, family visits, and the things
that make living in San Diego great. The
second reason was the approach of what I would call “Conference Season.”
Working in early stage and innovative healthcare technology
organizations, I had the opportunity to attend and speak at a variety of excellent
conferences around the country sponsored by organizations like ANCC Magnet,
Planetree, the Institute for Health Improvement (IHI—which was my personal
favorite), and more. Additionally, there
are high-quality industry events relating to IT and digital health, patient
experience, medical associations, and scientific sessions focusing on new and
better treatments for disease and conditions.
However, one need not look any further than San Diego this
fall for a truly exceptional conference experience. On October 26 at the Schaetzel Center on
the campus of Scripps La Jolla, SOHL is pleased to present our 10th Annual
Conference, “Facing the Drug Crisis:
Politics, Costs, Consequences and Solutions.”
Our conference committee has built a compendium of nationally
recognized speakers from government, healthcare, public health, law
enforcement, pharma and advocacy to share their insights about America’s drug
crisis. Keynote speakers include:
- The Honorable Mary Bono – Former U.S.
congresswoman from California, Principal at Faegre Baker Daniels Consulting,
co-founder of the Collaborative for Effective Prescription Opioid Policies
- Roneet Lev, MD FACEP – Chief, Emergency
Department Scripps Mercy Hospital San Diego, Chair, San Diego Prescription Drug
Abuse Medical Task Force, President, Independent Emergency Physicians
- Sherrie Rubin – Parent advocate, founder of
Hope2gether Foundation (dedicated to reducing and preventing prescription drug
addiction, overdoses and deaths).
- U.S. Congressman Scott Peters (D)
– Represents California’s 52nd Congressional District, member of the House
Energy and Commerce Committee (advocates for investment in basic scientific
research and commonsense healthcare reforms).
In addition to conference keynotes, expert panels will cover
key topics including key issues in addressing costs both in human terms and
costs to consumers; the role of pharmacy in addressing the crisis; plus a look
to creative solutions in the future. SOHL is pleased to offer conference
attendees 4.5 ACHE Face-to-Face credits and 12 ACHE CEUs.
Seating for this event is limited an we expect available
seating to sell out in advance of the conference so please register quickly: https://www.eventbrite.com/e/10th-annual-sohl-conference-tickets-49074641574.
Additionally, our colleagues at the Hospital Association of
San Diego and Imperial County (HASD&IC) are hosting their Annual Meeting on
Wednesday, November 14, at Hotel Estancia La Jolla
(www.hasdic.org). They too will be
exploring key topics including behavioral health and addressing health
disparities. The meeting will also feature
what should be an excellent keynote on “SuperHero” leadership from Brett Culp.
I would highly encourage SOHL members to take advantage of these
high-quality events while being able to “keep it local.”
Finally, as we approach our 2019 program year, we are always
looking for motivated and committed volunteers. Regardless of your interest or experience, I encourage SOHL members to
contact me directly to discover more about how to get involved with SOHL—a fast
moving and innovative chapter of ACHE striving to advance the
careers of healthcare professionals.
Message from Our ACHE Regent
There are many words we hear often in the healthcare
industry. Change, Innovation, Disruption,
Transformation. As healthcare leaders, we are all part of this complex and
evolving industry, bringing our experience as well as creative ideas and
practices to improve healthcare for the communities that we serve.
To keep up with the changing environment, cutting edge
information and agile leadership is a necessity. How can you access the most relevant
professional education and development?
Both ACHE and our two local chapters in Southern California
offer numerous programs to support you as healthcare leaders.
ACHE has a vibrant listing of programs, clusters, and courses,
which can be accessed on www.ache.org
on the ACHE 365 app, or via email communications.
Our two ACHE chapters, the San Diego Organization of Healthcare
and Health Care Executives of Southern California (www.hce-socal.org ) offer leading
edge educational programs and the opportunity to connect with colleagues.
You will find extraordinary programs, crafted by chapter leaders
and committee volunteers.
