When Dancing with the Stars performer Val Chmerkovskiy was recently hospitalized in Peoria, Illinois, because while on tour, he experienced intense dizziness and a spinning sensation. Doctors determined he was suffering from benign paroxysmal positional vertigo or BPPV — the same condition that has affected Bloomington, Illinois, resident David Williams for decades.

Chmerkovskiy’s issue was caused by loose “crystals” in his inner ear and forced him to miss a tour performance before undergoing treatment, including the Epley maneuver. His experience highlights a condition that can strike suddenly, and it’s one that OSF HealthCare specialists say is often treatable once properly diagnosed.

Williams, now 82 and retired as professor emeritus from Illinois State University where he taught and served as an administrator. He taught courses in music psychology and arts technology, a program he created in the late 1970s--now the new School of Creative Technologies. Williams remembers the first time vertigo hit him.

“Well in my 40s one night, I woke up and I thought I was having a heart attack because everything was spinning, and I had cold chills. I was in cold sweats.”

The episode turned out to be BPPV, a condition caused when tiny calcium crystals inside the inner ear move into the wrong part of the balance canals. The displaced crystals send confusing signals to the brain about the body’s position, creating the sensation that the room is spinning.

At the time, Williams said treatment options were limited. He couldn’t do anything except take motion sickness medication and sit in a comfortable chair and focus on an object to minimize the spinning sensation.

For years, Williams’ symptoms would appear unexpectedly, sometimes during travel or in the middle of the night. Eventually, he was referred to vestibular therapist Kristine Cottone, PT, DPT, MBA, manager of rehab services at OSF HealthCare in Bloomington, who specializes in diagnosing and treating balance disorders.

Cottone says the tools available to therapists have changed dramatically over the past two decades. When she first started, she used lenses that magnified eyes in a dark environment. Then, technology progressed, and cameras were put inside. Then, there were infrared video googles.

Goggles bring diagnosis into view

Today, Cottone says the latest goggles from Vestibular First have advanced features that analyze subtle eye movements linked to balance disorders and allow for a more exact diagnosis. Software was developed so therapists can record, play back, zoom in and slow down video. Therapists can see involuntary eye movements to determine which part of the inner ear is causing the problem and guide treatment maneuvers designed to reposition the misplaced crystals.

“So, it has changed significantly in the sense that it has made it very clear what the problem is and I think 20 years ago, sometimes we were guessing based on test position and symptoms,” says Cottone. “And I think that’s why we had a longer trajectory of recovery than we’re seeing now.”

For Williams the technology provided something he didn’t have for years – an explanation and a plan when he has an episode for his chronic condition.

“A good part of it is from the old days, when there wasn’t much you could do but take the meclizine [motion sickness medication] and wait it out. That, you know, with the right treatment, the right diagnosis, and the right exercises, you can fix it pretty quick.”

And that’s what he does – makes an emergency appointment with OSF Rehabilitation, and the goggles can pinpoint the canals impacted and whether the issue is crystals that are free floating or stuck. Once identified, Williams is given maneuvers he can do at home.

“I put my own name to them. Like, there’s the slam dunk I call it. And so, I would have to hit my head as hard as I could on the pillow to juggle the crystals loose and then rotate my head in a certain way and do that like twice a day to get the crystals unstuck.”

Cottone said most cases of BPPV improve after just a few therapy sessions using repositioning maneuvers similar to the Epley technique Chmerkovskiy received. Williams’ case is less typical. His vertigo has returned multiple times over the years and can involve different canals in either ear, making diagnosis more complicated. Still, he says the progress in treatment has been significant.

Positional vertigo is most common in individuals ages 50-70, with women being two to three times more likely to be affected, according to Cottone. For people with recurring symptoms, she recommends having your vitamin D levels checked because crystals in your ears are made up of calcium carbonate, and vitamin D helps them stay healthy and bind.

The Bertec system

OSF Rehabilitation also uses Bertec, a virtual reality platform equipped with force plates that sense where a person is in space. A half-dome screen creates an immersive environment with a variety of balance activities, tests and games, giving people real-time feedback on their movements, even when their feet remain still.

Cottone says the Bertec system can be helpful even when a person doesn’t have a diagnosis. It allows physical therapists to understand weaknesses in the vestibular system that are leading to balance issues.

