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Treating Our Family & Yours

Health Information Technology: A link to today and tomorrow

Volume 26, No. 1 The Journal of the Arizona Osteopathic Medical Association Winter 2011

INSIDE

■■Health IT Perspectives from an AOMA Member, MICA, AzHEC & AHCCCS ■■D.O. Day at the Legislature – February 15, 2011 ■■AOMA 89th Convention – April 5th – 9th, 2011


2010-2011 Board of Trustees President Kelli M. Ward, D.O., M.P.H. President Elect Jan Zieren, D.O., M.P.H.

Contents

Volume 26 No. 1

W int er 2011

Immediate Past President

Features

Lori A. Kemper, D.O., M.S.

Health Information Technology Special Feature

Vice President Thomas E. McWilliams, D.O. Secretary/Treasurer Craig M. Phelps, D.O. Executive Director Amanda L. Weaver, M.B.A. Trustees Craig R. Cassidy, D.O. Bradford Croft, D.O., M.B.A. Donald J. Curran, D.O. William H. Devine, D.O. Michelle E. Eyler, D.O. Jonathon Kirsch, D.O. Christopher J. Labban, D.O. Lawrence R. LeBeau, D.O. Julie A. McCartan, D.O. Jeffrey Morgan, D.O., MA Adam S. Nally, D.O. Kristin Nelson, D.O. Wendell B. Phillips, D.O. Vas Sabeeh, D.O. Paul M. Steingard, D.O. Anthony Will, D.O. Resident Trustee Jennifer Holmgren, D.O. Student Trustees Mathew Loesch, AZCOM Joshua Behlmann, Ph.D, KCOM Speaker of the House of Delegates John F. Manfredonia, D.O. Vice Speaker of the House

8  AOMA Member Perspective: The Electronic Health Record Reality 10  AzHeC: Meaningful Use: It’s Here – Are You Ready? 13 MICA: The Three “Cs” of Documentation 15 AHCCCS’ Role in Health Information Technology 16 Sonora Quest: The Importance of Structured Lab Data AOMA Events 22 Fall Seminar Highlights 36 D.O. Day at the Legislature 38 Student Clinical Case and Poster Competition 40  AOMA’s 89th Annual Convention Information and Registration Columns 4 President’s Message 6 From the Desk of the Executive Director 7 What We Have Done For You Lately 17  Practice Management: Are Non-Competition Agreements Enforceable or Not?

20 Welcome New AOMA Members 23 AOMA Business Partners Ost eopathic Community News 27 AzACOFP President’s Message 28 Midwestern University / AZCOM 31 A.T. Still University 35 Tucson Osteopathic Medical Foundation 46  Calendar of Events – Classified Ads – Advertisers Index

James W. Cole, D.O.

AOMA Staff Listing Assistant Director & Managing Editor Flannery H. O’Neil, MPH Member Services Manager Sharon Daggett Administrative Assistant Teresa Roland

Opinions expressed in the AOMA Digest are those of authors and do not necessarily reflect viewpoints of the editors or official policy of the AOMA, or the institutions with which the authors are affiliated unless explicitly specified. AOMA Digest does not hold itself responsible for statements made by any contributor. We reserve the right to edit articles on the basis of content or length. Although all advertising is expected to conform to ethical medical standards, acceptance does not imply endorsement by this magazine. The appearance of advertising in the AOMA Digest is not an AOMA guarantee or endorsement of the product, service or claims made for the product or service by the advertiser. Copyright 2011

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AOMA Digest Winter 2011


President’s Report Winter 2010-2011

presiDent’s message

P

racticing medicine

or because they didn’t want to wait 2-3 hours until their

in times of change –

appointment at the primary care office or because the urgent

how do are we

care where they went first was staffed with someone who was

doing? Parts of the

unable to care for the issue that brought them in. While many

health care law went

patients still feel that health care is a privilege, many believe it is

into effect on January 1,

a right and a right that they do not have to pay for, wait for, or

2011. I hear on the news

think about how many times they see a different physician the

about how much these

same day for the same problem. I am not sure about you, while

new provisions have

I agree that there may be an increase in access to care, I wonder

improved the system,

how this thinking can lead to cost-savings in health care.

but I have yet to see any I hope that osteopathic physicians in Arizona and

great changes trickle down to my practice,

Kelli M. Wa rd, D.O. M. P. H.

or hear much about it

2010-2011 AOMA President

throughout the United States will remain (or become) motivated in the political process as it is the only way to affect

from my patients. We

any visible, lasting change. My hope is that our vision and

seem to hear a lot of

the osteopathic philosophy of caring for the whole person –

information on TV and on the radio and read a great deal on

mind, body, and spirit – will enlighten our political leaders and

the internet and in the newspaper, but in the trenches, not

enable them to empower us, our patients, and themselves to

much has changed. Are we shell-shocked? Have we simply

continue to make changes in health care that will benefit all

resigned ourselves to continue to provide care no matter

concerned. We need to be at the forefront of this educational

what the environment? Do we just go to work and try not to

process. If we do not make time to reach out to the people

think about it?

who hold our professional futures in their hands, we may be mired with something that makes it impossible for us to

I have seen some changes in my community. Several

continue in the manner in which we are accustomed.

primary care physicians have changed their jobs. One has become the chief medical officer at the hospital, another

In this new year, set goals for yourself and help me achieve

has stopped doing office work all together and only takes

goals for our organization. Don’t be complacent. Build

hospitalist shifts, and even I am changing my role as a

coalitions with other osteopathic physicians. The AOMA

physician – transitioning from a traditional office family

is helping to strengthen the profession by working with

practice to doing shifts in the emergency department and

the Utah Osteopathic Association to build their leadership

serving an academic role as a director of medical education.

structure. Don’t underestimate the power of the osteopathic

Has the new health care law played a role in this? I believe it

vision and don’t under-communicate that vision. Join with

has. The uncertainty makes change appealing to some of us.

me and with the other members of the AOMA – together we are stronger. Keep your eyes and ears open for opportunities

What’s more, I have noticed a change in the way patients

to form new partnerships and collaborations to help not only

perceive the health care they seek – especially in the emergency

survive, but to thrive, while practicing osteopathic medicine in

room. Many come to the ER because they have no insurance

these times of change!

Visit the AOMA’s President’s Blog at www.az-osteo.blogspot.com to read more and add your opinions.

AOMA Digest Winter 2011

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From the Desk of the Executive Director

Health Care Reform Begins!

T

his year, 2011 will be a landmark year for changes in the

his experiences with

delivery of healthcare. AOMA hosted an excellent forum

implementing an EHR

on Health Care Reform at the Fall Seminar. Presentations

system. Please see his article on page 8.

were given by American Osteopathic Association (AOA) President Karen Nichols, D.O.; Arizona Health Care and Cost Containment System’s (AHCCCS) Medical Director

Is Health Information Exchange (HIE) in Arizona possible?

Marc Leib, M.D., J.D.; and Mutual Insurance Company of Arizona (MICA) Chief Executive Officer James Carland, M.D. AOMA President Kelli Ward, D.O. has an excellent article

There are several

addressing health care reform on page 4.

laws in Arizona that will need to be changed so

The role of Health Information Technology The effective delivery of health care requires Health Information Technology (HIT). Patient safety and quality

that Health Information

Amanda L . Weaver, M. B.A.

Exchange (HIE) can

AOMA Executive Director

occur. All healthcare

of care will be improved. Approximately 35% of medical

provider groups will be working with the legislature so that

practices in Arizona have implemented Electronic Medical

health information can be exchanged. A bill has been in the

Records (EMR). There will be incentives from Medicare

2011 legislature. HIE includes the physicians EMRs sharing

($ 44,000) and Medicaid ($ 63,750) for physicians who have

i nformation with hospitals, labs, other physicians offices and

achieved “Meaningful Use.” Please refer to articles on

other healthcare providers and vice versa. All of the systems

pages 8 and 10.

need to be able to “talk” to each other. The end result is true continuity of care for patients and increased patient safety. Please refer to article on page 16 about Sonora Quest Labs

The importance of “Meaningful Use” AOMA has a standing seat on the board for Arizona Health-e Connection (AzHEC) which consists of a variety

efforts in this area.

in Arizona. AzHEC, via its Regional Extension Center

AOMA’s Of fice Managers Institute to provide HIT education

(REC), has been charged with working with physicians to

The practice administrators and office managers are key

achieve Meaningful Use. They will provide resources to assist

players in physicians’ offices having smooth transitions

physicians. Please refer to the article on page 10.

implementing and/or understanding how EMRs can

of stakeholders who are helping to promote HIT and HIE

dramatically impact the practices, in a good way. The initial meetings will be held on March 8th in Phoenix and March

AOMA Ambassador Adam Nally, D.O. has been nominated by AOMA and selected by Arizona Health-e Connection as a EHR ambassador. He is giving presentations to physicians on

AOMA Digest Winter 2011

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10th in Mesa. Please contact Flannery at 602-266-6699 or flannery@az-osteo.org for more information. Happy New Year!


What We Have Done For You Lately

“What We Have Done For You Lately” This regular feature of the AOMA Digest provides members with a recent update of the Association’s activities. We are representing the profession as a healthcare stakeholder and are a voice and are “at the table.” This covers the six month period from July 1, 2010 – January 15, 2011.

Advocacy/Government Relations

Healthcare Community Leadership

• Met with governor Jan Brewer and other healthcare leaders

• Arizona Health-e Connection – Executive Director

to discuss the budget crisis.

representing AOMA is treasurer, a member of the Executive

• Participated in stakeholder meetings for several non-

Committee and Board, and member of several task forces.

physician clinicians’ expansion of scope sunrise applications.

• Executive Director representing AOMA is on the board

• President Kelli Ward, D.O. testified at the Joint Legislative

of Health Services Advisory Group (HSAG), Medicare’s

Review Committee (JLRC) opposing or expressing

Quality Improvement Organization (QIO).

concerns on expansions for pharmacists administering immunizations for children, Physicians Assistants (P.A.)

Membership/Member Services

prescribing controlled substances for more than 14 days,

• Added seven new members during this period.

and naturopaths administering “nutrients” via IV.

• Co-hosted a Member Forum on “Meaningful Use”. • Hosted an Office Manager Summit on the Federal Trade

American Osteopathic Association (AOA)

Commission’s (FTC) Red Flags Rule.

• Participated in the AOA’s Annual House of Delegates

• Added new Business Partner:

Meeting. AOMA Past President Karen J. Nichols, D.O.,

MD Tech Pro – provides technology and EMR support

MA, MACOI was installe d as the AOA’s President.

services for medical practices, physician offices and healthcare facilities.

• Executive Director serves on the Bureau of State Government Affairs. Charles Finch, D.O.

Students – the future of the profession

Community Service

• Announced the Student Clinical Case and Poster Competition for all third and fourth year osteopathic medical students in Arizona. For more information, please turn to 38.

• AOMA’s staff collected clothing and children’s items for a holiday donation to the Sojourner Center.

Education • Provided 12 hours of high quality AOA Category 1-A continuing medical education at the Fall Seminar at the Omni Tucson.

Licensed D.O.s in Arizona ­— 2006–2010 LICENSING – DO

FY06 actual

FY07 actual

FY08 actual

FY09 actual

FY10 actual

FY11 target

Number of licenses (on June 30 each yr)

1,987

2,167

2,262

2,399

2,426

2,432

181

215

189

191

186

200

Number of new licenses issued in FY

7

AOMA Digest Winter 2011


Features – AOMA Member Spotlight

The Electronic Health Record Reality By Adam S. Nally, D.O.

Y

es, I confess, I am an EHR enthusiast. I’ve even been called a “poster boy” for the electronic health record. So, why aren’t you? Oh, I’ve heard your complaints:

“An Electronic Health Record is much too expensive for my practice.” “I can see patients faster without a computer.” “You ‘computer people’ never look up from the screen to talk eye to eye with your patients.” “I can write faster than I can type. And, those computers, they aren’t really safe anyway!”

Yea, I’ve heard these excuses, and they’re wrong. How can I say that? Well, I’ve been using an electronic medical record, recently renamed electronic health record (EHR) for the last nine years. I guess I am considered an “early adopter” – one of those physicians crazy enough to start using a computer health record in early 2002, before the Medicare “Final Rule” or the Office of the National Coordinator for Health Information Technology (ONC) ever existed. At the time I finished residency in Family Practice, I realized that there was a vast number of menial, time consuming tasks in the office that a computer could do much more effectively. My initial interest in electronic health record was not one of conforming to the government reporting standard. My interest has been to make the practice of medicine simple, efficient, and enjoyable. In the words of Albert Einstein, “He who joyfully marches to music in rank and file has already earned my contempt. He has been given a large brain by mistake, since for him the spinal cord would suffice.”

WHAT IS YOUR MOTIVATION? Really, there were six motivating factors that convinced me going “paperless” was in my future.