To highlight a few, SOHL has an outstanding Executive Leadership
Program. HCE hosts its PathWays Policy
Program for early careerists. Both chapters hold mentoring programs, Advancement
prep courses, diversity and inclusion events, learning sessions from senior
leaders, networking events and much more.
Be sure to mark your calendar for SOHL’s Annual Conference
on October 26, on Facing the Drug Crisis:
Politics, Costs, Consequences and Solutions.
And later this year, HCE holds its Annual Conference, on
December 11, Inclusive Strategy: Moving
Healthcare Forward Together.
I would like to thank and recognize SOHL President Darrell
Atkin and HCE President Victor Carrasco, FACHE and the dedicated volunteer
Board and committee members for their countless hours and boundless energy in
developing these excellent and creative programs and events.
Please consider getting involved with your local chapter – Reach Out or Reach In - and let your chapter
know about you. Do you want to help plan an education program? Be a speaker or
moderator? Sponsor or host an event? Mentor or be mentored? Become a judge for
annual College Bowl? Visit one of our
local higher education institutions? Work on an ACHE Chapter Innovation Grant?
There is something for everyone.
I invite you to share comments or leadership stories for
highlighting in future messages.
California - Southern
College of Healthcare Executives
Vice President, Government and Industry Relations
Hospital Los Angeles
Welcome Our Newest Members of SOHL!
Please join us in welcoming the following new members, who have joined SOHL since June 2018 (listed in alphabetical order by last name):
- Elizabeth Ahumada, Neighborhood Healthcare
- Alberto Aldrete, MD
- Daniel Avery, PCU Tripoli (LHA 7)
- Cheryl Badaracco,San Ysidro Health Center
- Daniel Barbara, Sr., PhD, Sycuan Medical Dental Center
- Mike Bellissimo, Teradata
- Amanda Berry, SDSU
- PO2 Darius Brown, US Navy
- Samantha Burks
- Aubrianna Butler
- HMC James Carter, Jr., US Navy
- Michael Covert, FACHE, Covert and Company
- HMC Joy Theresa De Dios, Navy Medical Center San Diego
- Francis dela Cruz, MedImpact Direct
- Wilfred Flores, 1st Medical Battlion
- Joy Flournoy
- Ashley Flynn, Naval Medical Center San Diego
- Jerry Gardner, El Centro Regional Medical Center
- Gabriel Gomez
- CDR Adolfo Granados, DO, 3rd Marine Logistics Group
- LTC Scott Gregg, FACHE, TRICARE Health Plan San Diego
- Jonathan Guerrero
- LT Eyob Hawaz, Uniformed Services, University of the Health Sciences
- LT Aaron Hill, US Navy
- HM2 Landy Jean-Baptiste
- Jeffrey Jimenez
- Avram Kaplan, MemorialCare Health System
- John Kaufmann, Montefiore Medical Center
- Kathleen Kim, MD, VA San Diego Healthcare System
- Diana King, Agfa
- Kelly Knorr
- Laura Lettkeman, Scripps Health
- Gina Mautz, Sharp Memorial Hospital
- Haley McClure
- HMC Richard McCollough, Naval Hospital Camp Pendleton
- Megan Montgomery-West, Alvarado Parkway Institute Behavioral Health System
- LCDR Heather Neumeyer, US Navy / Naval Hospital
- Jocelyn Nunez, San Diego State University
- Sean Olmo, Scripps Encinitas
- CDR Jason Palmer, DO, US Navy
- Sonam Patni, Covance, Inc
- LCDR Eric Polonsky, FACHE, Defense Health Agency West
- Britney Prince, San Diego State University
- David Ranney, PhD, El Centro Regional Medical Center
- Lisa Rhodes
- Sacha Ridgway, Alvarado Hospital Medical Center
- Lidor Ritblatt Shuster, Delibrainy, LLC
- Ivonne Roche-Joseph, Neighborhood Healthcare
- Edgar Rodriguez, UC San Diego Health
- Marc Rubinstein, MD, Instrumentation Laboratory
- CAPT Paul Schiermeier, Naval Medical Center San Diego
- LCDR C. Christopher Schultheiss, DO, USS Dwight D Eisenhower
- Alena Shelton, UC San Diego Health
- Dipti Singh, Rady Children's Hospital-San Diego
- Donald Sonck, PeopleScout, Inc
- LT Christopher Spangler, US Navy
- HMCM Christopher Thorne, US Navy
- CDR Daren Verhulst, FACHE, Navy Medicine West
- Johnny Vo, Hoag Hospital
- Jennifer Whitney, Kindred Healthcare
- Michael Williams, San Ysidro Health
- Heather Woodling, Palomar Health
The 10th Annual SOHL Conference - Facing the Drug Crisis: Politics, Costs, Consequences and Solutions
National News Q3 2018
Are You Leading for Safety?
