Baylor Scott & White Research Institute exploring potential prevention options, therapies for COVID-19
Baylor Scott & White Research Institute, the research arm of Baylor Scott & White Health, is bringing clinical trials online at an unprecedented pace in response to COVID-19. A COVID-19 therapeutic task force of more than 20 multidisciplinary researchers positioned across the state of Texas has been putting their expertise in infectious disease, cardiology, immunology, molecular biology, and other specialties together to explore research opportunities for experimental prevention and treatment options and to develop investigator-initiated studies. Since the task force’s formation, Baylor Scott & White Research Institute has activated several clinical trials, each of which is available at multiple Baylor Scott & White sites, with work ongoing to launch additional studies.
Utilizing the intricate research network already established across the largest not-for-profit health system in the state of Texas, Baylor Scott & White Research Institute mobilized staff and resources, including the components needed to integrate critical patient safety measures at every participating site within the Baylor Scott & White footprint in just a matter of days. All four of Baylor Scott & White’s institutional review boards have also been doing emergency reviews at all hours as part of this effort, and they continue to evaluate new opportunities.
Baylor Scott & White was the first health care system in Texas approved to participate in these multicenter studies:
Antiviral for patients with moderate coronavirus disease. This trial utilizes an experimental drug called remdesivir in patients who have been hospitalized with moderate cases of COVID-19. The drug was originally developed as a possible Ebola treatment and has qualities that researchers believe could show efficacy against aspects of this virus.
Antiviral for patients with severe coronavirus disease. This trial also utilizes remdesivir. Patients who are hospitalized with severe cases of COVID-19 at one of our participating trial sites may qualify to receive the experimental drug.
Inflammation drug trial for critical patients. This trial specifically targets a dangerous byproduct of COVID-19’s attack on the body—inflammation. Utilizing a drug called sarilumab, the focus of this trial is to see whether the experimental option can address the extreme inflammation that causes a greater decline in severe and critical patients hospitalized with COVID-19.
The Healthcare Worker Exposure Response & Outcomes (HERO) Registry. This study is designed to help health care workers share their clinical and life experiences in order to understand the perspectives and problems faced by workers on the COVID-19 pandemic front lines. The registry, funded through an award from the Patient-Centered Outcomes Research Institute, is open to anyone who works in a setting where people receive health care, including nurses, therapists, physicians, emergency responders, food service workers, environmental services workers, interpreters, and transporters. Participating sites will aim to enroll 15,000 participants into the registry, which will also be used for other clinical trial and research study opportunities that address unmet needs for health care workers.
With the full force of Baylor Scott & White Research Institute’s infrastructure behind these efforts, the team has also designed protocols for two additional independent, investigator-initiated studies:
Frontline prophylaxis study. This is a first-of-its-kind study in Texas and one of the first in the nation. The study examines the use of hydroxychloroquine as a prophylactic option specifically for frontline health care workers exposed to COVID-19. The study seeks to determine whether hydroxychloroquine would help mitigate the severity of infection or potentially prevent infection in health care workers with high-risk exposure to patients infected with COVID-19.
Emotional impact of COVID-19. The longitudinal study is designed to identify what people are experiencing emotionally because of COVID-19 and the extended isolation, uncertainty, and other changes it has caused. The research team hopes to uncover how these emotional experiences are affecting people’s well-being—but also, ultimately, what is helping them cope. Though open to the public, the study will focus on health care workers and other first responders.
Early development of rapid COVID-19 testing in Baylor Scott & White laboratories
In late February 2020, the US Food and Drug Administration (FDA) responded to the call for the rapid development of diagnostic tests by clinical laboratories during the COVID-19 outbreak by allowing clinical laboratories to begin using their local laboratory-developed tests before FDA clearance. At that time, a Baylor Scott & White Health laboratory was one of only four independent clinical laboratories in the USA chosen by the Luminex Corporation to perform validation studies on laboratory-developed tests for automated, rapid detection of the SARS-CoV-2 virus using the sample-to-answer ARIES System. These validation tests demonstrated that high-complexity laboratories using the ARIES System could immediately add COVID-19 diagnostics to their testing menu. This work was critical to helping address soaring demand for tests and allows equipped laboratories to produce results quickly. Baylor Scott & White Health’s lab has since supported a second FDA-approved validation study for another Luminex test.
