Biventricular pacemaker helps to restore quality of by hss75292


									 October 2005
Volume 5, Issue 4

                          Biventricular pacemaker helps to restore
Announcements             quality of life to heart patients
The RQHR welcomes
the following new         For patients with compromised heart               active and are able to return to normal
physicians to the         function, quality of life can be reduced          activities.”
Region:                   significantly. Cardiac surgeon Dr. Stephen
Dr. N. Adams,             Korkola and his colleagues at the Cardiac         The average time for an implantation is
Department of Family      Cathetizeration Lab at Regina General             about an hour, although in more complex
Practice                  Hospital have a valuable tool – the               cases, it can take three to four hours. An
                          biventricular pacemaker – to help restore         overnight hospital stay follows, and the
Dr. S. Cheshenchuk,
Department of Family      quality of life to heart patients.                pacemaker is programmed in the Pacemaker
Practice                                                                    Clinic, to determine if any “tweaking” is
                          Over seventy of the devices have been             needed. In six weeks, a follow-up evaluation
Dr. J. Danielson,         implanted at the Regina General Hospital          is done in the Clinic.
Department of Family
Practice                  since 2003. The program was enhanced with
                          funding from Saskatchewan Health in               Pacemaker technology continues to race
Dr. N. Kazmi,             December 2004.                                    ahead. And with it, more experience in
Department of Family                                                        treating patients is gained. “Our expertise is
                          An unfortunate reality for heart patients is      growing, and our hope is that more patients
Dr. M. Youssef,           that quality of life can become diminished.       will be referred to us earlier, as we see that
Department of Medicine,   “When the left and right sides of the heart       the procedure works.”
Section of Physical       are no longer working together, patients
Medicine and
                          experience severe shortness of breath,” says      The modern biventricular pacemaker that Dr.
                          Dr. Korkola. “Mobility becomes limited. The       Korkola and his colleagues are implanting
                          patient may need to sleep propped upright in      has evolved in a difficult-to-imagine way
                          a chair, gasping for air.” A loss of confidence   from the pioneer pacemakers of the 1950’s. In
                          and depression can impact patients, as well.      those early days, patients relied on a device
                                                                            that plugged into a wall socket. The wearer
                          For patients with poor heart function, both       could move no further than the length of the
                          sides of the heart need to be stimulated and      extension cord, thus providing an anxious,
                          this is the function of the biventricular         worrying time for patients, families and
                          pacemaker. There are three leads in this type     doctors.
                          of pacemaker: one lead is attached to the
                          right atrium, one is attached to the right        “In the past, the device was cumbersome and
                          ventricle and a special electrode is implanted    it was a big operation to install. Now, the
                          on the left side of the heart.                    devices are more sophisticated and the
                                                                            procedure is non-invasive.”
                          Dr. Korkola says, “With both sides
                          stimulated, pumping action is more efficient      Dr. Korkola works with a team of people to
                          and cardiac function is improved.”                support biventricular pacemaker patients: Dr.
                                                                            George Garbe, section head of Cardiology, a
                          According to Dr. Korkola, patients often          group of trained cardiac nurses, respiratory
                          show improvement very quickly. “They come         therapists and John Fedirko, Team Leader for
                          out of heart failure, they are able to be more    the Cardiac Catheterization Lab.
Physicians and their Obligations under HIPA
Physicians employed by the Regina             their employees can be very severe,           • Saskatchewan Information and Privacy
Qu’Appelle Health Region (RQHR), and          resulting in discipline or discharge, with      Commissioner Web site at
those in private practice, should be aware    fines up to $50,000, or one-year      
of the legislative requirements under the     imprisonment and the possibility of civil
Health Information Protection Act             litigation for an individual. For medical     • The Saskatchewan Medical Association
(HIPA). These requirements have been in       corporations and health regions, fines          Web site offers
effect since September 2003 and may           can range up to $500,000.                       information, forms and a Privacy
affect physicians’ office routines and                                                        Toolkit for downloading.
practices.                                    Some key points to remember:

