UAB MEDICINE PULMONARY SERVICES
FEATURE STORIES
SUMMER 2019
To learn more, please visit uabmedicine.org/referpulm
EXPONENTIAL GROWTH OF THE UAB INTERVENTIONAL PULMONOLOGY PROGRAM
Since its launch in mid-2016, the UAB Interventional
Pulmonology (IP) and Pleural Disease Program has grown
rapidly. Under the leadership of Hitesh Batra, MD, the IP
program has grown from one physician to a team of eight
professionals, including three faculty, one IP fellow, one RN
coordinator, one nurse practitioner, and two administrative
assistants as of summer 2019.
The UAB IP and Pleural Disease Program is the first and
only such program in Alabama that offers a comprehensive,
multidisciplinary approach to a wide range of pulmonary
and pleural conditions, including central airway obstruction,
lung masses/nodules (malignant and benign), mediastinal
lymphadenopathy, suspected and proven malignant pleural
effusion, pneumothorax, and undiagnosed exudative pleural
effusion. Challenging cases are discussed at the weekly
Thoracic Oncology Tumor Board meetings, which are led
by the IP physicians and attended by collaborating medical
oncologists, radiation oncologists, thoracic surgeons,
radiologists, and pathologists.
This collaborative approach to patient care goes beyond the
weekly tumor board meeting. “Not a day goes by that we
are not in conversation with our counterparts in surgery or
oncology,” Dr. Batra says.
The new program also is engaged in clinical research efforts
to find new diagnostic and therapeutic approaches to lung
disease, and it will help train the next generation of pulmonary
physicians. Joseph Thachuthara-George, MD, is leading the
efforts in telemedicine in IP to improve access for patients in
remote areas, including rural Alabama.
Aline Zouk, MD, a former UAB Pulmonary and Critical Care
fellow, will join Drs. Batra and Thachuthara-George in August
2019 as their third partner, after completing an IP fellowship
at New York University. In other exciting news, the UAB IP
fellowship program was approved by the UAB GME office in
June 2019 and also received full accreditation from AABIP/
AIPPD. Mark McGinley, MD, will join the program in July 2019
as the first UAB IP fellow.
TELE-ICU PARTNERSHIP CONNECTS UAB AND THE COMMUNITY
Physicians in the UAB Medicine Division of Pulmonary, Allergy,
and Critical Care Medicine launched a new telemedicine
program, UAB eMedicine Critical Care, in July 2018. Led by
Steve Stigler, MD, and James E. Johnson, MD, the initiative
enables UAB Medicine physicians to monitor and treat patients
in the intensive care unit at Vaughan Regional Medical
Center in Selma, Ala., without leaving the UAB campus. This
consultative service emphasizes communication with local
primary care physicians and providing support to physicians
and nursing staff in managing critically ill patients.
As a community hospital, Vaughan Regional Medical Center
maintains a 10-bed ICU, but it doesn’t have a pulmonary
intensivist on staff to assist with the care of patients who need
a mechanical ventilator to support breathing. Telemedicine
connects the pulmonary experts at UAB Medicine with
the health care team in Selma, enabling UAB clinicians to
vicariously “round and respond” as if they were on-site
physicians.
The technology is similar to the popular consumer
videoconferencing platform FaceTime but with added digital
diagnostic tools, such as an electronic stethoscope. With a
secure computer and video hookup, the Vaughan team sets a
mobile cart next to the patient for examination.
Through the electronic link, the UAB Medicine physician
can listen to the patient’s heart and lungs, review his or her
medical record, and see the ventilator settings. The physician
then can enter orders directly into the system. Drs. Stigler and
Johnson believe this program will have the most impact on
patients with shock, particularly septic shock, and respiratory
failure requiring ventilatory support.
About a dozen UAB Medicine pulmonologists currently
operate the tele-ICU service 24 hours a day, seven days a
week. In addition to providing consults and care, they also
will help train Vaughan’s family medicine residents in critical
care medicine through both on-site and remote lectures. The
team has expanded this program to Russell Medical Center
in Alexander City, Ala., and it plans to do the same by the
end of summer 2019 at two other Alabama hospitals: Bryan
W. Whitfield Memorial Hospital in Demopolis and L.V. Stabler
Memorial Hospital in Greenville.
Dr. Johnson says the team is excited to stretch its boundaries
and explore this new means of patient care. “It’s good that
we’re getting outside the four walls of UAB and helping smaller
hospitals,” he says. “The telemedicine approach offers a win
for all involved. The smaller community hospitals have access
to pulmonary experts, UAB is able to serve more patients, and
the patients themselves are able to stay closer to home and
family support.”