NGPG Accomplishments 2020

ACCOMPLISHMENTS

2020

Improving the health of our community 2020 was definitely one for the history books. Our children and grandchildren will learn about COVID-19 and how pandemics are shaped by people’s actions and politics around the world. Like our grandparents telling war stories, we will be able to give them our own insight of the diligent, faithful and often heroic actions we witnessed in our day-to-day lives as part of the Northeast Georgia Health System (NGHS) family.

Before we even had our first confirmed case in northeast Georgia, the

Daniel Tuffy, MBA, FACHE, CMPE, NGPG President & Chief Administrative Officer

Northeast Georgia Physicians Group (NGPG) team rose to the growing demands placed on them. The priority was to care for our patients – even though we were still learning about the novel virus. We stepped up safety protocols and the timeline for virtual health at a record pace. When patients in our offices could see nothing but our eyes above a mask, we made an extra effort to connect, to comfort and to let them know they were seen and heard and cared for. This was all done while we continued to expand NGPG to prepare for the growing needs of northeast Georgia.

It has been my privilege to be a part of the innovative adaptations among our clinicians, administrators, and office staffs. With a “must-do, can’tfail” diligence, you have overcome obstacle after obstacle to care for our patients and one another, to live our values and help calm a community by your genuine concern for others.

After all, we are one team with one goal – fulfilling the mission of improving the health of the community in all we do. Thank you for

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everything you do!

Learn more at ngpg.org/one-team

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COVID-19 Response

THANK YOU CRITICAL CARE, INPATIENT MEDICINE & URGENT CARE CRITICAL CARE

INPATIENT MEDICINE Our hospitalists cared for

Critical Care physicians cared for

5,377

22%

patients who spent a combined

more patients in 2020.

In addition, because the length of stay for many of those patients was much longer, those same physicians have seen the number of patient days increase by 83%.

48,459

days in our hospitals.

URGENT CARE VOLUME INCREASES BRASELTON

CLEVELAND

increase

increase

40%

COVID TESTS ADMINISTERED

DACULA

DAHLONEGA

DAWSONVILLE

OVER

increase

increase

increase

64,000

11%

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7%

9%

16%

Many of our NGPG Family Medicine, Internal Medicine and Pediatrics locations began offering special services to make accessing care more convenient for patients.

CURBSIDE FLU SHOTS & CHILDREN’S VACCINATIONS

SEPARATE HOURS OR WAITING ROOMS FOR WELL & SICK VISITS

CURBSIDE WAITING ROOMS

SEPARATE ENTRANCES FOR LAB & NURSE VISITS

Our Safety Precautions

COVID-19 Response

CURBSIDE APPOINTMENTS & LABS

Following guidance from the Centers for Disease Control (CDC) and other experts, NGPG implemented the following measures to keep patients and staff safe: • Screenings at our entrances to ensure that any patients, staff or visitors with

COVID-19 symptoms are not exposing others.

• More frequent cleaning and decontamination of our offices using products that are proven to kill viruses and bacteria.

• Equipping our care teams with face masks and additional PPE, and ensuring that patients who enter are wearing a mask.

• Adhering to social distancing guidelines by asking patients to wait for appointments in their cars, enforcing social distancing in waiting rooms and limiting the number of people in our offices by staggering appointments.

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EXPANDED E-VISIT OPTIONS In response to the pandemic, we added e-visit options for additional illnesses. Patients can now simply answer a few simple questions in MyChart that trigger an email to a provider who reviews symptoms, and then may order a prescription for pick up.

VIDEO VISITS FOR TELEHEALTH When the pandemic forced NGHS/NGPG to temporarily close some of its services, many patients were still able to get the routine care they needed through video visits using their phone, tablet or laptop. Now that video visits are standard practice, teams are working to improve this option by creating a standard experience across locations and services.

COVID-19 Response

ONLINE URGENT CARE WAIT TIMES To minimize crowding in our Urgent Care lobbies, we worked to make sure patients knew they could see current wait times for any Urgent Care location, save their spot in line, set text reminders for when to leave their house and get directions all in one place at nghs.com/urgent-care.

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YOUR CARE FROM ANYWHERE.

MEDICAL PARK 2 OPENS

In June, NGHS celebrated the completion of a three-story medical office building, Gainesville’s newest healthcare destination. NGHS expects more than 400 patients will visit Medical Park 2 each day – totaling a staggering 96,000 patients each year visiting one of four NGPG practices, the retail pharmacy with drive-thru, the onsite lab or the x-ray suite.

