FOCUS TOPICS HEALTHCARE FORECAST 2019 • OPHTHALMOLOGY • TELEMEDICINE/RURAL HEALTHCARE • HEALTHCARE LAW
January/February December 2019 2009 >> $5 PUBLISHER’S MESSAGE Happy New Year Readers! It seems that part of ringing in the New Year involves reflecting on the year just past. And 2018 was a big year for this publisher! Pam Haskins In August, I married the love of my life, Thomas Haskins, whom I have known for over 40 years. Happy times for sure. However, shortly after that, the retina in my left eye detached. Having your sight threatened is no doubt a very scary thing, but fortunately I had Dr. Stephen Davis of Arkansas Retina Clinic to walk me through it. He is a brilliant surgeon with a wonderful bedside manner. Obviously, Dr. Davis is my hero, but I realize he is also a Dr. Stephen Davis hero to many other Arkansans who have been through scary, sightthreatening eye problems. And for that reason, we chose to spotlight him in this issue and talk about his fascinating specialty. See the story on page 3. I also realize that most of the readers of this publication are heroes. I’m speaking of the physicians and nurses who get up every day and save someone’s life, repair broken limbs, and treat life threatening diseases. Even the leaders and administrators who make our healthcare organizations run smoothly are heroes in my book. I salute each and every one of you and hope that this publication is a resource for information and comradery as you share stories with your peers. Here’s to a bright 2019!
Experts’ Expectations for the New Year
The Financial and Business Case for Transformation By CINDY SANDERS
Despite a series of unexpected challenges to healthcare as 2018 drew to a close, experts who follow the industry in the United States forecast a number of trends for 2019 ranging from more investment in technology and artificial intelligence to business models driven by population health needs and a demand for increased access, value and convenience. In December, a Texas judge ruled the Affordable Care Act unconstitutional in its entirety after Congress removed the tax penalty associated with the individual mandate, thereby setting off what is anticipated to be a protracted legal challenge that will ultimately be answered by the U.S. Supreme Court. Judge Reed O’Connor, who handed down the decision, ordered a stay so that those covered under the ACA would continue to have access to healthcare while the case works its way through the appeals process. (CONTINUED ON PAGE 8)
UAMS Chancellor Cam Patterson Wants to Bend the Healthcare Curve in Arkansas
Chancellor Leading UAMS to Develop 2029 Vision Plan for Healthy Outcomes By BECKY GILLETTE
Cam Patterson, MD, MBA, who took over as chancellor at the University of Arkansas for Medical Sciences (UAMS) June 1, 2018, considers himself “ambitious, but real-
istic.” His goal for UAMS is to take the state from the bottom of the list of most health indicators to the top half of the U.S. in healthcare outcomes by 2029. “Leading up to the 150th anniversary of
(CONTINUED ON PAGE 4)
— Pamela Z. Haskins, Publisher
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Stephen J. Davis Specializes in Sight-Saving Retina Procedures
Intravitreal injections at Arkansas Retina revolutionizing treatments, saving eyesight By BECKY GILLETTE
It has been said that the eyes are the window to your soul. They are definitely a window to your health, said Stephen J. Davis, MD, an ophthalmologist who is a retina specialist at Arkansas Retina based in Little Rock. “With the eye, we can see systemic medical problems directly,” Davis said. “I have been the first person to diagnose patients with hypertension, high cholesterol, diabetes, and metastatic cancer. I have diagnosed syphilis a few times and even tuberculosis.” He can also usually tell what type of vision problem patients have without them describing their symptoms. He can see it in their eyes. “Eyes are very predictable,” Davis said. “I love seeing the pathology directly in the eye and fixing it with surgery, injections in the eye or laser procedures. In the clinic, 90 percent of my treatments involve intravitreal injections. Twenty years ago, lasers were all we had. Today, we can do so much more.” Davis said anti-VEGF injections used to treat advanced wet age-related macular degeneration have revolutionized treatment and saved many people’s vision. The injections can stop vision loss in 90 percent of patients, and improve vision in half of the patients, if caught in time. Patients often need very frequent treatments, some even coming every month, which is one reason why Davis has satellite offices in Conway and Fort Smith, and also travels to Arkadelphia and Searcy to see patients at doctor’s offices there. “There are not that many of us, less than 20 in the state,” he said. “It is a small field, so it is the nature of the job to travel to other offices. There is not a need for a full-time retina specialist in some of those communities, but there are many patients who need frequent treatment there. So, we go to them.” Obviously, it can be very difficult when patients are losing their eyesight and there is little to be done. In cases like a detached retina, emergency surgery can restore someone’s eyesight leaving patients very grateful. “In ophthalmology, there are some patients who will come in after a procedure and hug you,” he said. “They are smiling and so happy because we either saved or restored their vision. One of the reasons I wanted to do medicine was so I could help people. That is one reason I love ophthalmology. I can see a problem and fix it. But some conditions are more complicated or untreatable. They don’t always get their sight back.” Dry macular degeneration is one of arkansasmedicalnews
the most difficult conditions to treat. It is a slow, degenerative process. Doctors can only prescribe AREDS over-the-counter vitamins that can slow the progression of the disease. There is no current treatment that halts or reverses it. “This is one of the times where vitamins do make a difference,” Davis said.
“It doesn’t stop it, but it buys us some time. It is a frustrating disease.” His success rate is much better at preserving vision compared to getting it back. That is why he advises anyone with vision changes immediately see a doctor. Don’t wait to see if it will get better. “You don’t blow off vision loss when
you are older,” Davis said. “It may not be anything serious. But, if you are wrong, then you are in trouble. A lot of what I do is related to aging, high blood pressure and diabetes. Primary care doctors can help by asking patients if they have had any changes in their vision and by telling patients to immediately seek medical attention if there is any change in vision.” Although not common, detached retinas are one of few surgical emergencies faced by retina specialists. Davis said many people think retinal detachments are a result of trauma, but usually it is just a result of aging. “They are an emergency because the quicker you get them repaired, the less vision loss people will suffer,” Davis said. “There are a number of other problems that occur inside the eye related to aging or diabetes that require retinal surgery. Diabetes can cause vitreous hemorrhages or retinal detachments from scar tissue. We repair macular holes or epi-retinal membranes from aging. Then there are complications from other ocular surgery or procedures such as endophthalmitis, which is an infection of the eye itself.” Davis grew up in Conway and, as a kid, liked to take things apart, see how (CONTINUED ON PAGE 10)
At NYIT College of Osteopathic Medicine (NYITCOM) at Arkansas State University, we are educating the physicians of tomorrow today. Our medical school not only produces excellent physicians, but also cultivates “servant leaders” who recognize that healthy choices and wellness are vital components needed for the success of the people and communities to which they belong. Outside the classroom, NYITCOM at A-State students are involved in activities that provide mentorship, opportunity, and encouragement to the youth of our state with the goal of creating more educated, engaged, and responsible citizens for Arkansas and our region.
