The Message, March 2012

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A MON T HLY NE WS M AG A ZINE OF SPOKANE COUNTY MEDICAL SOCIETY – MARCH 2012

The Trials and Tribulations of Health Information Technology By Terri Oskin, MD SCMS President

Online Health Services: Meeting our patients when and where they want us The Statewide Health Information Exchange Partnership


ADpartners. SPACE Three One focus: your health. Introducing Rockwood Health System.

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RockwoodHealthSystem.com March SCMS The Message Open2 58453_DMC_Rockwood_7_5x10c.indd 1

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T a b l e o f C o n te n ts

2012 Officers and Board of Trustees Terri Oskin, MD President Anne Oakley, MD President-Elect Bradley Pope, MD Immediate Past President David Bare, MD Vice President William Keyes, MD Secretary-Treasurer Trustees: Robert Benedetti, MD Audrey Brantz, MD Michael Cunningham, MD Karian Dierks, MD Randi Hart, MD Louis Koncz, PA-C Shane McNevin, MD Gary Newkirk, MD Fredric Shepard, MD Carla Smith, MD Newsletter editor – Anne Oakley, MD

The Trials and Tribulations of Health Information Technology . . . . . . . . . . . . . . . . . . . 1 Online Health Services: Meeting our patients when and where they want us . . . . . . . . . . . 2 The Statewide Health Information Exchange Partnership . . . . . . . . . . . . . . . . . . . . . 3 WIREC and Provider Commitment to Reaching Meaningful Use . . . . . . . . . . . . . . . . . 4 Clarity Health Bringing Coordinated Care to Eastern Washington . . . . . . . . . . . . . . . . 5 See You on the Internet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 “Year-End” Report – Project Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Growing Medical Student Interest in Spokane Training . . . . . . . . . . . . . . . . . . . . . . 9 Diabetes Education Center a Resource for the Community . . . . . . . . . . . . . . . . . . . . 9 The Spokane County Medical Society Foundation’s 2012 Focus . . . . . . . . . . . . . . . . . 11 Priorities, Strategic Plans, Action Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Meet Mary Giannini and Greg Embrey of Witherspoon Kelley Attorneys at Law . . . . . . . . 13 SCMS Membership is Represented by Staff at Various National, State and Local Organizations 13 WSMA News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Spokane County Medical Society Message A monthly newsletter published by the Spokane County Medical Society. The annual subscription rate is $21.74 (this includes the 8.7% tax rate). Advertising Correspondence Quisenberry Marketing & Design Attn: Jordan Quisenberry 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 jordan@quisenberry.net All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein.

Meetings, Conferences and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Physician Leadership Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 New Physicians and Physician Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Classified Ads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

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The Trials and Tribulations of Health Information Technology By Terri Oskin, MD SCMS President It’s March and spring is in the air. We’ve survived another winter in the Inland Northwest. The robins are back and daffodils are peeking their heads through the ground. So why not brush up on your health information technology (HIT) knowledge before the weather takes us all outdoors? I’m not going to pretend to be a technical genius. I thought I was doing well when I figured out what Wi-Fi is. So what is HIT? And how will it impact my practice and how I practice? According to Wikipedia: Health information technology (HIT) is the umbrella framework to describe the comprehensive management of health information across computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers. HIT is in general increasingly viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system (Chaudhry et al., 2006). The U.S. Dept. of Health and Human Services explains it this way: “Health information technology (health IT) involves the exchange of health information in an electronic environment. Widespread use of health IT within the health care industry will improve the quality of health care, prevent medical errors, reduce health care costs, increase administrative efficiencies, decrease paperwork, and expand access to affordable health care.” I can’t speak for the younger doctors, but for me, I found HIT slowly sneaking into my life without my being aware of it. My first introduction was as a medical student. Our hospital system was already using Meditech. I remember racing to the terminals early in the morning to write down our patients’ lab values to present to our attending during rounds. Next was dictating the H&P’s and discharge summaries! What a relief it is now when you are admitting a patient to the hospital who has been there before to finally have a legible record that helps you know something about the person, rather than relying solely on the patient for their full history. Then came private practice. I joined Northside Internal Medicine in 2000. We still used paper charts in those days, dictated our notes and it was the world of fax. Next came voice- recognition dictation. We received some entertaining dictations if the author did not proofread them. Eventually we could access Meditech in our offices and Inland Imaging went digital. We were spared trips

to radiology to view chest x-rays before ICU rounds because we could now review reports and images in our office! I thought this was technology at its best. How could it get any better? In 2010, Northside joined Columbia Medical Associates and the era of the electronic health record (EHR) began. Electronic records are intended to improve efficiency and decrease paperwork. Hm, then why am I still at the office at 7 pm? I thought about moving my bed into my office a few times.

But seriously We’ve all been through the trial and error of implementing HIT, seen the pitfalls and shared the same laughs. Although I joke about these experiences, HIT does indeed provide a more secure environment for storing and exchanging health records between providers. We can’t go back, and who would want to anyway? We’ve struggled with it and fought it, and in the end we master and embrace it. That’s why it is so important for hospitals within our region to continue providing systems that are compatible with each other. Our medical society’s IT committee has been meeting regularly with the executives of area hospitals to ensure those shared systems continue. Thanks to George McAlister, Keith Baldwin, Dr. Jeff O’Connor and all of our IT members for their assistance. Several programs in the community are noteworthy for improving quality, safety and efficiency in our healthcare system. One is the Consistent Care Program at Providence Sacred Heart Hospital Medical Center’s Emergency Department. You can file your patient’s pain agreement with Consistent Care and those patients are flagged in the Meditech system. I hope everyone has had a chance to review and use the Uniform Pain Agreement that’s now available for download on the SCMS website. The Washington Prescription Monitoring Program is also beneficial to our practice. Developed by the Washington State Department of Health and available since January by simply registering online, this program collects all records for prescribed scheduled medications. Then prescribers or authorized individuals who register can access this information to look for abuse or drug interactions. Prescribers can also be alerted when there is reason for concern. Learn more at www.doh.wa.gov/ hsqa/PMP/default.htm. I encourage you to register if you haven’t already done so. Finally, don’t forget about the Medicare and Medicaid Incentive programs and meaningful use requirements. Deadlines are fast approaching to meet Stage 1 criteria without facing a penalty. But first you must have an EHR to qualify. Complete details about requirements and criteria can be found at the Centers for Medicare & Medicaid Services at www.cms.gov. HIT certainly has impacted my practice. Good-bye pager, hello smart phone. Good-bye writers’ cramp and hello carpel tunnel! Now, will someone just show me how to program my remote?

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Online Health Services: Meeting our Patients When and Where they Want us

Considerations for physicians

By Matthew Handley, MD Group Health Cooperative

Physicians have also expressed concern that secure messaging could eat into revenue, because time spent answering emails may not be reimbursed and in-person visits averted. Our experience is that some doctors report trading simple visits for more complicated visits. In our own medical group we are demonstrating the value of providing patient care online, but truthfully, we still need to figure out how to finance it appropriately. For now, Group Health tracks online visits and is learning how to assign a value for them. Collectively as physicians and physicians assistants, we will need to work together to advocate for proper financing of desktop medicine.

In the 11 years since Group Health first began working with patients online, more than 250,000 patients have registered and been verified to use our online services called MyGroupHealth. That’s about 68 percent of our Group Health Medical Centers population. Today patients can: »» Email their physician and care team using secure e-mail. About 800,000 secure e-mail conversations take place each year between our patients and care teams. »» Order Group Health prescription refills online. (56,000 last month) »» View their lab results and online medical record. (18,000 per week) »» Schedule appointments. (1,690 appointments per week) »» Request access to children's medical records if 12 years or younger, and view their online medical records, e-mail a child’s doctor and make appointments. Patients may also view their after-visit summaries following a visit to a Group Health Medical Centers clinic and check real-time details about their coverage and claims, so they can monitor their benefit usage and cost-share payments.

Going mobile Our latest advance is a mobile application for the iPhone and Android, so that members can connect with us on the move. The most popular feature is checking wait times for Group Health pharmacies and labs so patients can avoid lines. The app also includes a symptom-checker and phone link to our consulting nurse service.

Some physicians resist adopting secure e-mail because they worry that they will be overwhelmed by new patient demands. In fact, we’ve found the opposite—that patients manage their health better with more access and information. More transparency is better.