The NGPG Family Medicine and Internal Medicine practices in Medical Park 2 will greatly increase the number of primary care providers in Hall County, and both practices offer the community the opportunity to interact with some of NGMC’s resident physicians. Medical Residents are licensed doctors who are continuing their medical training in a specific specialty, and patients realize several benefits of having residents involved in their care.

In addition, Medical Park 2 is home to NGPG Surgical Associates, a well-established general surgery practice that moved from its previous location on the NGMC Gainesville campus to a larger suite on the third floor of Medical Park 2. The building also hosts the NGPG Pulmonology practice - which is a new specialty the group established to help fill a shortage in the market.

Administration

• Creation of Physician Service Line Directors • Monthly NGPG Newsletter • Secured and managed PPE donations

Physician’s Group Revenue Cycle • Adapted to constant (sometimes multiple times a day) changes in billing requirements for COVID-19 diagnoses and treatments • Rapidly initiated and implemented a work-from-home strategy for the Coding, Accounts Receivable, and Payment Posting Teams keeping cash flowing for NGPG • Increased our Employee Engagement Scores, even in the middle of a pandemic • Developed a mechanisms to apply for and receive CARES Act funding for non-insured patients with COVID-19 related diagnoses and treatments • Surpassed our FY20 cash goal, even with COVID-19, as a result of strong commitment within the NGPG Revenue Cycle teams

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Allergy & Asthma

• First in region to start Palforzia treatment (peanut immunotherapy) as an option for our patients.

• Dr. Andy Nish was listed in GEORGIA TREND MAGAZINE’S 2020 TOP DOCTORS LIST. • Added a new provider, Faria Khan, MD, MBA.

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Behavioral Health • Excelled at providing psychotherapy virtually.

• Exceeded records for patients requesting appointments.

• Worked collaboratively to create the most access possible for people in need.

Cardiovascular & Thoracic Surgery GAINESVILLE & BRASELTON • Added two new surgeons – Jason Budde, MD and Dimitrios Tsirigotis, MD. • Consistently scored high through the STS data base.

Critical Care GAINESVILLE & BRASELTON • Opened and staffed the COVID ICU, caring for the sickest COVID-19 patients in our region.

• As of October 1st, Gainesville’s Medical ICU and 12 beds in Braselton’s ICU are considered “closed” units. This is years in the making and a huge accomplishment for this team! A “closed” unit means our team of Medical Intensivists are the only attendings, caring for all patients in this unit, which has shown to improve communication and quality for patients.

• Welcomed many new providers, including more than 30 disaster locums to help support our team in the COVID ICU.

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Family Medicine

AUBURN • The team received a certificate of recognition from the NCQA for delivering high quality diabetic care in July 2020.

BUFORD • Margaret Doku, FNP-C, and Dena Patel, FNP-C, started a sick clinic prior to it becoming regional.

• Welcomed three advanced registered nurse practitioners (ARNP): Amanda Meeks, Dellinia Burgess and Joslin John.

• Implemented “curbside” services that included labs, vitals, and vaccinations for patients with fears of entering the office and to aid with video visit appointments.

CLAYTON • The team at NGPG Clayton Primary Care has come together to make the office safe and secure for all patients.

• We offered video visits with patients and curb side service with Zoom for patients who did not have electronic devices.

• We have been successfully escorting patients in and out of office without crossing with other patients.

• The staff has done an amazing job to help keep the patient flow going without patients having to wait for long.

• We are so blessed to have such a great TEAM at NGPG Clayton Primary Care.

CHESTNUT MOUNTAIN • Dr. Christina Nguyen and Dr. Tuhina Patel began offering non-surgical weight loss services.

• Shaniqua Sims, FNP joined the team.

• Implemented IRIS and began offering retinal screenings in office.

CLEVELAND • NGPG Cleveland has been able to flex with the changes that occurred with COVID. • Our lab made significant financial gains with the number of services we have been able to keep in house.

CUMMING • Implementation of registration and check in for patients by telephone which allows them to wait in their car until ready to be roomed.

• Despite the changes, NGPG Cumming has been able to maintain very high patient satisfaction.

• Opening of Regional Sick Clinic.

DACULA • Found ways to adapt to the pandemic.

• All Primary Care providers became credentialed with Urgent Care Dacula to lend support on high volume days.

• Staff became great at cross-training between job roles and departments and were ready to lend a hand wherever needed.

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DAHLONEGA • Dr. Allison Turk was named Best Doctor of the County for 2020.