Automation: In medical school and residency I found that I was often rewriting the exact same information over and over and over: “Cardiovascular exam reveals heart with regular rate and rhythm without murmur. No lifts or thrills. . .” There really are no ‘lifts or thrills’ to writing this 23 times. I found I was re-writing much of the same information multiple times Adam S. Nally, D.O. throughout the day with only a few variations between patient exams. And, if you want to get paid for evaluating it, you better record that you looked. From my recollection of basic computer programming courses taken in high school, I knew I could get a computer to legibly chart those things that I repetitively evaluate in every patient, and do it a whole lot faster than I could with my gel pen. Efficiency: I knew that my home computer could calculate my checkbook for me, and my telephone could store all my contacts at my fingertips.  Why couldn’t my office computer make the writing of chart notes easier, more legible, and then transmit that data to a pharmacy or to a lab?  Why couldn’t I have all my laboratory data in one place that I could compare and trend? Two very important things were clear.  First, doing today’s work today (and actually finishing it) seemed to make me feel better at the end of the day.  Second, I spent 13 years of my life and thousands of educational dollars learning to make difficult life-or-death decisions. I spent years being trained to access and analyze diagnostic data in order to make important physical health decision. Why, then, was the majority of my day cluttered with other time consuming clerical activities? I found that my electronic health record could streamline the reception of data for evaluation and allow me to efficiently finish all of today’s work today. Mobility: I can’t tell you how many times I have been at the grocery store or the restaurant after hours when a patient would call with a question about a lab or an x-ray I had not see or reviewed yet. If I can check my stocks, my bank account, my email and even see Lady Gaga’s “dress made of meat” over

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Features – AOMA Member Spotlight my smart phone, why couldn’t I use my phone in real time to check my charts? Well, now, I can, and I do. Via a simple phone application, I can now log in to my office and review that lab or CT scans anywhere I have cellular service. Legibility: My handwriting looks like chicken scratch, especially after a long day. The busier the day, the more hen pecked it looks. I can type 100+ words per minute, and in the last years advances in voice recognition software, I can now dictate 400-600 words per minute right into my EHR. Why am I still writing in paper charts? I’m not.   No, I don’t sit and stare at my computer, ignoring my patients while typing or dictating. My software has allowed me to created hundreds of pre-examination questions based on the patient’s chief complaint. My nurse asks and enters this information, the patient’s medications, and other pertinent history into the chart before I ever get near the exam room. Then, when ready, my nurse presents the chief complaint to me as well as the patient’s history in the room in the presence of the patient. I spend the entire time in the room communicating face to face, counseling, asking additional questions and educating my patient while my nurse or medical assistant transcribes my additional questions, exam and assessment into the computer. My plan, medications and orders are transcribed while still in the room. And with a just few keystrokes, super bills, prescriptions and detailed instructions are ready for my signature on the printer. Between patients, I can review the transcription and make any needed corrections to the note with the voice recognition dictation software that works seamlessly with my EMR. Retrieve Data, Understand Data, and Make Your Decision: Yes, data tracking, quality monitoring and electronic interchange of information appear to be the wave of medicine’s future. The powers that be want to convince us that these are the Holy Grail of EHR adoption. But that isn’t really why EHR adoption is important. You and I were trained to make decisions – often difficult decisions. Any tool that will help you rapidly retrieve data, rapidly understand that data, and then make relevant decisions based on that data is well worth significant consideration and any reasonable cost.  That’s what your EHR should do for you, and it should be fine tuned to your style. The electronic health record is NOT just a medical record in digital form. It is a tool that should allow you to do what you were trained to do much more effectively. If your EHR doesn’t do that, you need to find another piece of software. Colonoscopy Anyone? Yes, adoption of an electronic health record can be likened to a GI prep and colonoscopy without the sedation. The conversion to EHR is doable, but “it ain’t painless.” If anyone tells you otherwise, they’re lying. I spent a few weeks reviewing software companies, contracts and service plans. I evaluated web based and on site systems. I reviewed as many as I could. I played with

the demonstration models of them. Two of my favorites took up an entire Saturday while I playing with them on my home computer. Don’t take this decision lightly. Your EHR software is like a marriage. I’ve seen some bad marriages. I quickly realized which one I liked after working with the demo for over an hour. It took an entire day to load the software on each of the workstations and server in my office. It took another five days to train my staff to use the software effectively. It took us 2-3 months to recognize that the computer will change your office workflow drastically.  (It took me a week to realize that there is nothing wrong with changing the office workflow.)  It took me a month to understand that you can practice medicine “outside the box.”  The workflow methodologies you learn in medical school and residency and establish in your office are malleable. And, often, your efficiency drastically improves when you change them. There is a learning curve – it can be much bigger for some. When you accept this curve and stop fighting it, using your EHR becomes really enjoyable. Cost: Cost you say? Yes, that’s important. These systems are not cheap. They can run anywhere from $50,000–$150,000 to install. I know. Stop for a minute, take a deep breath, and check your pulse. I got palpitations, too, when the salesman quoted the price. But I realized when I did a little math that it is actually doable. • How much do you earn with each patient visit? I shot low estimating $50 per visit. • How many days do you work per month? Let’s say you only work 20 days. • So, you and your partner pick a system that costs $75,000, and the term of your loan after installation costs you each $1000 per month. How many extra patients will you each need to see per day to cover the extra loan expense? Only one extra patient per day. I found that once we began using our EHR to its full potential, I can comfortably see an extra 8-10 patients per day in the same amount of time. Murphy’s Law: The probability that the buttered side of the bread will fall face down on the carpet is directly proportional to the cost of the carpet. Hiring a database manager is essential. Your system will crash. Your system will hang. Hard drives will fail. The internet will go down. The power will go out. Your database manager does not have to be on your payroll, but should be available to you throughout the day for computer and database emergencies. What really makes it all worthwhile is when all the parts of the puzzle fall into place. Lab interface, electronic prescribing, interoffice and inter-patient communication links allow streamlining of processes. It really is possible to do today’s work today. I know... I neglected to mention the system we use in my office. We use “Praxis EMR” and we love it.

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AOMA Digest Winter 2011


Features

Meaningful Use: It’s Here–Are You Ready? CMS Incentive Payments Begin this Year for Eligible Providers Who Meet Meaningful Use Requirements for Electronic Health Records. By Melissa A. Rutala, MPH Chief Executive Officer, Arizona Health-e Connection

“Physicians don’t go into medicine because it’s easy. They go through grueling training—spending endless days and nights at the bedside or in the OR. They face tough personal and clinical decisions throughout their professional lives. They consistently have to grow and learn to keep up with the science and practice of medicine. That’s what makes them the professionals they are …The EHR is just another of the transitions that physicians are constantly called upon to make in the interest of their patients, their professional competence and their professional self-esteem.” 1 Dr. David Blumenthal, National Coordinator for Health Information Technology

C

urrently, almost 200,000 health care providers nationwide use electronic health records (EHRs). According to a survey published in the New England Journal of Medicine, 90 percent of all physicians who adopt an EHR are glad they did.2 With federal incentives now available to assist with the cost of EHR adoption, thousands more providers are considering making the switch.

Why Now? According to Dr. David Blumenthal, national coordinator for health information technology, “The federal government is making a once in a lifetime, never to be repeated, offer: it will help physicians pay for the transition [to EHRs] with up to $44,000 in extra fees from Medicare, or $63,750 from Medicaid.”3 Aside from the financial incentives to adopt EHRs, reports spanning a 20-year period cite the value of EHRs to patient care and increased system efficiencies. A 1991 report published by the Institute of Medicine (IOM) noted “early evidence indicates that the introduction and use of robust computer-based patient records (CPRs) will enhance the health of citizens and reduce the costs of care.”4 Subsequent IOM reports noted that 98,000 deaths per year are due to hospital errors5 and that “health care delivery has been relatively untouched by the revolution in information technology that has been transforming nearly every other aspect of society … information technology must play a central role in the redesign of the health care system if a substantial improvement in quality is to be achieved over the coming decades.” IOM’s Crossing the Quality Chasm contributed to the policy behind the Health Information Technology for Economic and Clinical Health (HITECH) Act, a component

of the American Recovery and Reinvestment Act of 2009 (ARRA). This legislation created an unprecedented opportunity for health information technology (HIT), with an estimated $40 billion investment in it over the coming decade.6

What is Meaningful Use? Under ARRA, the Centers for Medicare & Medicaid (CMS) incentive payments Melissa A. Rutala, MPH are available to eligible Chief Executive Officer, health care providers. In Arizona Health-e Connection order to receive incentive payments, providers must demonstrate Meaningful Use of a certified EHR system. The final rule for Meaningful Use, released July 13, 2010, focuses on the following categories: • I mproving quality, safety, efficiency and reducing health disparities •E  ngaging patients and families in their healthcare • I mproving care coordination •E  nsuring adequate privacy and security protections for personal health information • I mproving population and public health Across these five categories are individual objectives and metrics that comprise Meaningful Use. Following is a Meaningful Use Checklist for the Core and Menu Set objectives to help you assess if you have what it takes to meet Meaningful Use.

1 Blumenthal, MD, David. HealthIT Buzz Blog, Promoting Use of Health IT: Why Be a Meaningful User (April 27, 2010). Retrieved from http://healthit.hhs.gov/blog/onc/index.php/2010/04/27/promoting-use-of-health-it-whybe-a-meaningful-user/ 2 Catherine M. DesRoches, Dr.P.H., Eric G. Campbell, Ph.D., Sowmya R. Rao, Ph.D., Karen Donelan, Sc.D., Timothy G. Ferris, M.D., M.P.H., Ashish Jha, M.D., M.P.H., Rainu Kaushal, M.D., M.P.H., Douglas E. Levy, Ph.D., Sara Rosenbaum, J.D., Alexandra E. Shields, Ph.D., and David Blumenthal, M.D., M.P.P. (July 2008). Electronic Health Records in Ambulatory Care – A National Survey of Physicians. N Engl J Med 2008; 359:50-60. 3 Blumenthal, MD, David. HealthIT Buzz Blog, Promoting Use of Health IT: Why Be a Meaningful User (April 27, 2010). Retrieved from http://healthit.hhs.gov/blog/onc/index.php/2010/04/27/promoting-use-of-health-itwhy-be-a-meaningful-user/ 4 Institute of Medicine. The Computer-Based Patient Record: An Essential Technology for Health Care (1991). Washington, DC, National Academy Press. 5 Committee on Quality of Health Care in America, Institute of Medicine (1999). To Err Is Human. Washington, DC, National Academy Press. 6 Committee on Quality of Health Care in America, Institute of Medicine (2001). Crossing the Quality Chasm. Washington, DC, National Academy Press.

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Features

Table 3: Meaningful Use Checklist* Meaningful Use Core Objectives and Measures** Do you use computerized physician order entry (CPOE) for medication orders and do more than 30% of your patients have at least one medication in their medication list ordered by CPOE? Are at least 40% of your permissible prescriptions sent electronically? Do you report on ambulatory clinical quality measures (CQMs) from your EHR? Do you know how to utilize your EHR system to report on 6 CQMs (3 required, 3 elective) in order to receive EHR incentive payments? Have you implemented at least one clinical decision support rule besides drug-drug and drug-allergy interaction checks? Do you, upon request, provide at least 50% of your patients with an electronic copy of their health information with 3 business days? Do you provide clinical summaries for 50% of all office visits within three business days? Is drug-drug and drug-allergy interaction checking enabled in your EHR system? Do you record demographics, including preferred language, gender, race, ethnicity and date of birth, as structured data for more than 50% of your patients? Do you maintain an up-to-date problem list of current and active diagnoses for more than 80% of your patients, ensuring that the problem list has at least one structured entry? Do you maintain an active medication list for more than 80% of your patients? Does the medication list have at least one structured entry? Do you maintain an active medication allergy list for more than 80% of your patients? Does the medication allergy list have at least one structure entry? Do you record and chart changes in vital signs (height, weight and BP) for more than 50% of patients age 2 and over as structured data? Do you record smoking status for more than 50% of all unique patients 13 years or older? Does your EHR have the ability to exchange key clinical information among providers electronically? Have you conducted at least one test of this functionality? Have you conducted a security risk analysis for your system in the last 90 days, incorporating any available security updates and corrected all identified deficiencies?

Meaningful Use Menu Objectives and Measures*** Is drug-formulary checking enabled in your EHR system? Have you accessed at least one internal or external drugformulary from your EHR? Do you incorporate clinical lab test results into your EHR as structured data for more than 40% of all clinical lab test results? Do you generate at least one report of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach? Do you send reminders to more than 20% of unique patients 65 years or older or 5 years old or younger for preventive/ follow-up care? Do you provide more than 10% of unique patients access to their health information (lab results, problem list, medication lists, allergy list) within 4 business days of information being updated in the EHR, subject to your discretion to withhold certain information? Do you use your EHR to identify patient-specific education resources and provide such resources to more than 10% of unique patients? Do you perform medication reconciliation for more than 50% of transitions of care? Do you perform a summary of care record for more than 50% of transitions of care or referrals? Have you submitted or do you know how to submit at least one test of electronic data and follow up submission to the state’s immunization registry? Have you submitted or do you know how to submit at least one test of electronic syndromic surveillance data and follow up submission to public health agencies? * For eligible Medicaid providers, achievement of the Meaningful Use objectives and measures are waived in the 1st year of program participation. Eligible Medicaid providers will have to meet the Meaningful Use objectives and measures in their 2nd year of participation. ** All of the core objectives and measures must be met in order to receive EHR incentives. See note above for how Medicaid eligible providers are affected in their 1st year of program participation. *** A minimum of five menu objectives and measures must be met in order to receive EHR incentives, including at least one public health objective and measure. See note above for how Medicaid eligible providers are affected in their 1st year of program participation.

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AOMA Digest Winter 2011


Features

Who is Eligible for CMS Incentives? CMS offers a Path to Payment tool to assist health care providers in determining eligibility for the CMS Incentive Programs available at http://www.cms.gov/EHRIncentivePrograms/10_PathtoPayment.asp.

Is There Help Available? A barrier to EHR adoption—aside from costs, which the CMS Incentive Program seeks to address—is access to education and technical assistance to assist with an effective transition from paper-based to electronic systems and optimizing existing electronic systems to achieve Meaningful Use. To address this challenge, 62 federally funded regional extension centers (RECs) have been established nationwide to offer subsidized education and technical assistance services to eligible health care providers. In Arizona, Arizona Health-e Connection (AzHeC) was awarded funding to develop a REC program to serve Arizona’s health care providers. The program is a collaboration of AzHeC, Arizona State University’s Department of Biomedical Informatics and Health Services Advisory Group and the Purchasing and Assistance Collaborative for Electronic Health Records. Table 2 below outlines eligibility for subsidized REC services, and Table 3 details REC services. While the REC’s initial focus is on assisting providers outlined in Table 2, later this year the REC will offer services to any Arizona health care provider seeking EHR assistance.

Table 2: Professionals Eligible for Free* or Low-Cost REC Services Primary care providers (physicians, physician assistants or nurse practitioners with prescriptive privileges, practicing in family medicine, general/internal medicine, OB/GYN or pediatrics) in any of the following settings: • Individual and small group practices (ten or fewer professionals with prescriptive privileges) primarily focused on primary care • Public and Critical Access Hospitals • Community Health Centers and Rural Health Clinics • Other settings that predominantly serve uninsured, underinsured and medically underserved populations Note: Unsubsidized assistance available to all providers, subject to availability. Free services are subject to compliance to an agreed upon project plan. *Available to eligible providers who sign-up for REC membership by February 28, 2010.

Table 3: REC Services • Education • Project Management • Vendor Assessment, Selection and Contracting • Ancillary Vendor Matching • Practice and Workflow Redesign

• System Implementation • Interoperability and Health Information Exchange • Privacy and Security Best Practices • Peer Mentoring • Achievement of Meaningful Use

Summary The movement from a paper-based to electronic healthcare system is inevitable and is the future of health care. The transition to EHRs is not without challenges, but right now there is financial, technical and educational help available to make the transition easier and recognize the benefits of EHRs, including safer, more efficient and coordinated care.

