OSF HealthCare is strengthening its medical assistant workforce with an immersive trainee program that hires participants first, then trains them through a combination of classroom learning, simulations and hands-on clinic experience.

Leaders say the program was designed to prepare medical assistants for the realities of patient care while easing staffing pressures across OSF Medical Group clinics. Leaders are looking for candidates with a good mix of soft and clinical skills.

“It’s very important that medical assistants have empathy and emotional intelligence,” says Amanda Lambie, director of Clinical Education and Professional Development at OSF HealthCare. “They’re caring for patients day to day. Clinics can be busy, patients have different needs, and sometimes you unexpectedly have to set up for a procedure. We need them to be flexible and adaptable and ready to take care of the patient, whatever it is that they need.”

Classroom work comes first

Trainees are hired into a medical assistant trainee role and begin their education in a classroom and skills lab before rotating through clinics with certified medical office assistant preceptors. They also participate in simulations with standardized participants who are trained actors and complete certification coursework through the partnership OSF has with Guild.

For one trainee, 19-year-old Sandy Jones of Lacon, Illinois, the program felt like the natural next step in a long-standing desire to care for others.

“So basically, when I was 16, I was actually a CNA because I saw my grandma in the nursing home,” Jones shares. “I just loved the residents and the way that you got to take care of them and make a smile on their face.”

She was one of nine trainees selected from nearly 100 applicants for the Medical Assistant (MA) Trainee program, confirming for Jones that she was meant to answer the call to help others.

Trainees rotate among clinics

The program places trainees in clinics across Central Illinois, including Peoria, Morton and Washington, exposing them to primary care and in Jones’ case, pediatric care as well. Trainees focus on mastering clinical skills and Lambie emphasizes it stresses professionalism and patient safety.

“Our certified medical assistants administer medications and give injections. A lot of these skills could introduce risk if they weren’t serious and professional and diligent in making sure they were following all of the appropriate procedures.”

The cost of all training, coursework and certification exams is fully covered by OSF. While the national certification process is rigorous, leaders say support continues until every trainee succeeds.

Three of the nine trainees needed to retake the certification exam, but everyone was able to achieve their goal.

Jones was among those who needed to take the test a second time, but she says educators worked to find creative ways, including gaming, to help her grasp the material.

Games helped reinforce material

“We also did some Jeopardy games, which really helped. I love being competitive, so when you bring a game into it and it’s not so serious, you start really learning it and it really helped me.”

Every MA trainee has transitioned into a certified medical assistant position. Most medical assistant programs last 28 weeks, but the employer-based training with OSF Medical Group created an accelerated pathway with nine weeks of training for most.

Jones points out that for the trainee, the pace was demanding but rewarding.

As a hands-on learner, simulations stood out to her as the most valuable part of training. The simulation allowed her to practice the rooming process with trained actors.

“They came in for a cough and fever, and we literally went through the exact rooming process I’m doing now. And for a baby, we would have to get their length and head circumference and do a whole well-child (exam). It was amazing,” Jones recalls.

She now works in pediatrics, a setting she says allows her to connect quickly with patients and families and she enjoys making kids smile. Jones often rewards them with stickers after a successful visit to the OSF Center for Health in Morton.

Nurses spend more time on direct care

Lambie says the program also significantly reduced onboarding time for clinics.

Managers in OSF Medical Group offices reported that they were cutting onboarding time down by about half. Lambie stresses filling medical office assistant positions quickly helps care teams perform efficiently.

“Which permits our nurses to stop doing the task and responsibilities which a CMA is capable of doing and enjoys doing and allows nurses to really work at their top of scope and top of licensure.”

With strong feedback from medical group leadership, OSF plans to expand the program in small cohorts to other regions.

For Jones, the experience has already shaped her future plans. She plans on starting nursing school in the fall. She’s always wanted to be a pediatric nurse and follow in her grandmother’s footsteps with a career in nursing.

Her advice for others considering the program is simple. Go for it.

“This is a very good opportunity for you to step into the medical field and take it very seriously because it’s a real job and at the end of the day you’re going to love it.”

Here is an option to learn about the next round of applications for the medical assistant trainee program.

Sandy Jones

Amanda Lambie

B-roll-Medical Office Assistant Trainee 

A potentially life-saving pilot program is launching in Bloomington, Illinois to detect a little-known but surprisingly common genetic condition that can dramatically raise cholesterol levels—and the risk of heart attacks and strokes—even in children.

It’s called familial hypercholesterolemia, or FH. It’s estimated that 1 in 200 Americans has the genetic disorder where the body can’t effectively clear LDL or ‘bad’ cholesterol from the blood.