Operationalizing HIT From the onset, online services became a key component of our patient-centered medical home model. Using this model, we provide fewer in-person visits yet we actually touch patients more often. We have built time into our physicians’ day to respond to patient e-mails and they rely on other team members to respond when it’s appropriate. Generally nurses screen e-mails first and respond to about 25 percent of them; our physicians handle the rest. Patients love our online services. Patient-satisfaction surveys show that compared to non-users, our patients who use MyGroupHealth said they received more attention from their provider and reported having more opportunities to ask questions. Users also believed they received more thorough care and that their practitioner was more prepared, compared to non-users. Finally, online sevices improve retention—we keep 6.5 percent more members who are online compared to non-users.

The future: patient-entered data The next step for HIT will be to expand patient-entered data. For some time patients have completed electronic health risk assessments at Group Health and at other health plans, but we can take the model much further. We would like for patients to be able to provide more detail about symptoms and quality of life and to answer pre-visit questions before coming in for their appointments, so we can best manage their care. Online care-planning tools also look promising, especially for patients with chronic illness. Once a patient sets goals with the health care team, the team will deploy online tools to support the patient, for example by tracking progress toward a goal. I also predict that streaming video decision aids will become used more widely with patients with preference-sensitive conditions, so they are better informed about the pros and cons of their medical options.

Mobile app home

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Continued from page 2 Technology is changing people’s lifestyles, including the way that patients interact with their health care teams. But it is not about the box—technology needs to support patients and clinicians, not the other way around. The trick is to make sure that technology is patient-centered, so that it is convenient, accessible and relevant for patients. Physicians require training and the financing of virtual consults needs to be worked out. However, they just may find that their patients are happier—and their practice more rewarding.

Matthew Handley, MD, is the medical director for quality and informatics at Group Health Cooperative.

In the June 2011 edition of The Message, the SCMS Medical Informatics Committee discussed this issue and defined HIE: “In a robust healthcare environment that fosters competing business interests and multiple EHR systems and platforms, there is an urgent need in the greater Spokane community to keep our HIE efforts focused on the primary needs of the patient, regardless of the healthcare setting where they seek care. This patientcentric approach requires the secure exchange of data between providers and across care settings.” Further on in the article the committee also spoke to HIE governance:

The Statewide Health Information Exchange Partnership

“Ultimately, our community will need an HIE governance structure that develops creative solutions to resolve conflicts over the management and exchange of vital health information.”

By Richard D. Rubin, CEO OneHealthPort The Spokane medical community has long been a pioneer in the use of health information technology (HIT); now the rest of the country is catching up. The blend of recent investment by the federal government in Meaningful Use Incentives and passage of legislation by the state are accelerating deployment of HIT and Health Information Exchange (HIE) across the state and the nation.

The Committee correctly anticipated and highlighted two main obstacles to constructing an effective HIE; practical governance and cost-effective data exchange across care settings. The statewide HIE partnership described below has tackled both of these challenges. Continued on page 4

Hopefully, if you have an Electronic Health Record (EHR) or are planning to purchase one you are pursuing Meaningful Use Incentive dollars for your practice. Details of the program and other news about state and federal HIT/HIE initiatives can e found at http://www.healthit.wa.gov/lead_organizations.html. EHRs are a critical step in migrating health information from paper to electronic form. However, to achieve the best results for patients, physicians need to be able to assemble a more complete picture of the patient than is likely to be found in any one system.

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Continued from page 3 In 2009 the state legislature passed SSB 5501. The bill is designed to accelerate secure exchange of high value health data. The bill also directed the Health Care Authority (HCA) to designate a private sector organization to lead implementation of the HIE. The HCA designated OneHealthPort as the lead organization for HIE in Washington State. OneHealthPort gathered business requirements for the HIE from stakeholders across the state. For governance, stakeholders liked the idea of having a lean and neutral private sector organization managing the HIE. However, they thought it was important to establish independent community oversight to ensure OneHealthPort operated the HIE in the public interest. Functionally, the conclusion of the stakeholder group was to pursue a “Thin-Layer” HIE that would emphasize secure transport and directory services. It was believed this model would complement the significant investments already made in EHRs and data repositories. The Thin-Layer model also recognized that in Washington state there will be multiple HIE’s. As such, the HIE’s will have to exchange information with each other. Finally, the stakeholders thought the Thin-Layer model offered the best potential to operate the HIE at very low cost over the long-term. OneHealthPort brought this vision of low-cost, secure exchange to life in 2011. The OneHealthPort Statewide HIE offers a single point of low- cost connection for organizations interested in secure exchange of data. Currently, the statewide HIE can assist practices to exchange information with a variety of trading partners including other practices, hospitals, payers, public health, labs, etc. The HIE is also working on a series of special projects including: »» HIE-to-HIE connections with the INHS BCIN project and the Idaho Health Data Exchange »» Meaningful Use testing to assist practices attesting under the Medicaid Incentive Program »» Referral Management to assist practices with patient referrals between primary care and specialists »» Transmission of quality reports from all ESRD treatment facilities across the nation to CMS using the Nationwide Health Information Network (NwHIN) Oversight of the HIE’s pricing, privacy, security and access policies are provided by the Foundation for Health Care Quality, a community not-for-profit and the HCA. OneHealthPort’s initial task has been to encourage a critical mass of organizations to sign on to the HIE as early adopters. Among the initial group of organizations signing HIE contracts include Group Health, Medicaid, PAML, Virginia Mason, Wenatchee Valley Medical Center, Kadlec Regional Medical Center, PTSO of Washington and Puget Sound Family Physicians, with many others in discussion.

OneHealthPort and its partners are working to address the worthy HIE goals the SCMS Informatics Committee described last year. Further information on the statewide HIE and how to participate can be found at: http://www.onehealthport.com/ hieindex.php.

WIREC and Provider Commitment to Reaching Meaningful Use By Rick Reed WIREC Communications Consultant The Washington & Idaho Regional Extension Center (WIREC), an initiative of Qualis Health, has been working diligently with eligible professionals across both states to help them achieve meaningful use of electronic health records (EHR), in accordance with the HITECH Act. WIREC was selected by the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health IT (ONC) as this region’s pipeline to the national Regional Extension Center program. WIREC offers an integrated, comprehensive suite of services that includes technical assistance, guidance, education, vendor-neutral EHR adoption services, and information designed to bring eligible professionals to meaningful use (MU) successfully, so that they can improve the quality of patient care and earn incentives. Currently, WIREC is helping over 2, 600 primary care providers successfully use EHRs. Of those providers, over 100 have achieved meaningful use. WIREC enrollees share a common aim above and beyond reaping Centers for Medicaid & Medicare Services (CMS) incentives— namely, to meet meaningful use to improve the quality of care they provide to their patients across the board. John Fisher, Clinic IT Manager for The Doctors’ Clinic in Spokane, had this to say about WIREC, meaningful use and bettering care for all patients. “WIREC’s meaningful use assessment demonstrated to us that we could achieve MU. We had the Certified EHR and now our focus was to ensure that we used it as it was meant to be used. We also wanted to make certain we documented the quality measures that we were already doing, but just not documenting properly. I stay in touch with our WIREC Health IT consultant too for additional assistance on our workflow so that we will be able to continue to achieve MU and provide the best possible healthcare to our patients. After all, that is what it is all about: better patient outcomes.” The Doctors’ Clinic successfully attested to meaningful use in August of last year and received their first incentive check in late September.

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Challenges Facing Providers Preparation is the key to successfully reaching meaningful use. As the experiences of two WIREC Health IT Consultants show, practices can never be too prepared for the rigorous demands of attestation. Trudy Bearden, PA-C, MPAS, CPHIT, offered the following tips, garnered from lessons learned from practices with whom she consults, for ensuring successful meaningful use attestation. »» Install certified EHR technology well in advance of the reporting period »» Start meeting meaningful use before the reporting period begins; do a dry run »» Ensure that clinic staff are communicating with physicians along the way; make sure that physicians “know their numbers” »» Get commitment and buy-in from leadership especially by keeping MU as a standing agenda item for meetings And Helen Stroebel, RN, MPH, CPHIT shared the following story about her work in the field that substantiates the claim that the key to successful meaningful use is being prepared. Helen notes that the measure related to clinical summaries for 50% of office visits within three days is often problematic for clinics. Clinics often fail to “adequately address the workflow redesign aspect of meeting this measure because it requires the most behavior change among their clinicians. To meet 50% of visits during the reporting period, they would have to have an effective workflow in place to assure provision for every patient visit and compliance among all their EPs no later than roughly the mid-point of the reporting period (assuming equal visit volumes throughout the 90-day period). It is easy for clinics to overlook this one measure especially if EPs are meeting performance thresholds on all the other core measures.” But these challenges do not have to be insurmountable. When providers take advantage of the technical guidance their WIREC consultant can offer, they can make the transition to meaningful use much more easily and smoothly. Mr. Fisher adds that his practice’s WIREC consultant was really a boon to their progress. “The WIREC audit helped us to focus on specific areas, but we have been preparing for a long time, so there weren’t any real negative surprises. One pleasant surprise was our clinic actually met ten different quality measures, but we only had to report three. Both our WIREC consultant and our vendor support team provided tremendous assistance when we had questions along the way. We attended countless webinars by WIREC to be sure we were prepared. These were extremely valuable for us.” Want to know more? Visit the WIREC website at www.wirecqh. org or send an e-mail to wirec@qualishealth.org. Expert health IT consultants throughout Idaho and Washington are ready to help any providers needing guidance and support in reaching meaningful use goals.