“The Bertec really helps us identify, ‘Well, I think you’re having trouble in a busy environment, or you’re having trouble when you’re scrolling on your phone or reading on your Kindle because the ear is weak and the eyes are working overtime,’” Cottone explains. “So, it allows us to see where in the system the weakness is, and from there, we can put the patient through fairly lifelike circumstances to rehab them.”

Cottone emphasizes that people should never brush off dizziness, because many causes are treatable, and in some cases, the symptom can signal a more serious underlying medical condition.

An evaluation by OSF Rehabilitation can rule out vestibular issues, and you can be referred to another medical specialist.

Transformative care close to home

Cottone says the latest generation of equipment is transforming care, even in the many smaller, more rural communities served by OSF.

“Having this equipment, especially the goggles and then the Bertec, is an added plus. It really allows community members to stay within their community and get the best care possible and very thorough care. And then if we’re not the ones that can help you with whatever is going on, we’ll at least know that and we’ll be able to then move you on within OSF to the right provider.”

For Williams, knowing help is available has made a major difference.

He now encourages others experiencing the sudden spinning sensation to seek medical care instead of waiting for it to pass. He stresses it’s also important to rule out more serious conditions that could be causing your symptoms.

Video clips with Kristine Cottone

Video clips with Dave Williams

B-roll-Equipment to diagnose-treat vertigo

A new generation of 3D Virtual Reality (VR) imaging technology at OSF HealthCare is giving surgeons a clearer view of cancer than ever before – and in some cases, completely changing surgical plans. For OSF HealthCare thoracic surgeon Richard Anderson, MD, that level of insight recently made the difference between removing part of a patient’s chest wall and preserving it entirely.

Dr. Anderson, chair and Norman Estes Professor of Surgery at University of Illinois College of Medicine Peoria, says the leap from standard imaging to 3D modeling is transformative for surgeons.

A better view

“So the real difference between a 2D and 3D is, just imagine looking at something on a piece of paper with two different pictures, looking at it from side to side, as opposed to having a model in your hand and being able to take that model and move it all around in all different directions, upside down, inside out, even open up things within the model and look at it. It’s really the difference between 2D and 3D.” Dr. Anderson adds, “It’s really quite impressive.”

The technology allows his team to isolate tumors, peel away layers of anatomy, and examine the intricate relationships among bones, vessels, and muscle before they ever enter the operating room. That clarity is especially crucial in complex thoracic oncology, where anatomy is delicate, variable and easily injured.

For Dr. Anderson and others who use 3D imaging, it increases the surgeon’s confidence.

“In the more complex oncology cases, it can make a big difference. It can help the surgeon really identify what structures they have to worry about during the operation, what structures they might have to sacrifice, before they actually do the operation and gives them a little bit more level of confidence going into the operation than probably they would have before.”

A tumor in a rare location

That level of detail proved critical in a recent complex thoracic oncology case. Thoracic surgery presents unique challenges because of the delicate and complex anatomy of the chest.

“The arteries aren't made the same, and so they're easier to tear. They're much more delicate. Lung tissue is sometimes like tissue paper, too. It’s easy to injure and tear. You have got to be very careful when you do the dissections in thoracic surgery. That's what makes it so challenging.”

Dr. Anderson treated Jake Wilson, a 69-year-old retired farmer and former prison guard from Central Illinois. Wilson’s case was challenging. He was diagnosed with a rare form of lung cancer and in August of 2025 began a series of chemotherapy and radiation to shrink the aggressively growing tumor.

Still, as surgery approached, Dr. Anderson was challenged with removing a nearly six‑centimeter tumor (about the size of a small egg) situated high in the chest, closely hugging the first three ribs. Standard 2D scans suggested the cancer had invaded the bone – a scenario that would typically require removing three ribs to ensure the cancerous tumor was completely removed.

Seeing is believing

But when Wilson became the first adult patient with lung cancer to have his case analyzed using advanced 3D modeling and virtual reality, the picture changed dramatically. The technology revealed that his ribs were not invaded at all. The tumor, though large and aggressive, was confined to muscle.