Key Resources Arizona Regional Extension Center Provider Interest Form – http://azhec.org/REC.jsp Complete this brief form and a REC Provider Success Coordinator will contact you to discuss your needs. Arizona Regional Extension Center Website – http://www.azhec.org/regionalextensioncenter.jsp CMS Incentives Program Website – http://www.cms.gov/EHRIncentivePrograms/ Certified HIT Product List – http://onc-chpl.force.com/ehrcert State Medicaid (AHCCCS) HIT Webpage – http://www.azahcccs.gov/HIT/ Governor’s Office of Health Information Exchange (GOHIE) – http://azgovernor.gov/hie/About.asp

AOMA Digest Winter 2011

12


Features

The Three “Cs” of Documentation Karen Connell, RN, BSN, MA Ed

P

hysicians typically approach documentation with the goal of communicating effectively with themselves. Think about that statement a moment. This approach can create problems when malpractice allegations are made and plaintiff attorneys, arbitrators and juries engage in what is often anger or sympathy driven reviews of physicians’ records that assume negligently omitted or committed acts in the absence of contrary evidence. This article focuses on three important things to remember about your documentation: Be CLEAR, CREDIBLE and CONSIDER the broader audience. Since healthcare communication is comprised largely of individual perceptions concerning decisions and actions, the only credible evidence that remains of what was said or done takes the form of word descriptions entered into the medical record. These word descriptions will be used to reconstruct the pattern of care in the event of litigation. Descriptions entered in the medical record at the time of an event are more credible than record entries that are written later or than testimony based on memories of witnesses. Your memory of an event, where it differs from the medical record, is unlikely to be persuasive. What is most persuasive is a medical record that appears accurate, credible, professional, and presents a clear, timely picture of events even years later. To insure accuracy, be clear and precise in your documentation, pay special attention to such things as dosages, decimal points, sound-alike medications and so forth. Accurately document and update allergies, drug interactions, and problem lists. Verify these with the patient on a regular basis. And remember, every entry should be accurately dated and timed.

Avoid Key Credibility Gaps There are some key credibility gaps to avoid. Keep entries legible and avoid a careless appearance. A major credibility problem is that of altering or destroying a record after it has been created. Under no circumstances should you discard and rewrite a portion of the record. If a prior record entry must be changed in a handwritten note, line out the material to be deleted with a single line, then initial and date the change. As an alternative or in an electronic record, a new note should be made referring to the prior content and addressing any new or conflicting information. Late entries must be identified as such and dated and timed when they are added. An important goal of the medical record is to depict

a caring healthcare professional. In a juror’s viewpoint you’re no better doctor than what or how you document. Do your records portray a harried, disorganized practitioner or a skilled, caring professional? Do you use professional word choice and avoid obscure jargon or unapproved abbreviations? What about the content of the medical Karen Connell, RN, BSN, MA Ed record? Your goal is to give a clear representation of the facts as they existed at the time of your care, as well as your thought process for the way you interpreted the information and formed the plan of care. You should read, and respond as necessary, to the notes created by other healthcare professionals. You should record interactions with patients including any information you provide along with the patient’s response. Clear documentation of informed consent discussions may be particularly critical and should serve to augment signed consent forms.

Informed Consent Documentation Essential MICA’s claims experience clearly demonstrates that lack of documentation of the informed consent process creates major defense difficulties. Not only is the communication process between the physician and patient critical, but the written evidence of that conversation cannot be underestimated. Demonstrate that you discussed specific risks, benefits, and alternatives of the proposed treatment or surgery. Include no implied guarantee. Establish realistic expectations and provide an opportunity for patient feedback. Document the use of any educational aides. In addition, be sure to document the patient’s refusal of a care recommendation and the conversation that preceded the refusal. Even when the patient doesn’t verbally refuse care, we are all familiar with the non-compliant patient. In this situation it is not enough to label or blame the patient for the lack of adherence. It is important to demonstrate that you assessed the reason for the patient’s response such as: lack of knowledge or understanding, denial, fear or perhaps age, intellectual or literacy issues. Document your efforts to assist

13

AOMA Digest Winter 2011


Features the patient and demonstrate that the patient understands the consequences of not following through. Phone call documentation is also critical. This is one of the most important things you can do to provide a defense for your actions in the event of a claim or suit. This includes calls taken both during and after office hours. Your documentation should clearly portray the content and context of the call as well as your response. After hours calls should be documented timely so that the information is available if the patient calls the following morning. Successful clinical care is a collaborative activity with shared responsibilities. The patient and physician work together to learn about the patient’s illness and concerns, review the diagnostic and treatment options and enact a mutually agreed upon plan. Medical documentation records this shared effort. Documentation following an adverse outcome is also vital. What you say and what you write immediately following an adverse outcome is a frequent source of defense difficulty and may actually trigger a claim or suit. Be objective and concise, stating only what is known at the time of the entry. Avoid speculation and blame shifting. Resist the temptation to explain, rationalize or argue your case in the records. Make a clear record of any disclosure conversations, briefly and factually. All of the premises discussed above hold true whether the record is a traditional paper chart or one of the new electronic records. There are, however, some additional considerations with the electronic medical record (EMR).

is easier for a physician to cut and paste history and/or physical examination findings from a prior visit rather than documenting the current findings. Such notes may appear “canned” when phrases or progress notes are identically reproduced on successive office visits and may suggest to a jury the care was not individualized. When this practice is evident on one or multiple visits, the credibility of the particular treatment encounter, the documentation, and often the entire record, may be called into question. It is a good idea to individualize all discussions and treatment encounters as much as possible. Fields allowing for free-form comments make this much easier. An important issue to consider with an electronic documentation system is the integrity of the entries. A medical record, whether paper or electronic, with any appearance of alteration is extremely difficult to defend. How can the integrity of an electronic medical record be maintained where any change will eliminate the original information and change the date of the entry in the files? The best way to support the accuracy and integrity of the EMR is to store information in a manner which can be retrieved and read but cannot be altered. In the case of a malpractice suit, such storage would allow a physician to present records as authentic and unaltered. Just as with paper records, any addendum should be made without obliterating or destroying the original entries.

Electronic Medical Records (EMRs) Concerns

No EMR issue is more important or under more scrutiny than confidentiality of patient information. The public has become increasingly concerned about privacy, and some healthcare entities have experienced the unauthorized release of large amounts of patient data in the last few years with severe penalties paid. A critical factor is the presence of safeguards for security of the system. One method of protecting information from unauthorized access or tampering is through the use of passwords combined with varied levels of access. Completely restricting access to “a need to know” basis provides additional security. Passwords should not be shared and each person should log out when exiting the area. In closing, no matter how busy your practice, documentation is a key to successful care, as well as a valuable defense in case of a malpractice allegation. While the electronic record may be different in format and full of additional, helpful tracking tools, the goals of medical documentation remain the same regardless of method: Be CLEAR, CREDIBLE and CONSIDER the broader audience. For more information on this important topic, contact MICA Risk Management or go to www.mica-insurance.com

We have seen several main concerns regarding missed or inaccurate information that may arise when using EMRs. The first involves previous data input not easily found. This can be caused by a confusing template or data storage program. This makes it much more difficult for the record to be used as a communication tool for shared care. Another is trended information, located in one area in a paper record (e.g. vital signs, lab studies, allergies, etc.), which is now located in various places, requires scrolling, or is located in an area of the record which is rarely accessed. There is also a growing concern physicians tend to rely too heavily on standardized templates. Often, these templates do not provide a place for the physician to demonstrate “cognitive thinking” critical to a correct diagnosis. Instead, physicians may be tempted to simply check off boxes to demonstrate what the patient does not have, while leaving out specific information which allowed the physician to formulate a working diagnosis for the patient. Additionally, many EMRs have a copy and paste feature. This feature allows a physician to reproduce an earlier note or portion of a note, rather than rewrite it. Too often it

AOMA Digest Winter 2011

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Confidentiality of Patient Info is Critical


Features

arizona HealtH Care Cost Containment sYstem’s (aHCCCs) role in HealtH information teCHnologY

I

n February 2009, Congress enacted the Health

they will be directed to AHCCCS and after July 2011, the

Information Technology for Economic and Clinical Health

EPs and Hospital can apply for incentive payments. Under the

Act (“HITECH”) as part of the federal stimulus package.

Medicaid program, the following types of professionals are

The legislation includes a Medicare and Medicaid Electronic

eligible, assuming that they meet the Medicaid patient volume

Health Record (EHR) incentive program for Eligible

requirements:

professionals (EPs) and hospitals that adopt and meaningfully

1) A physician

use certified EHR technology. EPs may receive up to $44,000

2) A nurse practitioner

under Medicare or $63,750 under Medicaid, and hospitals may

3) A certified nurse-midwife

receive millions of dollars for implementation and meaningful

4) A dentist or

use of certified EHRs under both Medicare and Medicaid

5) A physician assistant practicing in a Federally Qualified Health Center or Rural Health Center led by a physician

Starting in July 2011, AHCCCS will be able to register

assistant.

eligible providers and hospitals that want to participate Medicaid EPs also cannot be hospital-based and must

in the Medicaid incentive program in Arizona. Eligible Providers and hospitals will need to start their registration at

meet a minimum Medicaid patient volume of 30% for all

the Centers for Medicare and Medicaid, where they will select

EPs except pediatricians, who need only a 20% volume.

which program, either Medicaid or Medicare; they want to

For calendar years 2011–2021, participants can receive

receive incentives through. If an EPs selects Medicare they will

up to $63,750 over six years under the Medicaid EHR

continue their registration with CMS. If they select Medicaid,

incentive program.

2011

2012

2013

2014

2015

2016

2011

$21,250

2012

$8,500

$21,250

2013

$8,500

$8,500

$21,250

2014

$8,500

$8,500

$8,500

$21,250

2015

$8,500

$8,500

$8,500

$8,500

2016

$8,500

$8,500

$8,500

$8,500

$8,500

$21,250

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

$8,500

2017 2018 2019

$21,250

2020 2021 Total

$8,500 $63,750

$63,750

$63,750

$63,750

$63,750

$63,750

AHCCCS has created a Health Information Technology tab on its agency webpage to assist EPs and hospitals to learn more about the incentive program at: http://azahcccs.gov/HIT/default.aspx under HIT Resources.

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AOMA Digest Winter 2011


Features

tHe importanCe of struCtureD laB Data to HealtH information eXCHange

S

onora Quest Laboratories (SQL) is strongly committed currently is a Director on the boards and executive boards for to health information exchange (HIE) in Arizona. Lab Arizona Health-e Connection (AzHeC) and HINAz. data accounts for more than fifty percent of health data Dexter stated, “Seven Arizona laws must be modified to elements in an electronic medical record, and lab results legally allow labs share data through a health information impact 70-80% of all diagnostic decisions. Each year, SQL exchange; HIE will not happen without structured lab performs more than 45 million tests on 6.3 million patient data.” Additionally, EMR systems are disparate and lack encounters. Their goal is to be 100% electronic for ordered interoperability. There are more than 200 EMR vendors and tests and reported results. Currently, Sonora Quest Labs is labs have to build an interface with each one. “We are working at 60% electronic collaboratively requisition orders. with the Regional SQL expects Extension Center the percentage (REC) to decrease of electronic the cost and requisitions timeline for lab to increase interfaces with dramatically over EMR vendors,” the next year. At said Dexter. In the end of January, addition, he SQL will build emphasizes that an interface to the business model provide two years for HINAz has of lab data to been designed WellLogic, which to be selfis building the sustaining, and infrastructure and is not dependent interfaces for Phase upon state or I deployment federal funding of the Health for deployment or David Dexter Information longevity. President and Chief Executive Officer (CEO), Network of Dexter is keenly Sonora Quest Laboratories Arizona (HINAz), aware that the the new statewide adoption of EMRs health information exchange. Six hospital systems, two has been slow to occur in physicians’ offices, because of cost community health centers, and eight insurers will also be and operational issues. Initially, there is a loss of productivity participating in Phase I of the HIE, which is expected to because of the training required for the staff and providers, operate for 6 months before extending participation in Phase conversion activities and running parallel systems. It may take II to other healthcare providers across the state. up to two years to regain and then exceed the productivity, President and Chief Executive Officer (CEO), David but quality will improve immediately, and up front costs for Dexter, is one of the key leaders driving health information providers will now be subsidized by Medicare or Medicaid technology and health information exchange in Arizona. Since incentives. 2005, he has been involved with HIT when he was appointed Sonora Quest Laboratories’ long term goals are to improve as the Lab seat for the Steering Committee for the Arizona quality, efficiency, and productivity. This mirrors physician Health-e Connection Roadmap by Governor Napolitano. He goals; most importantly to provide better patient care.

AOMA Digest Winter 2011

16


Features

Are Non-Competition Agreements Enforceable or Not?

N

on-competition agreements usually bar healthcare professionals both from encouraging patients to follow them to a new practice and from practicing for a certain period of time within a certain distance of the former employer’s location. There is much debate in the healthcare and legal communities, however, over the extent to which these non-compete clauses are enforceable–if at all. The truth is that non-competition agreements are sometimes enforceable and sometimes not, depending on their specific restrictions and circumstances.

Advantages Employers often consider non-compete clauses a legitimate condition of employment since an employee develops skills, knowledge, and reputation because of his or her association with the employer. These agreements also serve to protect the employer’s investment in employees by discouraging them from leaving the practice in the first place. It seems disingenuous for an employee to receive the long-term benefits of working in an established practice only to subsequently leave the practice and compete for the same patients. Employers may be legitimately concerned about healthcare professionals working with a group solely to develop a patient base and referral sources before opening their own practice. Non-competition agreements, may alleviate these concerns.

Disadvantages One important consideration in using non-competition agreements is the hardship that they can cause the employee. A geographic restriction may force an employee leaving the practice to relocate outside the restricted area, which could entail a major, life-altering move. Some in the medical community are wary of this seemingly “inherent unfairness” in requiring a healthcare professionals to give up their future right to work as a condition of current employment. There are also less obvious hardships caused by noncompetes. For example, an employer who knows employees will be reluctant to leave the practice, may be less concerned about employee retention. The employer may be less sensitive to employees’ needs and concerns or may be less likely to offer pay increases. Employees who are worried about the adverse effects of non-competition agreements should negotiate with

their employers for the narrowest possible restrictions, and consider negotiating for additional compensation or severance in exchange to agreeing to the non-compete. Non-competition agreements may also have an adverse effect on some patients, who are forced to stop seeing their preferred healthcare provider because of a non-competition agreement. It may result in increased costs for the patient, decreased quality of care, and lowered satisfaction.