• A 4th physician was identified to join the office in the Fall of 2021: Nathan Smith, MD. DAWSONVILLE • John Travis Nelson, MD joined the team.

• We welcomed Dr. Andrea Huntley with NGPG Psychiatry to Dawsonville.

• We successfully implemented video visit appointments for our patients.

FAMILY HEALTH ASSOCIATES • Had very engaged providers who participated in many administrative aspects including chairing on multiple committees. They are actively working to move this organization forward in positive directions.

• Persevered through massive staffing issues and still maintained top box scores in customer satisfaction.

• Worked together creatively to help bring and keep a festive spirit through the holidays. One thing that really helped was our first gingerbread house competition which was appreciated by staff and patients alike.

FLOWERY BRANCH • We communicated with our patients and the City of Flowery Branch about our presence in the office, which resulted in volumes higher than our budgeted visit volume during COVID-19 Pandemic.

• Our team remains fully engaged, with 100% participation, Team Score 4.21, +.23 vs organization.

-- Team Index – 2; Leader Index 97.

-- Our strengths are: I am satisfied with my job security; Where I work employees and management work together.

• Received NCQA Recognition • Staff Activities -- Employee Appreciation Dinner -- Bi-Weekly Friday grilling cook-out -- Dream Mile 10K -- Pumpkin Decorating Contest (And the winner is Dr Paul Cerny) -- Heroes Work Here

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GAINESVILLE • Started inpatient service in January of 2020; delivering continuity of care to our over 6,000 patients. We have been supporting Psychiatry with medicine consults, seeing their patients at Laurelwood. Service is currently averaging 10-12 patients per day.

• Practice has shown overall growth of panel size of 200% since 2018.

• COVID patients without PCPs are seen here at our clinic to support the needs of the ER and inpatient teams.

• All core faculty completed 20 hours of live Lean Six Sigma ending in all 12-program faculty and our stellar admin team achieving the Quest Green Belt certification with the help of NGHS Quest Leadership • Moved from our space in Med Park 1 to a 25,000 sq ft space in Medical Park 2. In this transition we began a medical complex lab with Dr. Leslie David as the director, four MLTS (the largest lab in the network).

• We started new service lines within our clinic including OB and women’s health complete with suite for colposcopy, procedures, and OB ultrasound. This brought us two great providers, Dr. Margaret Erwood, an FM provider with OB Fellowship, and Michele Clark a seasoned Nurse Midwife. We have also added a Pediatric service line component to our clinic with our certified pediatric nurse practitioner, Katherine Bergdale and are currently accepting now all ages of patients.

• Our GME faculty have grown. We have added 2 more core faculty. Dr. Nhi-Kieu Nguyen and Dr. Omari Hodge as our APD. We have 3 new program faculty, Dr. Faile, Dr. Purser, and Dr. Rojas. They help us teach our 12 top tier inaugural class of family medicine residents. We have pharmacy students completing co visits and contiguous GM monitoring with our patients being championed by our pharmacist Dr. Mandy Reece.

We have 4-6 medical school students a month that we coordinate in our inpatient and outpatient setting.

NGPG Flowery Branch Recognized

on Achievement of Recognition for Systematic Use of Patient-Centered, Coordinated Care Management Processes October 26, 2020

November 25, 2021

GATEWAY EXCHANGE • In the midst of the COVID pandemic, NGPG Gateway Exchange managed to stay within their financial budget for FY20.

HAMILTON MILL • Lorraine LaPlace, NP joined the practice caring for patients after hours.

• Primary Care now open 7 days a week.

JEFFERSON • We are a small clinic with a very tight space and we were able to provide safe, in-person visits for our patients through the worst of the pandemic.

• We were one of the first NGPG clinics to provide our patients with Moderna’s COVID-19 Vaccine.

LAVONIA • NGPG Lavonia Family Medicine came together as a team to provide quality care to our patients during the COVID-19 pandemic.

• We offered video visits and curbside service along with some lab services.

• We received NCQA Recognition.

MED ACCESS • Opened sick clinic for patients with COVID-19 symptoms and offered COVID-19 testing.

• Implemented procedures to minimize exposure of COVID-19 to patients without symptoms

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OAKWOOD • At the end of March, we went to mostly a Video Visit model, but we had to come up with a way to do blood work on our patients for proper medication therapy, so we implemented a drive-up lab in the middle of our building.

• More and more of our population were getting sick and needed further evaluation so on 8/7 we started the drive-thru Sick Clinic where we tested for COVID, flu and strep. The Patient was evaluated at car side by a provider.