At NYIT College of Osteopathic Medicine (NYITCOM) at Arkansas State University, we are educating the physicians of tomorrow today. NYITCOM at Arkansas State University is committed to addressing
the primary care physician workforce shortage in Arkansas and the Our medical school not only produces excellent physicians, but also cultivates “servant leaders” who Delta region. By 2030, NYITCOM at A-State will produce more than recognize that healthy choices and wellness are vital components needed for the success of the people 1,000 physicians to serve this state, region, and beyond. and communities to which they belong. Outside the classroom, NYITCOM at A-State students are in activities that provide mentorship, opportunity, and encouragement to the youth of our state Are youinvolved interested in learning more? the goal of creating more educated, engaged, and responsible citizens for Arkansas and our region. Visit uswith at nyit.edu/arkansas 870.972.2786 email@example.com NYITCOM at Arkansas State University is committed to addressing the primary care physician workforce shortage in Arkansas and the Delta region. By 2030, NYITCOM at A-State will produce more than JANUARY/FEBRUARY 2019 1,000 physicians to serve this state, region, and beyond.
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UAMS Chancellor Cam Patterson Wants to Bend the Curve, continued from page 1 UAMS, we are in the middle of creating a plan called Vision 2029,” said Patterson, a cardiologist who, over his career, has received more than $60 million in grants and has had his work published in 323 peer-reviewed scientific publications. “Our long-term goal is to bend the healthcare curve in Arkansas. In many healthcare indicators, we rank 47th, 48th or 49th. We can do better.” In addition to the obvious humanitarian benefits from helping people live healthier and longer lives, Patterson said having a healthy workforce is important to recruiting more jobs. UAMS, the only academic health sciences university in Arkansas, offers 73 degrees and certificates. It is the state’s largest public employer with UAMS Chancellor Cam Patterson (left) is shown with Laura Hutchins, interim director of the UAMS Winthrop P. Rockefeller Cancer more than 10,000 employees. Institute and Gov. Asa Hutchinson. (Photo courtesy of UAMS) Along with its clinical affiliates, out and provide care where no one else “The people who work here are Arkansas Children’s Hospital and the is providing care. We are helping provide committed to staying here and improving VA Medical Center, the estimated anhealthcare workers for all 75 counties in healthcare for three million Arkansans,” nual economic impact is $3.92 billion. Arkansas.” Patterson said. “I’ve never seen anyone The statewide impact of UAMS provides Improving healthcare for Arkansas who comes to work here thinking about many opportunities for having a favorable means going to where the opportunities themselves. What makes the place very impact on the health of state residents. are. special is the mission is not just making Patterson said the people and the “You need to focus on areas undermoney or keeping the hospital full, but mission are what impresses him the most served with medical services,” Patterson training healthcare people who will go about UAMS. said. “For example, there is an epidemic
of colorectal and prostate cancer in African-American men in the Arkansas Delta. We have food deserts even here in central Arkansas. There are big challenges in the state with respect to obesity and way too much use of tobacco products. We need to advocate for education in early life of the importance of exercise and good diet. We need to work with our partners in the Arkansas Department of Health to advance that mission.” He considers one of the biggest accomplishments of UAMS since he took over as chancellor is to change the discussion from thinking about the past to planning for the future, outlining a vision of what a better state of health in Arkansas would look like. “UAMS is here for the state,” Patterson said. “We train 60 percent of physicians and 70 percent of other types of healthcare workers in the state. We have more than 1,000 affiliation agreements to collaborate with service providers across the state. We are the only comprehensive stroke program in the state, and the only organ transplantation program – and at a very cutting-edge level. We are the hospital when no one else will take care of you…we will take (CONTINUED ON PAGE 5)
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UAMS Chancellor Cam Patterson Wants to Bend the Curve, continued from page 4 care of you.” Patterson sees big opportunities ahead focusing on seeking National Cancer Institute designation for the Winthrop P. Rockefeller Cancer Center, and expanding digital health services. “I’m committed to UAMS being the place that is doing digital health well in a rural environment,” Patterson said. “We are a statewide entity with eight campuses for training. Northwest Arkansas, especially, is an opportunity for us with its rapid population growth. We have more than doubled our footprint in Northwest Arkansas in the past two years.” Earlier in his career, Patterson held academic and clinical appointments at the University of North Carolina, including as physician-in-chief at the UNC Center for Heart and Vascular Care and executive director of the UNC McAllister Heart Institute. He served as senior vice president and chief operating officer at WeillCornell Medical Center in New York City from 2014 until taking the job at UAMS. His path from doctor to administrator was not a straight line. As his career developed, he got asked to take on various leadership roles. “I never went into medicine thinking about administration, but instead patient care, education and research,” Patterson said. “But what I found was my impact working in administration was magnified. By bouncing around in different leadership positions, I ended up acquiring teaching, practice management and hospital management experiences. There was the opportunity as chancellor to incorporate all of the different experiences I have had in one job.” Patterson said it helps in his job that he has had such a breadth of experience. “It helps me avoid the temptation to micromanage,” Patterson said. “I don’t overinvest and make decisions for members of our team. I consider myself a servant leader. Somebody this morning called me their boss and I don’t really think of it that way. My most important role is to make sure the team is highly functional. I have been fortunate we have been able to assemble a great team.” Patterson said he and his family are very happy here. “My wife and I love living in Little
Keep your ﬁnger on the pulse of Arkansas’ healthcare industry.
Rock,” Patterson said. “The outdoor activities are really terrific. Our three kids, Celia, 16, Anna Alyse, 14, and Graham, 12, are enjoying and being challenged at school. We have developed good social networks.” His wife, Kris Patterson, MD, is also a physician, an infectious disease specialist. Growing up in Mobile, Ala., Patterson was inspired by the father of a friend, ‘little’ Barney March, whose father, “big” Barney March, was an internist and cardiologist. After earning a BA in psychology from Vanderbilt University, Patterson received his medical doctorate from Emory University School of Medicine and then
an MBA from the University of North Carolina Kenan-Flagler School of Business. After a residency at Emory University Affiliated Hospitals, he was a research fellow at the Cardiovascular Biology Laboratory in the Harvard School of Public Health and a clinical fellow in cardiology at The University of Texas Medical Branch at Galveston, Texas, where he became a faculty member in 1998. While he has lived in a number of different states, he said he is in Arkansas to stay. “I plan to retire in this job,” Patterson said.
While fulfilling career goals is important, Patterson also has a big focus on being a good husband and father. “Everything else is secondary to that,” he said. In addition to family time, music is a top leisure activity. “I am obsessed with music,” he said. “I have about 2,000 CDs and several thousand pieces of vinyl. I have formed a band in Little Rock that is very eclectic, old country stuff and blues. I play the guitar, the mandolin, and a steel guitar. I grew up with Indie rock back in the 80s, so I listen to a lot of that. I also listen to a lot of African music now, and a lot of hip hop.”
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Expansion of Federal Anti-Kickback Prohibitions By LyNDA JOHNSON AND TIMOTHy EZELL
In October 2018, a new Federal antikickback law (the Eliminating Kickbacks in Recovery Act of 2018, or EKRA) became effective. This new law could have significant (even unintended) impact for providers in the substance abuse and/ or clinical laboratory markets. Like the existing Federal Anti-Kickback Statute (Federal AKS), EKRA is a criminal statute, which provides for criminal fines and imprisonment. EKRA is a separate and distinct statute from the Federal AKS. EKRA was enacted as one part of the Federal SUPPORT Act, which is an aggregation of numerous, separate bills / acts, including EKRA. The primary purpose of the SUPPORT Act is to legislatively attack the opioid epidemic which is certainly a nationwide crisis. However, with regard to EKRA specifically, the new prohibitions pertain to services that may have nothing to do with the opioid crisis. In other words, EKRA applies to laboratory services, regardless of whether the laboratory services relate to matters of substance abuse. There are many differences between EKRA and the existing Federal AKS. This article focuses on two material differences.