Enforceability Employers should make sure they attempt to enforce noncompetition agreements in a consistent, timely manner. If an employer only enforces the agreements some of the time, a court may refuse to enforce any isolated one. Enforcing these non-compete agreements can be problematic, though, since courts construe the agreements narrowly and determine their enforceability on a case-by-case basis, considering all of the attendant circumstances. Arizona courts generally disfavor non-competition agreements. Thus, courts read the restrictions in a non-compete as narrowly as possible, with any ambiguities being construed against the employer. To be enforceable, a non-compete agreement cannot merely be aimed at protecting the employer from competition. Rather, the agreement must be drafted to protect the employer’s legitimate interest in preventing, for a limited time, a leaving employee from using information or relationships that were acquired by the employee during the course of employment because of the employer. In determining whether a non-compete is reasonable, courts look at all of the surrounding circumstances. Generally, a non-compete clause is unreasonable (1) if the restraint is greater than necessary to protect the employer’s legitimate interest, or (2) if that interest is outweighed by the hardship to the employee and the likely injury to the public. The first factor, whether the restraint is greater than necessary to protect the employer’s interest, depends on the duration of the agreement and the scope of its geographic limitations. Courts consider the restraint too great if the limitations last too long or cover too great a geographic area. With respect to the second factor, whether the employer’s interest is outweighed by the hardship to the employee and the public, Arizona courts are generally wary of noncompetition agreements between healthcare professionals.

17

AOMA Digest Winter 2011


Features Courts have held that patients are entitled to choose their own provider, regardless of the contractual obligations between their provider and his or her former employer. Courts reason that the harm to patients who are restricted from choosing their healthcare provider is greater than an employer’s economic interest in enforcing a non-competition clause. Accordingly, non-competition agreements between medical professionals and their employers are read very narrowly. Each agreement is considered on a case-by-case basis to determine if the public policy considerations at play outweigh the employer’s interest in protecting its investment through enforcing the non-compete clause. In contrast, non-competes are less scrutinized when it comes to the sale of a practice. When a dentist sells a practice, the value of the practice’s goodwill and its existing patient base usually figures prominently in into the purchase price, so the buyer of the practice is allowed some protection from competition from the former owner.

The Blue Pencil Doctrine “Blue penciling” occurs when a court decides not to enforce certain sections of a non-competition agreement that it considers too broad, but still enforces the rest of the agreement. Instead of declining to enforce the entire agreement altogether or rewriting unenforceable provisions, the court will literally cross out unreasonable provisions but keep the rest of the agreement intact. A key component of the blue-pencil doctrine in Arizona is that courts can strike out unenforceable parts of the contract, but it cannot otherwise add to or change the terms. Some courts disfavor the practice of blue penciling, however, because it tends to encourage employers to draft non-competition agreements with broad or additional terms that can have the effect of scaring employees into never leaving the practice.

Step-Down Provisions Step-down provisions, combined with severability clauses, are the best way to make sure a non-competition agreement is enforceable. These terms provide alternative time and area restrictions that allow a court using the blue-pencil rule to strike restrictions it considers too broad while enforcing a less restrictive provision. A sample step-down provision might be similar to the following: 1. NONCOMPETITION. For the TIME PERIOD set forth in paragraph 2, Employee shall not, directly or indirectly, own, manage, operate, participate in or finance any business venture that competes with the Company within the AREA. . . 2. TIME PERIOD. TIME PERIOD for purposes of

AOMA Digest Winter 2011

18

paragraph 1 shall mean the period beginning as of the date of Employee’s employment with the Company and ending on the date of death of the employee; provided, however, that if a court determines that such period is unenforceable, TIME PERIOD shall end five (5) years after the date of termination; provided, however, that if a court determines that such period is unenforceable, TIME PERIOD shall end six (6) months after the date of termination. Because different courts rule differently on what provisions are overly broad, it is important to have an attorney draft these provisions if the practice wants to ensure that they are not stricken altogether.

Remedies for Breach Injunctive relief is usually the most desirable option for the employer, as it allows the employer to immediately stop the competitive behavior before very much damage is done. Injunctions can be a difficult to acquire, however, as courts consider them an especially extreme form of relief. This does not mean that injunctive relief provisions are always unenforceable. Although consent to injunctive relief does not guarantee that the relief will be entered by a court, it goes a long way to increase a court’s comfort level with the remedy. Alternatively, money damages may be available if the former employee’s breach was the actual cause of the monetary harm to the employer. This form of relief, however, may take years of litigation to acquire.

Conclusion Non-competition agreements can be a useful tool for healthcare practices, but making sure those agreements will be enforced can be extremely difficult and requires a high level of precision. On the other hand, an employee struggling to work around a non-compete agreement can rarely know for sure if it is truly enforceable or not, since courts consider each one on a case-by-case basis, considering all of the attendant circumstances. The best way to deal with noncompetition agreements is to find an attorney with a thorough understanding of the law regarding these restrictive covenants. Edward O. Comitz, Esq. heads the healthcare and disability insurance practice at the Scottsdale-based law firm, Comitz | Beethe. He can be reached at ecomitz@cobelaw.com, (480) 998-7800. For more information about disability insurance issues, please visit www.disabilitycounsel.net. DISCLAIMER The information in this article has been prepared for informational purposes only and does not constitute legal advice. Anyone reading this article should not act on any information contained therein without seeking professional counsel from an attorney. The authors and publisher shall not be responsible for any damages resulting from any error, inaccuracy, or omission contained in this publication.


Welcome New Members

WelCome neW aoma memBers _______ First Year Members _______ Joel Cooper, D.O. Family Practice Peoria, AZ Elizabeth M. O’Connor, D.O. Family Practice Scottsdale, AZ (480) 882-4545

__________ Full Members __________ Dominick Barone, D.O. Pediatrics – Board Certified Scottsdale, AZ (602) 971-3700 Scott Ekdahl, D.O., MPH Family Practice – Board Certified & OMM Chino Valley, AZ (928) 636-0754 Ray Jonathan Lara, D.O. Otolaryngology Tucson, AZ (520) 795-8777 Bichhoa Nguyen, D.O. Family Practice – Board Certified Winslow, AZ (928) 289-4646 Rutvik Patel, D.O. Family Practice – Board Certified Phoenix, AZ (602) 992-1900 Denise Viola, D.O. Obstetrics & Gynecology Tucson, AZ (520) 269-6636

______________________ Second Year Members ______________________ Betsy Myers, D.O. Psychiatry Tucson, AZ (520) 792-1450 x 2808

Janette M. Reeves, D.O. Family Practice – Board Certified Mesa, AZ (480) 834-7546

Christopher K. Oros, D.O. Hospitalist Flagstaff, AZ (928) 214-2920

in MeMOriAM

We are all diminished when one of our number leaves us. We will miss them and strive on for the betterment of our profession in their memory.

Kenneth M. Levine D.O. Ivan Brauer, D.O.

inFOrMAtiOn uPdAtes

Try as we may, there are member updates that are missed or not updated until in print. Please note the following changes to your 2010 – 2011 Directory. The 2010 – 2011 Membership Directory was published electronically only. It is available for all members in PDF format (please contact Flannery O’Neil at flannery@az-osteo.org if you never received an email with your Directory). The Directory is also available online at http://www.az-osteo.org/displaycommoncfm? an=1&subarticlenbr=201. Joseph C. Collins, D.O. New Address & Phone Number Thoroughcare Family Medicine 605 N. Gilbert Road Mesa, AZ 85203 (480) 969-3030

Bunnie Richie, D.O. Updated Suite Number 18404 N. Tatum Blvd., Ste. 207 Phoenix, AZ 85032

19

Eddie Chun-Nam Wai, D.O., PharmD New Address & Phone Number 3201 W. Peoria Ave., Ste. D800 Phoenix, AZ 85029 (602) 689-6783

AOMA Digest Winter 2011


Features

AOMA Hosts its 30th Annual Fall Seminar

T

he AOMA hosted its 30th Annual Fall Seminar at the

be implemented by March 31, 2011. The AOA House of

Omni Tucson National Resort on November 6th & 7th,

Delegates, in which Arizona has 15 Delegates, determines this

2010. Boasting near record high attendance, the seminar

policy. There was a quote from one of the presenters that “if

featured eight lectures including the very popular “Health

you are not at the table, you won’t be on the menu.”

Care Reform” panel. Other lectures featured a variety of pain management topics including TMJ, integrative medicine approach to pain, chronic pain in children, nutrition and pain, and OMM in pediatrics. American Osteopathic Association (AOA) President Karen Nichols, D.O. from Arizona; AHCCCS Medical Director Marc Leib, M.D., J.D.; and Mutual Insurance Company of Arizona’s (MICA) CEO James Carland, M.D. gave presentations on the impact of the national health care reform laws on physicians practices, Medicaid, and medical professional liability. Dr. Nichols stated that the AOA gave a letter of “measured” support for HR 3200 because 70% of the AOA’s priority issues were included in the bill and will

Moderator Lori A. Kemper, D.O. guides the question and answer period during the Health Care Reform panel.

The Health care reform panelists answer questions from the audience. (L to R) MICA CEO James Carland, M.D., AHCCCS Medical Director Marc Leib, M.D., J.D., and AOA President Karen Nichols, D.O. The Fall Seminar audience enjoys the lectures.

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AOMA Digest Winter 2011


Business Partner Listings

AOMA Business Partners

Provide Services for a Health Practice and your Finance USE YOUR MEMBER DISCOUNT

Answering Service

Business Loans/Equipment Leases/Lines of credit Management firm partnering in all types of medical specialties nationwide since 1992. ABC Mediand all other Banking Services. A Professional Image cal Billing Specializes in Billing, Coding, Practice Management, Credentialing, Contract Review/ Answering Service Wells Fargo Negotiations and HIPAA Compliancy. When you Lori Horton, General Manager (602)381-2820 hire ABC Medical you are partnering with profit(480) 921-1300 Jean Ann Morris ability and the knowledge that your practice is 1140 S. San Jose Dr., Ste.1 Jean.Ann.Morris@wellsfargo.com reaching its maximum potential. Mesa, AZ 85202 http://www.wellsfargo.com www.aprofessionalimage.com ABC Medical Billing is bonded, insured and 4742 N 24th St A Professional Image (API) has provided quality licensed by the Arizona Department of Financial Phoenix, AZ 85016 telephone answering, emergency dispatch, order Institutions. entry, dealer locate and referral services nationwide Wells Fargo provides many products and services tailored to meet the needs of any medical practice at highly competitive prices since 1986. including all forms of comprehensive Professional J.R. Brothers Financial, Inc. A Professional Image offers a 5% discount off of and Personal Insurance, Financial Planning, (602) 371-1001 the base rate and will waive set up fees for AOMA Practice Credit Lines, SBA and Conventional Robert Antenucci – President Members. Please contact Lori Horton at lori@ Financing for real estate or equipment, and www.jrbfinancial.com aprofessionalimage.com or (480) 921-1300. discounted Merchant Card and Banking Services Darlene Antenucci – Secretary & Treasurer exclusive to AOMA Members. Contact Jean Ann J.R. Brothers Financial, Inc. (JRB) is a medical Bank Card today to learn more! collection agency since 1986.

AOA / AOMA’s Platinum Plus Mastercard Call toll free 1-(800) 847-7378 Save with a 1.7% Introductory APR. Use Priority Code UABCFP when calling. NO annual Fee.

Health Benefits

Whitley Benefits

Ken Whitley (602)432-9288 (Cell) ken@whitleybenefits.com http://www.whitleybenefits.com/ Bank Card Processing Whitley Benefits has been in the employee benefits Affiniscape Merchant Solutions business for over 40 years. We are specialists in Visit the AOMA website, Member Services individual and group health benefits in every Business Partner Listings or call (800) 644field. This includes Medicare, life insurance, 9060 Ext. 6974 disability and retirement plans. We developed your As a benefit of your membership in AOMA, you dental program exclusively for members of your are entitled to a very special processing package association, only. It has the pricing and benefits from Affiniscape Merchant Solutions. Our on-line that are reserved for very large groups, in excess of reporting lets you quickly see your deposit and 100 employees. The plan’s features include easy payment information. administration, stability and competitive pricing.

Banking Services

Billing & Collections

U.S. Bank

(480) 538-5663 David Baxter, Home Mortgage/Equity Loans david.baxter@usbank.com 17851 N. 85th St., Ste. 205 Scottsdale, AZ 85255 Contact David Baxter, AOMA’s representative for all banking services. He will direct you to additional representatives for such services as

AOMA Digest Winter 2011

22

ABC Medical Billing Consultants

Elizabeth Medina-Peralta - ElizabethP@ ABCMedical.net Client Services Manager Office :(602) 273-6770 Fax : (602) 889-0488 http://www.abcmedical.net 4441 E. McDowell Rd., Phoenix, AZ. 85008 ABC Medical Billing is a Professional Practice

AOMA members are offered a lower collection fee with exceptional service and recovery. Clients can access the status of their accounts online through the JRB Client View Program. Visit their website at www.jrbfinancial.com.

Car Rental

Avis & Hertz

Discount coupons available through the AOMA Office, call (602) 266-6699 or our toll free number (888) 266-6699. You may also request coupons by emailing tammy@az-osteo.org.

Financial Planning

Mosaic Financial Associates

(480) 776-5920 Fax: (480) 776-5925 637 S. 48th St., Ste. 201 Tempe, AZ 85281 http://www.mosaicfa.com Mosaic Financial Associates provides a holistic approach to wealth management. We believe that your financial advisor should provide a pathway to the financial goals you dream of and work hard to achieve, while taking into account all aspects of your life and building a long-term relationship based on trust and top-notch service.


Business Partner Listings

Strategic Wealth Solutions MetLife

(480) 638-2100 x2211 Kathryn A. Marchwick, CFP®, Financial Services Representative Fax (480) 638-2200 Jonathon Staats, Financial Services Representative 60 E. Rio Salado Pkwy., Ste. 610 Tempe, AZ 85281 Our purpose is to enrich the financial aspects of the doctor’s practice and personal lives through knowledge, integrity and personal service beyond expectations. The financial planning team includes an accountant and knowledgeable attorneys who can assist in providing trust agreements, wills and business agreements.

Healthcare Technology

Information Strategy Design (ISD)

Information Strategy Design (ISD), a leading healthcare technology solutions provider with its central office in Scottsdale, has been conducting business in Arizona for 12 years. ISD focus is on medical practices to allow them to provide costeffective computer networking, telephony, off-site backup and remote monitoring. ISD’s value offering to members allows for one time and ongoing discounts based on using two or more ISD services. Contact Michele Liebau at (480) 970-2255 x107 (Michele@isdesign.com) for details.