Clarity Health Bringing Coordinated Care to Eastern Washington By Peter Gelpi, Chief Executive Officer Clarity Health Services Clarity Health Services, a healthcare-information company that helps physicians and hospitals streamline and simplify the coordination of patient care in other parts of Washington, has launched its service in Spokane. Seattle-based Clarity Health Services , founded in 2008, gives physicians and hospitals a secure, Web-based system that helps them manage referrals more effectively, track a patient’s care as they enter the hospital or see other physicians and create a community-based approach to accountable care. By forging commitments between healthcare providers to work together for a patient’s benefit, Clarity Health Services presents a path to more effective and efficient care. Clarity Health started by linking six hospitals from the Critical Access Hospital Network (CAHN) in eastern Washington with the Rockwood Health System to coordinate patient care between their practice settings and track the care those patients receive. Clarity’s service will equip the CAHN participants with a connected community of primary care providers and specialists. The network will offer a significant improvement over the current system in which staff members at rural hospitals call specialists' offices to set appointments and manually follow-up on patient status. After that initial phone call, it's difficult for a rural hospital to track whether a patient actually was seen by a specialist as arranged, if subsequent care is required or whether a patient will be returning to the primary care provider. Patients are well aware of the challenges. With Clarity Health a seamless link is created between primary care and specialist physicians so that all participants in a patient’s care are informed of patient status. Pierce County, Washington may offer a preview of what’s possible in Spokane. Clarity Health entered that market in 2010, working initially with the independent physician practices within the Northwest Physicians Network to help them better manage referrals. As more practices joined, the value to the community increased as care became more integrated. Today practices, ancillary services, and hospital systems share clinical information through Clarity Health as patients transition between them. Primary care physicians that often originate these referrals are once again returning to the center of their patients’ care teams, enjoying stronger, more accountable relationships with the physicians and services that see their patients.

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Continued from page 5 Practices outside of the Rockwood Health System (Rockwood) will need to participate in order for eastern Washington’s CAHN members to realize the full potential of the Clarity Service. Lincoln Hospital CEO Tom Martin is working with Clarity Health to encourage local physicians to join the service as a means of improving clinical integration within the Spokane area. Inland Imaging has agreed to use the service to support the patients they see from the CAHN communities. Rockwood leaders believe Clarity Health will help them better manage the challenge of coordinating care in an area where patients, family members and physicians often are widely separated. Rockwood hospitals already have in place a nursing team to help facilitate patient transitions to and from the outlying communities. Rockwood’s aim is to keep CAHN-affiliated physicians and family members apprised of a patient’s status. Clarity’s service will be used to manage transitions from a hospital to post-acute care settings and between an admitting physician and the patient’s primary care physician. Clarity has also reached out to the Beacon Community, the Emergency Department Information Exchange (EDIE) project and the North Idaho Health Network to coordinate with their efforts and ensure that Clarity’s service helps to complement their objectives.

See You on the Internet Have You Tried MEDICOR’s Special Version of PubMed? What is PubMed? PubMed is the premiere, on-line database developed by the National Library of Medicine (NLM) that provides free access to over 21 million citations, abstracts and full-text from more than 5,400 biomedical journals. For both novice and advanced users, PubMed’s powerful search system will help you to find timely, authoritative research and patient care information. What is LinkOut? Working with the National Library of Medicine, we have created a special version of PubMed that uses MEDICOR’s link resolver* to help you find full text information. Depending upon your affiliation, hundreds of electronic biomedical journals are accessible to you through license agreements arranged for by Providence Health & Services and Rockwood Health System. To use LinkOut you will need to enter PubMed through the special PubMed link on MEDICOR’s home page at http://spcmsmedicor.org (look for the PubMed icon). What is the MEDICOR “Get It” Icon? Once you have searched MEDICOR’s special version of PubMed, you will see the MEDICOR “Get It” icon in the upper right corner of the page displaying your found journal article. Clicking the icon will open a new MEDICOR services window to let you know whether full text is available. Clicking the “GO” button will take you to the electronic full text of the journal article. If full text is not available online then you will be given the option to request the document through your affiliated hospital’s document delivery service.

We are continuing to add resources to MEDICOR and improve its features and services, so keep watching for updates. To access MEDICOR, go to http://spcmsmedicor.org. See the “Click Here to Register” link if you don’t already have a user ID and password. If you have questions, or would like to set up a personal demo or group training session, please contact George McAlister at george@spcms.org.

*a link resolver is software that checks to see if any of MEDICOR’s affiliated hospitals has a subscription to an electronic copy of a journal, and then directs the user to its location on the Web.

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“Year-End” Report – Project Access

Other highlights: »» Project Access client appointment no-show rate for 2011 was less than 4%. »» We have improved our application process and are able

By Lee Taylor Director, Project Access Spokane

to determine eligibility with greater efficiency. »»

It always takes more time than we would like to get the full picture of our performance in the previous year. Much of the claims data for the clients who received medical services through Project Access reaches us a couple of months after the services were rendered, so we need that much time to get complete information for the year. Now that we are about a quarter of the way through the year, we are ready to share our performance information with the community. Project Access had a very productive year in 2011! We created a new staff team that has improved processes and is getting clients to specialist appointments faster than in previous years. This important work to improve efficiency that we started in 2011 will help us be more productive in the future.

Major accomplishments: »» Clients served increased by 14% from 571 to 651. »» Total value of medical services provided for clients

We have improved our process time from receipt of application to appointment. It now takes an average of about 30 days for our clients to have an appointment, which is down from about 50 days a year ago.

»» We are working to better communicate with the community clinics and donating providers. Links to our new newsletters are available on our website at www. spcms.org/projectaccess. These are truly very important and valuable improvements that I attribute to the small yet great staff team at Project Access. Thank you to all the community clinics, private clinics, specialist offices, emergency departments, hospitals and other medical organizations throughout Spokane that partnered with Project Access in 2011. Please call me if you have questions or if you have ideas that you would like to share, at (509) 220-2651 or email me at lee@spcms.org.

increased 14% from $6.3 million to $7.2 million. »» Return on Community Investment, (the ratio of Project Access operating costs versus the value of services provided to our clients), increased from $12 for each $1

Membership Recognition for March 2012

invested to $14.96.

Thank you to the members listed below. Their contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today. 10 Years Deborah J. Vermaire, MD

3/27/2002

Lynda K. Williamson, DO

3/27/2002

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» 509.228.1000 March SCMS The Message 8

comprehensive innovative compassionate integrated


Growing Medical Student Interest in Spokane Training By John McCarthy, MD WWAMI Clinical Medical education – Eastern and Central Washington I am a graduate of the University of Washington School of Medicine and am proud of that fact. My medical education was a rich and impressively fun experience, especially once I hit the wards. I have dear friends from that stage of my life. Seattle was a great place to train; my colleagues were brilliant and worldly; my mentors were nationally renowned and supportive and my attending in Internal Medicine at the University hospital, Paul Ramsey, MD, was very supportive of my desire to go into Family Medicine. Additionally, I loved the regional nature of the UWSOM. Outside of Seattle, I had the opportunity to train in Idaho, Eastern Washington, and Alaska (Wyoming was not yet a part of WWAMI and my attempts at getting to Montana didn’t work out). The regional education was integral in helping me understand medicine and it affirmed my desire to find a place where I was needed and could make a difference in the health of a community. Although it was 26 years ago, I vividly remember my travel across the state from Spokane to interview in Seattle for the medical school. I was ecstatic to have the opportunity to interview but frankly it was a bit of a hassle to borrow a car from a friend for the journey. It would have been much nicer to have biked/walked to my interview which I would have inevitably done had I had the opportunity. Likewise, I would have been eager to have had the opportunity to do my first year of training in Spokane. I was living less than a mile from the current campus. I had a well-established, diverse support network and I would have thrived in the more intimate classroom environment available at the current campus. Over the last three years, the Office of Admissions for the School of Medicine under the direction of Carol Teitz, MD has been supporting the regional nature of our school. Recently there were 53 interviews in Spokane for TRUST (Targeted Rural and Underserved Track). By the end of the year, Spokane will have interviewed just under 19% of the 400 plus Washington State applicants. The ability and intent to spread Admissions outside of the Seattle region is in line with the mission of the School of Medicine which in part is to help produce a workforce for the WWAMI region. I am convinced that getting students to train locally will result in having students return to local residencies and eventually practice locally. The Spokane campus will see its entering class E-08 starting residencies this year. I predict there will be a boost to our local residencies as a result of our first year students who will go through their match in a month. Last month, I had the opportunity to spend a week interviewing applicants in Bozeman, Montana. There I was impressed with the students, the interviewing team, the campus and the applicants.