• In June, a long-time patient of ours was admitted to rehab and, due to the pandemic, his wife and family could only visit him through the window. Our office discovered that he and his wife would be celebrating their 54th wedding anniversary and made a way to close early and be a part of the celebration! With homemade signs in hand and masks on faces, we showed up at the rehab facility to surprise Jack, his wife and family. It was a special moment that brought some tears and meant the world to this sweet family.

• In October, we opened as one of NGHS fully operational Regional Sick Clinics.

PRIMARY CARE AT THE HALL COUNTY HEALTH DEPARTMENT • National Committee for Quality Assurance (NCQA) Recognition Delivering High Quality Diabetes Care.

• Patient Center Medical Home Renewal.

THOMPSON BRIDGE • Our team quickly implemented video visits; adapted to Zoom.

• We were recognized for being one of the leaders in the transition and in volume of telehealth visits.

TOCCOA • Implemented telehealth and parking lot visits for sick patients or those who did not want to be seen in person.

• Providers utilized the MedAccess sick clinic during office hours to care for patients with COVID-19 symptoms.

• Established a well waiting room and sick waiting room to minimize exposure.

WAUKA MOUNTAIN • We started loaning our Kindle fires and tablets to patients to see providers shortly after COVID hit. These patients benefited from our technology by staying connected and safe. The patients would arrive at the office, we would deliver a device to their vehicle and they would stay in the car to complete their video visit with the provider.

• We also set up lab services on one side of our front lobby. We provided lab draws, one patient at a time and periodically provided the same service curbside.

• The staff rallied together and adapted to all the changes very well. Along the way, they provided candid feedback that enabled process improvements to help work flow – which ultimately benefited our patients.

WEST JACKSON • Recruited, hired and onboarded Kayla Joplin, FNP. • Throughout the pandemic and staffing shortages, West Jackson’s visit volume only decreased slightly and we were still able to stay on budget.

• The staff have worked tirelessly to remain dedicated to our patients – this is reflected in our positive CGCHAPS scores.

WINDER • Reopened in October after being closed for two years.

• Welcomed a new physician, Dr. Michael Timmel, from Orlando, Florida.

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General Surgery BRASELTON • We experienced minimal disruption during peak COVID months as surgeons continued to take call and operate on patients with urgent needs. Our staff displayed deep interdependence as they flexed to other departments to help meet patient care needs.

• Employee engagement indicator +.37 vs organization, Team Index increased from 3.81 to 4.16, Leader Index of 99.

• Celebrated & honored our Veterans: Dr. Christopher Soika and Dr. Tre’ Walker, with a socially distanced in office lunch.

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GAINESVILLE - MEDICAL PARK 2 • Successfully moved and began seeing patients in our beautiful new office within Medical Park 2.

• Increased employee engagement score by .15.

• Once the OR’s opened back up after the COVID shutdown, we successfully and efficiently caught up all elective surgeries and continued to welcome new patients in the months after despite the new normal.

Gynecology/Oncology • We secured additional space for chemo and for NGPG Gynecologic Oncology.

• Contracted with Dr. Chandler and having her join us this fiscal year.

• Earned phenomenal Press Ganey scores: - Recommend this provider office: 100% - Physician Comm Quality: 97.7 - Office Staff Quality: 98.6 - Access to care 3 month: 94.3 - Care Coordination: 81.1

Infectious Disease • Supported NGHS and our community during the COVID-19 pandemic, providing care for these patients and guidance for the system.

• Successfully implemented telehealth at our outpatient practice, conducting over 900 visits via telehealth.

• Hired and will be welcoming Dr. Vetriselvi Moorthy in July 2021.

• Expanding to cover the Braselton hospital.

Inpatient Medicine/Hospitalists

• Quickly brought telemedicine up-to-speed to increase safety for patients and staff and to improve overall efficiency across the organization as physicians cared for COVID and other patients across multiple campus locations.

• Designed COVID-19 workflows with leadership on the Taskforce, COVID floor, COVID Medical Mobile Unit, Order sets .

• Extensive work on improving LOS with potential discharges, IDT optimization including Virtual IDT, tightening geographic localization.

• Implemented Eagle telemedicine nocturnist coverage at Barrow and Lumpkin.

• Implementation of in-house telemedicine program Virtual Hospitalist shift creation.

• Established Clinical Leadership structure with Medical Directors, Assistant Medical Director for Braselton, Lead Hospitalist for Barrow.

• Primary Stroke Certification at NGMC Braselton and Barrow.

