FOCUS TOPICS GASTROENTEROLOGY • UROLOGY • HIT • PRECISION MEDICINE • NEUROLOGY
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Gastroenterologist Terence Angtuaco has a Passion for Treating GI Complications Terence Angtuaco, MD, president of Premier Gastroenterology Associates in Little Rock, is a man of many talents. His passion for gastroenterology led to prolific research and publication activities while doing specialty training in liver transplant medicine at Rush University in Chicago, where he did his fellowship.
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AMA Issues New Privacy Principles
Organization Looks to Restore Trust, Power to Patients
NIH Precision Medicine Project is Changing the Research Landscape By CINDY SANDERS
Historically, medicine has been a ‘one size fits all’ proposition. It’s only been in the last few decades, as researchers have begun to uncover specific mutations and mechanisms driving disease, that the concept of precision medicine has really begun to take root and flourish. While the field is still in its infancy, a bold initiative from the National Institutes of Health – the All of Us Research Program – is working to move the science forward dramatically. “Our goal is to improve health and medical breakthroughs for everyone,” stated All of Us CEO Joshua Denny, MD, MS. The ambitious initiative looks to enroll one million individuals in the United States across the full spectrum of age, gender identity,
race, ethnicity, sexual orientation, socioeconomic status, education, geography, health status and other factors influencing health. Denny noted many segments of the population have been underrepresented or left out of research projects in the past. “We specifically said we wanted this population to be reflective of the diversity of the United States,” he explained. By capturing this huge amount of deidentified data, the hope is to build one of the most comprehensive precision medicine platforms in the world, allowing researchers to speed discovery by tapping into a breadth and depth of information that is not currently available. Moreover, Denny said the goal is to make this rich dataset easily accessible. (CONTINUED ON PAGE 4)
From wearables and fitness apps to EHRs and patient portals, an individual’s health data resides in a lot of different places.
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Bringing it All Together
OrthoArkansas’ Levi Bauer leads through merger, pandemic in first year as CEO By MELANIE KILGORE-HILL
The largest orthopaedic practice in Arkansas recently celebrated its first year postmerger, and is flourishing under the thoughtful leadership of CEO Levi Bauer, MBA. In June 2019, the Missouri native stepped up to lead OrthoArkansas following its partnership with Arkansas Specialty Orthopaedics. Once competitors, the Little Rock-based practices now comprise 34 physicians, 13 physician extend-
ers and 400 employees in eight clinics. The road to Arkansas “I’ve been interested in business leadership since I was eight years old,” laughed Bauer. “In those exercises where you draw what you want to be, I was always a guy in a suit with a suitcase.” Originally from Springfield, Missouri, Bauer’s family moved to St. Louis and then Nebraska, where he later re(CONTINUED ON PAGE 4)
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Gastroenterologist Terence Angtuaco has a Passion for Treating GI Complications Overwhelmed with patients, decreases in reimbursement means spending time on a good history and physical examination is very challenging By BECKY GILLETTE
Terence Angtuaco, MD, president of Premier Gastroenterology Associates in Little Rock, is a man of many talents. His passion for gastroenterology led to prolific research and publication activities while doing specialty training in liver transplant medicine at Rush University in Chicago, where he did his fellowship. In addition to his medical career, he studied and competed in Taekwondo for 11 years, has a 4th degree black belt and was World Champion in 2010. He plays a lot of tennis and actively competes in USTA sanctioned tournaments and leagues. He is also studying how to play the drums, enjoys writing poetry, and is currently working on finishing two books he hopes will be published soon. He finds gastroenterology a very dynamic field of medicine. “There is constantly new research coming out and new technology being developed,” Angtuaco said. “Digestive diseases are very common and there are still a lot of questions on many important diseases that need to be answered. It is not uncommon that GI symptoms are what lead patients to go see their PCPs. There are also many gastrointestinal complications that can be prevented by proactive preventive measures.” He finds gastroenterology the perfect choice that allows him to enjoy the mental challenge of tackling difficult medical cases and the physical challenge of fixing pathologies with his hands doing endoscopic procedures. Angtuaco appreciates having the platform to make a difference in someone’s life. “Certainly, it is about helping the patient feel better by treating their digestive diseases but, more so, it is about making patients feel that someone truly cares about them,” he said. “This is a great profession where patients entrust their lives to us and trust us with information that is personal and sensitive. I do not take this for granted and take great care to earn and maintain that trust. More than anything else, being a doctor allows me to serve God and do something important arkansasmedicalnews