Sister M. Pieta Keller, Connor Davey, and Reid Jockisch, innovation engineers at Jump Simulation worked to segment the tumor for 3D viewing in virtual reality. Sister M. Pieta recently showed Wilson the 3D rendering. It was something he’ll never forget as she displayed his chest wall anatomy in vivid color and manipulated the images to reveal why Dr. Anderson could spare all three ribs.

“That was one of my biggest fears was losing my ribs,” Wilson explained. “Just the concept of that,” he said as his voice trailed off. Sister M. Pieta explained, “And your recovery and your pain would have been a lot higher,” to which Wilson responded, “I’m sure.” Sister M. Pieta added, “So this was quite the gift.”

After years of lung scans due to his history of smoking, seeing the vivid digital model after his successful surgery made the size and seriousness of the tumor undeniably real. Having only retired from farming six months earlier, Wilson admitted that going into the surgery, he was really scared.

“That put the fear of God into me, needless to say, because I’m an active person. I’m a farmer. I thought, ‘I could see being debilitated for the rest of my life.’”

A recovery that surprised everyone

The new imaging technology altered not only the surgical approach, but Wilson’s experience afterward. Instead of the severe pain typically expected after chest wall removal, his discomfort was minimal; it was largely limited to the area where an intercostal muscle was removed.

Wilson required only mild pain medication and never needed supplemental oxygen after losing half of his lung, something his care team described as highly unusual.

Even more astonishing, follow‑up imaging showed his remaining lung tissue had expanded far faster than expected. His post‑surgical biopsies revealed a remarkable result: the tumor was completely non‑viable (dead) at the time of removal.

A message about screening

Today, Wilson is cancer‑free and sharing his story. He credits many people along the way, including his primary care doctor, who five years ago, when Wilson was still smoking, encouraged him to get an annual CT screening to detect lung cancer.

“I thought, ‘I’m the one that’s stupid enough to do this to myself I ought to at least be smart enough to use a little preventive maintenance.’” He added, “And thank God I did because I might already be gone.”

But above all, Wilson returns to the strength of his faith which he credits with leading him to Dr. Anderson and his care team at OSF HealthCare Cancer Institute in Peoria and OSF Cancer Center in Bloomington. He is sharing his story to show the power of prayer and faith, and to instill hope.

“I know for a fact that the most important thing a person can have in these ordeals is hope because without hope you give up. And this is one time you can’t afford to give up because if you give up, you’re done,” Wilson declared.

For Dr. Anderson, the case represents the promise of 3D technology not just to guide surgeons, but to change outcomes. He calls that, “A good day at work.” And for Wilson, it represents something even bigger: a second chance he intends to use to encourage others to seek preventive screenings, face fear with hope and share gratitude for every day.

Video clips with Dr. Richard Anderson

Video clips with oncology patient Jake Wilson

B-roll of 3D imaging and Dr. Anderson

Top 5 Digital Health stories of 2025

Digital health continues to reshape how people connect with care — breaking down barriers of distance, time and access in ways that were once unimaginable. In 2025, those advances moved from promise to practice, with new technologies helping patients get care faster and using data to make more informed decisions. OSF HealthCare, through its OSF OnCall digital health arm, has been able to reach communities that have long been underserved. From artificial intelligence and virtual care to immersive technologies and smarter data use, OSF OnCall continued to push health care forward.

These are the Top 5 digital health stories of 2025, in no particular order.

From crisis to confidence: Patient praises new OSF 24/7 primary care – Marci Schneider Batsakis of Orland Park, Illinois was the first patient enrolled in OSF CompleteCare 55+, a new hybrid model of primary care in Evergreen Park, using virtual visits and digital connections to help older people get fast access to providers and stay on top of their health. Schneider Batsakis called the round-the-clock care team number when her blood pressure became dangerously high and that led to timely treatment in the hospital, follow-up support, and a care plan tailored to her needs.

OSF HealthCare receives $1.5 million for new mobile pregnancy and postpartum care unit An OSF OnCall Connect mobile van will offer doorstep service as an extension for women on Medicaid enrolled in a pregnancy and postpartum digital support program. Meridian and Centene Foundation provided $1.5 million in funding for the van to operate in maternity deserts in 12 Illinois counties.