Darrel Gumm, MD, vice president of OSF HealthCare Cardiovascular Institute says the pilot will identify people who, due to their genetics, might not know they are at risk.

“It’s estimated about 1.3 million people in the United States have it [FH] and 90% of those patients don’t know they have it, Dr. Gumm stresses. “So, it’s a tremendous opportunity for us to step in and find those patients, identify those patients and provide therapies that may prevent terrible things from happening down the road.” 

OSF HealthCare and OSF Innovation are using artificial intelligence (AI) to conduct a pilot program for detecting and treating FH. To identify high-risk patients for this pilot, the Digital Innovation Development team used a two-step approach. First, an algorithm flagged patients over the past 18 months who had concerning cholesterol levels. Then, they applied an AI tool to scanned physician notes to detect clues—such as yellowing of the eyes or hardening of the Achilles tendon—signs a doctor may have observed but not flagged as FH-related.

People inherit FH from one or both parents, and it puts them at risk for cardiovascular events far earlier in life than normal, sometimes even in childhood.

Two Types of FH

According to Dr. Gumm, there are two kinds of FH:

• Heterozygous FH, inherited from one parent, which can lead to early heart attacks or strokes—before age 65 in women and 55 in men.
• Homozygous FH, a rarer and more severe form inherited from both parents, which can lead to strokes and heart disease in teenagers or even young children.

While most people begin cholesterol screenings around age 40, those with FH can silently develop sky-high levels from a young age.

"They can be a very healthy person, think they’re doing great, be a marathon runner and really they could have astronomically high cholesterol that’s not of their fault,” explains Ryan Loudermilk, a strategic program manager in Performance Improvement at OSF Innovation.

The new screening program was launched in Bloomington, starting with support from a strong primary care network involving 9 providers including Richard Ginetti, MD, who is a champion for the effort. It started with 200 patients found to potentially have FH. If testing confirms the diagnosis, individuals will be offered treatment, typically statins, which can reduce cardiovascular risk by up to 80%.

Dr. Gumm says every time someone is identified with FH, outreach will occur to encourage screening for parents, siblings, and children.

“One of the things I love to tell my patients is the best way to treat a heart attack is not have one. Same thing with a stroke. So, even if they’ve had a heart attack and survived it, now we’re going to be aggressive at not letting the second one occur. But here’s a chance to never let it occur in the first place. It’s primary prevention … really fantastic.” 

Education in a Short-Attention-Span World

Understanding FH—and the importance of early detection—isn’t easy in a world flooded with information. That’s why the pilot program teamed with OSF Innovation’s Medical Visualization team, to create for people identified at possible risk, mobile-friendly education designed to meet people where they are.

Loudermilk emphasizes it’s not just a brochure. The visuals use a unique, semi-animated shimmer effect that adds emotional weight without overwhelming the viewer.

“It’s something that can be easily read on their cell phone; they don’t have to log onto a computer. It’s something that’s eye-catching, something that’s straight to the point – what your risks are, why it’s important for you to get tested and checked … thinking about family members, so it speaks to that. It speaks to the ease of this. That’s the other big piece of this.” 

A Simple Test with a Big Impact

The testing process is easy. It’s just a cheek swab with no needles or blood draw. It takes a couple minutes.

The pilot is tracking how many people go on to be screened after the initial outreach with a goal of at least 30%. The initiative will follow not just how many patients test positive, but how many then go on to get family members tested, the true measure of ripple effect success. Additionally, the pilot includes having the Medical Visualization team provide insights about which content drove the most engagement.

The FH pilot is part of a broader effort at OSF HealthCare to advance care through personalized medicine that is specific to a person’s genetic make-up. Loudermilk sees a time in the future where genetic testing will be even easier.

“Where I could see this going – a patient doesn’t even have to come in. These kits could actually be mailed to them, to their house and they could do the check swab themself and get it mailed in. So, those who don’t want to deal with making an appointment and seeing their provider in person, they could do a virtual visit and have the kit sent to them. That’s the future of all of this.” 

If you receive primary care in Bloomington, talk to your provider if you think you would like to be screened for familial hypercholesterolemia.

Dr. Darrel Gumm

Ryan Loudermilk

B-roll-Familial Hypercholesterolemia (FH)

When it comes to the end of your life, the decision on what kind of medical treatment you want should not be left up to your loved ones or your medical providers. In fact, a study by the National Institute on Aging says people incorrectly guessed nearly one out of three end-of-life decisions for their loved one.

No one likes to think about the end of life, but without advance care plans (ACPs) in place, others could make decisions on your behalf if you are unable to convey them.