It was clear the applicants were happy to interview locally (they could have interviewed in Seattle). In both Spokane and Bozeman, students like that they belong to this regional medical school and identify the national leadership that the school continues to hold. This regional medical school has evolved significantly from the school I entered 26 years ago and the evolution continues to feed our region with leaders in medicine and a workforce which is committed.

Diabetes Education Center a Resource for the Community By Colleen Carey, MD Endocrinologist, Medical Director for the CHER Diabetes Education Center The CHER Diabetes Education Center (the Center) is a community-based out-patient center and has been helping people live with diabetes since 1994. CHER stands for Community Health Education and Resources and operates under the auspices of Inland Northwest Health Services which is a nonprofit organization in Spokane. The Diabetes Education Center has expanded its services over the years to embrace the many needs of people with diabetes and their families. The Center is staffed by an Advanced Registered Nurse Practioner, Registered Nurses, Registered Dietitians and Certified Diabetes Educators that specialize in diabetes. The diabetes team’s goal is to give patients the tools they need to live successfully with diabetes and provide the most up-to-date information regarding diabetes and its management. People living with diabetes have an extra work load. They monitor glucose levels during the day, eating carefully, adjusting insulin doses to diet and activity, as well as, learning how to combine a variety of oral and injected medications to optimize control. The CHER team helps teach strategies for dealing with stress and for problem solving. In addition to providing diabetes self-management education classes and individual consultations, the CHER Diabetes Education Center has been a leader in the community, providing education for gestational diabetes, pre-diabetes, community nutrition classes and a monthly diabetes support group. The technology available for monitoring and treating diabetes can be tremendously helpful but also bewildering. The CHER staff help patients find the right glucose meter, show them how to use insulin pens, provide 72-hour continuous glucose monitoring and interpret the results which help patients improve glucose control. Education is also provided on use of personal glucose sensors for real time monitoring. Certified pump trainers are knowledgeable about the variety of pumps available and can help transition patients from multiple daily injections to insulin pump therapy.

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Dues: only $130/year


Continued from page 9 This includes education to patients on how to use pumps to mimic normal pancreatic insulin secretion as clearly as possible. Telehealth services with video conferencing reaches people in rural communities who would have difficulty accessing diabetes programs due to travel to Spokane. The epidemic of Type 2 Diabetes mellitus has focused attention on prevention. Risk factors include obesity, sedentary lifestyle and positive family history. The combination of being overweight, having abnormal lipids and high blood pressure, which is referred to as metabolic syndrome, has a strong association with abnormal glucose tolerance and diabetes. People who show mildly elevated fasting glucose levels or mildly abnormal glucose levels on a two hour glucose tolerance test (impaired fasting glucose and impaired glucose tolerance respectively) are at very high risk for progression to Type 2 Diabetes. However, early intervention with healthy diet, weight loss and exercise may reverse this condition or slow down its progression. CHER Diabetes Education Center offers classes on pre-diabetes at reduced cost to the public and no referral is necessary. Weight management is a huge part of diabetes prevention and treatment. The Diabetes Education Center offers an in-depth program for weight management to the community entitled “Make Your Calories Count”. This is offered to people with diabetes, people who would like to lose weight to prevent diabetes or to those who would like to learn the skills to lose weight and keep it off. This comprehensive six-month program includes 14 classes addressing principles of weight loss which enables patients to make permanent change. Classes are small and interactive. One-on-one nutritional counseling for weight loss is also available. The goal is to find what works best for each patient. Dietitians are available to anyone with special nutritional needs such as kidney disease, hypertension, food allergies and intolerance and unintentional weight loss. Selected evening classes on diabetes and nutrition are offered at no charge to the public and are posted on the CHER website. These include topics such as meal planning, supermarket shopping, diabetes medications including new drugs on the market, foot care, ways to increase physical activity and diabetes prevention. A monthly diabetes support group is held on the first Tuesday of every month from 5:30-7pm at the diabetes Center and is free of charge. The CHER Diabetes Education Center is a wonderful resource for our community. The center is located at 501 N. Riverpoint Blvd Suite 245 Spokane, WA 99202. It is on STA Bus Route 29, with a drop off in front of the Center, and parking is convenient and free. For more information on the Center and its services call 232-8145 or visit www.cherspokane.org

The Spokane County Medical Society Foundation’s 2012 Focus By Keith Baldwin, SCMSF Secretary-Treasurer Representing Brad Pope, M.D., SCMSF President I recently attended a Community Needs Assessment discussion co-sponsored by the Spokane Regional Health District, the Empire Health Foundation and Providence Health Care. There were many individuals representing the disparate providers of services to the underprivileged in our community - the safety net. They were all passionate about their particular role in helping people who for many reasons have found themselves homeless, in a very dysfunctional family situation, without a consistent care giver and in many cases dealing with medical and mental health issues simultaneously, including addictions. You might be asking at this point what this has to do with the SCMS Foundation. One of the questions discussed had to do with the three most critical issues that need to be addressed in our community. At the top was “access to care” in the broadest sense. There are too few medical, dental and mental health providers to serve the needs of all those in this vulnerable population. It can be an overwhelming problem if you try and address the whole picture at once. The medical community and the SCMS specifically understood that there was a need a number of years ago and commissioned a study from EWU’s Institute for Public Policy and Economic Analysis to evaluate the workforce needs for primary care physicians. It substantiated the need for 19-20 primary care physicians each year over the next decade. With that forecast in hand, Greater Spokane Incorporated (GSI) and then a collaboration of WSU and the UWSOM also took up the discussion of how to address this workforce issue. It is clear now that the SCMS work was a precursor to some very fundamental changes taking place in the delivery of healthcare in our community today. We now have a state funded Biomedical/Health Sciences building coming out of the ground that will house four years of medical education in Spokane through the WSU/UWSOM collaboration. The WSU School of Pharmacy will move all four years of that program to the building as well. Research will also be a cornerstone of the space as the plan unfolds. The SCMS Foundation has determined that their efforts should focus on this public/private educational endeavor to support the operational aspect of medical education when the second year students begin their education in Spokane in the fall of 2013 and join the first, third and fourth year classes. As the SCMS Foundation solicits your contributions this year, remember that they will be FOCUSING on how to support the workforce initiative on your behalf. Remember, you got this ball rolling; now you have the opportunity to help complete the process. Go to www.morethanamedicalschool.com for more information on the progress being made!

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Priorities, Strategic Plans, Action Plans By Keith Baldwin, SCMS CEO I recently sent each of you, our SCMS members, the 2012 Priorities for your review and encouraged you to not only be aware of how the leadership and staff are advocating on your behalf but to engage in or become involved in the activities of the SCMS. A short time ago I had the opportunity to attend a Greater Spokane Incorporated event where Mayor Condon unveiled his 100-Day Action Plan. I think it is instructive to note what the city thinks is important and how we, many of the SCMS members and significant other medical providers who reside in the city of Spokane, fit into their agenda.

And, you could assume that the medical community would be a part of engaging in activities related to the Quality of Life goal, right? I am not sure it is a shoo-in either. The medical community is a major force in the local economy and has a profound effect on the “quality of life” we all share. Take a look at the Mayor’s Action Plan and consider engaging in the activities of Spokane in 2012. Should we monitor the activity, should we participate and will we help create a healthier community in the process?