Healthcare leaders are guided by the highest calling—to care for those who entrust their care to us. This means that we must keep our patients and workforce safe. Improving healthcare safety requires leaders who are committed to take a stand.
That is why ACHE has partnered with the Institute for Healthcare Improvement/National Patient Safety Foundation Lucian Leape Institute and other safety experts to help healthcare leaders take a stand.
Join us and commit to leading for safety by signing the We Lead for Safety pledge online at ache.org/Safety. While you are there, you can find resources, tools, self-assessments and best practices to help your organization measure, build and sustain a culture of safety.
Maximize Your Leadership with ACHE’s CareerEDGE
Are you taking advantage of your complimentary access to ACHE's CareerEDGE®? More than 4,300 of your fellow ACHE members have registered for this unique and interactive tool designed to support you in planning and managing your career. Early careerists and senior executives alike can use the tool to support their own career development as well as those they lead. CareerEDGE includes free assessments and tools to enhance your self-awareness as well as a comprehensive framework that makes it easy to map a plan to achieve your goals. Visit our CareerEDGE webpage to login and explore CareerEDGE today!
Attend a Local Prep Course for the BOG Exam
A new review course is available to help ACHE Members prepare for the Board of Governors Examination. The BOG Exam Prep: Brought to You by ACHE and Your Local Chapter includes a thorough content review of the 10 knowledge areas addressed in the Exam, practice test questions and test-taking strategies. Participants may earn up to 12 hours of Face-to-Face Education credit when they complete the review course.
Three ACHE chapters recently piloted the BOG Exam Prep, and course revisions are being made based on participants’ feedback. The national rollout for the course is planned for September 2018.
Members who would like to take the new review course through a local ACHE chapter should contact their chapter leadership to learn more and express their interest in preparing for the Exam.
BOG Exam Prep is also available as an On-Location Program. Contact Katherine M. Stack, FACHE, manager, program development, Division of Professional Development, at (312) 424-9304 or firstname.lastname@example.org for more information.
Share Your Professional Announcements
Improve your visibility in the healthcare field and build your professional brand by sharing career updates with ACHE. Have you started a new job or been promoted recently? Are you planning to retire? If the answer is yes, then get yourself listed in the "On the Move" section of Healthcare Executive magazine! All you have to do is email the job title, organization and location of both your former and your new job, as well as a high-resolution headshot, to email@example.com.
Offering a Postgraduate Fellowship? ACHE Can Help
If your organization is offering a postgraduate fellowship for the upcoming year, we encourage you to add it to the Directory of Postgraduate Administrative Fellowships at ache.org/Postgrad.
As a healthcare leader, you know how crucial it is to attract and develop highly qualified professionals in your organization. Gain exposure and start attracting top-notch applicants by posting your organization’s program on the directory. You may add a new listing or update a previous one at any time by completing the Online Listing Form.
Questions? Please contact Audrey Meyer, membership coordinator, Division of Member Services, at (312) 424-9308 or email firstname.lastname@example.org.
ACHE Communities Can Enhance Members’ Experience
ACHE offers four community groups that align with our members’ professional backgrounds and commitment to diversity and inclusion. Encourage members in your area to join any of the communities that meet their professional needs and goals (pending satisfaction of eligibility requirements).