OSF HealthCare offers another layer of monitoring for moms and babies – OSF HealthCare launched 24/7 virtual labor monitoring to enhance in-person care with AI technology. AI software alerts OSF OnCall Acute OB nurses to potential risks, enabling quick coordination with staff at Family Birthing Centers at hospitals across the OSF HealthCare Ministry. This is part of a broader effort to reduce mortality rates among women and babies which remain high compared to other wealthy nations. As part of that effort, we also opted to extend to all patients in the I-80 region, regardless of payor, a Medicaid program for virtual visits and digital support. The area has lost a number of OBGYN providers.

Skip the wait with new OSF OnCall virtual exam visit – OSF OnCall Urgent Care walk-in clinics can get busy, especially during the winter with respiratory viruses. So OSF HealthCare installed new technology in urgent care clinics, allowing patients to do in-office virtual visits and bypass the waiting room. Visitors to the OSF OnCall Urgent Care can get accurate testing and diagnoses using digital tools and an on-screen OSF medical provider.

OSF HealthCare using virtual ER to cut patient wait times – OSF HealthCare is using an innovative approach to help reduce wait times in the emergency departments at OSF HealthCare Saint Elizabeth Medical Center in Ottawa and Peru. Patients who meet certain criteria will be given the option to divert to a virtual medical exam through the use of advanced technology and an onsite nurse.

Top 5 OSF Innovation stories of 2025

As we kick off a new year at OSF HealthCare, we’re looking back at 2025 and the big steps we took to make it easier for patients to access care and health information. Working alongside our academic and business partners, we continued to tap into shared expertise and use artificial intelligence in thoughtful, responsible ways — always guided by what’s fair, appropriate, valid, effective and safe (FAVES).

Those efforts are reflected in our Top 5 OSF Innovation stories of 2025, listed in no particular order.

OSF HealthCare named one of America’s Most Innovative Companies – Fortune recognized OSF for its innovation culture and forward-thinking approach, highlighting digital and AI-driven advancements transforming care delivery. OSF first received this distinction in 2023.

OSF Innovation brings VR beating hearts to life for safer surgeries – Thanks to a breakthrough at OSF Innovation, surgeons can “see” their patient’s heart beating in 3D before ever stepping into the operating room. For surgeons, the benefits are game-changing. They can see not only the anatomy but also how it changes with every beat. This is especially critical for conditions such as hypertrophic obstructive cardiomyopathy, where the problem lies in how the heart contracts. Even more surprising, the AI began rendering valves — structures notoriously difficult to see on CT scans.

An OSF inventor collaborates to help kids play safely through cancer – Exercise physiologist Nick Kemp collaborated with OSF Innovation Studio to design Port Guard that protects the central venous access port for kids with cancer who want to play and stay active. Seven-year-old Amaneigh Stevenson, pediatric cancer patient, was part of testing and declared, “It makes me feel safe. I love it a lot.”

OSF developing app to diagnose migraines sooner and more accurately – For millions of people living with migraine headaches, getting the proper diagnosis can take years, sometimes even decades. A new digital tool developed by a team at the University of Illinois College of Medicine Peoria (UICOMP) and OSF HealthCare aims to change that by helping primary care and other first-contact healthcare providers to identify patients with migraine quickly and accurately.

Decoding your DNA to prevent disease – Using innovative genetic testing, OSF HealthCare stepped farther into personalized medicine in 2025, with a pilot to allow people to be tested with just a swab of their cheek for genetic mutations to determine if someone is at high risk of any of 10 major diseases. So called polygenic testing is not yet covered by insurance but for someone with a a family history of heart disease, cancer or Alzheimer’s, this $250 test could provide some early warning signs and better yet, early intervention.

Payton Glinkski watches TV medical shows with her mom, but she never thought about a career in medicine because she doesn’t like, as she puts it, “blood and guts.” But, with a virtual reality (VR) controller and headset she learned not every job in health care has a potentially gory element.

“I just knew there were nurses, doctors, dentists and social workers but it kind of went into more depth into every part of what a doctor does or (what) everyone in a hospital does … all the workers.”