Mayor Condon outlined the city’s focus and those consistent with the Mayor’s transition priorities: »» Public Safety: Restoring public trust in law enforcement and enhance community safety. »» Jobs & Economic Growth: Creating an atmosphere to attract and retain jobs. »» Budget: Promoting long-term fiscal health without undue burden on citizens. »» Infrastructure: Maintaining critical public infrastructure at an affordable price. »» Quality of Life: Engaging citizens and improving the quality and character of our community. So, this is the plan for the first 100 days. I noticed that the Mayor mentioned health in his Budget goal which isn’t the type of health that we in the medical community usually want to deal with since the state and federal budgets haven’t exactly been our favorite topics these days.

Visit our updated website • View "The Message" Online

• Legislative updates

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• Membership information

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-Information about credentialing, committees, bylaws, etc.

-The online medical library is a SCMS membership benefit.

• CME information -Topic and dates for upcoming CME courses

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Meet Mary Giannini and Greg Embrey of Witherspoon Kelley Attorneys at Law – An SCMS Community of Professionals Partner

Self-introduction M.G. My name is Mary Giannini. I am an attorney and shareholder at the law firm of Witherspoon Kelley in Spokane and Coeur d’Alene, Idaho. I have practiced law for approximately 25 years. G.E. My name is Greg Embrey. I am an attorney and shareholder at the law firm of Witherspoon Kelley in Spokane and Coeur d’Alene, Idaho. I have practiced law for twelve years.

How long have you been in Spokane? M.G. I moved to Spokane in 1988. I met my husband, Art, here several years later and have called Spokane home ever since. I was born and raised in Hawaii and graduated from Punahou School in Honolulu. I have a B. A. in biology and an M.B.A. in health administration from Cornell University. I obtained a J.D. from the University of Idaho College of Law in 1984. G. E. I grew up in Spokane Valley, attended Whitman College and went to law school at Gonzaga. I currently live in Coeur d' Alene and divide my time between the Spokane and Coeur d' Alene areas.

What service do you provide for professionals? M.G. My practice of healthcare law and employment law fits well into the full legal service environment at Witherspoon Kelley. My practice focuses on transactions, compliance and privacy matters for healthcare practitioners, as well as employment matters. G. E. My practice is focused on estate and business planning. I also assist clients with real estate matters and entity formations, operations and reorganizations. M.G. & G. E. Our colleagues at Witherspoon Kelley provide tax, corporate, litigation, real estate, intellectual property, employment and employee benefits services to individuals and businesses.

What makes your organization stand out as a “good” partner? M. G. & G. E. Witherspoon Kelley has been part of the legal and business communities of the Pacific Northwest for more than 125 years. No two clients have the same needs, so we take an individualized approach with each client. Our breadth of legal and business skills allows our clients to resolve all of their legal needs in our collaborative environment. We are committed to always staying one step ahead in the ever-changing legal landscape. This translates into valuable insight that we provide to our clients.

What is your thinking about the Spokane area medical community? M.G. & G. E. The region is incredibly fortunate to have the skilled and forward-looking Spokane medical community. That we will likely have the full range of medical and healthcare training available here soon is incredibly exciting. The inevitable changes in healthcare delivery and financing sometimes feel like major bumps in the road, but the medical and healthcare practitioners and the business people in our community are adaptable and well equipped to deal with change, and to create high quality, efficient healthcare solutions. We are very grateful to have developed a law practice that has allowed us to be involved in healthcare delivery and to meet and work with so many in the healthcare community.

SCMS Membership is Represented by Staff at Various National, State and Local Organizations SCMS staff continue to participate in activities that support and further the priorities of the SCMS membership. Here are a few examples recently where other organizations recognized the value of including SCMS staff in their activities to represent and support the membership of the SCMS. Keith Baldwin was recently appointed to the American Association of Medical Society Executives (AAMSE) County Executive Committee which plans the national annual meeting for the County Medical Society Executives. Keith also worked with the Spokane based Critical Access Hospital and NW Rural Health Conferences to create a preconference panel on Health Information Technology issues including Clarity Health, Emergency Department Information Exchange, Consistent Care, North Idaho Health Network and the Critical Access Hospital Network. George McAlister was invited to be on the National Networks of Libraries of Medicine Regional Advisory Council.

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Valuable benefits now available to our members . . .

He was also appointed Chair of the Inland Northwest Health Sciences Libraries (INWHSL) Group for 2012. INWHSL is a consortium of regional health sciences libraries formed to facilitate cooperative efforts, promote continuing education among its members and improve information services for patient care, research and education in the Inland Northwest. Lee Taylor was invited to participate in the Community Needs Assessment for the Spokane Regional Health District/Providence Health & Services.

WSMA News

• PDR Drug Alerts PDR Drug Alerts offer immediate, electronic delivery of FDAapproved, specialty-specific drug alerts and related safety information to registered WSMA members. Recalls are also sent electronically to you. You’ll no longer have to deal with the delays and inefficiencies of traditional paper alerts. Other benefits and features: improved safety for patients that may help reduce your liability; endorsement by WSMA and liability carriers; privacy oversight from the governing not-for-profit board, the iHealth Alliance; and CME opportunities for reviewing drug alerts and full FDA labels. Register for PDR Drug Alerts at www.WSMA.pdr.net.

• Know the label/drug label CME Scholarships Available for May Leadership Conference WSMA's annual Leadership Development Conference is scheduled for May 18 and 19, 2012 at Campbell’s Resort at Lake Chelan. This weekend conference has received rave reviews from past attendees. We have scheduled several compelling speakers and topics for this year’s conference. Kevin O'Conner "When Creativity and Innovation Are Required for Tough Times." This four hour workshop will focus on the hard and soft skills of leadership in three areas of creativity: innovation, problem solving, and process management. Kevin is an American College of Physician Executives faculty member who specializes in physician executive leadership, innovation and organizational development. In addition to his work with ACPE, he teaches at Loyola University in Chicago. Jack Silversin "Leading Physicians Through Change." This session will focus on actions needed to facilitate change and will address developing a shared vision, aligning a team for change, involving physicians from design to implementation, developing a tension for change, and addressing resistance. Jack Silversin is a nationally recognized speaker on physicians and change, and is a regular presenter at the Institute for Healthcare Improvement conferences and serves as faculty for the MGMA executive education programs. Online registration can be found at www.wsma.org.

WSMA DocTalk Since 80 percent of Internet users gather health information online, the WSMA is featuring members as experts on various health and wellness topics. WSMA Doc Talk Blog – is where WSMA members “blog” about various health and wellness topics and readers can post comments. Recent topics included “Key Medical Appointment to Kick Off Good Health in 2012” by Dr. Gondo; “6 Simple Steps to Keep Your Holiday Merry” by Dr. Schlicher; and “Top 5 Flu Prevention Tips” by Dr. Benz. The blog link is included in the e-newsletter. If you would like to author a blog post or have a subject to cover, please Susan Callahan, WSMA’s Director of Community Engagement at slc@wsma.org or 206.441.9762.

WSMA members can now earn free CME for improving their knowledge of the safe and appropriate use of the FDA-regulated medical products they most commonly prescribe. Nationally, nearly 30% of medical malpractice suits involve pharmaceuticals, and FDA-approved pharmaceutical labeling is often the standard to which physicians are held. Since more than 25% of drugs have material labeling changes annually—from new warnings to changes in dosing and indications—reasonably frequent review of FDA approved labeling for commonly prescribed drugs is a reasonable approach to clinical accuracy and liability protection. To get started, please register at www.WSMA.pdr.net.

Save the Date September 15-16, WSMA’s Annual Meeting at the Hotel Murano in Tacoma with keynote speaker Dr. Abraham Verghese, famous memoirist and author of the bestselling “Cutting for Stone.” Verghese’s topic – “Touching Where it Hurts: The Role and Ritual of the Bedside Exam.” The Annual Meeting is free to all WSMA members, but attendees must register. Registration and program details will follow shortly. Check www.wsma.org.

Be sure to order your copy of the 2012 Official Membership Directory of the Washington State Medical Association. The WSMA Membership Directory lists WSMA member physicians alphabetically with name, specialty, address, phone, fax and email. The publication also includes a list separated by specialty and county. Other useful resources such as clinics, hospitals and other references that busy practices and the medical community refer to daily are also included. Directories can be purchased for $55.00 via the Online Member Center at www.wsma.org or by calling the WSMA Seattle office 1.800.552.0612 or 206.441.9762. There is no limit to the number of directories you can purchase for your office, however, supplies are limited so be sure to place your order today.