Sign up today! Join or renew one or more of these groups for an annual fee of $100 each in addition to your ACHE membership dues. All benefits are accessible online and include a quarterly newsletter, an exclusive LinkedIn Group and special designation in ACHE’s online Member Directory.
Questions? Please contact Liz Catalano, marketing specialist, Division of Member Services, at email@example.com or (312) 424-9374, or Erika Joyce, assistant director, Division of Member Services, at firstname.lastname@example.org or (312) 424-9373.
Forum Member Directory Connects Executives With Healthcare Consultants
Are you a healthcare executive searching for a consultant? The directory’s robust search functionality can help identify ACHE Consultant Forum Members who may meet your needs.
Are you a consultant looking to gain visibility with decision makers? Join the Healthcare Consultants Forum, and select your primary area of expertise now!
Are You Due to Recertify Your FACHE Credential in 2018?
Demonstrate your continued dedication and commitment to lifelong learning by recertifying your FACHE® credential. Login to my.ache.org to learn when you are due to recertify. Please submit this application no later than Dec. 31; include your Qualified Education credits and your community/civic and healthcare activities. For more information, please visit ache.org/Recertify.
You may also contact the ACHE Customer Service Center at (312) 424-9400, Monday–Friday, 8 a.m.–5 p.m. Central time, or email email@example.com.
Increase in Healthcare M&A Activity Continues in 2018
The number of hospital and health system partnership transactions continues to climb, with a total of 50 transactions announced in the first half of 2018, according to a recent analysis by Kaufman Hall.
Activity remains particularly strong among not-for-profit hospitals and health systems, with 16 of 21 transactions announced in the second quarter involving acquisitions by such organizations, compared to five transactions by for-profit acquirers. When combined with first-quarter results, more than 76 percent of deals announced in the first half of 2018 involve not-for-profit acquirers, while less than 24 percent involve for-profit acquirers.
“Not-for-profit hospital and health system leaders nationwide are moving aggressively to broaden their organizations’ base and expand their presence, extending capabilities across larger geographies in order to address continued uncertainty in the industry,” said Anu Singh, managing director at Kaufman Hall. “Partnerships provide them the size and enhanced positioning within their markets to help ensure that these legacy organizations can continue their missions of providing vital care in the communities they serve.”
Here are four additional findings from the report:
IHI Publishes Guide for Providing Safe Home Healthcare
Millions of people are recovering from acute illness or coping with chronic conditions in their own homes, but their care may not always be delivered under the safest of conditions, according to a new report from the Institute for Healthcare Improvement.
Care in the home is increasing due in part to rising healthcare costs, an aging population, patient preference and advances in technology that allow for some complex care to be administered locally.
Home care has its advantages—including greater autonomy for care recipients, lower risk of certain complications (such as sleep disruption) and lower costs—but IHI cautions that in order to achieve these benefits, healthcare providers must be cognizant of risks of harm in the home setting as well. Potential issues include injuries due to physical hazards or medical equipment, pressure injuries, infections, poor nutrition, adverse events related to medication or other treatment, potential abuse or neglect, and healthcare worker burnout.
To help promote safe, person-centered care in the home, IHI’s report outlined the following five guiding principles:
Self-determination and person-centered care are fundamental to all aspects of care in the home setting.
Every organization providing care in the home must create and maintain a safety culture.
A robust learning and improvement system is necessary to achieve and sustain gains in safety.
Effective team-based care and care coordination are critical to safety in the home setting.
Policies and funding models must incentivize the provision of high-quality, coordinated care in the home and avoid perpetuating care fragmentation related to payment.
As the numbers of people receiving care at home continue to increase, we hope this report will serve as a useful reference for those committed to building on that foundation,” said Tejal K. Gandhi, MD, CPPS, chief clinical and safety officer for IHI.