• Hired and onboarded 2 Nocturnist APPs at Braselton.

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Internal Medicine

BRASELTON • Welcomed 10 new PGY 1 residents to our clinic in July 2020 and 10 of our residents graduated and became PGY 2’s. With the addition of these resident physicians, the access to care in Braselton has improved significantly and we are able to get New patients seen same day or even the next day.

• We successfully implemented telehealth visit appointments for our patients.

• We re-located our lab downstairs in our building at the beginning of the pandemic.

• We welcomed a new physician, Dr. Tata, who has been a great addition to our team!

• We worked hard to enroll our patients in MyChart to improve communication for the patient, especially for telehealth visits.

GAINESVILLE - MEDICAL PARK 2 • NGPG Internal Medicine moved to Medical Park 2 in June 2020.

• Certificate of Recognition for Patient-Centered Medical Home.

• Our staff was trained and qualified to perform IRIS Diabetic Exam Capabilities in our clinic.

CLEVELAND • Kaitlyn Vann, DO, joined the practice.

GAINESVILLE - SIMS STREET • Came up with a new plan that allowed patients to continue coming to their visits, with as little contact DAHLONEGA as possible. This consisted of our team bringing • New physician, Dr. Tara Brayboy, joined our staff in patients in through the side doors and getting start September. (check in) to finish (check out process) in the exam • Half of staff got COVID-19, but everyone was able to rooms. return to work.

• Added a new Provider, Kayla Gee, FNP-C. • Office got a face lift with fresh paint and new • Obtained certification for PCMH by the NCQA. shared-office space that was helpful to all staff

Interventional Pain Medicine

TOCCOA DAWSONVILLE • Kept department open during this time of COVID-19 • Worked together to continue treating patients in the and added the Regional Sick Clinic midst of the COVID-19 pandemic.

• Continued to see well patients in our office, along • Developed workflows that kept patients safe and with sick patients in the Regional Sick clinic volumes at a steady pace, without decreasing.

• Rotate our advance nurse practitioners in the Regional Sick Clinic, where we see new and established patients.

• We opened NGPG Interventional Pain Medicine Dawsonville.

• Leena Lake, MD joined our team.

• We exceeded productivity budgets despite COVID-19 pandemic.

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Neurology/Neurosurgery • Started a new clinic/practice with Dr. Lee (Neurointerventional Surgery). Dr. Lee is doing amazing and already has multiple success stories of fully recovered stroke patients.

• Added 2 new full time Neurology doctors: Dr. Adebimpe Oyowe (Braselton) and Dr. James Starr (Gainesville). This team pulled together to make sure patients were getting the care they needed during COVID by performing telehealth visits.

• Completed over 4,000 telehealth visits to ensure our most at risk patients maintained good access to Neurology care during the COVID pandemic.

• Every staff member learned new roles and stepped out of their comfort zones to help wherever there was a need during COVID. INPATIENT NEUROLOGY • Welcomed Vijayamala Bondugula, MD, Harsh Singh, MD and Miranda Trammell, NP to our team NEUROSURGERY • Hired Wesam Daker, P.A. to the Neurosurgery group

OB/GYN BRASELTON • In FY2020 OBGYN Braselton started a Midwifery program and welcomed 5 new CNMs: Stephanie Dees, CNM, Kylie-Ann Hamilton, CNM, Tappie Hurdelbrink, CNM, Kortney Rogers, CNM, Kathrin White, CNM DAHLONEGA/DAWSONVILLE • OBGYN Dahlonega beat their 2020 Budget year by 24%; OBGYN Dawsonville by 23%.

• Grew Dr. French’s Bioidentical Hormone specialty practice and greatly improved patient access by adding Sherry Nored, CNM and Kelly Chase, NP. • In the initial planning stages for combing the Dahlonega and Dawsonville offices to be able to continue to grow our OBGYN presence in the Dawsonville area and surrounding areas. Our goal is to give the best quality of care and to be recognized as the #1 OBGYN provider in the northern area.

• The staff came together at a very trying time with COVID and worked together to continue to give the best care to our patients even in times of much confusion.

GAINESVILLE • Dr. Jason Bailey moved to a dedicated GYN only space and Malissa Osborne, PA-C was hired.

• The staff quickly came together to notify patients and keep them updated during the pandemic.

• During the pandemic we were able to flex staff and control expenses and did not have to furlough or layoff any employees.

Occupational Medicine • Worked with the State Board of Worker’s Compensation to get telehealth WC visits approved by the state board and on the fee schedule. The telehealth visits have remained on the fee schedule.