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PRESENTED BY PROVIDENCE SPOKANE HEART INSTITUTE

Current Trends in Cardiovascular Disease XIV A Primary Care Approach Saturday, April 14 8 a.m. – 4 p.m. Spokane Convention Center 334 W. Spokane Falls Boulevard, Spokane Category 1 CME

This program will focus on providing current practical guidelines for differential diagnoses, proper evaluation, and treatment of common cardiovascular clinical challenges. Providence Health Care is accredited by the Washington State Medical Association CME Accreditation Committee to sponsor continuing medical education activities for physicians. Providence Health Care designates this live educational activity for a maximum of 6 hours in Category 1 to satisfy the re-licensure requirements of the Washington State Medical Quality Assurance Commission. Providence Health Care designates this live educational activity for a maximum of 6 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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FYI

In the News

More Than a Medical School - Big projects like the expansion of medical education at WSU Spokane don't happen without strong support and strategic partners. A group of volunteers from communication, healthcare and higher education organizations have developed a new resource for the community to stay informed on the Academic Health Science Center. MoreThanAMedicalSchool.com shows how this project is more than an extension of the UW School of Medicine - it's a partnership and collaboration among business, educational and civic organizations, working to transform the future of health care here in Spokane. Medical, dental, pharmacy and nursing students will all benefit and study together at the Riverpoint Campus.

Dr. Jeffery Snow retires

SCMS Leadership Advocates for Members in Olympia - It was impressive that over 65 people with the Greater Spokane Incorporated delegation, including Anne Oakley, MD SCMS President Elect, traveled across the mountains to communicate support for a regional legislative agenda in January. The top priority of the group was to secure the remaining funds for the construction of the Biomedical and Health Science Building on the Riverpoint Campus. They also communicated their support for various transportation, higher education, K-12, economic development and health and human services issues and projects

The Spokane Eye Clinic is pleased to wish Dr. Jeffery Snow, M.D. (former SCMS President in 1990) a wonderful retirement that was effective January 1, 2012. After thirtytwo years of private practice medicine at the Spokane Eye Clinic, Dr. Snow said his two strongest memories are; (1) The joy of serving many wonderful patients and (2) The pleasure of collegiality within the extraordinarily fine Spokane Medical Community of talented, dedicated MDs, DOs, PAs, and Nurses. He is quoted as saying, “I will miss the daily challenges and intellectual stimulation, but new challenges await. Thank you all�. Happy Travels, Doctor and Mrs. Snow.

The 2012 WSMA Legislative Summit in Olympia was well attended by Spokane County Medical Society physicians including Terri Oskin, Thomas Schaaf, Anne Oakley, J. Courtney Clyde, Brian Seppi and Dean Martz.

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Continuing Medical Education Promoting Healthy Families (Practice Management Alerts from the American Medical Association ) is designed to help physicians successfully talk about healthy behaviors with their adult patients in a way that may spark—and help sustain—positive changes for the whole family. The continuing medical education activity includes a video module, a detailed monograph and patient handout. These activities have been certified for AMA PRA Category 1 CreditTM. For more information www.ama-assn.org. Update in Pain Management 2012: This 2.75 hour AMA Category I CME seminar is sponsored by the Spokane County Medical Society. This activity has also been reviewed and is acceptable for up to 2.75 Prescribed credits by the American Academy of Family Physicians. This conference is one of the evening workshops for the 2012 Primary Care Update and will be held on May 3, 2012 at the Red Lion Inn at the Park. Contact Jennifer Anderson at (509) 325-5010 or email jennifer@spcms.org for more information.

Chronic Opioid Therapy: Join Group Health and Spokane area healthcare providers for a CME program focused on Group Health’s guideline-based approach to managing the challenges of chronic opioid therapy. We will demonstrate treatment techniques for handling difficult situations and describe how we risk-stratify patients and track the development of care plans to comply with new state guidelines and other changes in our practice. Wednesday, April 11, 2012, 6:00–8:30 p.m. The Davenport Hotel, 10 South Post Street, Spokane Complimentary (includes parking and buffet dinner) Information and registration: cmetracker.net/ GHC/Catalog Questions call (509) 241-7146 This activity has been approved for AMA PRA Category 1 Credit™

Primary Care Update: Friday, April 29 – Saturday, April 30 Red Lion Hotel at the Park, 303 W. North River Drive, Spokane Now in its 29th year, this well-established update is a tremendous opportunity for physicians and other health professionals to choose from more than 20 CME sessions and workshops designed specifically for primary care practitioners. This activity has been reviewed and approved for up to 23.25 Prescribed credits by the American Academy of Family Physicians. For more information call (509)358-7640 or e-mail ahec@wsu.edu.Online Brochure & Registration: http://extension.wsu.edu/ahec/Pages/PCU2012.aspx

Meetings, Conferences and Events Institutional Review Board (IRB) – Meets the second Thursday of every month at noon at the Heart Institute, classroom B. Should you have any questions regarding this process, please contact the IRB office at (509) 358-7631.

Caduceus Al Anon Family Group – Meets every Thursday evening from 6:15 pm until 7:15 pm at 626 N. Mullan Road, Spokane, WA. Non-smoking meeting for spouses and significant others of Healthcare Providers who are in recovery or who may need help seeking recovery. Facilitated 12 Step Al Anon Format. No dues or fees. Contact (509) 928-4102 for more information. Physician Family Support Group — Physicians, physician spouses or significant others, and their adult family members share their experience, strength, and hope concerning difficult physician family issues which may include medical illness, mental illness, addictions, work-related stress, life transitions, and relationship difficulties. The meetings are on Tuesdays from 6:30 pm – 8 pm at Sacred Heart. Format: 12 Step principles for everyone, confidential and anonymous personal sharing; no dues or fees. Contact Bob or Carol at (509) 624-7320 for more information.

Health Information Exchange Panel: Regional Projects Aimed at Creating an Integrated Patient Medical Record Monday, March 12, 5:30 to 7:30 p.m. – Red Lion Hotel at the Park (no cost, light refreshments served) As hospitals and providers begin to determine the type and functionality of patient information that they need to reduce the cost and provide better care for their populations; the panel will discuss specific and broad solutions for discussion among rural and urban providers. Each panelist will present for 10-15 minutes with an overview of their program then the moderator would ask several questions for each panel member to address with an open Q&A to follow. Content Questions Contact: Keith Baldwin, Spokane County Medical Society, (509) 325-5010 x24 or keith@spcms.org Registration: http://www.regonline.com/rhc2012 More Info: http://extension. wsu.edu/ahec/Pages/conf2012.aspx .

10th NW Regional Critical Access Hospital Conference: 3/13/12 Red Lion Hotel at the Park, 303 W. North River Drive, Spokane This one-day conference is designed specifically for CAH administrators, staff, clinicians, and board members. Experts present on the federal update, ACO impact on CAHs, out migration of patient care, board leadership, mental health and telemedicine, and more. Registration Fee $75. This conference is produced and supported by state offices of rural health for Alaska, Idaho, Montana, Oregon, and Washington. For more information call 509.358.7640 or e-mail ahec@wsu. edu. Online Brochure & Registration: http://extension.wsu.edu/ ahec/Pages/conf2012.aspx Continued on page 18

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Buprenorphine in the Treatment of Opioid Dependence March 13, 2012 Red Lion Hotel at the Park 303 W North River Dr 7:30 AM to 5:00 PM Program Overview: Washington State is currently facing an epidemic of addiction and deaths related to the use of prescription opioids. This course aims to help physicians and their clinical teams improve their care of patients with chronic pain and addiction. Recent legislation, Washington State HB 2876 requires physicians to have four hours of education on long acting opioids. This course will satisfy the requirement. Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending. Register online at the 25th NW Regional Rural Health Conference Website: http://extension. wsu.edu/ahec/Pages/conf2012.aspx . Follow instructions to register for the NW Regional Rural Health Conference and an option will appear for this training. The cost is $65.00 includes materials, breakfast, and lunch. Registration closes March 7, 2012. The course is limited to 50 participants. This course combines on-line training and face-to-face training. Before attending this session, participants should go to the PCSS-B website at pcssb.org and complete the 5 required modules listed under the header “half and half training modules’. Contact mccatlin@ uw.edu for questions.