and impactful with my life that is beyond looking out for my own self-interests.” IBS is one of the most common GI problems. But there are many other diseases that present like IBS. “It is important to do a thorough investigation and rule out important causes other than IBS before committing to that diagnosis,” Angtuaco said. “It is also important to protect IBS patients from unnecessary procedures, surgeries, and tests. In patients presenting with vague symptoms, it takes less time to order these than to spend time with the patient and do a thorough investigation to find out the true underlying cause. In this day and age when physicians are overwhelmed with the number of patients and the decrease in reimbursement, spending time to get a good history and physical examination has become a very challenging task.” There has been a lot of research done studying the link between the alteration of normal bacteria in the human body and certain diseases. “Probiotics are live microorganisms, either bacteria or yeast, that are ingested in the form of food or dietary supplements,” he said. “They are the good bacteria and yeast that help the body maintain its normal and healthy composition of microorganisms. They produce substances
that help keep us healthy and support our immune system in its fight against diseases. Prebiotics are nondigestible food components that promotes the growth and enhance the actions of the healthy microorganisms our body needs. Probiotics have been found effective in the treatment of antibioticassociated diarrhea, C. difficile infection, inflammatory bowel disease, IBS, constipation, diarrhea, and many other nongastrointestinal related diseases.” He talks to patients about eating more fiber and exercising. Most adults consume less than half the daily recommended amount of fiber needed, 25 to 30 grams. “Fiber helps keep our digestive tract healthy by promoting regular elimination of stools and absorbing toxins,” he said. “It also helps maintain cardiovascular health by helping maintain healthy cholesterol levels and blood sugar levels. Regular exercise has tremendous benefits for the cardiovascular system, our gastrointestinal health, and our mental health.” Eating an apple a day is good advice that has persisted for decades. “Apples are a good source of fiber,” Angtuaco said. “A medium-sized apple has about 4 grams of fiber. It is also a good source of several vitamins and minerals. Because of its fiber content, it helps with weight loss, cardiovascular health, and blood sugar control. It contains polyphenols that have antioxidant effects, lowers blood pressure, and lowers the risk of
stroke. It contains pectin, a non-absorbable fiber that acts as a prebiotic that feeds the good bacteria in the colon.” LPR or laryngopharyngeal reflux is a very important GI issue that PCPs, ENT specialists, and pulmonologists need to be aware of. Angtuaco said increased awareness about its presentation helps in early intervention and prevents possible long-term complications. Symptoms of LPR include chronic cough, hoarseness, excessive throat mucus, frequent throat clearing, the feeling of having a lump in the throat (globus pharyngeus), recurrent asthma exacerbation, recurrent sinusitis, recurrent bronchitis, recurrent ear infections, chronic nasal congestion, and runny nose, especially after meals (post-prandial rhinorrhea). Born in Manila, Philippines, Angtuaco migrated to the U.S. after graduating from medical school in 1993. He comes from a family of physicians. His father was a surgeon, his mother was a pediatrician and his wife, Josephine, is a pediatrician. Her three siblings and their father are doctors, too. His grand-uncle was the dean of the medical school Angtuaco attended. “Several of his children are doctors, with two of them in Little Rock,” Angtuaco said. “One of them, Edgardo, was a neuro-radiologist at UAMS for many years and recently passed away. The other, Edward, is still practicing radiology at Radiology Associates, PA.” Currently there are six Dr. Angtuaco’s in Little Rock including Terence, his wife, Edward, and Teresita, who is a radi(CONTINUED ON PAGE 6)
All of Us Looks to Improve Care for Each of Us, continued from page 1 “We really believe that the best science is done in a broad, open fashion,” he noted. Denny has been involved with the initiative from the very beginning. He was part of the NIH’s Precision Medicine Initiative Working Group while serving in his previous role as director of the Center Joshua Denny for Precision Medicine and vice president for Personalized Medicine at Vanderbilt University Medical Center in Nashville. The work group released a detailed report in September 2015 that became the framework to create the All of Us research platform. At the end of last year, Denny was tapped to lead the NIH effort.
Participation was purposefully made easy. Anyone aged 18 or older who lives in the United States is eligible to become part of the large study by simply logging onto JoinAllofUs.org. Participants answer health surveys, share electronic health records and might be asked to provide key physical measurements and biospecimens of blood and urine. Some will also be asked to provide saliva for lab and DNA tests. Those asked to share biosamples are able to visit a convenient partner site. However, participants decide how much data they are willing to share. Those who opt not to share their EHR can still participate in health surveys but wouldn’t be included in other aspects of the program.
Denny noted active engagement among participants sets the program apart. “We’re not a typical research study that just collects information and does research … we engage participants,” he said of actively seeking input and sharing information.