Baylor Scott & White Health receives $100,000 from Reliant to support remote monitoring of COVID-positive patients
Baylor Scott & White Health announced a $100,000 donation from Reliant in support of its MyBSWHealth mobile app. Launched in 2018, the MyBSWHealth app has emerged as a leading digital tool in Texas in the fight against COVID-19, providing nearly 175,000 digital screenings and more than 45,000 e-visits related to the virus. This process has allowed tens of thousands of Texans with mild symptoms to be evaluated outside of Baylor Scott & White clinics and emergency departments–further ensuring that hospitals are ready for those who need care most during this time.
Baylor Scott & White’s integrated “Digital Care Journey” for COVID-19–positive patients is available within its MyBSWHealth app and includes support for those treating at home, with detailed quarantine instructions, twice-daily symptom checking, and dedicated care management. The MyBSWHealth app and online portal provide patients digital access to appointment scheduling, virtual visits, and digital care journeys. Patients can communicate directly with their care teams and manage their prescriptions with the Baylor Scott & White Pharmacy. More than 1.4 million patients currently have a MyBSWHealth account, and 500,000 of those are active users.
UPCOMING CME PROGRAMS
The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is offering the following program:
Cardiology Update, December 4–6, 2020, Westin at the Domain, Austin, Texas
For updated information please see BSWH.md/CardiologyUpdate
The 39th Annual Internal Medicine Review (originally scheduled for July) and the 12th Biennial Bereavement Conference (originally scheduled for September) have been postponed. For more information, visit https://www.bswhealth.med/cme.
RECENT GRANTS
Synergy flu rVE/COVID-19
Principal investigator: Manjusha Gaglani, MD
Sponsor: Centers for Disease Control and Prevention
Funding: $1,500,000
Award period: 5/4/2020–5/3/2021
Texas Veterans + Family Alliance Grant Program
Principal investigator: Suzy Gulliver, PhD
Sponsor: Texas Health and Human Services Commission
Funding: $441,915
Award period: 3/13/2020–8/31/2021
The role of APE1/Ref-1 in reflux-induced epithelial-mesenchymal transition in benign Barrett’s metaplasia: A novel target for preventing recurrent Barrett’s esophagus radiofrequency ablation
Principal investigators: Rhonda Souza, MD, and Stuart Jon Spechler, MD
Sponsor: National Institutes of Health
Funding: $360,968
Award period: 4/13/2020–1/31/2021
Closed-loop neuromodulation to treat PTSD
Principal investigator: Mark Powers, PhD
Sponsor: University of Texas at Dallas/Department of Defense
Funding: $341,395
Award period: 10/1/2018–9/30/2020
Building and deploying a genomic medicine risk assessment model for diverse primary care populations
Principal investigator: Heather Kitzman-Carmichael, PhD
Sponsor: Duke University/National Institutes of Health
Funding: $235,674
Award period: 7/1/2019–6/30/2020
CARES funding for poison centers
Principal investigator: David Baker, PharmD
Sponsor: Health Resources and Services Administration
Funding: $46,616
Award period: 4/1/2020–3/31/2021
PHILANTHROPY NOTES
Having a heart for Hispanic culture
Effective communication is the basis of any good relationship, especially between a patient and a physician. When barriers to communication exist, the social, cultural, and linguistic needs of a patient are often not met. To address the opportunity for a strengthened connection with the growing Latino population in North Texas, a new Hispanic Heart Group program within Baylor Scott & White Heart and Vascular Hospital was created to provide care with a special understanding of the Hispanic culture.
“Our goal is to meet the needs of the Spanish-speaking community with heart and vascular disease and give patients and their families quality care in cardiac surgery and preventive care in a very friendly environment,” explained Aldo Rafael, MD, advanced heart failure and transplant cardiothoracic surgeon on the medical staff and founder of the Hispanic Heart Group program at Baylor Scott & White Heart and Vascular Hospital. “In simple words, it’s to eliminate barriers.”