• Worked with local employers to create a telehealth Return to Work process for their employees who had been out with COVID-19.

• Remained open during all of FY20 and continued to provide outstanding in-clinic and on-site services to our local business partners, all while following CDC guidelines. We also continued to add local employers to our client list.

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Orthopedic Surgery • • • •

Hired Justin Barrett, M.D., Fellowship trained Hand and Upper Extremity Specialist Hired Rachel Metz, P.A. for Orthopedic Surgery Gainesville Opened new Hand and Upper Extremity Specialty suite in Medical Plaza 1 – Braselton Opened Orthopedic Surgery clinic located in NGPG Cleveland

Ortho/Trauma • Hired a 5th APP, Travis Ford, PA-C. • Beat our surgical volume budget by 130 cases, despite the COVID-19 shutdown.

• Managed to approve three new full-time positions for our outpatient clinic – a phone triage RN, a 2nd Rad tech and a work comp coordinator.

Palliative Care • Successfully implemented video visits in our outpatient Palliative & Support Care clinic, conducting over 600 video visits, keeping this high-risk population home and safe during the COVID-19 pandemic.

• Received approval to expand our Palliative Care services to NGMC Braselton.

• Welcomed a Chaplain, Daina Salnitis and Monica Pope, LCSW.

Pediatrics • All five pediatric clinics (Toccoa, Clarkesville, Clayton, Demorest and Lavonia) were recognized by the National Committee for Quality Assurance (NCQA) as Patient-Centered Medical Home sites. This endorsement means these practices demonstrated that their model of care puts patients first.

• Two providers, Dr. Grace Patterson and Katelyn Goodwin, FNP-C, joined the Toccoa office and we added more staff to better serve our community.

• The Toccoa office has expressed deep interdependence this year by working together as a team to meet QM goals. We surpassed our QM goals while working through a pandemic (COVID).

Pre-Surgical Clinic • Expanded our Pre-Surgical Clinic team by adding an APP. • Continued to grow our pre-surgical services to care for patients who need a more in-depth clearance before surgery, which reduces same-day surgery cancellations.

• Expanded Pre-Surgical clinic to NGMC Braselton, via telehealth.

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Psychiatry

NGPG PSYCHIATRY EXPANDS With nearly one in five U.S. adults currently living with a mental health illness, there is a growing need for compassionate and whole-person psychiatric and behavioral health services. At Northeast Georgia Physician’s Group Psychiatry, we believe that mental and emotional well-being are an integral part of overall wellness. From child and adolescent therapy to adult psychiatry, NGPG provides comprehensive behavioral health and psychiatric services along with an integrated network of resources through Northeast Georgia Health System. NGPG Psychiatry’s board-certified physicians and dedicated licensed clinical social worker offer the option of video visits for the treatment for a variety of psychiatric conditions including: Anxiety, Depression, Eating disorders, PTSD, Personality disorders, OCD, Mood & Psychotic disorders.

• Added 3 new outpatient providers and 6 new inpatient providers • Opened new locations in Buford and Dawsonville • Expanded our Psychiatry Consult Liaison service line to include weekend coverage/availability

1 IN 5

COVID PATIENTS WERE DIAGNOSED WITH PSYCHIATRIC DISORDERS WITHIN 90 DAYS SOURCE: THE LANCET PSYCHIATRY

During a crisis like the COVID-19 pandemic, taking care of mental and emotional health is more important than ever. NGHS made it a priority to provide employees and physicians with resources and support to help with stress, depression, anxiety, grief, anger, family and/or parenting problems. An interdisciplinary group formed at the beginning of our response effort to continuously monitor the physical, financial and emotional support needs of our employees and provide assistance where needed.

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Pulmonology NGPG Pulmonology - a new specialty the group established to help fill a shortage in the market. This same team also provides inpatient care at NGMC Gainesville 24/7, offering advanced techniques and procedures for diagnosing, staging and treating lung cancers as well as pulmonary nodules, benign airway disease and pleural diseases.