The first material difference between the Federal AKS and EKRA, is that EKRA applies to any “health care benefit program” (which includes commercial pay insurance programs). The Federal AKS applies only to “state or federal” healthcare programs (i.e., Medicare, Medicaid and other government pay programs). Depending on a provider’s business structure and payor mix, EKRA’s broad scope could have material ramifications. For example, a clinical laboratory now must now be concerned with its business arrangements and referral sources as they relate to commercial pay patients as well, and not just government pay patients. As an aside, it will be interesting to see how various government enforcement agencies pursue violations of EKRA which are alleged and relate to non-government pay business. Under the Federal AKS, the government enforcement agencies have readily available access to information from CMS and its contractors to determine whether a provider has violated the Federal AKS because the Federal AKS applies only to government pay matters. If the government is going to enforce the EKRA statute with regard to commercial insurance matters (i.e., not government pay), it will presumably have to obtain supporting information/evi-
dence from commercial insurance companies in order to do so, which may be more difficult than obtaining information from other government agencies. A second, more subtle, difference between EKRA and the Federal AKS is that it seems, at least on EKRA’s face, that the “bona fide employment” safe harbor that is so often relied upon by providers under the Federal AKS, is much more restricted under EKRA. The Federal AKS provides numerous “safe harbors,” which (if a provider meets the requirements of an applicable safe harbor) may give the provider assurance that the provider is not in violation of the Federal AKS. One such safe harbor is the “employee” safe harbor, which essentially indicates that, so long as payment is made from one party to another under a bona fide employment relationship, such payments from the employer to the employee will not be considered illegal kickbacks under the Federal AKS. There are nuances to this safe harbor. It is not the purpose of this article to address all possible nuances. But, suffice it to say, that this “employee” safe harbor is often relied upon with regard to Federal AKS compliance matters, particularly by clinical laboratories. EKRA is materially different. EKRA does also have an “employee” safe harbor. However, under EKRA’s employee
safe harbor, payments from employer to employee may not vary by a number of individuals referred, a number of tests or procedures performed, or an amount billed to a health care benefit program. Thus, under EKRA, in order to qualify for safe harbor protection, a laboratory provider may not compensate even bona fide employees in a manner that takes into account the amount of business that such employee generates for the laboratory, whether government pay business of commercial insurance pay business. As a practical matter, existing laboratories could have bona fide W-2 employment arrangements with a sales representative that arguably meets the “employee” safe harbor under the Federal AKS, but now fails to meet the employee safe harbor under EKRA. There are many unanswered questions regarding EKRA. It was enacted for a good purpose, but as with many new pieces of legislation, there may be unintended consequences. Hopefully further guidance will be forthcoming to clarify the apparent overbreadth of the statute. Lynda Johnson and Timothy Ezell are both partners at Friday, Eldredge & Clark, LLP. Visit fridayﬁrm.com.
Stephanie Stank Cell: 870.974.3777 6
ARKANSAS on the MEND
BY BECKY GILLETTE
Mission Outreach NEA: Housing the Homeless For 36 years Shelter helps people find jobs and save money toward a home of their own By BECKY GILLETTE
PARAGOULD – Few things can have a more adverse effect on the mental and physical health of an individual or a family than to be homeless. It creates a profound sense of insecurity and often homeless people have difficulty obtaining healthy meals and having access to healthcare. The Department of Housing and Urban Development estimated that there were 2,467 homeless people in Arkansas in 2017. In Arkansas, many smaller communities don’t have shelters to house the homeless until they can find housing. A beacon of light in the situation is the Mission Outreach Northeast Arkansas (NEA) in Paragould, a 58-bed emergency home shelter that has been in operation for 36 years. Mission Outreach NEA Director Cheri Peters said the problem with homelessness is particularly bad in the winter when it is really cold, and in the summer when it is really hot. The shelter is able
to provide not just beds, but has an onsite food kitchen that serves meals 365 days of the year. “You are looking at folks with poor nutrition, which affects health, obviously,” Peters said. “Fortunately, we don’t have that happen here because we have a food kitchen. We also have an onsite food pantry for low- to moderate-income
families who can receive a food box once a month.” Because they have the largest homeless shelter in Northeast Arkansas, they end up providing shelter to people not just from Paragould, but Jonesboro, the Boothill area of Missouri and even from Little Rock because the shelters in those areas are often at capacity.
There is a major focus on helping the homeless find jobs. “There is no shortage of jobs here in Paragould,” Peters said. “One of the big focuses at our shelter is giving people two or three weeks to get a job. We have a case manager who provides them with the resources they need to obtain employment. We provide transportation to get to work. Once they get employment, they are required to save 75 percent of their earnings that go toward getting them in an apartment or a house. Sometimes people don’t know all the resources that are out there for them. The reason we have a case manager here is to help them with their applications. Those applications for free or reduced government housing can be complicated, so she is here to help with that.” Mission Outreach NEA partners with temp employment agencies and with Goodwill, which has a work program. Peters said her job is very rewarding. “We have successes and then we have failures,” Peters said. “But the majority of (CONTINUED ON PAGE 10)
Healthcare 2019: Experts’ Expectations for the New Year, continued from page 1 While legislative and legal policy changes undoubtedly have a very real impact on consumers and the broader healthcare landscape, the shift away from fee-for-service to value-based care and an emphasis on population health strategies seem to transcend politics as the industry continues the steady movement toward a more holistic approach to efficient, effective care across the continuum.
The Money Trail
Duncan Dashiff, head of U.S. Healthcare Services & HCIT Investment Banking for global financial services firm Canaccord Genuity, LLC, said he typically doesn’t worry too much about legislative change impacting financing for companies looking to transform healthcare. In fact, he noted, disruptors in the private sector Duncan Dashiff often set the stage for later transformation at the state and federal level. “We’re in a place where the private sector is driving real change. If you’re a company meeting the ever-increasing demand for better outcomes at improved cost, there will be capital for your solution,” Dashiff said of funding healthcare services and IT companies that embrace disruption and innovation. “Stepping back, one of the relevant macro-level factors is what’s happening in the world of private equity,” said Dashiff. “There’s an abundance of capital. Healthcare is obviously a very large component of the economy, and as a result, there are a significant number of private equity firms seeking exposure to healthcare services and HCIT from an investment thesis standpoint.” However, he continued, there is also a rise in funds that have not traditionally been healthcare centric but recognize the role the industry plays in the economy and have decided to jump into the fray, as well. “So, not all the firms chasing healthcare have a lengthy track record of experience in the space,” he noted. Dashiff added, “The current state of private equity won’t last forever. After the next generation of fundraising takes hold in a more significant way over the next 12-24 months, I suspect that the amount of private equity capital chasing healthcare in the subsequent years may not be quite as significant.” For those ready to strike while the iron is still hot, Dashiff said there appear to be three main drivers in the current marketplace. “One is there is clearly a continued interest in the opportunity for consolidation, which has always existed in healthcare services … in particular because of the fragmented nature of the industry and the benefits of scale.” Dashiff said there is a broad recognition of economies of scale and the advantage of creating critical mass to create value. “The other dynamic is there’s an in8
terest in playing on demonstrable sector trends ranging across aging demographic trends, the influences of consumerism in service delivery, employer-driven change and industry demand for more holistic population management strategies,” he said of recent marketplace transactional activity. The third area where he sees interest is in companies that are willing to break away from ‘business as usual’ in healthcare and can demonstrate success in their approach. “We’re in this zone now where I think there are some transformative shifts taking place across healthcare services, healthcare IT … and importantly … tech-enabled healthcare services where there are pockets of opportunity to invest in things that are highly disruptive for the betterment of the delivery system,” Dashiff explained.