At the heart of All of Us is the desire to move science forward in a safe, effective, efficient manner by building one of the world’s largest and most comprehensive databases. “It is really to drive medical care, treatment and prevention,” Denny said of the massive undertaking. “It is both about population research and precision medicine research.” He pointed to cystic fibrosis research that led to the 2013 debut of the first drug targeting a specific CF mutation. “It only worked in 5 percent of the population, but it was almost curative,” he said of the breakthrough. Building off that genetic knowledge led to further discovery. By 2019, novel treatments were available to improve function and quality of life for 90 percent of CF patients. From a population health standpoint, Denny said researchers discovered a small population of African-Americans in Dallas had a rare mutation that corelated with significantly lower cholesterol and was protective of heart disease. That discovery by geneticists at UT Southwestern ultimately led to a new class of drugs for lowering LDL cholesterol in the broad population. “Those two stories highlight the
power of genomics and how data can impact specific populations and everyone,” Denny said. Having easy access to rich data allows researchers to move more quickly and with greater assurance, he said of the repository of millions of pieces of information All of Us will contain that can be easily sorted by population characteristics, disease characteristics, geography, age, exposures, medication regimens, genetic signatures and more. “You don’t have to recruit a new population of participants,” he pointed out. “Once you have a research database that’s large and has dense disease data and molecular information like genetics, it’s almost a look up.” Denny added the current COVID19 pandemic underscores the need for this type of information that could provide scalable insights into who is protected and affected by the virus. “We’re trying to rethink the whole process of doing research,” he said, adding the goal is to allow broad access for both public and private researchers following beta testing, which launched at the end of May. Once researchers have registered and gone through the onboarding process, All of Us uses a ‘data passport’ model that provides wide access to explore data rather than having to be granted permission for each study on a project-by-project basis. As part of beta testing the All of Us Researcher Workbench, participating researchers have begun using the study’s initial dataset and tools and have been asked to provide feedback. “We really welcome any U.S. academic researcher at this beta phase,” Denny added. Go to
ResearchAllofUs.org for more information on applying for access.
To date, All of Us has more than 349,00 individuals who have taken the first steps of enrolling. Of that group, over 271,000 have completed the initial stages of the program, which include completing the in-person visit for measurements and biospecimens, off ering consent for EHR access, and finishing the initial surveys. Denny noted progress has been slowed over the past few months during shelter-in-place orders that accompanied COVID-19. He added genetic testing was slated to begin just as the pandemic hit. “We’ve actually paused our in-person recruiting right now,” he explained, adding the team is assessing safety and timing to restart visits to partner facilities. Despite that pause, Denny encouraged anyone interested in being part of this seminal study to begin the enrollment process now. In addition to providing important information online that could be immediately useful, it also puts participants in a ready position when in-person visits start back. While Denny said it is crucial for physicians to share the importance of All of Us with patients to increase representative enrollment, he encouraged providers to become part of the cohort, as well. “The program is only as powerful as the participants who join us on this journey,” Denny concluded. “We want to make sure everyone is represented here at the table.”
Bringing it All Together, continued from page 1 ceived his bachelor’s degree in economics from the University of Nebraska-Lincoln. While working as a project manager for Securities America, Inc., Bauer pursued his MBA from the University of NebraskaOmaha. He went on to serve as chief operating officer at HDM Corporation and director of financial operations at Surgical
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Care Affiliates before serving as division director of orthopaedics, spine and neurosciences at Omaha’s CHI Health. “Once I hit healthcare, my eyes widened, and it became clear what I could do with my life and put my skills and talents to good use,” he said. “I could use my business talents to help make people’s lives better, and orthopaedics is the perfect mix of healthcare and business.” Creating a culture While mergers can be notoriously tricky, Bauer said the opportunity to be on the ground floor and help shape OrthoArkansas’ new culture was an exciting opportunity. “I’m big on creating a place at which employees love to work,” he said. Following a two-year merger process, Bauer has been focused on blending two distinctively unique cultures, building new foundations and laying groundwork for fresh relationships and processes – the new OrthoArkansas way of doing things. Bauer said 2020 started off incredibly well for the practice, and that they’ve excelled despite the unforeseeable challenges of COVID19. “Our employees have had to go to battle together, and these challenges have brought them together in so many ways,” he said. “We’ve been very proud of the team and how they’ve handled everything. They’ve led with ingenuity and crisis plan-
ning while focusing on what’s important and leaving the noise to the side.” Their teamwork was reflected in OrthoArkansas’ near immediate transition to curbside check in – a protocol embraced by patients that will likely remain for the foreseeable future. Telemedicine also was enacted within 24 hours. “It’s been an incredible thing to be a part of and watch,” Bauer said. “Our team has demonstrated that they’re always prepared for innovation.” Looking ahead Despite the ongoing challenges of a global pandemic, Bauer is moving forward on the new OrthoArkansas Spine Institute. The “one-stop shop” for spine care is located on the third floor of the Little Rock Midtown clinic and is expected to open early 2021. Bauer also is overseeing the transition toward more outpatient surgeries, including the use of robotic-assisted technology at OrthoArkansas’ two outpatient surgery centers. “We continue to be innovators in the area of outpatient surgery, and patients love it,” he said, noting that robotic-assisted surgery is already offered to inpatients at St. Vincent and Baptist Health facilities. “Our overarching goal is getting people back to living lives they’re meant to live,” said Bauer. “We want that to drive what we’re doing, and within that goal our focus is on patient sat-