A two year-collaboration between OSF HealthCare, LaSalle County government, and the Regional Office of Education District 35 in North Central Illinois included design, equipment installation and training, led by OSF STEAM, under the umbrella of OSF Innovation. Healthcare Careers 360, a web-based application, and the Enduvo VR Career Explorer remove barriers and allow middle school students to explore a wide variety of health care careers.

OSF I-80 Innovation Hub Director Zack Vankeulen of OSF HealthCare explains the web-based app and VR offers immersive learning in health care settings that would otherwise be off-limits to students due to federal privacy and safety regulations.

“An observer isn’t allowed in the emergency room or in the operating room (OR) so they can’t learn about those careers as well as some of the other areas (outside of health care) that they have access to. So, by creating this virtual reality environment the students are immersed right in the middle of an OR during a surgical case and they’re able to do as close to hands-on experiences they can without actually being in the room.”

Gamified learning

While some students used the VR headsets and worked in such careers as surgery technician, dental assistant, or an emergency medical technician, other students worked on computers playing games to identify and learn about items in medical settings. For example, Brooklyn Verda showed how she found a pressure washer in a biomedical engineering lab. Kids also had to find a bonus ‘lucky pickle’ and then watched videos about the environment and career they were exploring.

Verda liked the gamified learning and didn’t find it too challenging

“I didn’t really have any difficulties. It was pretty fun and easy to do. But other than that, it was really cool.”

Vankeulen says OSF targeted careers that are hard to fill in rural communities such as Earlville, Mendota and Ottawa.

“So, we focused on those, mainly, as well as the large volume careers such as nursing and dental hygiene, which you wouldn't think traditionally is an OSF career, but we recognize the need and included that as well.”

The collaboration for STEAM programming picked up steam when state lawmakers enacted Illinois PaCE, which requires school districts prepare students in grades 6-12 for a career or technical education pathway by introducing them to opportunities for a wide variety of high-skill, high-wage or in-demand career fields. It also requires high schools to implement College and Career Pathway Endorsements or opt out of implementation by July of this year.

ROE 35 Superintendent Chris Dvorak says he would love to continue the collaboration and possibly expand the career opportunities included in the programs. Additionally Dvorak says, “The ROE will hold future professional development opportunities that will allow teachers to share thoughts, ideas, and successes as we continue to support STEAM implementation.”

Earlville Junior High Principal Jenette Fruit has a philosophy that small schools can do big things and collaboration is key. Even if the technology brings a new challenge, Fruit says, students readily embrace it.

“And they will figure it out and they like being able to explain what they did to solve the problem. And I think that comes with this too. I didn't know about the boundaries. I didn't know about the different things with the VR and they're like, ‘No Mrs. Fruit. This is what you have to do, and this is why.’ And kids just like to know how to solve stuff. We just have to put it in their hands.”

The ‘boundaries’ she references are the areas within the sterile environment in an operating room. Those are the kinds of concepts students are learning as they experience surgical procedures, patient interactions and medical decision-making in a simulated environment that mirrors a real hospital and clinical setting.

Science teacher Kirsten Sweeney says for a small, rural school district it’s rare that students would have exposure to using VR headsets.

“To be able to work with equipment like this, that they just aren’t going to be able to because they just can’t afford these types of systems, so it’s so valuable to be able to have that in the school system for them.”

Next steps

OSF STEAM builds programs to help students see how their skills and interests align with potential careers, encouraging them to pursue further education and training. In fact, Sweeney says the next steps for students include using another OSF STEAM-designed web-based app called healthcareers.guide.

It will allow them to explore more deeply one health career including such things as duties during a typical day and of course, salary.

“They always want to know how much they’re going to make so we’ll be looking at what the average pay is for those positions, and we’ll actually have them create a resume and a cover letter as if they were sending it off to OSF," Sweeney says.

And that’s what it’s all about. Getting the next generation ready to fill the significant shortage of health care positions, not only physicians, nurses and vital staff, but the many important support roles. Without a strong pipeline, patient care and access to quality medical services could be in jeopardy, particularly in rural and underserved areas.

Schools interested in partnering with OSF for STEAM programming, can contact events@jumpsimulation.org. 