InVision Technology Solutions

providing service designed to reduce your risk of a We don’t outsource, we are the source – You get malpractice claim or suit. MICA is owned by all of enterprise-level IT support with comprehensive the physicians it covers. expertise to tackle any challenge, without the overhead! AOMA Discounts: We are pleased to extend the following special pricing for valued Legal – Disability Insurance Claims AOMA members; *10% off all support agreements. and

Insurance

AFLAC

Karen Jones, Independent Agent (602) 229-1970 x213 4707 N. 7th St., Ste. 101 Phoenix, AZ 85014 No Deductible, No Copay, No Preauthorization. Association Rates: AFLAC supplemental insurance policies are available at special Association Rates for AOMA members and their families.

Applied Medico-Legal Solutions Risk Retention Group

Dan Delfini Phone: (866)461-1221 ddelfini@bpmp.com http://www.amsrrg.com/ Applied Medico-Legal Solutions Risk Retention Group (AMS RRG), a new generation of medical liability insurance, was founded on the principle of providing superior services to its member physicians. As a Risk Retention Group (RRG), the members are owners, but more importantly, partners in the success of the organization. As physicians and healthcare executives, the founders of AMS RRG understand the medicolegal challenges facing today’s physicians. AMS RRG has developed strategies and procedures that will help our member physicians realize favorable premium pricing as well as overall reductions in medico-legal risks. AMS RRG offers “preferred pricing” to AOMA members.

For a complimentary consultation, please contact Sandra Juarez (480) 699-8077 4745 N. 7th Street, Ste. 215 Phoenix, AZ 85014 Sandra.juarez@invisionaz.com InVision Technology Solutions is a complete IT solutions provider for the Medical industry including network design, server configuration and installation, Ian B. Ackerman, Ltd. EMR/PM implementation, phone system solutions (602) 265-8093 4747 N. 7th Street, Ste. 426 and all your on-going computer support. Phoenix, AZ 85014 Offering Individual healthcare plans through Blue Cross Blue Shield of AZ as well as discounted MD Tech Pro premiums on disability insurance. Let us review IT Solutions for Medical Practices your current insurance programs to determine if Michael Vanderslice your Discounts offset your dues. Phone: 480-463-4638 | 888-638-3242 Email: michael@mdtechpro.com Web Site: http://www.mdtechpro.com Mutual Insurance Company of IT and EHR Solutions by MD Tech Pro Based in Phoenix AZ, MD Tech Pro is the national Arizona leader in IT and EHR solutions for medical (602) 956-5276 practices and your strategic partner for all (800) 352-0402 healthcare technology needs. We have been www.mica-insurance.com providing pro-active, top-flight technical services Each medical practice is unique with individual risk in the medical community since 1997 and focus management needs based on specialty and practice exclusively on working with healthcare clients. We characteristics. Our experienced Risk Management are medical experts! Consultants can assist you in assessing and

Healthcare Litigation

Comitz | Beethe

Edward O. Comitz, Esq. Scottsdale Spectrum 6720 N. Scottsdale Rd., Ste. 150 Scottsdale, AZ 85253 Phone: (480)998-7800 Fax: (480)219-5599 ecomitz@cobelaw.com http://www.disabilitycounsel.net Mr. Comitz has extensive experience in disability insurance and healthcare litigation, representing physicians in reversing the denial or termination of their disability insurance benefits. Mr. Comitz has earned a national reputation for prosecuting claims based on fraud and unfair practices in the insurance industry. A free consultation is provided.

Medical Record Scanning & Management

DocuSafe

Drew Miller Phone: (623) 478-9393 Fax: (623)478-0777 dmiller@docusafe.net DocuSafe of Phoenix is an Information Security and Records Management company servicing the greater Phoenix metro area, as well as with capabilities of nationwide services. Our services include records storage and management on both a box level and chart/file level, certified document destruction, scanning (for both independent files or to electronic record management systems), and data/media storage and rotation services. At DocuSafe, we consider ourselves to be your one-stop-shop that can offer you prescription perfect solutions for your storage and service needs with competitive pricing and service that is second to none. Call for a no-obligation cost analysis to see what ways we can help you efficiently and securely manage your records today. Docusafe offers a 10% discount for AOMA members.

Payroll Processing

Automatic Data Processing (ADP)

Diana Foley, Regional Account Specialist (480)773-1457 (cell) diana_foley@adp.com Through our partnership with ADP, we are able to provide members with a user friendly way to streamline the payroll process, improve productivity, and simplify administration on a yearround basis. In addition ADP’s tax services ensure your company’s compliance with local, state, and Federal regulations as well as automatically

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AOMA Digest Winter 2011


Business Partner Listings calculating, filing, depositing, and reconciling your payroll taxes. We are excited to offer all new clients a 20% discount on ADP services. Diana Foley, Regional Account Specialist is available to help our members in simplifying and outsourcing their payroll process from punch to paycheck! Other Available Services: Retirement Plans, Background Checks, Time & Attendance Systems, Human Resource Assistance, Workers compensation, etc.

Human Capital Strategies

Jason Knight, Principle/Market VP (480)962-1580 jason.knight@hcscando.com www.hcscando.com Human Capital Strategies is a national provider of Professional Employer Organizations (PEO) Services, Administrative Services Organizations (ASO) Services and Payroll Services - “we do what small business owners and office managers, don’t like to do, don’t know how to do and, often times, don’t even know they are supposed to do.” Managing every aspect of payroll, human resources, taxes, employee benefits, 401(k) plans and workers’ compensation management is what makes Human Capital Strategies “the next best thing to no employees!”

Human Capital Strategies offers a 10% discount and $0 setup fees for AOMA Members.

Practice Management

Sunbelt International Consulting, LLC

(602) 380-6012 111 East Dunlap Ave Suite 1-511 Phoenix, AZ 85020 info@sunbeltinternationalconsulting.com www.sunbeltinternationalconsulting.com Sunbelt is owned and operated by a practicing physician who not only consults on practice management, but also actually runs a medical practice on a day-to-day basis. We provide comprehensive and practical business management solutions to solo and group practices.

for Retirement, will serve as the basis for the free initial consultation. A listing of these services can be reviewed at www.wolfeconsultinggroup.com. Real Estate services from Office Leasing to Building Purchase are also available through a wholly owned subsidiary of Wolfe Consulting Group, Ltd., Healthcare Realty Advisors, Inc., at no direct cost to AOMA’s members.

Real Estate

Medical Office Brokers

Aaron Kuhl, Designated Broker (480) 947-5845 aaron@arizonamob.com www.arizonamob.com Medical Office Brokers (“M.O.B.”) is focused exclusively on representing medical tenants and buyers in their commercial real estate transactions.

Wolfe Consulting Group

(602) 324-0416 Craig Heiser, M.B.A. – Medical Consulting/ Revenue Enhancement chh@wolfecon.com AOMA members will receive a free initial problem definition meeting and also receive a discount on a wide array of business consulting services. Services, from Improving Income to Practice Sale

Staffing

Jobing.com

Julie Schoor, Healthcare Industry Specialist (602) 200-6766 Jobing.com provides AOMA members with a great online local employment advertisement source at a discount. Julie Schoor, Healthcare Industry Specialist, is available to help our members with writing ads, posting positions online and answering any questions that come up.

TriStaff Group- Healthcare Staffing

Michael Hughner, Healthcare Staffing Expert O: 480-890-1700 E: mhughner@tristaff.com W: http://www.tristaff.com Since 1971, we are your healthcare staffing experts! Through our AOMA partnership, we will be a talent resource for all your hiring needs at a special, member only discounted rate!

Telephone Messaging Services

MedVoice

(480) 481-9292 Renae Dotson rdotson@medvoice.com Imagine….Thousands of calls you never have to make or take!!!! • Results • Reminders • Preventative Reminders • Message On Hold No expensive equipment to purchase, no telephone lines to install and no hardware to buy or software to maintain. All you need is your office telephone.

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In the News

in tHe neWs... AOMA Member Assumes Leadership Role in National Medical Society Denver, CO – David Bryman, DO of Scottsdale, Arizona was recently inducted as President-elect of the American Society of Bariatric Physicians (ASBP). He also received the Dr. Vernon B. Astler Award which recognizes the efforts of an association member to advance ASBP’s place and purpose to the media, government and medical community. Formed in 1950, the ASBP is the primary source for clinical education and training for the non-surgical medical management of obesity.

AOMA Past President Charles A. Finch, D.O. honored with Hon Kachina Award Charles A. Finch, D.O. was recently honored by being named one of the 2010 Hon Kachina recipients. The Hon Kachina Award recognizes the achievement of outstanding Arizona volunteers and increases public awareness about volunteerism. Dr. Finch was honored for his efforts in helping children to grieve the loss of close family members. Dr. Finch started Camp Paz, a weekend camp program for grieving kids which has since morphed into the Stepping Stones of Hope organization. Stepping Stones of Hope offers a variety of programs for grieving families. Visit http://www.steppingstonesofhope. org/ for more information on their programs.

SOMA Student uses Woodcarving for Relaxation School of Osteopathic Medicine in Arizona (SOMA) student Shane Monnett recently completed a carving of A.T. Still out of aspen. Mr. Monnett, a second year student located in Flagstaff, uses his wood carving as a way to relax and recuperate from the stresses of medical school. His carving of A.T. Still was completed over Thanksgiving and took him approximately 30 hours to finish. He was inspired to create Dr. Still’s bust as a reminder of the roots of osteopathic medicine. Mr. Monnett is a self-taught artist and uses a chainsaw, hand chisels, and a dremel as his tools. He hopes to specialize in General Surgery after his medical training.

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26

AOMA Members installed as Fellows of the American College of Osteopathic Internists Please join us in congratulating AOMA Members Rama Kunkle, D.O. and Ariana Peters, D.O. upon their recent installation as Fellows of the American College of Osteopathic Internists.


Osteopathic Community News

Arizona Society of AzACOFP Presidents Perspective Jan D. Zieren, DO, MPH, FACOFP, dist.

I

DOc TALK

hospitals were conducive to physicians chatting or

have to admit that my mind was wandering a bit the

dining together in the

other day when I should have been paying more attention

doctors’ lounges, the ice

to the matters at hand. But I was wondering if all our

cream fountain or the

delegates and leaders in our local, state and national medical

surgery lounge. Hospital

organizations are representing us well. And because I am one

staff meetings drew a

of those delegates – and presidents – I worried that I was not

crowd and not only

doing such a great job. “Did I really know what my district

informed the physicians

would want if we took a vote?” “Did I know how my state

of hospital issues and

physicians would want me to represent them in a national

concerns, but had time

concern?” “What if I was in the wrong and was only thinking

for the physicians to chat

for me and not my fellow physicians – Did I really know what was in their best interests or what they would have me do?” “What is our position or stance on ____?” So you see, I really wasn’t paying attention to the matters

the politics of the day.

Jan D. Zieren, D.O., MPH, FACOFP President 2010-2011

Communication. We

hope we are hitting several venues to inform and communicate with physicians who still use print, those now using the

at hand, but was worried about perhaps a much bigger

internet and even Facebook. But we want feedback. We need

concern that seemed more important.

to know what you are thinking. How is “what is going on”

My emphasis for this presidency and the organization we have been trying to mobilize and grow is communication. Should I be putting out topics in a question format and expecting responses? Should I travel to small group meetings

affecting you and your practice? For us to do our best on state and national representation, give us your concerns – tell us your thoughts – share your issues. Better yet! Join us – at meetings, online, as a board member!

and hold court? Should I email or mail questionnaires? How

We do not have the benefit of the hospital cafeterias like

can I possibly know the sense of the majority for some of the

family docs used to have. But we need to revive the passion

major issues we have in health care today? Arizona docs have

and power of a group that lives and works the health care

often had situations that physicians in another state may not

system. We shall use new methods to bring together our

even have to address. So am I a good enough representative

members – to communicate both ways and be a voice…

with only my own experiences to share? Have I studied

Can we talk??

enough Health Policy to be aware of a higher level position than my personal stance? I remember the “olden days” when the AOMA House

How can we talk? Our new upgraded website, acopf-az. org, offers a blog and the option to participate in a survey, check it out. We also have a Facebook page, start a Chat or

of Delegates was full of passion, political arguments and

Email me at zierendo@aol.com, or contact Max Maxwell,

positioning if not a pecking order of physicians from different

Executive Director at AzACOFP (480) 284-6434, or

Districts. The meetings went on and on before they were done

max.maxwell@cox.net, we want to hear from our members.

and docs were able to hit the receptions and dinners. The

Help us serve you.

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AOMA Digest Winter 2011


Osteopathic Community News

miDWestern universitY/arizona College of osteopatHiC meDiCine Midwestern University Dental and Eye Institutes – NOW OPEN

M

idwestern University’s Glendale Campus recently opened two new specialty clinics to augment the existing Multispecialty Clinic. The Midwestern University Dental Institute opened in June 2010, while the Midwestern University Eye Institute opened in October 2010. Students and faculty work together at both clinics to provide patient care in a unique learning environment. The 242-chair Midwestern University Dental Institute provides comprehensive dental treatment and specialty service areas such as cone beam imaging, wheelchair patient exams, oral surgery suite, and pediatric treatment at about half of the cost of traditional private practice. The Midwestern University Eye Institute is the largest optometry clinic in the State of Arizona, housing 61 exam rooms, an optical retail center, classrooms, and specialty areas. Services include comprehensive eye exams, glasses and contact lenses, disease screenings, sports vision care and vision enhancement for athletes, low-vision and rehabilitative vision services, pediatric care, and a 24 hour on-call optometrist. For more information about these new state-of-the-art patient care facilities at Midwestern University, please call 623/537-6000 or visit www.mwuclinic.com.

Practice Management Workshop! March 2-3, 2011 at the Tempe Hyatt Place 1413 Rio Salado Parkway, Tempe

For 2011, AAFP is offering additional resources for AzACOFP Family Physicians at an AzACOFP Member Discount!

For details and registration go to the Arizona Society of ACOFP website and click on the Events Tab: www.acofpaz.org

Joy Newby, a Family Medicine Billing and Coding Guru returns again this year with an exciting new program. Fortunately (or unfortunately) as long as the government is involved in paying for health care, Family Physicians and their staffs must stay up to date with ever changing coding, documentation, and reimbursement issues! Don’t miss the 2011 Practice Management Workshop! Osteopathic billing and coding is also addressed in this comprehensive workshop.