isfaction. It’s a tough goal to meet, but we want 100 percent of patient experiences to be ‘wow’ experiences, and we want employees to love being here. Working at OrthoArkansas should make your entire life better, and it’s been going really well.” Building a team While becoming CEO of one of largest physician groups in the state is a tremendous accomplishment, Bauer is quick to credit his success to a dedicated team, coupled with a constant desire to understand bits and pieces of a rapidly evolving industry. “Part of a CEOs job is to ensure a great team and developing that team over the last year has been so satisfactory for me,” he said. “Helping others understand the concept of their team is 80 percent of your success and seeing them build their teams has proven successful as well.” When he’s not working, the father of seven (ages two to 13) enjoys reading, weight training, running and baseball coaching. He’s also transitioning to his new life in the Natural State – a place he considers “breathtaking” for its lakes and mountains. “The people of Little Rock have blown me away by how nice they are, and how quickly they are to strike up a conversation,” he said. “You don’t find that anywhere else, but it’s very apparent when you’re not from here.” ARKANSASMEDICALNEWS
AMA Issues New Privacy Principles Organization Looks to Restore Trust, Power to Patients By CINDy SANDERS
From wearables and fitness apps to EHRs and patient portals, an individual’s health data resides in a lot of different places. In the wake of rising privacy concerns, however, the American public has grown increasingly worried about how their information is used and with whom it is shared. In response to this unease, the American Medical Association released new privacy principles in May that support an individual’s right to control, access and delete personal data collected about them. Jesse Ehrenfeld, MD, MPH, immediate past chair of the AMA Board of Trustees, said it was important for the organization to take a leadership role on the topic. “Trust is a funJesse Ehrenfekd damental component of the physician-patient relationship. For me to provide the best care to my patients, my patients have to trust they can share information with me they might not want anyone to know,” he said, adding there’s only one opportunity to get it right. “Once privacy is lost, you can’t get it back. Privacy
has to be fiercely protected.” Rock Health and Stanford Center for Digital Health recently released a white paper outlining findings from the 2019 Consumer Adoption Survey. In its fifth year, the study highlighted another reason the AMA is well positioned to take the lead in outlining privacy expectations – physicians remain the most-trusted group when it comes to sharing health data. Even physicians, however, have seen consumer confidence slip a little over the last three years. Yet, nearly three-quarters of respondents still were willing to share information with physicians and more than half with insurance companies compared to 23 percent willing to share with health tech companies, 12 percent with the government, and only 10 percent with general tech companies. Confidence has been shaken by a number of tech sector breaches and scandals over the last few years, said Ehrenfeld, a public health policy expert who serves as director of the Advancing a Healthier Wisconsin Endowment. Additionally, there is growing recognition and frustration over the tech business model that quietly collects personal data, often without consumer knowledge or consent and without the strictures that accompany HIPAA.
Highlights of AMA Privacy Principles The American Medical Association detailed expectations and rights for data exchange and privacy derived primarily from policy approved by the AMA House of Delegates. In a release, AMA leadership said the goal is to create a national framework of transparency and guardrails to guide data collection, direct privacy legislation and build public trust. The privacy principles are available online at arkansasmedicalnews.com. Individual Rights: Recognition that individuals have the right to know who is collecting their data, why it’s being collected, how it will be used, and what is in the information. Furthermore, the AMA calls for individuals to have control over their info unless privacy rights have been waived “in a meaningful way,” the data has been appropriately de-identified, or in rare instances when a public health or safety issue warrant “limited invasions of privacy or breaches of confidentiality.” Equity: Commitment to adopting privacy protections promoting equity and justice to ensure individuals are safeguarded from discrimination, stigmatization, profiling or exploitation in the collection, processing or sharing of data. Entity Responsibility: Expectation that all entities that maintain an individual’s health information “should have an obligation or ‘duty of loyalty’ to the individual.” With that expectation, the entity should disclose exactly what data is collected and for what purpose. Applicability: Understanding that privacy legislation applies to all entities that “access, use, transmit and disclose data,” including entities not traditionally associated with healthcare that might be outside current HIPAA regulation. Enforcement: Recognition that individuals shouldn’t be responsible for the cost of enforcement except when exercising their private right of action. Furthermore, federal privacy legislation should serve as a “floor, not a ceiling” and shouldn’t weaken any state laws or regulations.
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Expertise. Experience. Excellence. Arkansas Urology’s Dr. Timothy Goodson is a Center of Excellence for the UroLift® System – a revolutionary, minimally invasive approach that provides rapid relief and recovery for men living with symptoms of an enlarged prostate, or benign prostatic hyperplasia (BPH). The UroLift® System breaks the cycle of medications and their potential side effects, all without the risks of traditional surgery. It provides immediate relief of BPH symptoms so patients can get back to a normal life as quickly as possible.
