News: Spring 2018

BWH ED Redesign to Help Cancer Patients and Researchers

A unique challenge of the emergency department (ED) at Brigham and Women’s Hospital has become the catalyst for a new project designed to improve emergency care for oncology patients and develop new technologies for the ED.

BWH is about to launch a four-year, $52 million renovation and expansion project. Approximately two-thirds of that funding will go to renovating and expanding its emergency department to better serve the needs of patients.

The Brigham ED services a larger than average number of cancer patients who typically present with more serious and complicated conditions.

The project will essentially double the size of the ED, which will help to reduce crowding and streamline emergency services. It will also create a dedicated ED for oncology patients within the overall umbrella of the ED.

A companion Innovation Lab will also be launched to test new strategies for monitoring and treating oncology patients in an emergency care setting.

“It’s an opportunity to bring the emergency department into a new era,” says Michael VanRooyen, MD, Department Chair of Emergency Medicine at BWH.

VanRooyen is working with Partners Innovation to identify industry partners who are interested in collaborating on research projects. “I want to be a testing lab for many of the new technologies and methodologies that are being developed, and Partners Innovation can help us connect.”

A Unique Patient Population

“One of the unique features of the emergency department at BWH is that we see many of the patients who are receiving treatment at the nearby Dana-Farber Cancer Institute,” VanRooyen says. “It’s an unusual patient population for an emergency department because 22 percent of our patients are oncology patients.”

These patients tend to have more serious health conditions and a greater need for social and medical support services, VanRooyen explains. “If an oncology patient has a stroke or heart attack or any other medical problem, their condition is also complicated by being an active cancer patient as well. In many ways, they are not typical emergency medicine cases.”

“There are also complications in cancer treatments that can result in admittance to the ED,” VanRooyen notes. “In immunotherapy or novel treatments like CAR-T, for example, patients have unique and unpredictable reactions to treatment, and can come in with really unusual presentations. We want to be better at understanding and treating these complex cases.”

The Innovation Lab

The Innovation Lab will work in partnership with the oncology ED to identify ways to improve patient care through technology. Projects could include testing new wireless, light touch and ingestible biosensors as well as creating decision aids to help ED physicians diagnose oncology patients and decide on a course of treatment.

“If I have a patient that has shortness of breath but he or she has many co-morbidities, including being a cancer patient, I’d like to know the likelihood of them having a complication of cancer therapy versus a clot versus a heart attack, and decision support can help to sort out those decisions more rapidly and accurately,” VanRooyen says.

Next Steps

The ED expansion project is scheduled to break ground soon. It will be two years before the ED moves into the new space, and another two years to renovate the existing space.

In the meantime, VanRooyen is hoping to raise the profile of the Innovation Lab with potential partners and sponsors and to start testing new technologies this summer. “Even if we don’t have the new physical space to use, we can use develop and test the concept.”