Activation and Transition Planning is Key to a Successful Move
article was contributed by SOHL-sponsor, Catalyst, a Haskell Company, and
written by Debbie Jacobs, Director-West Region. The views, thoughts, and
opinions expressed in the article represent those of the author and not
The San Diego region is experiencing
an unprecedented number of new hospital and ambulatory construction projects
consisting of millions of square feet and costing millions of dollars. The
drivers of this local healthcare construction boom include a need to comply
with seismic code requirements, numerous antiquated buildings being incapable
of delivering contemporary clinical services, and increasing consumerism, which
is impacting everything from service locations to inpatient room design to patient-family
amenities. The time from master planning through construction completion spans
years, even decades in some cases, and requires a tremendous investment of
human and financial resources over that time. While the planning and
construction of the new building is complex and time consuming, it is an
activity with which most healthcare leaders are at least familiar with and have
probably had some direct experience. What healthcare leaders find much more
unfamiliar and daunting is the task of activating the new building and transitioning
operations so the building is ready to safely treat patients on Day 1.
is activation and transition planning?
Activation and transition planning is
the coordination of the physical, clinical, human resource, and operational
components of the move into a new building or space to facilitate an on-time,
on-budget, safety-event-free move.
Given the sheer number and
magnitude of operational changes that typically come with the opening of a new
building, the number of staff who must be oriented to new processes and life
safety procedures, and the natural anxiety that always surfaces, an effective
activation schedule which lays out the tasks to be accomplished in a detailed
manner is paramount. An integrated activation schedule, much like orchestra
score, describes what should be done, by whom and when, resulting in staff
being able to competently conduct Day 1 operations. This planning usually
requires a minimum of 18 months, and could take as many as 36 months, depending
on the size of the building and scope of services.
Organizations that have
successfully activated new hospital buildings have identified the following factors
as key to their success:
The opening of new space to
better meet the needs of both consumers and staff is very exciting at first, however,
it is easy for leaders to become overwhelmed with the complexity of the move in addition to keeping day-to-day
operations humming along. Some organizations conduct an activation readiness
assessment to determine where the organization has the resources and capabilities
to execute the activation and transition plan, and in what areas it may need
outside assistance or expertise. The graphic below reflects the areas of
activation readiness that organizations should consider when determining their available
resources and capabilities.
While activation and transition
planning is complex with a lot of moving parts, it can be broken down into the
following six major activities (which often occur simultaneously):
Solid project management is the
glue that holds the activation and transition process together. It includes the
development of the project organizational structure and team charters, an integrated
activation schedule, a transition budget, and an issue identification tracking
tool and process. In addition, project management should include on-going
facilitation at the leadership team level with documentation of all decisions
and issue resolutions.
Activation Planning and Implementation
Activation Planning includes all
significant activities that are necessary to open the building. While the exact
scope of activation planning will vary somewhat between organizations, it
generally includes a human resources strategy and staffing plan, a communication
strategy and plan, a change management strategy and plan, and an information
Operations Planning and Implementation
Operational planning is where a
lot of time and energy are expended to prepare to transition services from one
location to another. Imagine the planning involved in transitioning the nursing
care model for an 18-double-bedded room nursing unit to a 24-private room unit.
That’s a lot of change! During this activity the future state operational
vision will be established, performance standards defined, and workflows
documented. Inter-departmental process flows need to be defined as well and
documented in operating manuals for future staff training.
Staff Training and Development
Staff training and development
is a huge undertaking and cuts across multiple parameters, i.e., process,
technology, life safety, security, and physical design. Once the scope of
training is determined, a detailed training strategy and plan need to be developed,
executed and monitored. Day-in-the-life scenarios are created to test real
patient-family situations and identify issues to be addressed in advance of
Move Planning and Implementation
Move planning focuses on the
physical move of equipment, technology, medical equipment, furniture, and
patients. “Department relocation and move” manuals are often developed to provide
staff and patients-families with consistent information on the details of the
move. A Command Center is established and operational both during and post move
to address any issues or concerns that arise.
Post Move Stabilization
Post move stabilization allow staff the time to adjust to the many changes in their day-to-day work. The
Command Center remains operational for several weeks after the move to respond
to urgent staff and safety concerns. For a period of 3-6 months after the move
there should be a moratorium on physical changes to allow the staff to
acclimate to their new environment. Any outstanding move issues should be resolved
and a post move evaluation completed.