The program, believed to be the first of its kind in the state, couples advanced care with cultural understanding. Everyone in the program—from the person who schedules appointments to the nursing staff and physicians—speaks both English and Spanish and was raised in the Hispanic culture. The multidisciplinary team includes cardiothoracic surgeons, vascular surgeons, and interventional cardiologists on the medical staff and other experts in heart and vascular care. From minimally invasive surgeries to heart transplantation, the group is able to provide the full complement of care with a unique cultural perspective.
This firsthand experience of Latino culture for caregivers is key, noted Anthony Picchioni, PhD, program director of science in the department of surgical education at Baylor Scott & White Health and professor at Southern Methodist University, who teaches classes in diversity, inclusion, and multiculturalism. “We need to meet people at their map of the world. In other words, we are all a product of a family of origin but also our culture of origin. We learn the scripts, the do’s, the don’ts, and the norms. It forms our worldview from a cultural perspective,” he said.
Understanding that many people in a traditional Latino culture approach life from a communal perspective instead of an individualistic one, allowances can be made to discuss care (with patients’ permission) with extended family, who may want to attend appointments, weigh in on care decisions, or be an integral part of their loved one’s recovery after surgery. The Hispanic culture is relationship driven, where families serve as important emotional support systems, so it’s important to involve that community in the way in which the patient feels comfortable.
The program also aims to help those who may not have access to health insurance by providing financial resources. Dedicated fundraising will provide an opportunity for the community at large to help those in the Hispanic community. “We are not Mexican, Cuban, Puerto Rican—we are all one Hispanic family in the United States. This program was created for us,” Dr. Rafael said.
No matter the culture of origin, Dr. Picchioni stressed that respect is key. “What’s important is that through listening, showing empathy and warmth, you’re showing your respect for that person,” he said.
“We live in a global village and a cosmopolitan community and international city. Baylor Scott & White is a recognized quality provider. It’s part of our mandate to take care of people to be sensitive to cultural diversity and respect the way in which they need to be treated,” Dr. Picchioni said.
G.R. White Trust makes big impact
For someone who is traveling far distances to battle cancer, having somewhere to call their “home away from home” is important. When Bart Wulff, chair of the selection committee for the G.R. White Trust, heard about plans for the American Cancer Society Gene and Jerry Jones Family Hope Lodge in Dallas, he knew it would be a fit for the mission of the trust. Founded by Bart’s great-uncle, George Rollie White, the G.R. White Trust focuses on making health care and educational resources available to Texans, particularly those in rural areas. The trust has committed to support Hope Lodge through a generous gift.
George Rollie White (1875–1965) came to Texas as a young child in a covered wagon with his family. They settled in Brady, Texas, a small community in McCulloch County. He became a successful rancher and banker who cared deeply about bettering the lives of his fellow rural Texans.
“We support local organizations based in McCulloch County dedicated to providing support to people who have cancer,” Wulff said, “and the creation of Hope Lodge seems to be the way to help from the other end—making support available in a metropolitan area to people from rural areas.”
Each year, thousands of patients battling cancer travel from throughout the region to receive potentially lifesaving treatments in Dallas. Hope Lodge will help ease the emotional and financial toll these families face when traveling long distances for care. Located on property donated by Baylor Scott & White Health adjacent to Baylor University Medical Center, the facility will offer cancer patients and their caregivers complimentary lodging while they are receiving care from any of North Texas’ premier medical centers.
Baylor Scott & White and the American Cancer Society broke ground on the facility in May 2019, and construction is well under way. The Gene and Jerry Jones Family Hope Lodge is expected to host its first visitors in early 2021. Once the doors are open, the facility is expected to provide more than 18,000 nights of free lodging annually.
In addition to their support of Hope Lodge, the G.R. White Trust has funded several initiatives at Baylor Scott & White that help make life better for Texans, including the system’s Child Life program, which received its first dedicated gift from the trust and whose continued support has enabled the program to expand to additional Baylor Scott & White Health hospitals across the state.
For information on how you can support these or other philanthropic initiatives at Baylor Scott & White Health–North Texas, please contact Baylor Scott & White Dallas Foundation at 214.820.3136.