The Business Model
Just as financing is flowing into innovation, the healthcare business model is also transforming. Last month, the PwC Health Research Institute released their 13th annual “Top Health Industry Issues” report, which includes survey findings from 1,750 U.S. adults representing a cross-section of the population. This year’s report, subtitled “The New Health Economy Comes of Age,” explores how the industry is transforming to more closely resemble changes that have been occurring for several years in other industry sectors. “The headline is that the U.S. health industry is finally demonstrating real progress in modernizing to be more digital, more consumer friendly and more transparent,” said PwC Health Industries Partner Nick Walker. “It’s finally starting to behave like other organizations,” he continued. “We feel like that is fueled by consumNick Walker ers.” With healthcare beginning to fall in line with other industries, Walker said this year’s report focuses on issues common across many sectors. “In every industry, there is the concept of digital transformation,” he pointed out. In healthcare, Walker said the movement is seen both in individual engagement and in larger population health and payment models. “Much more innovative partnership models are emerging,” he said of risk assessment and actionable data. Workforce issues, which have been a growing concern for healthcare, are similarly a concern across all industry sectors. The country’s low unemployment rates and a workforce that largely isn’t prepared for today’s technology exacerbate the problem. “The traditional education model hasn’t really been able to prepare for the digital transformation,” Walker explained. “It’s become imperative to retrain and re-skill employees to get the most out
of investments in technology.” It’s something employees are willing to undertake. In fact, 75 percent of those participating in the PwC survey said it was ‘very’ or ‘somewhat’ important that an employer offer training in emerging technologies, and 74 percent said they were more likely to stay with an employer that offers up-skill programming. Walker noted, “You have to have a workforce that’s able to move with you.” This is true across the spectrum of health-
care employees from administrative staff to providers. He added, “Clinicians are going to have to learn to work closely with technology to get the most out of it.” Another key takeaway on the changing business model is the push to create a ‘Southwest Airlines’ culture in healthcare where value and transparency play a prominent role while still meeting customer expectations. The report points to other examples, including Costco and (CONTINUED ON PAGE 9)
Telemedicine and Artificial Intelligence Excitement for All the Right Reasons Duncan Dashiff, head of U.S. Healthcare Services & HCIT Investment Banking for global financial services firm Canaccord Genuity, LLC, recently observed, “If you’re a healthcare service delivery organization, you are thinking about the portion of the population you address, the co-morbidities they have, the patients at high risk, those at moderate risk, and how you become more relevant in the context of being a real solution or more important component part for that population as a whole and in a more integrated way. “To do that effectively, you have to tech-enable your business, and you are seeing the necessary investments by traditional services companies and companies with new business models.” Dashiff continued, “The pace at which technology is moving is resulting in some pretty accelerated capabilities that just frankly didn’t even exist three to five years ago.” Telemedicine and artificial intelligence are two areas where he said there is a lot of excitement for all the right reasons . . . both from an investment perspective and the possibilities to improve health and outcomes. Telemedicine is not just an IT play, he noted, as it spans across health technology and healthcare delivery. “There has been capital that has poured into that marketplace over the last five-plus years,” he continued, adding the business is morphing beyond initial direct-to-consumer expectations. “What you’re now seeing is that telemedicine, in a lot of ways, can be more of a B2B solution as well, in terms of creating integrated delivery models and leveraging virtual care as a way to get at addressing the broader needs of a population.” He added the virtual care component also offers a solution for key clinical areas where provider shortages exist. “If you’re going to try to be in the population health management business, you better have some telemedicine solutions wrapped around behavioral and other specialties because you’re never going to have the feet on the street to do all of that,” Dashiff noted. Just as telemedicine is gaining traction, the use of artificial intelligence has taken off to help quantify where a population currently stands, predict risks from both clinical factors and social determinants, and recommend early interventions to change the trajectory. “Everybody has sort of talked about artificial intelligence for a while. It’s becoming a reality, and you’re going to see a lot more of that in ’19 and even more in ’20. There are very real companies that are doing some very compelling things in enabling healthcare organizations to do more transformative health service delivery,” said Dashiff. PwC Health Industries Partner Nick Walker noted that investors pumped $12.5 billion into digital health ventures in both 2017 and 2018, which is a 200 percent increase in funding compared to five years ago. Like Dashiff, Walker said actionable data allows healthcare professionals to intervene earlier and allocate resources based on risk profiles. “It directs care to areas where it’s needed more,” he said. Walker added wearables and other digital engagement offerings have gained acceptance among providers and the public. “A majority of consumers surveyed are interested in FDA-approved apps or online tools to treat their medical conditions. I think that’s a change from three to five years ago,” he said. Walker added the PwC survey found 56 percent of physicians are now incorporating digital therapy discussions in their interactions with patients, highlighting an increasing comfort level with data-sharing technology. Byproducts of sharing information at greater rates include the need for solutions to improve interoperability across the continuum and enhance cybersecurity measures to protect data flow.
Healthcare 2019, continued from page 8 Uber, as companies that have successfully created a ‘value line’ of products or services. “Those companies have optimized value, lowered cost, and most importantly have still figured out how to turn a profit,” said Walker. “Southwest was a disrupter in the industry,” he noted of the upstart Texas company that turned the airline industry upside down. While healthcare continues to be on a slow journey to greater price transparency, consumerism and efficiency, Walker said there has been significant movement over the last few years. “The interplay between regular industries and healthcare is greater than it’s ever been, and that’s also driving lower cost and greater efficiency,” he stated. “We know so much more now than we did about healthcare cost. We’re engaging the consumer in more efficient ways to deliver healthcare.”