Zack Vankeulen

Students Payton Glinski and Brooklyn Verda

Principal Jenette Fruit and Teacher Kirsten Sweeney

B-roll of ROE-OSF STEAM

The Illinois Science & Technology Coalition (ISTC) released a new report showing university campuses in Illinois founded 694 startups over the past five years, contributing 2,093 new jobs to the state. The unique data was released at Jump Trading Simulation & Education Center in Peoria, Illinois through ISTC’s Illinois Innovation Index on University Entrepreneurship. The report focuses on new business creation in the state through university assistance and affiliation.

The Index also found that of the active university-supported startups founded over the last five years, 82% (359) remained in Illinois. John Vozenilek, MD, vice president and chief medical officer, OSF Innovation and Digital Health says the report is impressive in showing how universities, which are anchor institutions in their communities, are economic drivers.

OSF HealthCare has 15 hospitals that also serve as anchor institutions in Illinois and Michigan. To accelerate innovation, OSF partners with five higher education institutions throughout the state. Dr. Vozenilek says leveraging their expertise in emerging technologies will advance new transformative ideas for health care coming from students as well as from OSF Mission Partners (employees).

Vozenilek was the keynote speaker at the event that highlighted the Illinois Innovation Index report findings. It also brought together key university, community and state economic development leaders to discuss the findings. Vozenilek stresses that new technology, such as virtual and augmented reality, as well as the Metaverse, will allow entrepreneurs to more easily scale educational simulations and training for new innovations, including new medical devices.

According to the ISTC report, women-founded companies increased their share of the startup population, from 28% in the 2018 Index to 40% in 2023. Vozenilek finds those results especially encouraging.

“I love to see the growth of women-owned businesses so the idea there are support structures and dedicated efforts to bring more diversity to our field, I think is incredibly important. We’ll see all kinds of new businesses coming from these constituencies.” 

Foreign-born founder percentages increased from 35% in 2020’s Innovation Index to 48% this year according to the coalition. As Vozenilek sees it, that could help OSF HealthCare ensure it is tapping into global expertise.

“I was also intrigued by the state’s interest in foreign born entrepreneurs to give them visas so that some of their ideas take hold in our communities; so think about how we can really draw from the world community (experts) to address challenges here in Central Illinois.”

The Illinois Science & Technology Innovation Index also provided evidence that for every dollar spent on a university-backed startup, it resulted in $10 in follow-up venture capital funding, offering more evidence that university supported efforts are a good investment that result in turning successful ideas into promising businesses.

Video clips with Dr. John Vozenilek

In a rapidly evolving technological landscape, machine learning has emerged as a transformative force; it is reshaping countless industries, health care included. Machine learning and artificial intelligence increases productivity, reduces human errors and frees up time for other tasks that can have greater impact. In the case of converting medical scans into 3D or 4D images for a deeper view of organs, tissues and tumors, AI has the possibility of changing how surgeons prepare to operate on patients with complex issues.

Matthew Bramlet, MD, is a pediatric cardiologist at the University of Illinois College of Medicine at Peoria who specializes in congenital cardiac MRI for the Children’s Hospital of Illinois.  His Advanced Imaging and Modeling (AIM) lab at Jump Trading Simulation & Education Center is focused on translation of medical images into 3D and 4D interactive models (for 3D printing for virtual reality) to assist in pre-surgical planning of complex cardiac and cancer cases. 

According to Dr. Bramlet, the heart is a unique organ because it changes shape as it expands and contracts to pump blood through the body. This change in shape becomes a problem when the muscle of the heart grows abnormally and obstructs its own ability to pump blood out of the heart. This is a problem, because no current technology exists that allows a surgeon to view this 4D, dynamic obstruction. 

Rather than relying on years of trial and error of surgical expertise to determine the correct way to cut out muscle to relieve the obstruction, this project seeks to provide the surgeon with a VR view of their next patient’s beating heart in 4D.

The Innovation for Health (IFH) grant program with Bradley University in Peoria, Illinois is designed to inject funding ($50,000) to combine clinical problems with computer science expertise.  Assistant Professor Sam Hawkins, PhD, and graduate students at Bradley University plan to utilize machine learning to convert standard medical images into a sequence of 3D models, that when played sequentially create a 3D beating heart; the “4D heart”.  