The Impact of Diabetes on Stroke Research Points to Worsened Brain Function, Increased Severity By CINDY SANDERS
Diabetes is well established as a risk factor for stroke. For diabetics, the chance of having a stroke is 1.5 times higher than in people who do not have the condition, according to the American Diabetes Association. However, the burden of diabetes is likely even higher. Recent studies find diabetes might impact post-stroke outcomes, as well.
Jorge Plutzky, MD, chair of the Diabetes Committee of the American Heart Association, said the systemic disease of diabetes accelerates atherosclerosis, increases risk for atrial fibrillation and is often accompanied by high blood pressure. All three of those conditions can lead to heart Dr. Jorge Plutzky attack and stroke. “We’ve always known we need to pay attention to people who have had a heart attack or stroke for another one,” Plutzky said. “People who had a history of diabetes but no heart attack had the same risk as someone who had previously survived a heart attack,” he continued, adding the same is true for stroke. Plutzky, who is also director of preventive cardiology at Brigham and Women’s Hospital and on faculty at Harvard Medical School, said diabetes intersects with stroke risks at several points – from the link between type 2 diabetes and obesity, which is often accompanied by high blood pressure and high cholesterol, to peripheral artery disease and microvascular disease, which have been linked to dementia and Alzheimer’s. Less clear is the role of prediabetes as a risk factor for stroke and heart attack.
“The absence of association between prediabetes and stroke does not inform us of the relationship of diabetes and stroke,” said Plutzky. “The complexity of the disease means it can be difficult to draw a circle around prediabetes – how you are defining it,” he pointed out. “We know that people with prediabetes do have a higher risk for diabetes, but not all will go on to diabetes.” However, he cautioned, it doesn’t mean someone with prediabetes won’t have a stroke. Nor does it mean those with prediabeties can bank on being in the group that doesn’t develop diabetes.
In May, the American Heart Association published a new analysis of seven international studies looking at post-stroke progress three to six months after the event. The analysis found study participants with diabetes functioned worse than those without on measures for memory, attention, mental flexibility, processing speed, language and other tests of cognitive function. Looking at 1,600 stroke patients in Australia, France, Korea, the Netherlands, Singapore and the United States – almost all of whom had ischemic strokes – researchers also considered whether there was a difference in outcomes between those with type 2 diabetes and those classified as being prediabetic. It should be noted, the classification was determined by a single measurement of fasting blood sugar levels at hospital admission and medical history without follow-up measurements or additional information on severity or duration of disease. With that limitation, and after adjusting for age, gender and education, researchers found that diabetic stroke survivors had “significantly poorer” function than others, including those with prediabetes. Even after adjusting for additional
Gastroenterologist Terence Angtuaco has a Passion, continued from page 3 ologist at UAMS. Sylvia is a cardiologist at Arkansas Children’s Hospital and Michael is an interventional cardiologist at ACH. Premier Gastroenterology Associates is comprised of seven GI doctors (Terence Angtuaco, Angelo Coppola, Brian Hughes, Steve Jones, David McElreath, Dhaval Patel, and Paul Svoboda) who left the Little Rock Diagnostic Clinic and formed the group in June 2018. The partners built a state-of-the-art clinic and ambulatory surgery center at the Premier Medical Plaza on Rodney Parham Road. “We provide all the basic GI services plus more including capsule endoscopy, Restech pH study for LPR, argon plasma coagulation therapy, weight loss management including gastric balloon placement and dietitian service, and fecal inconti6
nence treatment,” Angtuaco said. Angtuaco and his wife have three children. Tyler graduated from Pulaski Academy (PA) and is now a sophomore student at UCLA. Julienne is a junior at PA and Jaymie is a freshman at PA. “All our kids play a lot of tennis,” he said. “Julienne and Jaymie are still actively competing in USTA sanctioned tournaments and also play for PA. Tyler once played for PA and was state champion during his senior year.” Angtuaco completed an Internal Medicine residency at Mount Sinai Beth Israel Medical Center in Manhattan, N.Y., in 1998. He is a former assistant professor of medicine at the UAMS and practiced at the Central Arkansas Veterans Hospital.
factors including high blood pressure, smoking, body mass index, previous stroke history and ethnicity, the results held up with prediabetic stroke survivors not experiencing the severity of cognitive decline as seen in those with diabetes. According to the researchers, led by Perminder Sachdev, AM, MBBS, MD, PhD at UNSW Sydney, key takeaways include: A call to focus on early, more aggressive treatment for prediabetes to prevent the progression to type 2 diabetes; and The need to assess the capacity for self-care in diabetic stroke survivors to ensure patients have the ability to fulfill the complex tasks required to measure and manage diabetes.