OSF HealthCare is taking a more deliberate approach in helping individuals and families through these difficult end-of-life care conversations well before they might be needed. For example, when a person receives a critically ill diagnosis, it triggers an alert in their medical record to make sure there is documentation of an advance directive outlining what a person would and would not want as part of their care goals in a life-threatening circumstance.

Brian Curtis, MD, vice president and chief medical officer for OSF Medical Group, says the critical illness discussion begins with an explanation about the extent of the condition and the prognosis. 

“Mainly it talks about your understanding of your illness, and then I give you my impression of your illness. And then we start having discussions about what your overall plan is, and then our thoughts. And then we start talking about what the next step of?? our plan is, and part of that is usually if you haven't had it done, it would be advance care planning.”

OSF HealthCare providers also have another tool that is built into Epic, the medical record for OSF patients. It offers an End-of-Life Care Index score (EOLCI), which assesses the one-year mortality risk that can help clinicians determine what individuals could benefit from end-of-life conversations and reach out to them to discuss their wishes and care options. The EOLCI score takes in 46 different features including demographics, labs and comorbidities.

Often a medical provider can begin the discussion and then make sure a specially trained advance care planning facilitator continues the conversation with the patient and their family. Preparing for end-of-life conversations is now easier thanks to a new ACP resource page in OSF MyChart. Here, patients can upload any previous advance directive documents, edit their medical decision makers or self-schedule a visit with a trained facilitator.

Advance care planning is covered by Medicare as part of an individual’s annual wellness visit. If you have private health insurance, check with your insurance provider. Talking to a health care provider can help you learn about your current health and the kind of decisions that are likely to come up. For example, do you want a Do Not Resuscitate (DNR) or a Do Not Intubate (DNI) order on file?

Prevents second guessing

Discussing your wishes for life-extending medical treatment, Dr. Curtis emphasizes, can relieve stress on loved ones because tough decisions have already been made by you.

“It does not shift that burden onto somebody else, whether it's your wife, your children, siblings or whatever it may be. It doesn't shift that, and when these people are participating in a discussion with the physician, we have that as a groundwork of what you would want or what you would wish to be done to you. And so that we're respectful of your desires and wishes."

Dr. Curtis also stresses that having a documented medical directive also helps prevent your loved ones from second-guessing a care decision.

“And then it actually assists them in having that closure and then avoiding remorse and guilt of having to make these decisions of, ‘Did I make the right decision? Is this something they would have wanted?’ And then the strife that can occur between family members.”

It’s also important to appoint a durable power of attorney for health care. That requires filling out a legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself. But Dr. Curtis stresses that your medical directive is a living document. It can change over time.

“Before you were looking for quality of life, and now you’re looking at quantity because you have a graduation or a wedding or a grandchild on the way or something that makes you want to extend it [life]. So, really, it’s not permanent, and it can be changed. It can be revoked.”

The National Institutes of Health recommends you think of your advance directive as a document you review at least once each year and update if a major life event occurs, such as retirement, moving out of state or a significant change in your health.

As we approach national Healthcare Decisions Day April 16, here are some resources to get started with your advance care planning. 

Dr. Brian Curtis

People interested in making an appointment at the new clinic can call 217-337-3500.

B-roll

When it comes to oral health in kids, Emily Isom has seen it all.

Cavities, gum disease and infections, improper tooth alignment and tooth loss come to mind quickly. Not to mention all the missed school time dealing with these issues.

But she’s also seen plenty of young people who are the picture of good oral health. And she’s on a mission to make more of the latter.

“The mouth is the gateway to the body,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare and a former dental assistant.

“A lot of people don’t think about what our oral health can do to us if it’s not being taken care of,” she adds. “It can cause heart disease, diabetes and respiratory infections.”

Everyday prevention

Isom says kids and their parents should commit to daily habits that will improve their oral health.

For infants without teeth, Isom says parents should use a soft, cool washcloth to wipe the child’s gums twice a day. This helps clear bits of food and milk that can lead to bad breath, irritation and cavities.

“Touching their gums will help when they are older. They’ll be okay with brushing their teeth. They won’t fight the parents about it,” Isom says. “So, it’s good to start [oral health care] early."

Older kids should brush their teeth for two minutes, twice a day. Floss once a day. When a child has two teeth that touch, it’s time to start flossing. That could happen from ages two to six.

Before you rinse out your mouth with water, don’t forget about the tongue, Isom says.

“If we do not brush our tongue, bacteria can sit on it. It can get what I call ‘tongue sick,’” Isom says. “Bad breath can also happen.”