Osteopathic Residents Workshop – Friday, April 9th – 8:00am

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28

Schedule and participants are listed on the AzACOFP & AOMA Websites. Check the Events Tab.

Arizona Society Foundation for Osteopathic Medical Education – Annual Golf tournament Saturday, May 21st 1:30pm – The Legend at Arrowhead – Also on the Events Tab.


Osteopathic Community News

New Clinical Skills and Simulation Center Opens The new Clinical Skills and Simulation Center opened its doors to Midwestern University students in summer 2010. The facility, located in Mesquite Hall on campus, features 19 clinical and six specialty exam rooms, a mock OR/ER, scrub room, and student testing/faculty observation areas with high-resolution video. Students use the new facility to practice clinical skills on human and technologybased simulation models.

Midwestern University Honors Community Service “Stars” at Annual Gala Midwestern University and community leaders came together on Saturday, October 16th to recognize and honor individuals for their commitment to helping others at the annual Bright Lights, Shining Stars gala, a black-tie-optional event which raised $125,000 this year in scholarship funds for students in all of Midwestern University’s colleges. Paul M. Steingard, D.O., Physician, Steingard Medical Group and Member, Midwestern University Board of Trustees, received the 2010 COMET (Community Outreach: Motivating Excellence for Tomorrow) Award. As a board-certified osteopathic physician, Dr. Steingard founded the TOPS (Team of Physicians for Students) program in 1992 that provides free sports screenings for over 3,000 high school and community college athletes each year, including free EKGs to detect potential heart problems. Enid Blue Spear, Arts Commissioner, City of Glendale, received the 2010 Shooting Star Award, which recognizes a community leader for outstanding contributions to health care and education. Five Spirit of Service scholarships were also awarded for the 2010-2011 academic year to students representing three Midwestern University colleges. Scholarships were awarded to: Eric Huish, Tanya Lisko, and Pamela Simmons from the Arizona College of Osteopathic Medicine (AZCOM); Joelle Radosevich from the College of Pharmacy-Glendale (CPG); and Brent Woodmansee from the College of Dental Medicine-Arizona (CDMA). The Spirit of Service scholarship program recognizes outstanding Midwestern University students based on community service, leadership abilities, academic standing, and financial need.

Upcoming MWU Events: Mark Your Calendars Chippin’ in for Students Golf Tournament – March 21, 12:30 pm at Arrowhead Country Club Mark your calendars for the annual golf tournament to help support the MWU student scholarship and loan fund. For more information, call 623/572-3298 or go to www.midwestern.edu/azgolf. MWU Alumni REUNION – March 12, 6:00 to 10:00 pm All MWU graduates are invited to attend a Reunion Dinner at the MWU Campus. There will be a social hour, dinner, music, and a brief program to give you lots of time to visit with friends and see campus. Online reservations will be available midJanuary at www.midwestern.edu/alumni. For more information, call 623/572-3780. AZCOM Commencement 2011 – June 3 Commencement for AZCOM will take place again this year in Midwestern University’s new Auditorium. For more information, go to www.midwestern.edu/commencement. xml. Congratulations to the Class of 2011! Health Careers Institute for High School Students – July 7-16 9:00 am to 4:00 pm Do you know a high school or community college student interested in careers in health care? MWU will offer its annual eight-day Health Careers Institute this summer from July 7 to 16, sponsored by Wells Fargo. This FREE program includes hands-on labs, lectures, and workshops about careers in health care, including osteopathic medicine. Applications for this competitive program will be accepted until May 1. For more information, go to www. midwestern.edu/azhealthcareersinstitute, call 623/572-3310, or send an e-mail to kmatto@midwestern.edu.

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AOMA Digest Winter 2011


Osteopathic Community News

Doctor of Physical Therapy Program Matriculates First Class MWU’s Doctor of Physical Therapy Program opened in June 2010 and offers a full-time, continuous 36-month curriculum to prepare physical therapists to practice in a variety of settings. Graduates are trained to provide direct patient care as well as consultation, education, critical inquiry, and health promotion. Judy Woehrle, PT, Ph.D., OCS, is the inaugural Director of the new program. For more information, contact the Office of Admissions at 1-888-247-9277, send an email to admissaz@midwestern.edu, or go to www.midwestern.edu. Cuts for Kids: Haircuts for a Cause – March 14, 4:00 pm to 7:00 pm Join us for the annual Cuts for Kids hair donation and family fun event. Professional hairstylists will cut hair free of charge (minimum hair length of 10 inches required) to donate for wigs for children with long-term hair loss. For more information, go to www.midwestern.edu/azcutsforkids.xml or call the Office of Student Services at 623/572-3213.

APPOINTMENTS, AWARDS & GRANTS Jeffrey Costas, MS-II (AZCOM), was awarded a $2,227 grant from the American Medical Association (AMA) Foundation’s Seed Grant Research Program in March. He will use the funds to work in the lab of Jeffrey Plochocki, Ph.D. (AZCOM), Assistant Professor, Anatomy, to study the effects of exercise and prednisolone on the progression of dilated cardiomyopathy and cardiac fibrosis with muscular dystrophy. Julia Iafrate, MS-III (AZCOM), won first place in the poster competition at the annual AOA conference in San Francisco for her research poster “Magnitude and Timing of Neuroinflammation in a Forceps Lateral Compression Model of Spinal Cord Injury.” She was supported in her research through the Office of Research and Sponsored Programs Summer Fellowship program.

AOMA Digest Winter 2011

30

Charles Finch, D.O. (AZCOM), Chair, Integrated Medicine, received the 2010 Hon Kachina Volunteer Award for his work with Camp Paz, a weekend grief camp for children that he started in 1999. Lori Kemper, D.O., M.S., FACOFP (AZCOM), Dean, received the Arizona Osteopathic Medical Association (AOMA) Excellence in Osteopathic Medical Education Award. Cory Maughan, MS-IV (AZCOM), received the Arizona Osteopathic Medical Association (AOMA) Student Distinguished Service Award.

Alan Schalscha, D.O. (AZCOM), Clinical Assistant Professor, Clinical Education, was honored with the Arizona Osteopathic Medical Association (AOMA) Humanitarian Award for his annual work in the DOCARE International program and recent work in Guatemala. Krishnaswami Vijayaraghavan (Kris Vijay), M.D. (AZCOM), Director of Critical Care, Clinical Education, was one of several recipients of the President’s Award for Innovation from Arizona State University at ASU’s Presidential Recognition Reception on April 8. The award was presented to Dr. Vijay and his team from the ASU Center for Healthcare Innovation and Clinical Trials, where he serves as a member of the Executive Board.


Osteopathic Community News

t

School of Osteopathic Medicine in Arizona prepares for inaugural graduating class

he core of the ATSU-SOMA medical program is a partnership with the National Association of Community Health Centers (NACHC) to address those individuals living in the nation’s underserved communities. ATSU-SOMA students – in their second through fourth year of medical school – continue their basic science and clinical curriculum studies while serving in 11 Community Health Centers (CHCs) throughout the United States. Neil Aboul-Hosn is one of the students who will be graduating in June from ATSU-SOMA. “I am a direct, hands-on learner, and the SOMA program enabled me to apply didactic learning to the patient experience,” said Aboul-Hosn. “The experience at the community health centers also puts into perspective the fact that individuals who are uninsured or underinsured and live in a rural population can have access to sufficient primary care.” Grant Brinkley will also be participating as an inaugural graduate of ATSU-SOMA. “The clinical exposure in the second year is the reason I chose SOMA,” said Brinkley. “In addition, my experience at the community health centers allowed me to learn about the continuity of patient care from primary care to specialties. “I am definitely glad to be part of a trailblazing, innovative program of medical study.” “ATSU-SOMA’s unique approach to medical education equips ‘healers’ with the knowledge, skills, and attitudes necessary to improve the wellness of vulnerable populations,” said Dr. McWilliams. “It is our hope that most of these graduates choose needed specialties and return to practice in communities of need following completion of their residency training.”

June 3, 2011 will be an historic moment for ATSU’s School of Osteopathic Medicine in Arizona (ATSU-SOMA). That is when 97 students will participate in ATSU-SOMA’s inaugural graduation. For four years, students have been enrolled in a unique curriculum that includes interaction with patients as early as their second year of school. “This is a very special moment for both the state of Arizona and the nation as a whole,” said ATSU-SOMA Dean Thomas McWilliams, D.O., FACOFP. “This will be the first graduating class from a unique osteopathic medical school that combines the latest in curricular models with contextual learning while embedding students in underserved communities for three out of the four years of undergraduate training.”

AtSU receives $5.86 million in HRSA grants

t

Funds keep University programs and technology on cutting edge to benefit communities

he Health Resources and Services Administration (HRSA) recently awarded A.T. Still University (ATSU) eight grants totaling more than $5.86 million. These gifts will greatly benefit the Kirksville, Mo., and Mesa, Ariz., communities, and beyond. In all, ATSU was awarded more than 75 percent of HRSA’s Federal Health Professions grant funding in Arizona and more than 60 percent of all grants in Missouri. “These significant grants will allow ATSU to better serve our communities and to carry out our mission to serve rural areas and underserved populations in Arizona and Missouri,” said ATSU President Jack Magruder. All grant funds are dedicated to specific areas and cannot be used for anything else. Three of the eight grants are for five-year projects. A $1.75 million award will establish a department of family and community medicine at ATSU’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) for the purpose of training community health centers (CHCs) to meet the needs of vulnerable populations. ATSU News cont. page 32

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AOMA Digest Winter 2011


Osteopathic Community News

ATSU News cont. from page 31 ATSU’s Arizona School of Dentistry & Oral Health (ATSU-ASDOH) and the School of Health Management (SHM), headquartered in Kirksville, Mo., received $1.5 million for a workforce development initiative to produce oral health leaders for community health centers and public health settings. A grant of $1.11 million was awarded to ATSU’s Kirksville College of Osteopathic Medicine (ATSU-KCOM) to intensify instruction and assessment in health literacy, public health, and electronic medical records, emphasizing the medical home model of care. The five remaining grants were received through the HRSA’s American Recovery and Reinvestment Act (ARRA). Each ARRA grant is worth $300,000 and that $1.5 million is allocated for the acquisition and use of teaching resources and classroom technology, including simulated patients, defibrillators, and a video communications system. These grants were awarded to ATSU’s Arizona School of Health Sciences (ASHS), SOMA, and KCOM. Douglas Wood, D.O., Ph.D., ATSU Senior Vice President – Academic Affairs, said that “the funding from these awards will first and foremost benefit the patients and the healthcare professionals in primary care, public health, and underserved locations. These new resources will help ATSU to concentrate on sound and innovative education and compassionate practice.” HRSA is an agency of the U.S. Department of Health and Human Services and is the primary federal agency for improving healthcare service for the underserved. HRSA provides leadership and financial support to healthcare providers, healthcare professionals, and is committed to improving the healthcare system in rural communities.

KCOM alumnus assists in Chilean rescue

J

ames Polk, D.O., a 1993 graduate of ATSU’s Kirksville College of Medicine (ATSU-KCOM), met with President Barack Obama on Oct. 28 along with members of the NASA team and other Americans involved in the rescue of 33 trapped Chilean miners. NASA officials presented NASA’s Exceptional Achievement Medal to five agency employees, including Dr. Polk, who is chief medical officer at NASA Johnson Space Center in Houston. Dr. Polk and the NASA team traveled to Chili Aug. 30-Sept. 5 to visit the mine and consult with Chilean organizations. NASA provided technical advice to the Chilean government, as well as recommendations on medical care, nutrition, and psychological support.

J.D. Polk, D.O., ATSU-KCOM alumnus, with President Barack Obama. Photo Credit: (NASA/Paul E. Alers)

AOMA Digest Winter 2011

32

Lawrence LeBeau, D.O., joins SOMA faculty

L

awrence R. LeBeau, D.O., joined the faculty of A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) as assistant professor on Dec. 13, 2010. Dr. LeBeau’s primary responsibilities are assisting with the medical skills course and providing classroom presentations in clinical medicine. Prior to coming to Lawrence LeBeau, D.O. ATSU, Dr. LeBeau was a staff physician at Catholic Healthcare West Urgent Care Center in Gilbert, Ariz. He also served as a staff physician at Adelante Healthcare in Phoenix, Ariz. From 1996-1998 he was chairman of the Department of Family Practice at Mesa General Hospital. Dr. LeBeau received his Doctor of Osteopathy from ATSU’s Kirksville College of Osteopathic Medicine in 1992. He is an active member of the Arizona Osteopathic Medical Association (AOMA), the American Osteopathic Association, and the American College of Osteopathic Family Physicians. He currently serves on the AOMA Board of Trustees and in the House of Delegates.


Osteopathic Community News

M

Researchers collaborate at IBRS 2010

ore than 80 students, faculty, professionals, and guests gathered Oct. 9 in the Connell Information Technologies Center on ATSU’s Missouri campus for the second annual Interdisciplinary Biomedical Research Symposium (IBRS) sponsored by ATSU’s Still Research Institute. The IBRS 2010 gave local researchers the opportunity to present current research activity involving students and provided a foundation for promoting collaborative biomedical research between the ATSU and Truman State University campuses. The annual event consists of both research presentations and a keynote address. In total, 37 different research projects were presented. Brian Degenhardt, D.O., SRI Director, said he was impressed with IBRS 2010. “The scientists did an excellent job presenting their cutting edge research in a manner that was easily understandable,” he said. “All of the research presented has the potential to answer questions that will affect the future of healthcare.” William D. Pace, M.D., delivered this year’s keynote address. Dr. Pace is professor of family medicine and Green-Edelman chair for practice-based research at the University of Colorado. He is director of the American Academy of Family Physicians’ National Research Network, director of a consortium of practice-based research networks within the University of Colorado, and the Department of Family Medicine’s information services group. “Attendees seemed engaged and willing to explore a fairly full spectrum of research activities from the molecular to the practice levels,” Dr. Pace said. “The collaborative effort to reach across universities was quite apparent, as was the interest in reaching across the two campuses of ATSU.” Neil Sargentini, Ph.D., chair of Microbiology and Immunology at ATSU-KCOM and a member of the IBRS committee, hopes the event will grow in the future. “We are tapping into only a small fraction of students involved in biomedical research, so we still have lots of potential to grow,” Dr. Sargentini said. “At this symposium, Dr. Degenhardt outlined a new research program to facilitate the development of clinical researchers starting with Truman undergraduate students and beginning medical students. This program can be expected to significantly increase the number of student presentations at the IBRS in the near future.”