Adding Alzheimer’s to the Equation
Diabetes has also been linked to an increased risk for vascular dementia and Alzheimer’s disease. A separate study released earlier this year found the combination of diabetes and Alzheimer’s disease compounded severity for those with hemorrhagic stroke. Analyzing more than 2,000 adults in the Kentucky Appalachian Stroke Registry, researchers found 75 percent with both diabetes and Alzheimer’s either died or required hospice or long-term care post-stroke compared to 62 percent with Alzheimer’s alone, 42 percent with diabetes alone, and 39 percent with neither condition. Researchers did not have each patient’s specific blood pressure measurement at the time of stroke … but if high blood pressure, a common cause of
hemorrhagic stroke, had been previously diagnosed, the research team did control for that factor. Even with that limitation, the study’s authors stressed the need to effectively manage diabetes in light of the significantly worse outcomes that accompanied diabetes and Alzheimer’s, particularly in combination.
With prediabetes, Plutzky said it is essential to address lifestyle modifications to try to slow or halt the progression to diabetes. For those who already have diabetes, he said there has been a “sea change” in the management of the disease with the addition of two newer classes of therapies. Whereas older treatments didn’t reduce the risk of heart attack and stroke, sodiumglucose co-transporter inhibitors (SGLT2 inhibitors) and glucagon-like peptide-1 agonists (GLP-1 receptor agonists) do. “We do want physicians to be aware of these newer drugs because they are underutilized,” he noted. “The presence of diabetes increases one’s risk for heart attack and stroke,” summed up Plutzky. “Not only does it increase the risk for having a stroke but for not doing as well after having a stroke, and it may be linked to cognitive function, in general.” However, he added, early intervention and improved management through both drug therapy and lifestyle modification can change the trajectory for a patient. “Paying attention to all the red flags – both in prediabetes and diabetes – can make a difference in how patient’s ultimately do,” Plutzky concluded.
AMA Issues New Privacy, continued from page 5 “We fully support the right of patients to be able to access, download and share their data,” Ehrenfeld stated, adding that control belongs with the individual not an entity. To address these concerns and issues, he said the AMA Privacy Principles outline transparency expectations across five main categories – individual rights, equity, entity responsibility, applicability and enforcement. Ehrenfeld noted part of the impetus for AMA publishing these new principles stems from the spring release of final rules on data sharing and patient control from the U.S. Department of Health and Human Services in connection to the 21st Century Cures Act and the MyHealthEData initiative. “We advocated strongly and regularly to HHS to include controls in those final rules that would promote how apps use health data and how patients can prevent an app from using their information without consent,” he said. “Unfortunately, HHS didn’t take any action in that final rule to promote transparency.” Ehrenfeld added, “HIPAA is a law that predates almost all modern digital technology. HIPAA does not cover data
that is created or managed by a patient or third party app.” Without appropriate privacy controls, he said health information collected by apps or wearable fitness trackers could be shared with an employer or added to a credit score. “Once health information goes out the door and goes to a broker, you have the perfect recipe for harmful profiling and discrimination,” he pointed out. Yet, he continued, data collection is both ubiquitous and important to optimizing care. Trackers and apps can improve activity levels, diet, hydration and disease management. Data collection can highlight risk factors, identify at-risk populations or help clarify symptoms and spread of an infectious disease like COVID-19. “The more assurances people have about how entities will use that data, the more willing society will be to use technologies – whether it’s telehealth or contact tracing,” he said. “We think that having guardrails and transparency is key to building trust and not inhibiting data exchange. We want to restore confidence in data privacy, and that’s what our principles are all about,” Ehrenfeld concluded. arkansasmedicalnews
UroLift: A New Solution for Enlarged Prostate One of the most prevalent conditions men face as they age is the enlargement of their prostate, or what is often called benign prostatic hyperplasia (BPH). BPH affects a third of men older than 50, as many as 7 in 10 men in their 60s, and 9 in 10 men who are 85 years old, or By TIMOTHy GOODSON, MD older. The prostate is a muscular gland that sits between the bladder and the penis, in front of the rectum, and wraps around the urethra. As a chronic condition, BPH is one of the least morbid, most frustrating and uncomfortable (nevermind untreated) diagnoses in medicine, and results from the natural proliferation of epithelial and muscle cells within the gland. This might not spell trouble if the prostate sat apart, but it doesn’t. As it grows, it hugs, even pinches, the urethra. Today, there’s a revolutionary new treatment called UroLift that’s growing in number and recommendation. It’s nonsurgical, as minimally invasive as an internal procedure can be, and makes no physical change to the gland through cut-