Radiation Oncology • Welcomed Adnan Elhammali, MD, PhD, to the team • Successfully affiliated with the Emory Winship Cancer Center • Added a new high dose rate brachytherapy machine for delivering internal radiation at our Gainesville location

Sports Medicine • Hired John Alsobrook, M.D., and John Buchanan, M.D. in December 2020 • Opened our new Sports Medicine Buford office (Dr. Alsobrook) • Opened our new Sports Medicine Hamilton Mill office (Dr. Buchanan) • Opened a new Sports Medicine Dahlonega location with Dr. Chris Huckle • Completed over 3,000 free Sports Physicals for local high school and college athlete

Transformation and Clinical Quality • Collaborating with Providers on Care Gap Closures/Reconciliations Revenue 2020: $1,860,933.20 earned as quality awards • 2 Years of CMS Positive Pay Adjustments (an almost 2% increase) on Medicare Fee for Service claims • Annual Wellness Exams: 79% • Clinical Standard Work FY20: 38 published for staff use • NCQA PCMH Recognized Practice Sites: 19/30 (63%); Patient Family Advisory Councils: 18/25 (72%) • NCQA Diabetes Recognition Program Recognized Sites: 25/30 (83%) • NCQA PCCS Recognized Sites: 6 Urgent Cares (100%) • Safety Culture: Provider Reports: 12%; Staff Self-Reports: 17% • Opioid Prescribing declined 64.4% over past 2 years • Launched a Population Health Subcommittee of Quality Council to further our population health initiatives ª Expanded ambulatory pharmacy program:

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Free Medications for Patients via Prescription Assistance programs: $804,656.49 AHRQ Ambulatory Antibiotic Cohort Study for Antibiotic Stewardship Urgent Cares can now dispense medications

Trauma TRAUMA AND ACUTE CARE SURGERY • We welcomed the following providers: Timothy Stevens, MD Matthew Vassy, MD, FACS Katrina Parker, ACACNP Robert Poole, PA-C Jennifer Wood, PA-C • We hosted another successful trauma symposium, virtually this year. There were over 550 attendees from states across the country.

• We have initiated multiple research projects including a multi-institutional study with Navicent Health-Macon on TEG (thromboelastography).

• We have created a process for engaging undergraduate research volunteers.

• We implemented Brain Injury and Chest Trauma guidelines and many new treatment protocols for our patients.

• An ICU lecture series was created.

• We have worked collaboratively with Critical Care Medicine to unify processes across the MICU and STICU.

ACUTE CARE SURGERY AND TRAUMA NEVER STOPPED OPERATING Surgical Critical Care led the way with the closure of STICU in April 2020 and answered the call to provide Neurocritical care and help start the stroke program in spite the COVID-19 pandemic. They took on all COVID-19 patients with surgical disease initially or in the immediate / acute post-op period. They also took on multiple medical patients, as their unit was often the only unit with open beds. They led the fight against the limitation of drips on floors and IMCUs based only on geographic location, therefore freeing up ICU beds. Surgical Critical Care and the division turned over ICU beds in record time during the height of both pandemic surges (sometimes turning over as many as 12 ICU beds in one day). During the COVID-19 surgery shut down, Acute Care Surgery and Trauma never stopped operating. Trauma admitted 2,194 patients in FY20, which was a 3% increase over 2019 despite COVID-19.

NGMC AND REGIONAL TRAUMA ADVISORY COMMITTEE CHANGING HOW BLOOD TRANSFUSIONS SAVE LIVES NGMC and the Region 2 Regional Trauma Advisory Committee (RTAC) are partnering on new blood transfusion programs that will increase trauma patients’ chances of surviving both in ambulances and at the hospital. NGMC is the lead agency in a state-approved pilot program that will allow EMS teams in four counties Dawson, Habersham, Jackson and White - to provide blood transfusions to patients who need them during long ambulance rides. The goal

of the pilot program is to prove blood products can be safely administered by paramedics in ground ambulances. In addition to the pilot program, NGMC is also among the first hospitals in the state and nation to now offer whole blood transfusions. That means any patient who suffers major blood loss - which can occur during childbirth, surgery, traumatic accidents or various other situations - can be treated with whole blood for increased chance of survival.

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Urgent Care BRASELTON • In mid- March we became a COVID testing site for NGPG. We moved teams of providers and staff outside to take care of this pandemic • During the peak of the pandemic (summertime), we were treating/testing on average 325-350 patients a day outside in our mobile tent area • We’ve treated over 4400 positive COVID patients since mid-March • We moved back inside urgent care in September and still see on average 125-150 patients/day – and we have the clinic divided between COVID patients and non-COVID patients – while keeping patients separate and safe.

• One month, we had a positive revenue of $2 million.

• Performed antibody infusions.

CLEVELAND/DAHLONEGA/DAWSONVILLE • We successfully and efficiently provided COVID testing for patients in the parking during rain or shine.