Underscoring an earlier point, Dashiff said transformation often happens in the private marketplace where there is more flexibility and a direct value proposition. An example is the worksite clinics that employers have historically used to improve productivity and reduce absenteeism. “What’s happened over the span of a couple of decades is you have employers, particularly self-insured employers, who
are probably the most in control of their destiny as it relates to improving outcomes and bending the cost curve. They are probably the most motivated party participating in the healthcare delivery system to pursue significant change,” said Dashiff. He added their position allows them to look at the unique intersection of the patient, provider, and ultimate employer payor coming together in a way that can use the onsite or shared-site clinics as a hub to serve an entire population health management strategy when wrapped with the appropriate analytics capabilities and tech-enabled solutions for engagement and virtual care outside the walls of the clinic. While worksite clinics have been around for decades, Dashiff said what has changed is the ability and desire of self-insured employers to be able to bring the various component parts of a population health strategy under one umbrella, coupled with the technology to stratify risk and identify employees and family members who might benefit from specific interventions. The beginning of last year saw Amazon, Berkshire Hathaway and JPMorgan Chase announce their plans to form an independent healthcare company for their employees, and a number of other large employers have begun exploring population health management projects, as well. In addition, Dashiff continued, “The more sophisticated players in employer-
sponsored healthcare are doing more holistic things like narrow network management in connection with their approach. I believe this is an area where you’re going to see employer-sponsored healthcare evolve rapidly over the next several years and emerge as one of the more disruptive things that has happened to healthcare service delivery in a very long time. Not surprisingly, it will be another area of disruption that has been around a long time but simply had its model of care evolve.” He added, “As this all plays out, it won’t be at all surprising if you see similar models that address the commercial population, address the Medicare population, the Medicaid population. That’s not happening overnight, but the self-insured employer marketplace is happening now, and it’s pretty exciting.”
The Upside of Upheaval
“There continues to be a lot of areas in healthcare that have taken their licks over the years but are ubiquitous,” said Dashiff. Diagnostic imaging is an example where reimbursements took a pretty significant hit for several years. “That being said, imaging as a diagnostic modality is not going away. In fact, it’s a critical path area for effective and efficient care,” he pointed out. Dashiff added there isn’t much left to be taken away at this point so those reimbursement headwinds that
battered the sector have faded. He continued, “What you have left is a universe where the really good management teams figured out how to survive and come out on the other side. They figured out interesting strategies and are now at a point where they can grow with the market from a trend standpoint … and if they have the right strategy, they can grow market share.” That lean, mean model has become interesting to private equity firms looking for value. Dashiff said transactions are once again happening in areas like diagnostics and infusion that have weathered the storm. While change comes slowly … and sometimes painfully … in healthcare, Dashiff and Walker both pointed to very real signs of transformation and a growing willingness by industry stakeholders to innovate and rethink the business model to create a more efficient, more intuitive delivery system with a greater emphasis on wellness, early intervention and smarter disease management. “I think it’s a very exciting time in the industry both as a professional and as a patient,” said Walker. “The industry has just needed this efficiency for so long, and the innovation that’s taking place using best practices from other industries is creating new success stories across the healthcare continuum.”
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Growing Challenges in a Shrinking Field Memphis’ Dr. Lauren Ditta Is One of Nation’s Few Neuro-Ophthalmologists By BETH SIMKANIN
As one of only a very small number of pediatric neuro-ophthalmologists in the nation, in a field that medical experts say is in rapid decline, Lauren Ditta, MD, says versatility is key in her profession. A subspecialist in neurology and ophthalmology, Dr. Ditta believes her job brings with it a series of challenges that include: • A rising shortage in the pro- Dr. Lauren Ditta examines a patient’s eyes. fession. • The sizable amount of time required A recent national survey of ophthalto determine the cause of a vast range of mology residents conducted by NANOS vision problems. produced results that basically confirm • And the inability to prevent permaDr. Ditta’s assessment. Thirty-one pernent blindness. cent of residents were not interested in In contrast, she said there are signifineuro-ophthalmology because of a lack cant advantages that bring a high level of of surgery and surgical reimbursements, job satisfaction, including treating, and the difficult nature of the specialty and the sometimes curing, patients with complex time required to practice the discipline. and uncommon vision issues and collabo“The process to determine what rating with a variety of specialists to treat causes a patient discomfort is extensive,” patients. Dr. Ditta said. “We don’t usually figure Even though her specialty is in pediout what the cause of the problem is on atrics, she also treats adults. Her patients the first visit. I don’t see a lot of patients in go to her from across the nation with one day. By the time patients see me, they conditions ranging from double vision to are extremely frustrated because they may brain tumors. She sees them at Le Bonhave already seen several specialists.” heur Children’s Hospital and the HamilDr. Ditta performs various surgeries, ton Eye Institute, a nationally renowned including eye muscle surgery, but she said ophthalmology institute through the Unithis is a recent development in the field. versity of Tennessee Health Science CenShe treats patients with all kinds ter’s Department of Ophthalmology. of acute issues through referrals from Fellowship-trained in both pediatric specialists all over the country, typically ophthalmology and neuro-ophthalmolfrom neurologists and ophthalmologists. ogy, she assists the departments of ophSome patients travel from as far as Florida, thalmology and pediatrics at UTHSC as Missouri and Kentucky to see her at the an associate professor. Hamilton Eye Institute, which provides Neuro-ophthalmologists require specomprehensive eye exams and specialty cialized training in problems of the eye, eye care for patients. brain, nervous system and muscles. Ac“I see patients with acute issues every cording to the North American Neuroday,” Dr. Ditta said. “Fifty percent may Ophthalmology Society (NANOS), a have a disease of some kind and 50 percent professional organization consisting of may have something else. It can be hard 600 ophthalmologists or neurologists, for me to easily determine what condition neuro-ophthalmologists complete at least a patient has. I must do extensive testing, five years of clinical training after medical review records from several specialists and school and are board-certified in neurolorder scans to figure out if the problem ogy, ophthalmology or both disciplines. is in the eye or brain. The first visit can “We see with our eyes, but we process take three or four hours. The earlier I’m our vision with our brain,” Dr. Ditta said. referred the patient, the better.” “Neuro-ophthalmologists have an underDr. Ditta said the key to treating pastanding of how the eye and brain work tients is for physicians to refer them before together.” the patient goes permanently blind. Despite the need for the subspecialty “Sometimes, I get patients too late,” in both adults and children, Dr. Ditta said she said. “I can’t do much for the patient there is a local and national shortage of if he or she has gone blind. I stress to all neuro-ophthalmologists due to the historiclinicians that if they see something that cal lack of lucrative surgical procedures in looks suspicious to refer their patients as the discipline, the extra fellowship training soon as possible. I don’t want to see a required to practice in the field and the expatient become permanently blind, espetensive time and effort it takes to diagnosis cially if I could have prevented it.” and treat a patient. According to Dr. Penny Asbell, chair “I am one of about 25 pediatric of the Department of Ophthalmology at neuro-ophthalmologists in the country,” UTHSC and director of the Hamilton Dr. Ditta said. “The profession is exEye Institute, the Memphis area benefits tremely underserved in this region. There from Dr. Ditta’s expertise. just aren’t many of us.” “We are able to treat more unusual 10
and less common eye disorders in the Memphis area,” Dr. Asbell said. “We are fortunate to be able to provide an extra source of care for those patients at the Hamilton Eye Institute.” Dr. Ditta said that mostly she treats adult and pediatric patients with double vision and crossed eyes. “There are many reasons a patient may have crossed eyes or double vision,” she said. “The patient could have a brain tumor, a stroke, multiple sclerosis or an inflammation in the brain.” Over the past several years, she has seen a rise in adult women with idiopathic intracranial hypertension, which is a condition that occurs when pressure in the skull increases and the optic nerve becomes swollen. The symptoms mimic a
brain tumor, but a brain tumor isn’t present. Patients experience a headache behind the eyes, ringing in the ears and brief episodes of blindness. According to Dr. Ditta, researchers aren’t exactly sure why this condition typically occurs in overweight women of child bearing age, but they suspect it may correlate to progestin-containing contraceptives that are found in contraceptive implants and birth control injections. “I am seeing a massive rise in 28- to 30-year-old women with this disease who are experiencing vision loss, and it’s worrisome,” she said. “There is a change in hormonal regulation which causes a swelling in the optic nerve. I’ve seen patients with 20/20 vision slowly lose their vision.” In addition to the Hamilton Eye Institute, Dr. Ditta is in charge of the (CONTINUED ON PAGE 14)
Stephen J. Davis, continued from page 3
they worked and put them back together. In junior high, he decided he wanted to do something health-related. While in college, he had a job working for an optometrist and fell in love with the eye. While he really liked optometry, a mentor recommended he go to medical school and keep his options open. A job working for a retina specialist sealed his decision. His undergraduate degree was a BS in biology from the University of Central Arkansas. He completed medical school at the University of Arkansas for Medical Sciences where he was elected into the Alpha Omega Alpha honor society. He completed his residency in ophthalmology at the University of Arkansas’s Jones Eye Institute, and completed fellowship training in vitreoretinal surgery at Oregon
Health and Science University’s Casey Eye Institute. He joined Arkansas Retina in 2013. During his training, Davis received numerous awards for teaching and research. His work has been published in many professional journals, including Retina. He has presented at many local, regional and national meetings. Davis and his wife, Gretchen, have four children ranging in age from four to 12. “One of the things we love to do is go to state parks and we try to visit one or two national parks a year,” Davis said. “My leisure time is with my family going to their sporting events or playing outside. My hobbies and my life surround my family right now.”