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AOMA Digest Winter 2011


Osteopathic Community News

SOMA Students Impact Lives in Haiti

J

ean, a 28-year-old man who had lost most of his family in the January 2010 earthquake and was living in one of the tent cities in Port-au-Prince, Haiti, came to the medical clinic with a persistent cough. That is where A.T. Still University School of Osteopathic Medicine in Arizona (ATSUSOMA) students Grant Brinkley, OMS IV, and Neil Aboul-Hosn, OMS IV, first met him. Jean not only lost his home to the earthquake, but a subsequent storm had displaced him from his tent home and he was forced to go to a friend’s tent. Brinkley and Aboul-Hosn were in Haiti to provide medical care to survivors of the earthquake. From Oct. 3-10, 2010 they

AOMA Digest Winter 2011

34

accompanied Dr. Richard Kirsch, an ob/ gyn in private practice from Thomasville, N.C., on this medical mission to Haiti. The medical mission was organized through Maryknoll Fathers and Brothers, a Catholic faith-based organization located in New York. Included also on the trip were 12 other volunteers that included nurses, translators, a respiratory therapist, and laboratory technician. Over the seven-day mission, the medical group visited four different tent cities – displaced Haitian communities – across Port-au-Prince. General medical services as well as ob/gyn examinations were provided to more than 800 Haitian individuals.  “We

visited different tent cities every day,” said Brinkley. There was a critical shortage of medications and medical treatment.” “Disbelief was my initial impression when we landed in Port-au-Prince,” said Aboul-Hosn. “This disbelief was soon replaced by a sense of fear and sadness as we drove through the devastated city with the continuous view of poverty and destruction. “There was no means of public sanitation,” added Brinkley. “Clean water was hard to come by.” Each morning the mission group set up a small pharmacy, laboratory, and examination rooms for medical and ob/gyn exams. Many of the health problems of individuals included hypertension, uncontrolled diabetes, conjunctivitis and sexually transmitted diseases. Jean had a history of asthma, which was worsened by the everpresent dust from the earthquake rubble. The medical team was able to provide relief from his symptoms by giving him the needed medication to treat his asthma. “Many patients also had sleep issues and underlying depression and anxiety,” said Aboul-Hosn. “It was a true test of my physical exam and history-taking skills in order to provide appropriate medical care. I found that my training from SOMA was sufficient to provide the general care that was needed. Overall, this was an extraordinary experience of which I was happy to be a part.” “What amazed me was the resilience and outlook of the Haitian people,” said Brinkley. “Almost everyone we spoke with believed that Haiti –with the help of others – would rebuild and be alright.”


Osteopathic Community News

Doctors Snow, Hutchinson Elected New Leaders DOCTOR HA LLAQ HONORED

Fellowship at the Post Graduate Institute of Osteopathic Medicine New York City Hospital.

K

enneth S. Snow, D.O. is the new Chairman of the Board of the Tucson Osteopathic Medical Foundation. He was elected Chairman at the Foundation’s annual meeting in September, 2010 and will serve a two year term of office. Dr. Snow, who was the first person to grace the cover of the Foundation’s popular magazine for D.O. patients, and who was instrumental in naming it Something More for You the Osteopathic Patient, is a board certified ophthalmologist in practice with Barnet Dulaney Perkins Eye Center. He is a 1981 graduate of the University of Health Sciences, College of Osteopathic Medicine in Kansas City, Missouri. He also holds both a Masters and Bachelors degree from Utah State University and has served as a Trustee of the Foundation since 1992. He served as Chairman once before in 1996 and has been extremely active in guiding the financial affairs of the Foundation as well as inaugurating its web site which is now the primary resource for participation in all the Foundation’s programs. Jerry H. Hutchinson, Jr., D.O., is the new ChairmanElect of the Foundation. He has been the developer, Chairman and guiding force behind Tucson’s longest running, largest registration, regularly recurring CME conference, the Foundation’s Southwestern Conference on Medicine, started in 1991.

He was honored for his more than 40 years of service to osteopathic medicine, during which he served as mentor and preceptor for many of Arizona’s leading Lew Riggs, Ed. D., CAE osteopathic physicians, TOMF Executive Director including the dean of one of the colleges. He developed and chaired many of the key departments at Tucson General Hospital including its extensive teaching program. Upon the sale of the hospital he helped form the Tucson Osteopathic Medical Foundation and was instrumental in developing the precepts and guidelines for its successful Founder’s Awards Program which provided scholarships to osteopathic medical students. His experience and guidance was also recognized for shaping and implementing many of the Foundation’s successful programs in undergraduate and continuing medical education.

Dr. Hutchinson is board certified in Internal Medicine and is a 1985 graduate of the Kirksville College of Osteopathic Medicine and a Commander in the U.S. Naval Reserve. He is also a 1980 graduate of the University of Arizona holding a Bachelor of Science in Biological Science. Issa Y. Hallaq, D.O., outgoing Chairman of the Board, was honored at a special meeting of the Board of Trustees on December 17, 2010 at Lowe’s Ventana Canyon Resort in Tucson. A graduate of the Kirksville College of Osteopathic Medicine with an undergraduate degree from Eastern Michigan University, Dr. Hallaq also holds a Neurological

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AOMA Digest Winter 2011


D. O. Day

Arizona Osteopathic Medical Association

Tuesday, February 15, 2011 8:00am – 12 noon

Arizona State Capitol 1700 W. Washington Street Phoenix, AZ

D.O. Day will feature a new, morning-only format this year.

8:00am 9–12 noon 9:30am 10:00am TBD

Orientation (will also take place via webinar on February 9th at 6pm) Individual Office Visits with your Legislators Meet Chair of the Senate Health Committee, Sen. Nancy Barto Meet Chair of the House Health Committee, Rep. Cecil Ash Meet with Health Policy Advisor to Governor Brewer, Beth Kohler-Lazare

Contact Teresa in the AOMA Office for details – 602-266-6699; fax 602-266-1393 or go to the AOMA website http://www.az-osteo.org Please plan to join us for all or part of the event.

q Yes, I will attend D.O. Day at the Legislature. I plan to attend: All Morning: ______ (8am – 12 pm)

Other: ___________________________________ (please specify)

Name: ___________________________________________ Spouse / Guest: ________________________________________ Home Address: ________________________________________________________________________________________________ (We must have the HOME address to determine legislative district for meetings)

AOMA Digest Winter 2011

36


Just D.O. It

Team of Physicians for Students (Tops) Day TOPS

Just D.O. It for TOPS – Volunteers are needed for this free sports screening day for high school athletes participating in school-sponsored sports. This year’s event will be held at Sunnyslope High School in Phoenix on Saturday, April 30, 2011 from 7:00am - 4:00pm. The AOMA is asking its member physicians to volunteer for a two or three-hour shift for this year’s TOPS event. TOPS will be held on Saturday, April 30, 2011 at Sunnyslope High School (35 W. Dunlap) in Phoenix. Osteopathic Medical Students from AZCOM and KCOM will be performing the sports screenings, ECGs, and ECHOs (when indicated) are being offered. Osteopathic Physician volunteers will supervise the students to review their work and recheck for any potential pathology. Simply complete this form with your name, phone number, and shift preference then return it to the AOMA Office via fax (602) 266-1393 or email teresa@az-osteo.org Volunteering for TOPS helps:

3 High school students receive their free sports screenings and health tips to stay on the team; 3 Upcoming osteopathic medical students hone their skills; and 3 You feel good about participating in an osteopathic community outreach event.

Don’t Delay – Sign Up Today! (Please print clearly) Name:___________________________________________________________________________________________________________________ Phone: ________________________________________________________________________________________________________________________

________Shift 1 – 7 a.m. to 9 a.m.

________Shift 4 – 1 p.m. to 3 p.m.

________Shift 2 – 9 a.m. to 11 a.m.

________Shift 5 – 3 p.m. to 5 p.m.

________Shift 3 – 11 a.m. to 1 p.m.

[ ] I am willing to work a 3 hour shift.

TOPS needs more doctors who are willing to spend part of a Saturday, once a year to participate and supervise student doctors. The TOPS team promises to feed you, thank you and give you an experience to remember. Return completed form to AOMA via fax (602) 266-1393 or to the Steingard Medical Group, Attn: Betty via fax at (602) 336-0044.

37

AOMA Digest Winter 2011


Features

Third Annual Clinical Case and Poster Competition

T

he Arizona Osteopathic Medical Association is pleased

to the Presidential Gala on Friday night, April 8th, 2011 at

to announce its third annual student case and poster

which time a $500 award for the top clinical case and poster

competition. We are looking for interesting clinical cases

will be given.

and original research that osteopathic medical students have

Please take advantage of this opportunity to show off the

seen and diagnosed. If you or your students have a clinical

great work being done in the clinical setting. If you have

case or poster, we invite you to participate. Please see the

any additional questions, please contact Flannery O’Neil at

attached description and requirements.

the Arizona Osteopathic Medical Association by calling

The Professional Education Committee will review all of

602-266-6699 or via email flannery@az-osteo.org.

the submissions, and select the top three clinical cases and posters. The top three students in the case competition will

Sincerely,

present their case on Student Day, April 5th, 2011 at the

Charles Finch, D.O., FACOEP

Convention in Scottsdale, Arizona. All poster submissions

Past President, Arizona Osteopathic Medical Association

that follow the submission criteria will be displayed and

Chair, AOMA Clinical Case and Poster Competition

judging on the finalists will take place. The top three

Committee Member, AOMA Professional Education

individuals (cases and posters) and their guest will be invited

AOMA Digest Winter 2011

38

Committee


Features

3rd Annual Student Clinical Case and Poster Competition Case Competition Guidelines Open to all third and fourth year osteopathic medical students in Arizona 1. Select an interesting topic/illness 2. The case format should be presented in the following manner: a. Chief complaint b. History of present illness c. Past medical and surgical history d. Medications and allergies e. View of systems f. Physical examination (head to toe) to include vital signs g. Laboratory and ancillary data h. Diagnostic impression i. Plan/Disposition

3. Discussion a. This section should include adequate reference materials that demonstrate your clear understanding of the pathology, work-up, differential diagnoses and treatment. 4. References a. The references must be included in standard scientific format, with at least one reference from an osteopathic source.

Poster Competition Guidelines

Open to all osteopathic medical students in the State of Arizona. Interested students must submit an abstract of their clinical poster which represents research and review of literature supporting the clinical diagnosis. Guidelines 1. Select an interesting research topic 2. The poster should be formatted in the following manner: a. Title b. Abstract c. Introduction d. Materials and methods e. Results f. Conclusions g. Literature cited h. Acknowledgments i. Further information Submission Deadline: The deadline for submissions is February 15th, 2011.

Judging: The members of AOMA’s Professional Education Committee will review all submissions received by the deadline. All poster submissions that follow the submission criteria will be allowed to present at the AOMA Student Day, Tuesday, April 5th, 2011. The poster entrants and top three case presentations will be notified no later than March 15th, 2011. They will be asked to present their posters and case presentations during the AOMA Spring Convention Student Day, Tuesday, April 5th, 2011. The top three entrants in each category will be invited to attend the Gala event on Friday, April 8th, 2011. The winners of the case and poster competitions will each be presented a $500 award.

Submission Info: Abstracts should be submitted to Flannery O’Neil at flannery@az-osteo.org or Arizona Osteopathic Medical Association, Student Case and Poster Competition, 5150 N. 16th St., Ste. A-122, Phoenix, Arizona 85016.

39

AOMA Digest Winter 2011


Eighty-ninth Annual Convention

Call for Nominations

AOMA 2011 Awards Nomination Form WHAT YOU NEED TO KNOW:

These awards represent the highest honor that the Arizona Osteopathic Medical Association can bestow in recognition of outstanding service and contribution to the osteopathic profession in Arizona. 2) Only AOMA members can submit an AOMA Award nomination form. 3) Fill in your AOMA member nomination with information and sign and date the form. 4) Return nomination form to the AOMA Office by February 15, 2011. 5) The AOMA Awards will be presented on April 8, 2011 at the AOMA 89th Annual Convention. q PHYSICIAN OF THE YEAR AWARD – Been in practice at least five years; Provides his/her community with compassionate, comprehensive and caring medical service on a continuing basis; Directly and effectively involved in community affairs; Supports his/her community, state, professional associations and humanitarian programs. q DISTINGUISHED SERVICE AWARD – Honors a non-physician who has significantly contributed to improving the community and promoting osteopathic medicine. q PRESIDENT’S AWARD – Honors an AOMA member who has contributed significantly to the AOMA via the Board of Trustees, House of Delegates and/or Committees. q EXCELLENCE IN OSTEOPATHIC MEDICAL EDUCATION – Honors a physician or non-physician who has contributed significantly to the advancement of osteopathic medicine in Arizona. q HUMANITARIAN AWARD – Honors a socially responsible AOMA member who has donated his/her time and/or efforts to improve mankind. q STUDENT DISTINGUISHED SERVICE AWARD – Honors students currently enrolled in A.T. Still University’s School of Osteopathic Medicine Arizona and Midwestern’s Arizona School of Osteopathic Medicine who have provided significant contributions and service to the school. q OUTSTANDING MENTOR AWARD – Honors a physician who has volunteered his or her time to students or physicians as a mentor and is known as “one who makes a difference” in that person’s life. q VOLUNTEER OF THE YEAR AWARD – Honors those who have volunteered their time and provided significant contributions and services to the community and/or the Association.

Nominations: Award Name:____________________________________________________________________________________________________ Nominee’s Name:________________________________________________________________________________________________ Reason for Nominating:_ _________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ Award Name:____________________________________________________________________________________________________ Nominee’s Name:________________________________________________________________________________________________ Reason for Nominating:_ _________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ Please check the award(s) for which you will be making a nomination. Refer to next page for previous recipients. Return completed form to the AOMA Office by February 15, 2011 by mail to AOMA, Attn: Teresa Roland, 5150 N. 16th St., Ste. A-122, Phoenix, AZ 85016; orby fax to 602.266.1393, Attn: Teresa Roland, or email teresa@az-osteo.org. For more information contact AOMA Executive Director Amanda Weaver at 602-266-6699 or mweaver@az-osteo.org. Member Name_________________________________________________________________________

AOMA Digest Winter 2011

40

Date:________________


Eighty-ninth Annual Convention

AOMA Awards – Previous Winners January 2011

Physician Of The Year Award Previous recipients: Jan. Zieren, D.O.; James Dearing, D.O.; Carrol E. Wheat, D.O.; Kelli M. Ward, D.O; Lori Kemper, D.O.; Craig Hoffbauer, D.O.; Paul M. Steingard, D.O.; Steven Pitt, D.O.; David Bryman, D.O.; John F. Manfredonia, D.O.; Nicholas Pazzi, D.O.; Joseph J. Lovett, D.O.; William Inboden, D.O.; F. Timm McCarty, III, D.O.; Stanley Brysacz, Jr., D.O.; Karen J. Nichols, D.O.