• We safely and effectively moved COVID testing inside the clinic providing a more stable work environment while maintaining safety.

• We provided high quality care for all patients with the option for rapid COVID testing for highrisk employees and patients.

DACULA • Provided COVID-19 testing and were the first to bring the testing indoors.

GAINESVILLE • Testing 200+ patients a day in multiple tents outside when the COVID-19 pandemic first started.

• Performed weekly on-site nursing home COVID-19 testing for employees, as well as COVID-19 testing at Hall County high schools for teachers and students.

• Performed antibody infusions.

Urology • We welcomed Dr. David Stanley for Gainesville Urology.

• We were able to re-open our satellite office in Toccoa.

• Two PAs, Rosmary Duval and Anisha Patel, joined our team. They have brought a great dynamic to the team and able to help support the physicians in their busy work.

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Vascular GAINESVILLE • Dr. Niraj Parikh became one of very few doctors performing the T-Car procedure.

• Haley Queen, PA-C – vein specialist joined our team.

BRASELTON • We welcomed new provider Sarah Perkins, PA and are looking forward to increasing clinic volumes in 2021 when we onboard a second PA. • Our employee engagement indicator was +.37 v. the organization.

WELCOME NEW PROVIDERS: Allergy & Asthma Faria Khan, MD Behavioral Health Aaron Perez, LCSW Monica Smith, LCSW Cardiovascular & Thoracic Surgery Jason Budde, MD Susan Kemp, FNP Brittney Kirkpatrick, ACNP Dimitrios Tsirigotis, MD Critical Care Navneeth Bongu, MD Albert “Duke” Hancock, AGACNP Matthew Honea, AGACNP April McDonald, MD Jason Oh, MD Family Medicine Christina Bruner, FNP-C Michelle Clark, CNM Margaret Doku, FNP-C Margaret Erwood, MD Omari Hodge, MD Christopher Kiker, MD Lorraine LaPlace, FNP-C Ruth McCaffrey, DNP Travis Nelson, MD Nhi-Kieu Nguyen, MD Shaniqua Sims, FNP-C Kaitlyn Vann, DO General Surgery Alexis Clayton, PA Travelyan Walker, MD, FACS Inpatient Medicine Heather Haff, DNP Nikesh Patel, MD Urvesh Patel, DO Olubunmi Pitan, MD Ailin Puckett, CNM Amanda Scott, AGACNP Kailey Scott, PA-C Soha Taheri, MD Uday Tata, MD

Internal Medicine Tara Brayboy, MD Morgan Carter, FNP-C Katelyn Goodwin, FNP-C Merrie Hambry, FNP Nikeva Johnson, MD Interventional Pain Medicine Lena Lake, MD Neurology Vijayamala Bondugula, MD Adebimpe Oyowe, MD Harsh Singh, MD Monica Smith, LCSW Nathan Starr, MD Miranda Trammell, AGACNP Neurointerventional Surgery Sung Lee, MD Neurosurgery Wesam Daker, PA-C Obstetrics & Gynecology Kelly Chase, NP Stephanie Dees, FNP-C, CNM Kylie-Ann Hamilton, CNM Tappie Hurdelbrink, CNM Sherry Nored, CNM Malissa Osborne, PA-C Kortney Rogers, CNM Alexis Rylee, CNM Kathrin White, CNM Orthopedic Surgery Justin Barrett, MD Rachel Metz, PA-C Shan Sharif, MD Orthopedic Trauma & Reconstructive Surgery Travis Ford, PA-C

Psychiatry Lisa Aiello, FNP-C, PMHNP-C Kyle Armstrong, DO Jamison Daniels, PA-C Kaleigh Holmes, PMHNP Andrea Huntley, MD Safinaz Mostafa, MD Yana Kirova-Pancheva, MD Kalpana Prasad, MD Sarah Siddiqui, DO Aaron Tomberlin, PMHNP Pulmonology Nayneeth Bongu, MD April McDonald, MD Radiation Oncology Adnan Elhammali, MD, PhD Trauma & Acute Care Surgery Kelsey Bradford, AGACNP Katrina Parker, ACNP Robert Poole, PA-C Timothy Stevens, MD William “Matt” Vassy, MD Urgent Care Lesley Algert, MD Tyler Andrews, DO Gary Jordan, MD Urology Rosemary Duval, PA-C Anisha Patel, PA-C David Stanley, MD, FACS Vascular Megan Hull, PA-C Sarah Perkins, PA-C Phillip Rideout, MD

Pediatrics Grace Patterson, MD

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