Outside of the bathroom, Isom reminds us that sugary and starchy food and drinks are prime suspects in oral health issues like cavities. So, parents should offer those foods in moderation. Isom calls out sticky candy as an example. She says the sugar tends to sit on your teeth for a while. Isom also says starchy food like bread, potatoes, rice, pasta and cereal can sit between your teeth unless you floss right away.

Another must-know for parents with babies: don’t put your baby to bed with a bottle. Aside from a choking hazard, Isom says the constant stream of milk or formula can lead to cavities and corrosion. She also says this can cause infants to be fussy and demand a bottle more often.

It takes some convincing

A mother of a six-year-old, Isom knows that some kids won’t brush and floss willingly. They see it as a chore.

Her response: make oral health fun.

“Make a dental chart. Add stickers to it, morning and night,” Isom suggests. “Give them rewards like a little toy. After each cleaning, they can get a reward. Turn on music or a timer for two minutes [of brushing.] Get toothbrushes with their favorite characters on them.”

Dentist visits

Isom says children usually have regular visits with a dentist twice a year. Others with known mouth issues may go every three to four months. But see a dentist right away if you notice red flags: pain in the mouth, persistent bad breath, discolored gums or teeth, bleeding gums or trouble swallowing.

A regular dental visit usually includes a thorough cleaning of the teeth and gums followed by fluoride treatment.

“[Fluoride] protects the enamel of the teeth,” Isom explains. “It protects your teeth from cavities. It just makes your enamel really strong so you can eat the things you want.”

A dental professional may also perform X-rays on your teeth regularly.

Something else for parents to make sure the dentist has in mind: oral cancer screening.

“Those are huge,” for oral health, Isom says.

A dentist may use their hands to examine your mouth and neck. They could use a light or have you rinse your mouth with a blue dye. Each method looks for abnormal, possibly cancerous tissue.

At the end of a dental visit, you may be sent home with a prescription or just instructions to keep your mouth happy. For example, you may get a prescription mouthwash to help with gum disease.

Learn more

Read more about how to keep kids’ mouths in good health on the OSF HealthCare and U.S. Centers for Disease Control and Prevention websites. If you don’t have a family dentist, talk to your primary care provider about finding one. OSF HealthCare Children’s Hospital of Illinois in Peoria offers dental care for children with special needs.

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Feeling bloated today? You’re not alone.

It’s not uncommon to get the sensation caused by gas, air or fluid retention in the stomach or small intestine. But what’s important to know: bloating has many causes, says Aminat Ogun, MD, an OSF HealthCare family medicine physician. So don’t let it linger and hope it will go away. If symptoms persist, see a health care provider so they can rule out something more serious and give proper treatment.

“It might feel like your stomach is full, swollen or sometimes tender. It can cause some discomfort,” Dr. Ogun says.

Causes for bloating include:

• The body makes too much gas.
   
• An overgrowth of intestinal bacteria. H. pylori is a common type. Dr. Ogun says it causes chronic inflammation in the stomach lining, and it can lead to peptic ulcers or even stomach cancer if untreated.
   
• Diet issues, like intolerance of certain carbohydrates or a gluten intolerance.
   
• Hormone changes during a woman’s menstrual cycle.
   
• Abnormal gastrointestinal motility. Simply put, this is when your gut is not working properly. Dr. Ogun says one example is gastroparesis.

              “The body takes its time before its able to pass food from the stomach to the small intestine,” she explains.

• Stress, anxiety and depression.

Dr. Ogun points out that we can’t control some of those causes, but others we can. She says a typical first step for a person with bloating is to change their diet. She says doctors may recommend a diet with a long name: fermentable oligosaccharides, disaccharides, monosaccharides and polyols. But just remember the abbreviation: FODMAP. It describes carbohydrates that are difficult for the body to break down.

Foods to avoid on the FODMAP diet: pasta, cereal, bread, yogurt, ice cream, apples, cherries and peaches. Alternatives include quinoa, brown rice, eggs, cheese, grapes, strawberries, chamomile tea, peppermint tea and ginger tea.

“Have a food diary,” Dr. Ogun suggests. “See what triggers your bloating symptoms and see if you can eliminate those foods.”

People with bloating may also take medicine like Gas-X. If you have intestinal bacteria, you’ll be on antibiotic medication.

Dr. Ogun adds for people age 55 and up, bloating is less common, and other health issues are, simply due to older age. So, if you are of that age and have sudden bloating symptoms, see a provider to find out if your symptoms are bloating or something more serious. And for all ages, if you have severe diarrhea, nausea, vomiting or unintentional weight loss, stop by a doctor’s office.