This concept has been previously demonstrated by Dr. Bramlet’s AIM lab, but it took an entire summer to convert images of a 4D heart, showing both the expansion and contraction of the heart that could be viewed through a virtual reality headset. Dr. Bramlet says that’s not a sustainable approach.

“How do we put the CT data into a computer and slice by slice, say this is the myocardial tissue so we get an exact replica of the heart. But I don't need just one (3D replica of a heart); I need 20 to make each phase of that heart (he simulates the sound of repetitive beats) into a 4D heart.”

Assistant professor Hawkins believes machine learning can be leveraged to perform the labor-intensive process of converting images. Hawkins explains Computer Science graduate students at Bradley are part of the research effort.

“First, we need to figure out what part of the image is the heart and what part is not. And then we need to combine these tiny images into a 3D image. And then we need to do that many times to get the 4D.”

Improving pre-surgery planning

The solution should allow surgeons to virtually preview the beating heart of their patient, showing the obstruction in 4D, therefore providing a completely new pre-surgical analysis tool. The multidimensional view allows surgeons to zero in on structures of the heart, significantly enlarge elements and get a much better view of the anatomy. This machine learned 4D generation of a beating heart will be a first of its kind technology.

Researchers believe creating an automated solution can reduce the manual process of converting images from months, to hours, and eventually perhaps minutes. That option could eventually be applied to images for other types of complex medical cases in adults, children and the smallest infants.

Dr. Bramlet says new AI-supported software could provide a scaled solution for surgeons everywhere.

“The most immediate impact isn’t going to be the 4D heart. The impact at a grander scale will be the scalability of how any program will be able to create models for pre-surgical planning; 3D printed or for VR with this technology.”

Hawkins believes the technology will lead to other hospitals adopting the approach for pre-surgery planning.

“It has the potential to really remove the barrier of entry for institutions that don’t have the expertise or the time but do have images they wanted to view (more intricately).”

This entire machine learning project has been made possible by Jump Simulation’s long-term investment in sharing 3D insights. Since, 2014, Jump has contributed 3D models of congenital heart disease to Dr. Fauci’s 3D database at the NIH. This library of annotated 3D models provides the rich dataset of raw material needed for machine learned insights into automated segmentation of patient specific 3D models.  

Within a year, this project aims to automate, through machine learned algorithms, the conversion of cardiac CTs into virtual reality. The 4D view will enable surgeons to see the beating hearts specific to individual patients.

Imagine being a surgeon who can plan a surgery in VR by seeing the beating heart of your patient before you walk into the OR. This project seeks to transition this vision from science fiction to science fact.

Dr. Matthew Bramlet

Sam Hawkins, PhD

4D Hearts B-roll

OSF HealthCare has invested significant resources into developing advanced practice provider (APP) fellowships that have grown from five primary care fellows in 2016, to as many as 30 fellows among seven primary care and specialty areas. The advanced practice fellows include advanced practice registered nurses and physician assistants who support inpatient and outpatient areas, including adult, pediatric and neonatal care, covering almost all of the ICU services at OSF HealthCare Saint Francis Medical Center. There are fellows with advanced training in primary, urgent and pediatric care, as well as neurology.

The 7-year-old, robust, cutting-edge APP Fellowship program at OSF HealthCare is among the most mature of all health systems in the country. At a recent national conference, OSF leaders gave five presentations on various aspects of an expanding fellowship initiative, more than any of the large health systems represented, including Cleveland Clinic, Mayo Clinic and Providence Health.

Vice President of Advanced Practice, Lisa Pierce, DNP, APRN, told health system leaders that the OSF HealthCare investment has paid off. The specialized training ranges from teaching new providers procedural skills to delivering life-changing diagnoses to patients. Pierce explained the ability to simulate real-life experiences instills confidence and competence, so patients are better served.

“Our patients are getting better care, because our fellows are trained in this really critical learning environment that helps them hone their skills.”

APP fellowships also help retain providers, which is a challenge facing every health system . Pierce says because providers see a health system that has invested in their development, they often stay in practice with OSF HealthCare at the end of their year-long fellowship experience. Since the program was launched, the turnover rate among fellows is between 0-2%.

Using simulation & education for enhanced training

What makes the OSF APP fellowship program a unique experience also lies in the use of simulation and the ability of engineers at Jump Trading Simulation & Education Center to support educators' needs for new training modules for fellows to learn specific procedures.