25th NW Regional Rural Health Conference: 3/14-15/12 Red Lion Hotel at the Park, 303 W. North River Drive, Spokane The Northwest's largest conference on rural health always strives to stay abreast of current policy and regulatory developments at the federal, regional, state and local levels which impact healthcare delivery. Join colleagues from Washington, Oregon, Idaho, Montana, and Alaska to share strategies and cutting edge ideas, discuss innovations and out-of-the-box ideas, and share success stories. Registration fees range from $125 to $245. Scholarships are available by lottery. For more information call (509)358-7640 or e-mail ahec@wsu.edu. Online Brochure & Registration: http://extension.wsu.edu/ahec/Pages/conf2012.aspx

WSMA Practice Management Seminar ICD-10-CM GUIDELINES & PRIMER This workshop will provide much deeper and broader training in ICD-10-CM coding guidelines and protocols, focusing on specific chapters. Emphasis will be placed on understanding the differences between the old and the new coding systems, and specifically on the documentation requirements. Includes practical hands-on coding exercises. Accurate use and understanding of ICD-10 codes will drive appropriate reimbursement for your services, as health insurers and entitlement programs transition to the new coding protocols. Please bring your ICD-10 book. 12:30 – 4:30pm. Check in and on-site registration begins ½ hour before start time. Spokane Valley: Friday, March 16 Spokane Valley Hospital 12606 E. Mission Avenue WSMA and WSMGMA members $189 per person and may sponsor staff in the same practice for the member rate. Three or more members or sponsored staff from the same practice may register for a

group discount of $169 per person. Cancellations received within five full business days prior to the seminar receive a full refund. Cancellations thereafter receive a refund less a $50 cancellation fee. Space is limited, so register early! Register online at www.wsma.org/ memresources/seminars.html Questions? Contact Jenelle Dalit by phone at 1-800-552-0612 or jcd@wsma.org

Physician Leadership Resources Books A link for any of the resources listed can be found at the SCMS website (www.spcms.org) Leadership Resources tab.

The Complete Guide to Physician Relationships Based on extensive research and an in-depth survey of nearly 200 physicians, The Complete Guide to Physician Relationships outlines exactly what information physicians want and how they want to receive it from healthcare leaders, peers, marketing executives, and physician relations representatives. Get the critical data that you need to succeed with your physician relations, referral, and communication efforts.

The Healthcare Executive's Guide to ACO Strategy: A Healthcare Management Resource The Healthcare Executive's Guide to ACO Strategy is the first comprehensive book dissecting the integral components of ACOs from physician, provider, and payer views, including analysis of the CMS final regulations.

Attention Bloomsday Attention Runners Bloomsday & Walkers Runners & Walkers Need a safe place to leave

your warm-up suit? Need a safe place to leave your warm-up suit? Would you like a little something to eat or drink before the race? Would you like a little something to eat or drink before the race? This year UBS - The Prewitt Group, an SCMS Community Professionals - The of Prewitt Group, This year UBS Partner, is providing a secure, warm an SCMS Community of Professionals downtown location for all SCMS Partner, is providing a secure, warm members and their families and friends downtown location for all SCMS before and after the race. members and their families and friends before and after the race.

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Watch for more details! Watch for more details!


The following physicians/physician assistants have applied for membership, and notice of application is presented. Any member who has information of a derogatory nature concerning an applicant’s moral or ethical conduct, medical qualifications or such requisites shall convey this to our Credentials Committee in writing 104 S Freya St., Orange Flag Bldg #114, Spokane, Washington, 99202.

PHYSICIANS PRESENTED A SECOND TIME Balasubramanian, Ambalauanan, MD Internal Medicine Med School: Tirunelvcli Medical College (2000) Practicing with Apogee Physicians (Deaconess & Valley) since 2/2012

PHYSICIANS

Bullard-Berent, Jeffrey H., MD Pediatrics Med School: Wayne State U (1987) Practicing with Spokane Emergency Medicine beginning 3/2012

Abadir, Janet S., MD Surgery Med School: UMDNU- Robert Wood Johnson Medical School (2000) Internship/Residency: U of California, Irvine (2005) Practicing with Surgical Specialists of Spokane beginning 4/2012

Cackowski, Patricia M., MD Family Medicine Med School: Wayne State U (1978) Practicing with Rockwood Clinic since 2/2012

Baker, Drostan G., MD Family Medicine Med School: St. Matthews U (2009) Internship/Residency: Family Medicine Spokane (2012) Practicing with Rockwood Liberty Lake Clinic beginning 8/2012 Call, Jason A., MD Radiation Oncology Med School: Medical College of Wisconsin (2007) Internship: Aurora St. Luke’s Medical Center (2008) Residency: Mayo Clinic (2012) Practicing with Cancer Care Northwest beginning 7/2012 Conklin, Alissa, MD Obstetrics and Gynecology Med School: Southern Illinois U (2008) Internship/Residency: Indiana U (2012) Practicing with Rockwood OB/GYN Center beginning 8/2012 McCarthy, Anne Marie, MD Pediatrics Med School: St. George’s U (2004) Internship/Residency: U of New Mexico (2007) Practicing with Providence Medical Group Hawthorne since 2/2012 Monday, Kimberly E., MD Neurology Med School: Baylor College of Medicine (1992) Internship/Residency: Baylor College of Medicine (1996) Fellowship: Emory U (1997) Practicing telemedicine with Providence Medical Group - Stroke and TIA Center since 1/2012 Nakave, Abhijeet, MD Internal Medicine Med School: Seth GS Medical College, India (2003) Internship/Residency: Eastern Virginia Medical School (2011) Practicing with Apogee Physicians beginning 4/2012 Sharp-Saunders, Jennifer L., MD Pediatrics Med School: Baylor College of Medicine (1998) Internship/Residency: Baylor Affiliated Hospitals (2002) Practicing with Rockwood Liberty Lake Clinic beginning 6/2012

Germino, Kevin W., MD Pediatrics/Pediatric Emergency Medicine Med School: Northwestern U (2006) Practicing with Spokane Emergency Medicine beginning 3/2012 Hoehler, Amanda E., MD Pediatrics/Pediatric Emergency Medicine Med School: U of California, Irvine (2002) Practicing with Spokane Emergency Medicine since 2/2012 Jasman, Lora L., MD Internal Medicine Med School: U of Washington (1985) Practicing with Rockwood Clinic since 1/2012 Keats, John R., MD Obstetrics and Gynecology Med School: Brown U (1978) Practicing with Deaconess Perinatal Services since 2/2012 Le, Minh H., MD Family Medicine Med School: State U of New York (1999) Practicing with Riverstone Family Health since 1/2012 Ruiz, James A., MD Obstetrics and Gynecology Med School: U of California, San Diego (1986) Practicing with Deaconess Perinatal Services since 2/2012

PHYSICIAN ASSISTANT Garcia, James L., PA-C Physician Assistant School: U of Washington, Medex Northwest (2009) Practicing with Providence Health Services dba NW Heart and Lung Surgical Associates since 2/2012

PHYSICIAN ASSISTANT PRESENTED A SECOND TIME Jones, Christina L., PA-C Physician Assistant School: U of Washington, Medex Northwest (2011) Practicing with Cancer Care Northwest since 12/2011

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POSITIONS AVAILABLE PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatricians to join us in Spokane, the urban center of spectacular eastern Washington. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs. Contact: Mark Rearrick, mark.rearrick@providence.org, (509) 4746605, www.providence.org/physicianopportunities. PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS) Enjoy a quality life/ work balance and excellent benefits including competitive pay, generous personal time off, no hospital call, CME reimbursement, 401(k), full medical and dental, NHSC loan repayment and more. To learn more about physician employment opportunities, contact Toni Weatherwax at (509)444-8888 or hr@chas.org. QTC MEDICAL GROUP is one of the nation’s largest private providers of medical disability evaluations. We are contracted through the Department of Veterans Affairs to manage their compensation and pension programs. We are currently expanding our network of Family Practice, Internal Medicine and General Medicine providers for our Washington Clinics. We offer excellent hours and we work with your availability. We pay on a per exam basis and you can be covered on our malpractice insurance policy. The exams require NO treatment, adjudication, prescriptions to write, on-call shifts, overhead and case file administration. Please contact Gia Melkus at 1-800-260-1515 x5366 or email gmelkus@qtcm.com or visit our website www.qtcm. com to learn more about our company. PRIMARY CARE INTERNIST WANTED (Pullman) - Immediate opportunity for BE/BC primary care internist to join a privately owned, multi-specialty, physician practice. Palouse Medical offers a competitive employment package, guaranteed first year salary, comprehensive benefits and partnership potential. Dedicated to delivering quality care, we are proud to offer an extensive array of patient services and on-site laboratory and imaging departments. We can’t wait to introduce you to the communities that we love and serve. Call Theresa Kwate at (509) 332-2517 ext. 20 or email tkwate@palousemedical.com. Contact us today and discuss your future at Palouse Medical! FAMILY MEDICINE SPOKANE Immediate opening with Family Medicine Spokane (FMS) for a full time BC/BE FP physician who has a passion for teaching. FMS is affiliated with the University of Washington School of Medicine. We have seven residents per year in our traditional program, one per year in our Rural Training Track and also administer OB and Sports Medicine Fellowships. This diversity benefits our educational mission and prepares our residents for urban & rural underserved practices. We offer a competitive salary, benefit package and gratifying lifestyle. Please contact Diane Borgwardt, Administrative Director at 509-459-0688 or e-mail at BorgwaD@fammedspokane.org.