Time spent in activation and
transition planning is the differentiator between merely existing in a new
space and optimizing its ability to effectively support the delivery of
patient-centered care. Activation and transition planning allows staff to understand
how the new space will support their work long before occupancy. With well
executed activation and transition planning, move day can be simply the “opening day performance” after many carefully
Disasters and Healthcare: Are you Ready?
The following article was contributed
by SOHL-sponsor, University of St. Augustine for Health Sciences, and written by
Kathy Wood, PhD, FHFMA, Contributing Faculty Member. The views, thoughts, and
opinions expressed in the article represent those of the author and not
According to Santhanam (2017), the United States is on
track to set a record with an enormous number of natural disasters. As of
October, there have been natural disasters including coastal storms, freezes,
flooding, wildfires, and droughts. What does this mean for healthcare
All four of the University of St.
Augustine campuses were impacted by these natural disasters, as were students
and faculty. Some students and faculty were displaced from their homes; others
lost their homes entirely; some even lost their lives.
Natural disasters come with great
unpredictability and power, leaving people unprepared and in shock after seeing
the damage that they produce. In addition to treating patients, healthcare
organizations have found themselves in a position of providing shelter and
basic needs for many of their geographical neighbors.
Here are some guidelines for being
prepared for disasters.
Organization is Key
In order to prepare for disasters,
natural and other, it is important that healthcare organizations have a
disaster plan that is well documented and that they practice the steps they
will take. The most important piece of disaster preparedness is making sure the
patients are properly taken care of, including their diagnosis, treatment, and
follow up. For this to happen, healthcare organizations must have a method of
entering the patient into their “system” so the procedures and care process can
During disaster scenarios, typical
procedures such as looking up patients in the master index will not be
possible, especially if the individual arrives incapacitated or
unconscious. Instead, a numbering system can be used as a temporary
measure to get the patient entered. The patient access and financial
services personnel will be able to follow up once the crisis has subsided.
Staffing needs will increase during a
disaster. A properly prepared disaster plan for a healthcare organization
includes having access to a backup or reserve medical and administrative staff
network. The credentialing committee can implement a policy for temporary
privileges during emergency or disaster situations.
The intensity of the patient care
activities during this time may be much more like an emergency department than
a typical patient care floor. Consequently, healthcare organizations should
provide additional advanced training to prepare personnel.
Key staff members, usually directors or
mid- to high-level managers, should be assigned specific tasks during disaster
situations. Their primary responsibilities are to keep the process flowing as
smoothly as possible, handle press requests, keep the patients and family
members as calm as possible, and meet the needs of the clients.
Disasters can bring out both the best
and the worst in people. The best happens when others lend a hand to help
with the situation and take care of their neighbors. The worst is the panic
that seems to overcome many people leading to irrational behavior. This is
where training can help mitigate the chaotic atmosphere.
Prepare, Plan, Practice,
Advanced planning and practice is
necessary so that when an emergency arises the healthcare staff is prepared. In
my previous experience at a medium-sized hospital, we practiced drills for
disaster preparedness similar to the practice for fire and tornado
drills. Walking through an emergency operations plan in advance of a real
situation allows the personnel to encounter problems that could occur during a
real disaster and allows for further refinement of the processes.
Executive leadership should consider
allocating funds in advance for additional resources during disasters. Think
outside of the box when anticipating needs. For example, if the area is
flooding and water has been contaminated and power is off for a lengthy period,
the people nearby may depend on the nearest hospital to provide for their basic
needs, especially if that hospital is located in one of the highest points in
The reality is, in many cases, the
daily operations for patient care and patient billing usually win out over the
budget requests for emergencies. Disaster planning should also include
situations where the healthcare facility itself is the victim of a disaster
rather than the place where the victims can come for treatment and refuge.
As is common in healthcare, there are
national requirements set forth by the Centers for Medicare and Medicaid Services and the Joint Commission to
consider as you develop your plan. The Office of Emergency Preparedness of the U.S. Department of Health and Human Services offers a
vast database of resources available for preparedness and disaster response
planning, as does the American Hospital Association.