Mission Outreach NEA, continued from page 7
them do stick with it and maintain employment. We don’t have a time frame like only being able to stay 30 days like some shelters. You can’t get people on their feet in 30 days. The maximum you can stay in our shelter is two years. But most people find affordable or government housing and employment well before that.” Common causes of homelessness are addiction and mental illness. There are also single mothers, sometimes victims of domestic violence, and elderly people who simply have trouble making ends meet. Mission Outreach NEA has dorms for men, women and three dorms for families. Not all homeless shelters have accommodations for families, and that can be a big help. Single mothers, in particular, can often find it difficult to make enough money to pay for housing, child care and other expenses. “Family housing is very important to provide,” Peters said. Mission Outreach NEA is a non-profit
organization that depends on donations and grants to meet operating expenses. “Obviously, financial donations are critical,” Peters said. “We also need donations of non-perishable food goods.”
How can you help? • Mail a financial donation to Mission Outreach of NEA, P.O. Box 1122, Paragould AR 72451. • Donate non-perishable food items like canned goods for the food pantry. • Volunteer to help serve a meal. • Call 870-236-8080 if you have a job opening. • More information is available at http://missionoutreachnea.com/
GrandRounds Pro Visits UAMS for Study of Golfing Motion LITTLE ROCK - Standing in a long, rectangular room with his feet firmly planted on an artificial, green turf surrounded by a series of 10 different infrared motion-capture cameras, PGA golfer and Arkansas native Austin Cook aimed carefully with a driver as he prepared to send a golf ball flying from a tee into a net. “I’ve never done anything like this before,” said Cook, a former Arkansas Razorback who is in his second year on the PGA tour, having won the RSM Tournament at Sea Island and qualified for the prestigious Masters in his first year. As of late December 2018, he was ranked 112 in the Official World Golf Rankings. Obviously, it wasn’t the golfing Cook was referring to. It was the 78 retro-reflective markers he had positioned all over his body, along with electromagnetic sensors taped to his legs that measured the electrical output of his quadriceps and hamstrings. Together, the instruments were being used to create a comprehensive, real-time picture of the motion and energy Cook used in each swing he took, information that is useful to UAMS researchers. “There are really many aspects to what we can do” with the data captured, said Cecilia Severin, Ph.D., a postdoctoral fellow in the UAMS College of Medicine Department of Orthopaedic Surgery. “We can use this technique to compare movement before and after surgery, for example, or after surgery at three months, six months, nine months, et cetera, to track progress and improvement.” That’s why UAMS is recruiting golfers – and not just professionals – as well as surgery patients to study their movement patterns using the cameras and sensors. The hope is to find an optimal pattern of movement and muscle use in golf to prevent injury and improve performance. “A golf swing is not something our bodies are really designed for, so one of our goals in the study is to understand how healthy golfers, people who don’t have injuries, achieve a good golf swing,” said Erin Mannen, Ph.D., an assistant professor in the Department of
Orthopaedic Surgery and lead investigator on the study. “By learning something about that, we can learn about what we call pathologic populations, or people who have problems like knee or hip injuries, arthritis or lower back pain.” As a 27-year-old professional who works out three times a week and, by his own admission, has spent the past couple years paying a lot more attention to what he eats, Cook is an ideal candidate to provide a baseline of sorts, researchers said. Comparing the data captured in tracking his movements to those of a surgery patient and noting differences, for example, could provide valuable insight. “Looking at our elite golfers like Austin Cook, his variability – which is the measure of how different one swing is from another – is like nothing we’ve ever seen. It’s almost zero. Every single one of his swings was almost exactly the same,” said Mannen. Of course, Cook said he was fascinated to see the report on his results himself. “I do think it’s important to understand how the body moves, so you can max your swing to what your body is capable of,” he said, adding of his own body: “This is my tool. The clubs help, but our tool, ultimately, is our body, and if it’s not functioning properly, we can’t play well.” Golfers age 50 or older with a handicap of 15 or less interested in participating the study can call 501-246-4439. Potential participants must give their age, golf experience and any past surgeries they may have had. Those who meet study criteria will be invited to schedule an appointment at the study facilities in Little Rock.
Some 78 retro-reflective markers are attached to participants’ bodies to track them using infrared cameras.
Cook preparing to swing.
Cook stretching before swinging.