Under HIPA:                                   • Client records must be secured and
                                                protected until destroyed.
                                                                                            News Reel
• Physicians are considered trustees for                                                    Influenza Campaign Underway
  their patients’ personal health             • Personal health information that is no
  information in private practice.              longer needed, including personal           The Regina Qu'Appelle Health Region
                                                working notes by staff, must be             kicked off its annual campaign against
• RQHR is the trustee for personal health       shredded, using approved shredders.         influenza on October 4. The campaign
  information for the clients, patients and
                                                                                            offers free influenza vaccinations to those
  residents they serve.                       • Paper and electronic documents,             who are considered high risk. Included are
                                                including e-mail, come under HIPA.
• Physicians employed by the RQHR are                                                       adults 65 years and older; residents of
  required to follow RQHR policies,           • Access personal health information          nursing homes and long-term care
  procedures and guidelines.                    related to patients only on a “need to      facilities; anyone with chronic lung or
• All trustees of personal health               know” basis, for professional purposes.     heart disease, diabetes, lowered immunity,
  information are responsible for the                                                       cancer, kidney disease or severe anemia;
                                              • No public discussion of clients’ cases in
  appropriate collection, use, disclosure,                                                  and children or adolescents on long-term
                                                elevators, waiting areas, hallways or
  retention and destruction of personal         cafeterias.                                 ASA therapy.
  health information.
                                                                                            Influenza vaccination is encouraged for all
                                              • Maintain chart confidentiality, never
• Clients are able to request access to any                                                 residents of the Region. For those who are
                                                leaving charts open and unattended.
  personal information held by their                                                        not at high-risk, there is a fee. This year,
                                                Return charts to a secure storage space
  trustee. You should assume that any notes                                                 for the first time, children six to 23 months
                                                after use.
  may be accessed by clients.                                                               will receive free vaccinations, by
Those within the RQHR “Circle of Care,”       The federal privacy statute, Protection of    appointment with the Region’s Public
in the current episode of care, do not        Personal Information and Electronic           Health clinics, beginning on November 1.
require consent from the patient, because     Documents Act (PIPEDA), applies to
consent is deemed to exist. Family doctor,    doctors in private practice. Some offices     For more information on this year's
admitting doctor, attending doctor,           may be affected by both PIPEDA and            influenza vaccination or to view a
referring doctors, RQHR staff and             HIPA. For this reason, doctors may wish       calendar of clinic times and locations, visit:
physician employees with a need to            to consult with a lawyer to ensure their
know are all within the circle. Outside the   office practice is in compliance.             services/pubhealth/influenza.shtml
circle are social services, general public, The brochure, Protecting Clients’ Privacy,
lawyers, private insurance, including SGI,  is available in each department or unit,        New Provincial
to name a few. For these agencies, who
do not provide care but need access to
                                            all RQHR Health Services Libraries, on
                                            the RQHR Intranet and on the Region’s
                                                                                            Laboratory Site
the individual’s personal health
information, RQHR will either require the
                                            Internet Web site. If you need more             Confirmed
                                            information on HIPA, you may call the           On October 4, Health Minister John Nilson
patient’s expressed consent or some other   HIPA telephone line at 306-766-3399
legally supported reason to release their                                                   and Minister responsible for Saskatchewan
                                            (toll-free: 1-866-910-3399) or David
personal health information.                                                                Property Management, Deb Higgins,
                                            Wilson, RQHR’s Acting Privacy Officer,
                                                                                            officially confirmed the site for a new $27
Next of kin and friends or relatives are on at 306-766-6808.
                                                                                            million provincial health laboratory. The
the edge of the Circle of Care, because the
                                            Additional Information is also on the           new lab will meet future needs by
patient may wish to restrict access to
                                            Internet by visiting the following Web          improving testing capability and speeding
health information.
                                            sites:                                          up intervention in the event of a public
In some instances, HIPA allows                                                              health crisis such as SARS or an influenza
disclosure of personal health information • Regina Qu’Appelle Health Region Web             pandemic. The lab will be located at
without client consent; for example, for       site at Click on
                                               ‘Inside Story,’ then ‘Privacy.’              Regina Research Park, adjacent to the
billing purposes, warrant, subpoena and
                                                                                            University of Regina. Construction of the
other Acts that supersede HIPA.             • Saskatchewan Health’s HIPA Web site           facility will start late summer of 2006 with
The consequences under HIPA of                  at                    a completion date of March 31, 2008.
inappropriate conduct by a trustee or           ph_br_health_leg_hipamain.html

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