Distinguished Service Award Previous recipients: State Senator Carolyn Allen; Arizona Medical Association Leadership; Bradford Croft, D.O.; Lew Riggs, Ed.D., CAE; Senator Robert Cannell, M. D.; Ross Kosinski, Ph.D.; Marge Croushore; Shirley Carpenter; Karen J. Nichols, D.O.; State Senator Susan Gerard; U.S. Senator Jon Kyl; Paul M. Steingard, D.O.; Robert Bohm; MICA; H. Ted Podleski; Jerry Colangelo

President’s Award Previous recipients: Michael Altamura Jr., D.O.; Thomas McWilliams, D.O.; Sanford Moretsky, D.O.; Bradford Croft, D.O.; Jan Zieren, D.O.; Jeffrey W. Morgan, D.O.; Deborah M. Heath, D.O; Nicholas C. Pazzi, D.O.; Lawrence K. Sands, D.O.; Karen J. Nichols, D.O.; Lori A. Kemper, D.O.; Craig E. Hoffbauer, D.O.; Leonard Staff, Jr., D.O.; Harmon L.Myers, D.O.; John F. Manfredonia, D.O.

Excellence In Osteopathic Medical Education Previous recipients: Lori Kemper, D.O.; Harmon Myers, D.O.; Dana Sue Devine, D.O.; Ross J. Kosinski, Ph.D.; State Senator Susan Gerard; William H. Devine, D.O.; Thomas McWilliams, D.O.; Kathleen Goeppinger, Ph.D; Dean James Cole, D.O.; Richard Dobrusin, D.O.; Wilbur V. Cole, III, D.O.; Craig M. Phelps, D.O.; John F. Manfredonia, D.O.; Mitchell Kasovac, D.O.; Jack Kinsinger, Ph.D.

Humanitarian Award Previous recipients: Alan Schalscha,D.O.; Richard Reilly, D.O.; Kevin M. McCabe, D.O.; Lieutenant Colonel Michael Ward, D.O.; Robert Tognacci, D.O.; L. Markham McHenry, D.O.; James W. Cole, D.O.; Thomas B. Bennett, D.O.; Charles (Chip) Finch, D.O.; Thomas W. Eyler, D.O.; Lawrence R. LeBeau, D.O.; Kenneth E. Root, D.O.

Student Distinguished Service Award Previous recipients: Cory Maughan, AZCOM; Michael Paddock, KCOM; Melissa Blessing, SOMA; Brian Liem, AZCOM; Eugene Bukham, KCOM; Danielle Barnett, SOMA; Stacie Gooch, KCOM; Ben Wilde, AZCOM; Tom Chavez, ATSU; Amy Adams, AZCOM; B. J. Ho, AZCOM; Rebeccah Rodriguez, KCOM; Jessica Jewart, AZCOM; Melody Rodarte, AZCOM; Christine Estrada, AZCOM; Helene Labonte-Carroll, AZCOM; Suzanne Frasca, AZCOM

Outstanding Mentor Award Previous recipients: Thomas E. McWilliams, D.O.; Mitchell Kasovac, D.O.; Tracy O. Middleton, D.O.; Jordan Ross, D.O.; Karen J. Nichols, D.O; Scott Steingard, D.O; Ben Field, D.O.

Volunteer Of The Year Award Previous recipients: William Rappoport, M.D.; Rev. Dick Stafford; Deborah Hudak, D.O.; Leonard Staff, D.O.; Betty Toothman

41

AOMA Digest Winter 2011


Eighty-ninth Annual Convention

arizona osteopatHiC meDiCal assoCiation

Eighty-ninth Annual Convention April 5 – 9, 2011

Osteopathic Medicine:

Learning Today, Preparing for Tomorrow

Lori A. Kemper, D. O., FACOEP

Kelli M. Ward, D.O., M.P.H., FACOFP AOMA President

Convention Education Chairperson AOMA President

thank You to our Friends of the AOMA

Mutual Insurance Company of Arizona – Platinum Sponsor BlueCross BlueShield – Gold Sponsor

AOMA Convention Exhibits – 2 Days Only Tuesday, April 5 and Wednesday, April 6 Be sure to visit the AOMA Convention Exhibitors during their 2 days of exhibits

Exhibit Hours: Tuesday, April 5, 2011 – 7:00am to 5:00pm (Boxed lunches will be served in the Exhibit Hall) Wednesday, April 6, 2011 – 7:00am to 2:00pm (Open during lunch)

Meals Registration includes daily continental breakfasts, breaks, and three lunches (Tuesday, Wednesday, and Saturday).

Important Information: All events require credentials. Advanced registration deadline date is March 19, 2010. Registration includes daily continental breakfasts, breaks, and three lunches.

Presidential Reception, Awards & Silent Auction – Mardi Gras Theme

All Convention Attendees are invited to come to the President’s Gala! There is no additional charge for each registrant to attend the President’s Gala on Friday, April 8, 2011. When you receive your packet at registration, please make your reservation for the Gala to receive your dinner ticket and purchase additional tickets for your guest(s) at $70 each. Space is limited so please make your reservations by Wednesday, April 6, 2011 at 5:00pm. The Gala includes a reception, Silent Auction, Awards Ceremony, Dinner, and Dancing. There will be no entry without a ticket.

AOMA Digest Winter 2011

42


Eighty-ninth Annual Convention

2011 Convention Registration Form April 5th – 9th, 2010 — Hilton Scottsdale, Scottsdale, Arizona

Name: ______________________________________________________________________ AOA Number: ______________________ (type or print name as you would like it to appear on your name badge)

Specialty: ____________________________________________________________________________ (for badge purposes only) Office Address: _____________________________________________________________________________________________ City, State, Zip: _____________________________________________________________________________________________ Telephone: ____________________________________________ Fax: ________________________________________________ E-mail: ____________________________________________________________________________________________________ Full Name(s) of registered spouse/guests(s): ____________________________________________________________________ REGISTRATION OPTIONS Note: Out-of-State registration applies to osteopathic physicians who are members of their respective state association. Outof-State and Arizona D.O.’s who are not members of their respective association will be charged the non-member rate. Your registration includes breakfast every morning. Lunch is included for Tuesday, Wednesday, and Saturday. Additional luncheon tickets may be purchased for $30.00 each. President’s Gala – admission is free this year! The Gala is limited to 150 attendees and tickets are given out on a first come, first serve basis. Please indicat e below if you wish to attend. Tickets will NOT be available after they have all been given out or by Wednesday, April 6th, whichever comes first. Advance Discount Registration Late Registration Please check one Through March 4, 2011 Begins March 5, 2011 q AOMA Member $595 $695 q AOMA Retired Member / Military q Out-of-State D.O. Member q Spouse/Guest (per person)

$495 $595 $325

$595 $695 $325

q Non-Physician Clinicians (i.e. nurses, PA’s, etc.)

$495

$595

No Fee

No Fee

q Students, Interns, & Residents Must register for credentials. Meal tickets may be purchased onsite. q Non-Member (in-state or out-of-state)

$950 TOTAL $______

$1050

 Friday, April 8, 2011 President’s Gala q Yes, I will attend. Please list the name of your guest: __________________________________________________ PAYMENT Register by: q VISA q MasterCard q MasterCard q AmEx Amount $ ____________ VISA or MasterCard Number: __________________________________________________ Exp Date:___________ Code: _____ Signature (for credit card): ____________________________________________________________________________________ CANCELLATION POLICY All requests for refunds must be in writing. To receive a refund, requests must be submitted by March 4, 2011. A $50 processing fee will be deducted from the amount refunded. Refunds will not be available after this date.

To register, fax to (602) 266-1393, mail to 5150 N. 16th St., Ste. A-122, Phoenix, AZ 85016, go online at http://www.az-osteo.org or call (602) 266-6699

43

AOMA Digest Winter 2011


Eighty-ninth Annual Convention

Course Description The 89th Annual Convention of the Arizona Osteopathic Medical Association (AOMA) Continuing Medical Education (CME) program has been designed to assist osteopathic physicians in refining their skills and bringing them up-to-date on the most current research and findings. Each year, the Professional Education Committee of AOMA strives to provide new evidence based information regarding etiology, diagnosis, and management in a variety of general medicine areas that will not only benefit physicians, but also the care of their patients.

Educational Objectives:

• Learn, review and update clinical and technical knowledge • Compare and relate medical knowledge and skills with those of peers and experts • Gain insight into the distinctive osteopathic approach to the diagnosis and treatment of illness • Discuss new information in the different areas of medicine and how that information will impact on the care of their patients. • Earn 32.25 hours of Category 1-A CME (Continuing Medical Education) Credits

Osteopathic Medicine: Learning Today, Preparing for Tomorrow SCHEDULE All education sessions are held in Sonora Ballroom

Tuesday, April 5, 2011 Student Day Exhibit Hours – 7am-5:30pm Grand Ballroom 7:00 – 8:00am Continental Breakfast Visit Exhibits 8:00 - 9:00am Coining, Cupping, and Cultural Competence Laurel A. Mueller, D.O. 9:00 – 10:00am History of Medicine and Anatomy Gary L. Hoff, D.O., FACOI, FACC 10:00 – 10:30am

7:00 – 8:00am

Continental Breakfast

8:00 - 8:45am Iatrogenic Disease in Hospitals Speaker TBA 8:45 - 9:45am Drug Interaction in Iatrogenic Injury Pamela E. Potter, Ph.D. 9:45 – 10:30am Pneumonia – Community Acquired Pneumonia: Real World Challenges for the PCP Ronald J. Servi, D.O., FCCP Visit Exhibits

11:00 – 12 noon Antibiotics and the Treatment of Surgical Patients Speaker TBA

Visit Exhibits

11:15 – 12 noon Challenges of Underserved Medicine: the Indian Health Service Perspective CDR Ha C. Tang, D.O. 12 noon – 1:30pm LUNCH (in the Exhibit Hall) 1:30 – 2:30pm Colorectal Cancer Screening David B. Leff, D.O.

12 noon – 1:30pm LUNCH Pavillion Visit Exhibits 1:30 – 2:30pm Speaker TBA

Transplant Surgery Update

2:30 – 3:30pm Reconstructive Plastic Surgery Vas Sabeeh, D.O., FACS 3:30 – 3:45pm

BREAK

3:45 – 4:45pm International Medicine James Cole, D.O., FAODME

2:30 – 3:30pm Hepatitis B & C Update David B. Leff, D.O.

4:45 – 5:30pm Osteoporosis Joy Schechtman, D.O., FACOI, FACR

Visit Exhibits

3:45 – 5:30pm Student Clinical Case Competition

AOMA Digest Winter 2011

Exhibit Hours 7:00am-2:30p

10:30 – 11:00am

10:30 – 11:15am Medical Hypnosis Noel Carrasco, M.D., FAAP, BCIM

3:30 – 3:45pm

Wednesday, April 6, 2011

44


Eighty-ninth Annual Convention

Thursday, April 7, 2011 7:00 – 8:00am

Continental Breakfast

8:00 – 9:00am Heart Failure Speaker TBA 9:00 – 10:00am Valvular Disease – Medical Approach William M. Jaffe, D.O. 10:00 – 10:15am

BREAK

10:15 – 11:00am Valvular Disease – Interventional Approach David J. Caparrelli, M.D. 11:00 – 12 noon Continuous Chest Compression Ross J. Kosinski, Ph.D. 12 noon – 1:30pm Lunch on Your Own 1:30 – 2:15pm Open Heart Surgery Speaker TBA 2:15 – 2:30pm

BREAK

2:30 – 4:00pm OMM Workshop Anthony M. Will, D.O.

Friday, April 8, 2011 7:00 – 8:00am

Continental Breakfast

8:00 – 9:00am Family Health American College of Gynecology (ACOG) Recommendations for Preventive Screenings Robert Marotz, D.O., FACOOG, FACOG 9:00 – 10:00am Pre-Term Births – How to Prevent Speaker TBA 10:00 – 10:15am

BREAK

1:30 – 2:30pm Joseph Lillo, D.O.

Lipidology

2:30 – 3:15pm Child Abuse / Domestic Violence Speaker TBA 3:15 – 3:30pm

BREAK

3:30 – 4:15pm How to Implement Electronic Health Records in Your Practice Adam Nally, D.O. 4:15 – 5:00pm New Changes in ICD Coding Katherine White, CPA, CPC 6:30 – 10:00pm Presidential Gala – Reception, Silent Auction, Dinner, & Dancing

Saturday, April 9, 2011 7:00 – 8:00am

Continental Breakfast

Pediatrics 8:00 – 8:45am Food Poisoning in the 21st Century Joli R. Weiss, Ph.D. 8:45 – 9:45am Strategies for Improving Adolescent Immunization Rates Doug Campos-Outcalt, M.D., MPA 9:45 – 10:00am

BREAK

10:00 – 11:00am Care of Homeless Children Speaker TBA 11:00 – 12 noon Adolescents & Self Injurious Behaviors Randall Ricardi, D.O. 12 noon – 1:30pm President’s Luncheon Ballroom

Grand

10:15 – 11:15am Tuberculosis Maricela P. Moffitt, M.D. 11:15 – 12 noon Syphilis Melanie Taylor, M.D. 12 noon – 1:30pm Lunch on Your Own

Speaker program subject to change at the sole discretion of AOMA convention management.

45

AOMA Digest Winter 2011


Eighty-ninth Annual Convention

2011 Meeting Dates and Locations February 15, 2011 D.O. Day at the Legislature Arizona State Capitol April 5, 2011 AOMA Board of Trustees – 7:00 p.m. April 5 – 9, 2011 AOMA 89th Annual Convention Scottsdale Hilton Resort & Villas 6333 N. Scottsdale Road Scottsdale, AZ April 7, 2011 AOMA House of Delegates 3:45 – 6:00 p.m. PAC Reception – 6:00 p.m. November 12 & 13, 2011 30th Annual Fall Seminar Tucson, AZ

AOMA Digest Winter 2011

46

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2011 AOMA Winter Digest  

AOMA's 2011 Winter Digest - Special Health Information Technology Edition

2011 AOMA Winter Digest  

AOMA's 2011 Winter Digest - Special Health Information Technology Edition

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