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GrandRounds UAMS Researchers Receive $1.8 Million to Study Common Mechanisms Shared by Alzheimer’s, Other Diseases LITTLE ROCK — A team of University of Arkansas for Medical Sciences (UAMS) research scientists recently was awarded a $1.8 million, five-year grant by the National Institute on Aging to investigate common pathways that contribute to the aging of various tissues. Robert Shmookler Reis, D. Phil, professor in the UAMS College of Medicine’s Donald W. Reynolds Department of Geriatrics, and Srinivas Ayyadevara, associate professor in same department, are the co-principal investigators leading the study. Co-investigators are Steve Barger, Ph.D., professor in the Departments of Geriatrics and Neurobiology & Developmental Sciences, and Alan Tackett, professor in the Department of Biochemistry & Molecular Biology. The goal of the research is to identify what different neurodegenerative diseases like Alzheimer’s disease have in common with other age-progressive diseases and conditions such as heart disease, muscle wasting, kidney disease, and type 2 diabetes. Protein aggregation — clustering or clumping of protein molecules — has long been recognized as a hallmark of
neurodegenerative diseases like Alzheimer’s and Parkinson’s. Reis said the team has looked at protein aggregation for nearly a decade, funded by grants from the U.S. Department of Veteran Affairs. For the last two years, it has also been supported as part of a multi-investigator National Institutes of Health (NIH) grant led by Sue Griffin, Ph.D., professor and vice chair of research at the UAMS Donald W. Reynolds Institute on Aging. Peter Crooks, Ph.D., D.Sc., chair and professor of the Department of Pharmaceutical Sciences in the UAMS College of Pharmacy, developed novel derivatives of anti-inflammatory drugs. As part of the NIH grant, Crooks, Reis, Ayyadevara, and graduate student Samuel Kakraba tested these drugs for their ability to inhibit protein aggregation and to extend life. One drug, PNR502, was the main subject of a recently awarded patent covering several bioactive compounds. Reis said they have shown that protein aggregation accompanies aging of all tissues, and probably contributes causally to most or all age-associated diseases and that this fundamental molecular process may underlie most of the deterioration that defines aging. It’s a Pandora’s box that holds all the things that go wrong as we get older, so it of-
fers an unprecedented opportunity to finally understand how and why so many disparate factors contribute to aging.
Arkansas Autism Program Receives $2.17 Million in Federal Funding LITTLE ROCK — The Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) Program of the University of Arkansas for Medical Sciences (UAMS) recently was awarded a four-year grant of $2.17 million by the federal Centers for Disease Control and Prevention. The Arkansas monitoring program tracks the number and characteristics of 8-year-olds with autism spectrum disorder and/or intellectual disability. The new funding will enable the monitoring program to continue that work while also tracking 4- and 16-year-olds. “In this grant competition, we were one of only two new sites nationwide chosen to track 16-year-olds, an expansion to three from only one site before,” said Maya Lopez, M.D., the program’s principal investigator and an associate professor in the UAMS College of Medicine’s Department of Pediatrics. “We deeply appreciate this funding renewal because it means we can continue gathering data to promote developmental screening in health and educational ser-
vices and to connect these children with appropriate services.” Although previous grant cycles funded statewide monitoring, this new period focuses on central Arkansas. The program includes investigators with UAMS and operates in collaboration with the Arkansas Department of Health and the Arkansas Department of Education. Since 2000, the ADDM network has conducted autism spectrum disorder surveillance among 8-year-old children. This year ADDM has initiated the monitoring of 16 year-olds to help inform public health strategies for adolescents with autism. There are now 11 monitoring sites in different regions nationwide. Tracking 16-year-old adolescents with autism can also provide valuable information on transition planning in special education services and after the high school years. Sites will analyze the data to better understand increases over time in the number of children identified with autism and carry out education and outreach activities in their local communities. In this new funding cycle, UAMS received $1.57 million for four years of monitoring 4- and 8-year-olds, and $600,000 in a supplemental grant for the same period for monitoring 16-yearolds.
Who’s INCHARGE in 2019? A POWERFUL ECONOMIC DRIVER, Arkansas’ diverse healthcare offerings impact the industry on a local, regional and national basis. Knowing who is ‘in charge’ is important to
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fostering relationships and partnerships to keep this vital industry moving forward. Each April, Arkansas Medical News provides a definitive list of leaders in the annual InCharge Healthcare issue, which is formatted as a glossy, four-color magazine.
InCharge showcases a wide range of difference-makers, including:
Hospital, health system and large practice leaders
Top researchers and academic leaders
Go-to healthcare advisors including the top healthcare attorneys, bankers, accountants and consultants
Key healthcare investors and entrepreneurs
And other leaders … including some working behind the scenes … who continue to grow Arkansas’ multi-billion dollar industry.
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INSIDE: Listing of Top Healthcare Leaders Improving Health Across The Natural State
GrandRounds CHI St. Vincent Announces Key Leadership Changes
Mercy NWA Adds Providers in Hospital, Clinics
LITTLE ROCK – CHI St. Vincent has announced several key leadership changes as it transitions to address the shifting healthcare industry environment. The leadership restructuring will ensure the prudent stewardship of resources available to the 130-year old institution while also facilitating a sustainable model for its healing ministry. CEO Chad Aduddel said CHI St. Vincent, along with every institution currently operating in healthcare, recognizes that they must change to meet the long-term challenges facing the industry and that they believe these strategic moves position them for the future by putting strong clinical and operational leaders in place with the experience and dedication needed to ensure they remain true to their mission and commitment to excellent, compassionate care. Key changes to the CHI St. Vincent leadership team include: Shawn Barnett accepts the expanded role of Chief Operating Officer and Chief Financial Officer, responsible for the acute care operations and financial management of the health system. Doug Ross, MD takes on the expanded role of CHI St. Vincent Hot Springs President while continuing as the Chief Medical Officer for the health system. Marcia Atkinson has been promoted to President of the CHI St. Vincent Heart Institute, overseeing the largest cardiovascular team in the state and ensuring its continued growth and success. Chris Stines has been promoted to President of CHI St. Vincent North, continuing the growth of that facility as the Arkansas Neuroscience Institute transitions to its recently remodeled facilities and prepares to open the new education and research center. Bryan Williams has been promoted to Vice President for Patient Care Services for the health system. The leadership restructuring was made possible in part by the planned departure of two executive leaders at CHI St. Vincent. Polly Davenport, COO and President of CHI St. Vincent Infirmary and North departed on January 2 to accept a role as Senior Vice President / Regional Operations Officer Northwest with AMITA Health in Chicago. CHI St. Vincent Hot Springs President Anthony Houston accepted a position as the Chief Operating Officer of the group’s sister hospital CHI Memorial in Chattanooga. CHI St. Vincent remains committed to delivering the highest quality of care for patients and the communities it serves while simultaneously driving efficiencies to address the challenges facing healthcare providers and ensuring a sustainable future for its healing ministry in Arkansas.
ROGERS – Several providers recently joined Mercy Hospital and Mercy Clinic in Northwest Arkansas. Erik Sowell, M.D., has joined Mercy Clinic Primary Care – I Street in Bentonville. Dr. Sowell received his Doctor of Medicine from the University of Arkansas for Medical Sciences. He completed a residency in internal medicine at Louisiana State University Health Sciences Center. Before his medical degree, he worked as a scrub technician at Conway Orthopedic and Sports Medicine Clinic and as a multi-skilled assistant at Conway Regional Medical Center. Kyle Blair, M.D., has joined Mercy Clinic Family Medicine – Downtown Rogers. Dr. Blair earned a Doctor of Medicine from the University of Arkansas for Medical Sciences. He completed a residency in family medicine at University of Arkansas for Medical Sciences West in Fort Smith. A Rogers native, he volunteered for two years at Tree of Life Clinic in Rogers (now Community Clinic) from 2009-2011. Jesse Ford has joined Mercy Hospital as a neonatal nurse practitioner. He earned a Bachelor of Science in nursing from Henderson State University and a Master of Science in nursing from the University of Missouri-Kansas City. He has 20 years of experience in neonatal intensive care, most recently at University of Arkansas for Medical Sciences/ Arkansas Children’s Hospital. He also worked as a technician and coordinator in extracorporeal membrane oxygenation (ECMO) at Arkansas Children’s Hospital. Amanda Wood, M.D., has joined Mercy Clinic Family Medicine and Obstetrics – Physicians Plaza in Rogers. She earned a Doctor of Medicine from the University of Louisville School of Medicine. She completed a family medicine residency with a surgical obstetrics and global health components at the Waco Family Medicine Residency Program in Waco, Texas. In addition, she worked as a research assistant for the division of pediatric emergency medicine at Kosair’s Children’s Hospital in Louisville. Kristi Goodson, M.D., has joined Mercy Clinic Pediatrics – Lowell. She earned a Doctor of Medicine from the University of Arkansas for Medical Sciences. She completed a residency in pediatric medicine at the University of Oklahoma-Tulsa, including rotations at St. Francis Children’s Hospital and University of Oklahoma Schusterman Clinic. In addition, she completed a preceptorship in family medicine with the UAMS Center for Rural Health and Regional Programs in Clarksville.