ting or lasers. It’s helping a growing number of Arkansas men. BPH precipitates a variety of conditions around the act of micturition, from discomfiting (a weak stream or dribbling at the end of urinating) to alarming (starting and stopping, the sensation that your bladder is full despite having just emptied). If BPH continues unabated, the urethra will be pinched nearly closed, obstructing flow and inspiring the most severe lower urinary tract symptoms (LUTS). As with all conditions, early intervention is key. While BPH is a top reason that patients are referred to a urologist, only about one-third of patients with BPH actually seek help. Naturally, there are some issues that men are reluctant to talk about. It’s imperative to ask the right questions of patients to let them know something can be done and get a diagnosis. The good news for patients is that the UroLift System offers immediate relief. UroLift can even be the first line treatment for patients. It’s deployed by a thin guide that travels gently up the urethra to the prostate (under general or local anesthetic, and with the help of cystoscopic visualization). The device implants a suture with a Nitinol tab, a shape memory alloy of nickel and titanium that’s used in stents (and nontoxic, of course). These implants pin the obstructing lobes back, pinching
the prostatic bulge at the point of contact with the urethra, relieving the bottleneck. Typically, two to three implants are made against each wall. The procedure is performed in under an hour. This is a onetime procedure for patients, no ongoing medications or long-term therapy. The UroLift System doesn’t reverse the hyperplasia (or hypertrophy) or turn back the clock, and because it is a material stent, it is not without side effects including discomfort and the evidence of light bleeding during micturition immediately following the procedure, but these subside within a very short time. The advantages, meanwhile, are many:P • 100 percent effective relief immediately of the most common lower urinary tract symptoms caused by BPH • Minimally invasive with no cutting, heating or removing of prostatic tissue • Performed by a urologist in a clinical, not surgical, setting • Patients return home without a catheter or other aid • No subsequent pharmaceutical regimen • No sexual side effects such as erectile dysfunction or retrograde ejaculation The UroLift System might not be right for every man in every case. Many urologists may justifiably advise a course of alpha blockers for BPH, which relax the
muscles of the prostate, or 5-alpha reductase inhibitors (5-ARIs), which may shrink the actual tissue. Men with very enlarged prostates may be advised to have surgery, up to and including a prostatectomy, or receive a combination of drugs. All of these alternatives may carry significant side effects and are not without complications. The UroLift System carries no long-term side effects, and better still, it can be done first, or in conjunction, with other therapies. Patients are able to return to normal activities within one to two weeks. Most of them are able to discontinue medications. There is no new sustained erectile dysfunction and the patients have long-term symptom relief. Also, research shows that even five years out less than five percent of patients will need other therapies. At Arkansas Urology, we can help patients and we are happy to talk more about this revolutionary procedure as an option for your BPH patients. Timothy C. Goodson, MD, is a past president of the Arkansas Urologic Society and a member of the American Urological Association. He currently serves on the medical advisory board of the Arkansas Prostate Cancer Foundation and has been instrumental in bringing new prostate cancer treatments to the central Arkansas area. Arkansas Urology is the largest specialty of its kind in Arkansas. To learn more, visit http:// www.arkansasurology.com
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Governor Issues Executive Order on COVID-19 Related Healthcare Provider Immunity By Caitlin D. Kennedy
LITTLE ROCK - Governor Asa Hutchinson issued three Executive Orders on Monday, June 15, 2020, in response to the public health crisis posed by COVID-19. Below is a summary of Executive Order 20-34. Pursuant to the Arkansas Emergency Services Act of 1973, the Executive Order authorizes all healthcare providers to provide healthcare services directed at the treatment and mitigation of symptoms of COVID-19 in response to the pandemic and during the declared emergency. The Executive Order authorizes all healthcare providers who are licensed, certified, or otherwise authorized by law to administer health care in this State, to provide healthcare services in their normal course of business or operation, for the purpose of diagnosing, treating, mitigating, or curing COVID-19 or any complication, and to use any drug, device, or product approved or cleared under the Federal Food, Drug and Cosmetic Act (21 U.S.C. §§ 301- 392) (“FD&C Act”); licensed under the Public Health Service Act (42U.S.C. §§ 201-291n); or authorized for emergency use under an
Investigational Device Exemption or Investigational Drug Application of the FD&C Act. The Order requests healthcare providers to perform services directed at the prevention, treatment, mitigation, or cure of COVID-19, and to perform other Emergency Management Functions within the scope of their licensure. Emergency Management Functions include: triage, diagnostic testing, and/ or treatment to individuals with known or suspected COVID-19; cancelling, postponing, or denying elective procedures; redeploying or cross-training staff not typically assigned to such duties, to the extent necessary to respond to the COVID-19 health emergency; planning to or enacting crisis standards of care measures, such as modifying numbers of beds, preserving personal protective equipment, and triaging access to services or equipment; and reducing recordkeeping requirements to the extent necessary for healthcare providers to perform tasks as may be necessary to respond to the COVID-19 public health emergency. The Executive Order provides immunity from liability for any death, injury, or property damage alleged to have been sustained as a result of any act or
omission by a healthcare provider in the course of providing COVID-19 related emergency management functions during this public health emergency. Immunity
does not extend to an act or omission that is willful, reckless, or intentional misconduct.