CONTRACT BACK-UP PHYSICIAN 4 + HOURS/MONTH Octapharma Plasma is hiring a Contract Back-Up Physician in our Spokane, WA Donor Center! This position requires just 4 hours per month. GENERAL DESCRIPTION Provide independent medical judgment for issues relating to donor safety, health and suitability for plasmapheresis and immunization. Provide federal and international mandated training and supervision of donor center medical staff to assure compliance with applicable laws. We provide on-the-job training. WHO IS OCTAPHARMA PLASMA? Octapharma Plasma, Inc. is dedicated to improving the health and lives of people worldwide. OPI owns and operates plasma collection centers critical to the development of life-saving patient therapies utilized by thousands of patients globally. Learn more at www.OctapharmaPlasma.com! APPLY TODAY! Apply today by sending your resume/CV to Careers@ OctapharmaPlasma.com! PREMIER CLINICAL RESEARCH, an independent dedicated research facility here in Spokane with 20 years of research experience is looking for a Pediatrician to be a part of our physician network for future studies. For more information please contact: April Gleason, Director of Business Development, (509) 390-6768, premierclincalresearch@gmail.com. PROVIDENCE SACRED HEART CHILDREN’S HOSPITAL (Spokane, WA) is seeking a BE/BC Pediatric Hospitalist to join our inpatient team. Be part of an exceptional care-team serving children from four inland Northwest states. Work closely with the Pediatric Trauma Center, general pediatric unit, PICU, NICU (level III), and Pediatric Surgery known for exemplary care. Strong cross-specialty support, state-of-the-art equipment and technology, and wonderful quality of life in sunny eastern Washington. Competitive compensation and excellent benefits package, including relocation. Sacred Heart Medical Center and Children’s Hospital has 623 beds, a medical staff of more than 900 and a service area population of about 1.5 million. The children’s hospital alone includes more than 90 pediatric sub-specialists. Learn more: Mark Rearrick, Providence physician recruiter, (509) 474-6605, mark.rearric@providence.org, www.providence.org/ physicianopportunities. PROVIDENCE HEALTH & SERVICES is building its Urgent Care presence in Spokane. We are recruiting for BE/BC Urgent/ Immediate Care physicians and advanced practice providers (nurse practitioners and physician assistants welcome to apply). This is a great opportunity to join a growing employed medical group in beautiful eastern Washington. The exceptional Providence care team is implementing a system-wide standardized EHR and providers benefit from shared best practices and robust clinical and business support. Providence already operates hospitals, residency programs and numerous primary care and specialty clinics in Spokane. Competitive compensation and excellent benefits package, including relocation. Learn more: Mark Rearrick, Providence physician recruiter, (509) 4746605, mark.rearrick@providence.org, www.providence.org/ physicianopportunities.

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REAL ESTATE Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom Luxury Condos at the City View Terrace Condominiums are available for rent or purchase. These beautiful condos are literally within walking distance to the Spokane Hospitals (1/4 mile from Sacred Heart, 1 mile from Deaconess). Security gate, covered carports, very secure and quiet. Newly Remodeled. Full appliances, including full-sized washer and dryer. Wired for cable and phone. For Rent $ 850/month. For Sale: Seller Financing Available. Rent-to-Own Option Available: $400 of your monthly rent will credit towards your purchase price. Please Contact Dr. Taff (888) 930-3686 or dmist@inreach.com. For Sale: 17718 E Linke Rd, Greenacres WA $649,900 Elegance redefined featuring a custom-built rancher and horse property situated on 5 breathtaking acres. For you over 3,800 sq feet, opulent master bedroom, formal dining, open floor plan & a gourmet kitchen. For your horses a 56’ x 48’ metal show barn, heated tack room, 12x12 wash area, 11 matted stalls, mechanical horse walker. Everything to accommodate you & your equestrian needs. Offered by John L Scott Real Estate – John Creighton at (509) 979-2535. For a virtual tour www.tourfactory.com/709316.

South Hill – on 29th Avenue near Southeast Boulevard - Two offices now available in a beautifully landscaped setting. Building designed by nationally recognized architects. Both offices are corner suites with windows down six feet from the ceiling. Generous parking. Ten minutes from Sacred Heart or Deaconess Hospitals. Phone (509) 535-1455 or (509) 768-5860. Office space located at 1315 North Division. This location is two miles north of downtown Spokane and just west of Gonzaga and the university district. It consists of 902 sq. ft. and rents for $1015 per month plus 20% of the building Avista and City of Spokane bills. The rest of the building is occupied by a physiatry and pain management medical practice. The space would be ideal for an ancillary medical, chiropractic or therapeutic clinic. Parking is ample and convenient. The space has a nice waiting area and receptionist-enclosed area, with several office, storage or exam rooms. Call (509) 321-2276 for more information or for a showing of your ideal location.

MEDICAL OFFICES/BUILDINGS Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old. Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820. Northpointe Medical Center Located in North Spokane, the Northpointe Medical Center offers modern features, and generous parking. The facility is now open to nonmedical, professional tenants. The leases are full service with flexible lengths and tenant improvement allowances. Annual rental rates start at $20/sq ft. The available suites range from 1,072 to 2,707 rentable square feet. One suite is move-in ready. If interested, please contact Mann Jones at (509) 755-7526. Sublease: Furnished Medical Office Space ~ Need immediate space for one or more north Spokane care providers? This shared suite is ready for occupancy; all furniture and exam room equipment included. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/sq ft; will negotiate lower rate. Excellent location in a fullservice medical building with lab and full radiology services. For more information, call (509) 981-9298.

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Medical Director and Physician Airway Heights Corrections Center (AHCC) SALARY: UP TO $172,920 ANNUALLY PLUS EXCELLENT BENEFITS PACKAGE* The WA State Department of Corrections Health Services Division is seeking highly motivated individuals for the critical roles of Medical Director and Physician for our Airway Heights Corrections Center (AHCC) located 10 miles west of Spokane, WA. The Medical Director is responsible for directing the healthcare programs and services at the facility. The Medical Director and Physician are responsible to: • Supervise and participate in medical treatment of consulting physicians and other providers. • Perform diagnosis and treatment of diseases and injuries of patients at the institution. • Work in collaboration with others to ensure staff and resources are in place to provide offenders with appropriate and timely medical services consistent with established standards. • Create a work environment that values high ethical standards, emphasizes safe, high quality medical care, nurtures teamwork and encourages activities which lead to continuous improvement. The successful candidates will have: · Valid license to practice medicine and surgery in the State of Washington (or the ability to obtain prior to employment). · Completion of an approved residency program. · Board certified or board eligible. · Possess strong interpersonal skills and experience in directing medical operations. · Exceptional communication skills with the ability to communicate orally and in writing with a variety of individuals ranging from correctional administrator and staff, health care professionals to patient advocates and other laypersons. Compensation Package* Your paycheck is just part of your total compensation. Employees also have access to an outstanding benefits package to include medical, dental, vision, and retirement plans. We also provide TORT claim coverage. Mission Our mission is to provide medically- necessary health care that promotes wellness. Vision We are a team of committed professionals supporting successful re-entry through a patent focused integrated system of care. To apply: For questions or to apply, email your resume and a letter of interest to Jamie.robinson@doc.wa.gov or call (360) 413-5435.

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GONZAGA MBA In Healthcare Management

Because Better Business Means Better Care Gonzaga is committed to developing innovative and ethical leaders with the ability to think criticially about the current challenges facing the healthcare industry. MBA & MACC PROGRAMS

Learn More At An Upcoming Information Meeting: Tuesday, March 6th 5:30 - 7 PM at Gonzaga’s Jepson Center

RSVP at www.gonzaga.edu/mbainfomtg March SCMS The Message 24


SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING 104 S FREYA ST STE 114 SPOKANE, WA 99202

PRSRT STD U.S. Postage

PAID

Spokane, WA Permit No. 512

ADDRESS SERVICE REQUESTED

Printed on GP Spectrum速 Paper: Certified by the Sustainable Forestry Initiative. Please recycle.

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