Pierce explained, “We've seen things at conferences, training models that we don't yet have here, and our engineers can build them. Our educators have even approached our engineers saying , ‘This procedure is really critical for this particular service line. Can you build us a model to practice this in simulation lab?’”

OSF HealthCare is also tapping its health care consulting services arm, Pointcore Construction, to support developing virtual reality (VR) environments that resemble OSF HealthCare spaces, such as OSF OnCall Urgent Care clinics. The VR trainings use life-like avatars that interact with learners to simulate a variety of experiences.

“Our fellows are able to practice doing a neurological exam on a patient and tell the patient to, you know, raise their eyebrows, and this avatar will respond to it. So it's a great way for our fellows to practice some of their skills before they encounter them in real life.”

APP fellowships focus on professional growth, offering fellows mentorship, regular feedback and skills assessment to build on the knowledge they learned in graduate school. At the end, they are more prepared to transition into full-time practice. OSF HealthCare is also leveraging federal grant money to extend primary care support to high-need communities with vulnerable populations, using resources such as OSF Care-A-Vans to support street medicine teams or on-site clinics.

Pierce thinks those experiences build a culture of compassion that supports the OSF Mission of serving with the greatest care and love.

“It really helps the fellows better understand not only how they can build trust with patients who often don't trust health care providers, but also how they can assist them in ways that they have never really thought of before, just because of the unique challenges of that specific population.”

Specifically, Pierce says fellows are exposed to how social needs, such as transportation, housing or food insecurity, can drive overall health and wellness.

The APP fellowship curriculum stresses the importance of excellent communication with patients and colleagues. For example, as OSF HealthCare emphasizes the need for patients to have advanced care plans in place before a health emergency, training simulates those conversations using specially trained actors who provide feedback during debriefings. Other confidence-building exercises also result in developing decision-making and other soft skills that often result in fellows advancing quickly to leadership positions within their area, region, or even at the system wide level.

Video clips with Lisa Pierce, vice president Advanced Practice, OSF HealthCare

B-roll of simulation with Advanced Practice Provider Fellow

The prize? Not a restaurant gift card or a commemorative photo. Rather, the trio unlocks defibrillator pads to use on the “patient” – a manikin appropriately named Anita Shock.

No, this isn’t your traditional escape room.

The effort – technical name “gamification of simulated environments” – is part of advanced cardiac life support training for OSF HealthCare Mission Partners (employees). The innovative approach is the brainchild of OSF HealthCare clinical educator Ashley Bruens. She spent a week creating the scenario, crafting each puzzle in great detail.

“They would use their knowledge about [heart] rhythm to solve one puzzle. They would use information about medications and what indications they're needed for, for one puzzle,” Bruens explains. “There was one about what we call H's and T's, which are reversible causes of cardiac arrests. They will look at symptoms and presentations.”

Bruens calls the escape room her passion project, and she’s not alone. She says more hospital systems and universities are seeing the benefits of taking training away from computers and books and toward hands-on, puzzle-solving activities.

“In an emergent situation, it's important to have good communication, good team-working skills, and good delegation skills with the people involved in that team so that everybody is doing something pertinent that's going to help the patient,” Bruens says.

You can count registered nurse Laura Hauersperger among the supporters of those concepts. She was in the group of three who took part in Bruens’ game.

“It was a way to add in a fun learning element in a real-life situation that we deal with,” Hauersperger says.

“You’re kind of getting that hands-on learning, and so many people learn much better by hands-on learning,” Hauersperger adds. “And you have that knowledge base of ‘I've done this before. I can do it in this current situation. And I feel more comfortable and confident with it.’ And I think that's an ideal way to train medical professionals.”

At OSF, innovation is encouraged to make care better and easier for patients and providers. That includes coming up with agile solutions designed to meet every day needs, including developing simulations, such as what Bruens devised, to improve retention of life-saving skills.

Bruens says she’ll continue to think outside the box for training. More escape rooms and even tasks incorporating virtual reality could become common across OSF HealthCare.

And as for the “patient” Anita, she received her life-saving shock from defibrillators with four minutes to go on the escape room timer.