Taking steps now to prepare for an
emergency operations plan will pay off for all involved when one eventually occurs.
Meet the Inventor of NEXTGENPCR [Interview Part 1 of 2]
The following interview was contributed by SOHL-sponsor,
Canon BioMedical, and conducted by Dana Sullivan, Product Manager. The views,
thoughts, and opinions expressed in the piece represent those of the
interviewer/interviewee and not necessarily SOHL.
Recently, Dana Pfister Sullivan, a product manager at Canon BioMedical, sat down with Gert de Vos, the inventor of the NEXTGENPCR instrument and Director at Molecular Biology Systems, B.V. (MBS). Gert has master’s degrees in biology and physics from Leiden University in the Netherlands. After teaching physics in Curaçao, Gert returned to the Netherlands and embarked on a career as an entrepreneur and inventor in the life sciences.
DS: How did you come up with the idea for NEXTGENPCR?
Well, I was in a meeting focused on the detection of pathogens in milk. During the meeting, we were discussing gel electrophoresis and touched briefly on PCR. One person at the table mentioned PCR chips. I was aware of how PCR chips worked, specifically how the liquid or sample is pumped through different temperature zones, and also that they required nanoliter volumes rather than microliter volumes. I thought, wouldn’t it be great if we could do something similar — not only move the liquid around, but instead move the whole enclosure. That is when I got the idea — so then I went home, and we started on prototypes for what would become NEXTGENPCR. The first experiment we did was around ten minutes, and it worked brilliantly. I said, “Wow, we have something here!”
DS: How is NEXTGENPCR different than standard end-point PCR instruments?
In a typical PCR instrument there is an aluminum or silver block with cavities that holds the individual tubes of the PCR plate. These tubes are made of polypropylene, and they have a 200 to 300 micron wall to help hold their shape. The block is heated to the desired temperature, usually 95°C for denaturation, and then cooled down to the desired annealing temperature. What happens then is interesting; the cooling is done by Peltier elements. The moment you start to use a Peltier element for cooling, the other side gets hot; so, you have to cool a lot more than just the block. When the other side gets hot, the efficiency tumbles; so, while it is initially cooling at eight degrees per second, after a few seconds it slows down to two to three degrees per second. Therefore, it takes some time for the instrument to achieve the correct annealing temperature. Also, the sample inside the tube relies on convection to reach the correct temperature. Rather than use the common Peltier technology, NEXTGENPCR uses temperature zones that eliminate the time it takes to heat and cool during a three-step PCR.
DS: How does NEXTGENPCR achieve such fast PCR?
The technology differs from typical thermocyclers in two ways that enable fast PCR. One, the instrument has three temperature zones, one each for denaturing, annealing, and extension. Two, we decrease the thickness of the well so that the liquid can reach the needed temperature quicker. Our plates have polypropylene enclosures where the PCR mix has been added inside. These enclosures are squeezed between two blocks at the correct temperature. So, if the sample has to go from 95°C to 60°C, the plate moves from the 95°C temperature zone to the 60°C temperature zone. The instrument then presses the blocks together, slightly deforming the enclosures, which allows the PCR reagents to not only mix instantly but also come to the desired temperature, essentially removing the ramp time.
DS: What was important to you when you were designing NEXTGENPCR?
That is an excellent question. While developing the NEXTGENPCR instrument, I met an expert in the PCR market. I think he sold his first PCR instrument in 1984 or 1985. He told me this is potentially a market-disruptive technology, but not in its current shape. He noted the need to have a microplate format because then it will be compatible with all the current downstream applications. We started to work together because of what he said. We started making an instrument that accepts microplate formats. Our plate matches the rim of your typical microplate; in the middle there is a polypropylene sheet with either 96 or 384 wells. Our blocks are flat faced, so it does not matter what plate format you use in the instrument; there are no changes needed.
In addition to the plate, it was important to achieve high-speed PCR while also considering those things important to a user such as how much space the instrument takes on the bench, how much energy is used, and, in the end, how much the device will cost.
DS: How are the plates and consumables used with the NEXTGENPCR instrument different than standard 96- and 384-well plates?