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A punch in the gut
 

A veteran urologist, Uwais Zaid, MD, has heard the comparisons.

Pain from a kidney stone is like giving birth.

“It’s true,” says the man who provides care at OSF HealthCare in Alton, Illinois.

“It’s horrible. They just can’t get comfortable. They’re writhing around in pain,” Dr. Zaid says of people suffering from a calcification-turned-blockage in the urinary tract.

“When the kidney gets obstructed, everything gets swollen upstream. That causes everything to get stretched out,” Dr. Zaid explains. “And it hurts a lot. Your body responds with severe pain in the flank area. It’s a sharp, stabbing pain.”

Other signs: you suddenly start feeling an urgency to urinate or your urine is anything but clear or yellow.

All those unpleasant symptoms are why prevention of kidney stones is key. It starts with what you put in your body.

Drink plenty of water, Dr. Zaid says. Doctors even recognize a “kidney stone belt” in the southern United States where people deal with sweltering weather and dehydration.

Avoid excess salt and sugar in your diet. That means cut back on soda and sweet tea. Too much meat, nuts and leafy vegetables can also cause problems.

“Other risk factors include a family history of kidney stones. Chronic diarrhea can cause dehydration and a loss of electrolytes,” Dr. Zaid says.

For small kidney stones – less than five millimeters across, or about the size of an eraser on the end of a pencil – a provider may see if the stones can pass out of your body through the urethra on their own. Medication can help with that.

But for trickier stones, there are several ways doctors can intervene. Dr. Zaid says providers can blast sound waves at the kidney stone from outside the body to break the stone apart. A doctor can send a camera through the urinary system, find the stone, use a laser to fragment it and remove the pieces. For larger stones – two to four centimeters – surgery involves an incision through your back to reach the stone, break it apart and remove it.

If you have symptoms of a kidney stone, don’t try to tough it out. Your symptoms may subside, but there may still be issues that could turn serious. Instead, see a doctor right away. They will perform a CT scan or ultrasound to find the cause of the pain, then develop a treatment plan.

“If the kidney remains obstructed for several weeks, that can lead to kidney damage,” Dr. Zaid warns. “If the kidney stone causes urine to get infected upstream, that can lead to sepsis, which is a life-threatening infection.”

Learn more about kidney stones on the OSF HealthCare health library and the OSF HealthCare blog.

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Andrew Zasada, MD, can’t help but chuckle when asked about the “latest and greatest” body cleansing fads.

But the internal medicine physician at OSF HealthCare says these whims can turn into anything but a laughing matter.

“When you put stuff that’s not really regulated in your body, you don’t know what’s going in,” Dr. Zasada says. “And if you mix in your regular medicine, too, you’re not doing yourself a favor.”

Dr. Zasada is reminding you to talk to your primary care provider before starting any significant treatment. Don’t believe everything you read online or on a label.

Diatomaceous earth as a cleanse

Dr. Zasada says diatomaceous earth has several legitimate uses in industry. But it’s also seen in powder form as a dietary supplement.

The product comes from ground-up and processed skeletons of algae. It contains silica, one of the main components of sand. There are two types of diatomaceous earth: edible, which contains 2% to 4% silica, and industrial with 60% or more silica.

Dr. Zasada says ingesting silica in small amounts – for example, mixing it in water – is harmless because it does not absorb into your body. But you should never inhale it.

“It causes irritation of the lungs which can be permanent and cause scarring. It can cause you to be short of breath. It’s called silicosis,” Dr. Zasada explains. “It’s similar to what coal miners get when they inhale coal dust. People die from silicosis every year.”

Dr. Zasada says some people claim diatomaceous earth cleanses your digestive tract and improves cholesterol. But he says scientific evidence for and against these claims is “scant at best.”

“There have been a few studies that showed that it lowers cholesterol. But at the same time, we don’t know what else that patient may have eaten because it was a poorly designed study,” Dr. Zasada says. “Was the silica responsible? Was it dietary? We simply don’t know.”

Dewormers and other cleanses

Dr. Zasada says dewormers do what the name suggests – remove intestinal parasites from your insides. He says they serve a purpose in livestock but not humans.

“Some people believe we all carry some type of parasite, and we need to deworm ourselves,” Dr. Zasada says with a sigh.

“If you really think you have an intestinal parasite, see your doctor. The test is simple. If you do, in fact, have a parasite, it can be eliminated.”

Dr. Zasada adds that there’s no evidence that our bodies are loaded with toxins that must be removed. He says that removal happens naturally through our liver, kidneys and bowel movements.

“We’ve been around as a species for hundreds of thousands of years without colon cleanses, and we’ve done pretty well,” he quips.

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