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GrandRounds Baptist Health, Arkansas Urology Welcome Dr. Lauren N. Hendrix CONWAY – Dr. Lauren N. Hendrix is now part of the Baptist Health family after joining Arkansas Urology’s team of urologists in Conway. Hendrix, a native of North Little Rock, received her medical degree from the University of Arkansas Dr. Lauren N. for Medical Sciences Hendrix and had her residency training in Urologic Surgery at the University of Kentucky in Lexington. She is board-certified by the American Board of Urology. Hendrix is also a member of the Alpha Omega Alpha medical honors society, American Urological Association and Society of Women in Urology. She joins Arkansas Urology providers Jeff Marotte, MD, and Robbie Hurtt, MD, in Conway. The clinic is open from 8 a.m. to 5 p.m. Monday through Friday. Arkansas Urology, the largest urology practice in Arkansas, continues to offer the latest innovative technology
and surgical techniques like the MRI guided prostate biopsy procedure offered only at Baptist Health.
Dr. Jasmine Brathwaite Joins North Little Rock Family Practice NORTH LITTLE ROCK – Jasmine Brathwaite, MD, has joined North Little Rock Family Practice-A Baptist Health Affiliate. Brathwaite, who has spent 12 years in medicine, studied at the University of the West Indies in Barbados and had her resiDr. Jasmine dency at the University Brathwaite of Arkansas for Medical Sciences. She also obtained a fellowship in Geriatric Medicine at UAMS. North Little Rock Family Practice-A Baptist Health Affiliate is open Monday through Friday from 7:30 a.m. to 4:30 p.m. It offers a wide range of medical services for the entire family in North Little Rock and surrounding communities. At the clinic, Brathwaite works alongside three other people on staff: Hannah Baugh, APRN; Jenny Andrews,
PA; and Adam Grant, DO.
Arkansas Children’s Names Brent Thompson, JD, as Senior Vice President & Chief Legal Officer LITTLE ROCK – Arkansas Children’s has hired Brent Thompson, JD, to lead its Legal Services division as senior vice president and chief legal officer. Thompson currently serves as chief legal officer for Cape Fear Valley Health System Dr. Brent in Fayetteville, NC, a Thompson system with more than 900 licensed beds and 6,000 employees. His experience there – coupled with his previous experience as assistant general counsel for Blue Cross and Blue Shield of Oklahoma – give him an excellent skillset for helping Arkansas Children’s further strengthen its Legal Services division. Thompson earned his law degree at the University of Tulsa College of Law and is also an alum of University of Oklahoma in Norman. He has extensive experience in litigation, hospital policies and procedures and hospital compliance with federal laws.
Mercy Names Kelli Huntley VP of Finance ROGERS – Kelli Huntley has been named vice president of finance for
continued from page 10 Conway Regional Board Approves $40 Million Bond Issue CONWAY - The Conway Regional Health System Board of Directors has approved a $40 million bond issue to fund several projects over the next few years including construction of a 42,000-square-foot, three-story medical office building dedicated to Women’s Services. The building will house two of the three primary obstetrics/gynecology practices in Conway: Conway OB-Gyn Clinic and Conway Women’s Health Center. The third major OB/GYN clinic, Renaissance Women’s Center, owns and occupies its own building adjacent to the Conway Regional campus on Robinson Avenue. The second floor will house the practices of the Conway Women’s Health Center which includes Drs. Debra Lawrence, Amy Johnson, Brandie Martin and Josh Ward along with nurse practitioners Theresa “TJ” Moix and Heather White .Their Med Spa will be located inside their clinic offices and the layout of this space will be more efficient than their current clinic space. The third floor will hold the entire practice of the Conway OB-Gyn Clinic, combining their two current locations into one. The providers in this clinic include Drs. Andrew Cole, Katy Cox, Phillip Gullic, Keith D. Holland, Carole Jackson and Lauren Nolen and nurse practitioner Katie Boyd. The new medical office building will be located on the northeast end of the Conway Regional campus. Design options are being developed for an enclosed walkway that would connect the building with the rest of the Conway Regional Medical Campus. Other components of this expansion plan include an expanded Critical Care Unit to be located on a newly constructed story atop the OR building as well as enlarged space for the lab and pharmacy and expansion of the Greenbrier Family Medicine Clinic. Women’s Services is one of Conway Regional’s largest service lines. In 2017, more than 1,800 babies were delivered in the Conway Regional Women’s Center and the Mammography Department added 3D breast imaging technology. The 3D imaging is considered more effective in detecting breast cancer in women with dense breasts.
neuro-ophthalmology program inside the Le Bonheur Neuroscience Institute at Le Bonheur Children’s Hospital. Named one of the nation’s top neuroscience programs by U.S. News & World Report, the institute treats pediatric patients with various neurological conditions. Surgeons performed 200 brain surgeries there in 2016. In 2017, the institute treated pediatric patients from 32 states. Dr. Ditta sees pediatric patients with common neuro-ophthalmologic conditions and eye-related issues related to neurologic conditions on an inpatient and outpatient basis at Le Bonheur. She said one of the most rewarding aspects of her job is collaborating with other specialists. She works closely with a variety of medical specialists, including pediatricians, genetists, nephrologists, neurosurgeons and occupational therapists. Despite her busy schedule and the amount of research and testing it takes to treat each patient, she said she achieves high job satisfaction through her profession. “This is not a glamorous subspecialty; it’s definitely a labor of love,” Dr. Ditta said. “It’s gratifying to help a patient who has double vision to be able to have normal vision again. I have adult patients tell me, ‘I have a life again.’ It’s highly satisfying to get them functioning again.”
Mercy Hospital and Mercy Clinic in Northwest Arkansas. Huntley was promoted to the position after serving since 2012 as regional executive director of clinic Kelli Huntley finance for Northwest Arkansas, Fort Smith and Joplin. Huntley helped lead strategic planning for Mercy’s ongoing $277 million expansion, which will add seven clinics around the region and a seven-story tower to Mercy Hospital. Huntley has 15 years of financial management experience spanning manufacturing, nonprofit ministry and health care. She earned a Bachelor of Science in accounting from the University of Arkansas and an Master of Business Administration from Texas A&M University.
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