The plates are the same size as a typical microplate because we use the same outside rim. They adhere to the standard defined by the Society for Laboratory Automation and Screening, so they fit in all robotics – both upstream and downstream. However, they differ in the center where we have inserted polypropylene film that has either 96 or 384 wells with a well thickness of 30 to 40 microns. The user’s current PCR mix is pipetted into the wells and then sealed with a heat sealer to close the wells.
DS: You mentioned that energy usage was an important factor in the design. How is the instrument able to save energy?
That is simple to explain — since the instrument has three temperature zones, we don’t need to change the temperature of the blocks. This means we isolate the blocks in the denaturing zone and the extension zone, and in the annealing zone we are able to cool at a certain rate so that the instrument is capable of touchdown and stepdown experiments. Because of this isolation, the instrument is running at 150 to 170 watts rather than 800 to 1200 watts that a standard cycler uses. Then, if you take into account that a PCR experiment lasts between five and 20 times shorter with NEXTGENPCR, you can imagine the amount of energy you use. It could be up to 100 times less compared to other PCR instruments.
Special Thanks to Our Platinum Sponsors
The generosity of SOHL's Platinum Sponsors make all that we do possible! Special thanks to the following organizations (listed in alphabetical order):
AMN Healthcare is the leader and innovator in healthcare workforce solutions and staffing services to healthcare facilities nationwide. With insights and expertise, AMN Healthcare helps providers optimize their workforce to successfully reduce complexity, increase efficiency and improve patient outcomes
Canon Solutions America offers solutions that enable healthcare professionals to be more efficient and profitable while enhancing the quality of patient care. We help streamline admissions and discharge processes, support HIPAA compliance, and integrate patient information with EHR systems. Our solutions are designed to help clinical staff share information quickly and securely.
Catalyst, a Haskell Company, is a healthcare consultancy devoted to bringing customer-driven healthcare solutions to provider organizations across the country. Catalyst deploys innovative strategic, operational, and facility planning solutions that enable healthcare organizations to optimize the patient care experience while improving access and reducing costs.
The Hospital Association of San Diego and Imperial Counties (HASD&IC) is a non-profit organization representing 38 hospitals and integrated health systems in the two-county region. Our mission is to advance the organization, management, and effective delivery of affordable, medically necessary, quality health care services for the San Diego and Imperial County communities.
Kaiser Permanente is a leading health care provider and not-for-profit health plan, serving over 11.3 million members in eight states and the District of Columbia. Dedicated to care innovations, clinical research, health education, and the support of community health, Kaiser Permanente’s focus is on total health.
Founded in 1924, Scripps Health is a nonprofit health system in San Diego. Scripps treats more than 700,000 patients annually through the dedication of 3,000 affiliated physicians and more than 15,000 employees throughout five hospital campuses, 25-plus outpatient centers, and hundreds of affiliated medical offices throughout the region.
Sharp HealthCare is a nonprofit health system that includes four acute-care hospitals, three specialty hospitals, three affiliated medical groups, and a spectrum of other facilities and services. Sharp has 2,900 affiliated physicians and more than 18,000 employees across its care sites.
Sodexo is the worldwide leader in quality of life services. Every day, we strive to improve the quality of life of 100 million people. We develop, manage, and deliver a unique array of on-site services, benefits, and rewards service, and personal and home services.
UC San Diego Health has cared for the community for 50+ years, while researching new treatments and training tomorrow’s doctors. Our physicians and scientists have made important contributions to numerous fields. Our specialty care in cancer, cardiology, and surgery consistently ranks among the nation’s best by U.S. News & World Report.
The University of Phoenix is the first of its kind created for—and by—working adults. Our flexible programs are available online and on campus, with a curriculum influenced by real industry expectations and taught by instructors who have actual experience in the health care world.
The University of St. Augustine for Health Sciences (USAHS) is a graduate institution that offers degree programs in physical therapy, occupational therapy, nursing, and health sciences, as well as continuing education programs. Founded in 1979, USAHS has campuses in Florida, California, and Texas.