GrandRounds UAMS, Arkansas Children’s, Baptist Health and Proton International Sign Letter of Intent to Build State’s First Proton Treatment Center LITTLE ROCK - The University of Arkansas for Medical Sciences (UAMS), Arkansas Children’s, Baptist Health and Proton International (PI) have signed a Letter of Intent to bring proton therapy — an alternative to radiation therapy for treating cancer — to Arkansas. The proton treatment center will be the first in Arkansas and one of only about 40 in the country. It will be located at the UAMS Radiation Oncology Center. Proton therapy precisely targets tumors, sparing the surrounding healthy tissues. The Proton Treatment Center will bring cutting-edge therapy to patients and will be the basis of many new and novel clinical trials that will benefit patients
and clearly move the cancer research field forward according to Michael Birrer, M.D., Ph.D., director of the UAMS Winthrop P. Rockefeller Cancer Institute. Proton therapy is particularly effective in treating solid cancer tumors, including tumors of the brain, spine, head and neck, lung, prostate, colon, and some breast tumors. It is widely used to treat children with cancer, as children are particularly sensitive to the effects of radiation therapy. Every new center will increase the number of proton treatment facilities enrolling patients in national data registries and in clinical research trials to document clinical outcomes and enhance the benefits from an appropriate use of the therapy. The agreement is pending approval by the University of Arkansas Board of Trustees and the boards of Arkansas Children’s and Baptist Health.
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GrandRounds CARTI Announces Plan to Build CARTI Cancer Center in Pine Bluff LITTLE ROCK/PINE BLUFF – CARTI announced its plan to build its fifth comprehensive CARTI Cancer Center in Pine Bluff, bringing its statewide presence to 17 treatment locations in 15 communities. The cancer treatment facility’s planned services will include medical and radiation oncology, an infusion suite, imaging, mammography services and an on-site lab. Construction is set to begin in December 2020 and the project is anticipated to be completed by January 2022. The project will be realized in two phases: 1. Phase I: Begin Treating Patients at an On-site Modular Building a. Anticipated Open Date: December 2020 b. Ahead of the building’s opening, CARTI will start seeing patients at a modular building that will be installed on the construction site. Phase I will include an on-site lab, infusion suite with 12 infusion chairs, patient consults for surgical and radiation, and patient support services, including financial counseling, social workers, nutrition and genetic counseling. 2. Phase II: CARTI Cancer Center Opens a. Anticipated Open Date: January 2022 b. Phase II will include all of the services of Phase I, plus radiology services, including mammography, MRI, PET/ CT, CT and ultrasound, and radiation therapy. The Pine Bluff medical team will consist of experts representing each of CARTI’s cancer specialties. Together, these renowned providers will provide the region’s patients and families with a team approach to comprehensive cancer treatment. The Pine Bluff treatment facility will be near Interstate 530 on a seven-acre tract adjacent to Trotter Ford. This will be the fourth cancer center the organization has launched within the past two years and the largest facility outside of its main cancer center in Little Rock. The facility will employee approximately 30 full-time employees. CARTI also announced the addition of five new physicians, bringing its team of cancer experts to a total of 38 physicians. Marian Miller, M.D., Breast Oncologic Surgeon Dr. Miller served as a breast surgeon and director of the Women’s Breast Center of Houston in Houston, Texas, and as a surgeon at Kaiser Permanente in West Los Angeles, California. She completed a fellowship in breast oncology at City of Hope National Medical Center in Duarte, California, and completed her residency in general surgery at Orlando Health in Orlando, Florida, where she was named general surgery chief resident. She earned her medical degree from the University of Toledo Colarkansasmedicalnews
lege of Medicine in Toledo, Ohio, and a Bachelor of Science in Chemistry from Wright State University in Dayton, Ohio. She is board certified by the American Board of Surgery. Jessica McElreath, M.D., Breast Imaging Specialist Most recently, Dr. McElreath has served as an assistant professor at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. She was previously the director of breast imaging at the Central Arkansas Veterans Healthcare System in Little Rock, Arkansas. She completed her fellowship in breast imaging and residency in diagnostic radiology at the University of Arkansas for Medical Science in Little Rock, Arkansas. She earned her medical degree from the University of Arkansas for Medical Science in Little Rock, Arkansas, and a Bachelor of Arts with an emphasis in Biology from Hendrix College in Conway, Arkansas. She is board certified by the American Board of Radiology. David Kuperman, M.D., Medical Oncologist Most recently, Dr. Kuperman is a partner in Van Amburg and Busiek, LLC in Chesterfield, Missouri. Previously, he was an adjunct instructor in the division of oncology at Washington University in St. Louis, Missouri, and a staff physician at John Cochran Veterans Administration Medical Center in St. Louis, Missouri. He completed his fellowship in hematology/oncology at Barnes-Jewish Hospital/Siteman Comprehensive Cancer Center at Washington University in St. Louis, Missouri. He completed a residency in oncology at Johns Hopkins Hospital in Baltimore, Maryland. He earned his medical degree from the University of Arkansas for Medical Science in Little Rock, Arkansas, and a Bachelor of Arts in Chemistry from Hendrix College in Conway, Arkansas. Jaclynn Elias, M.D., Supportive and Palliative Care Dr. Elias will launch CARTI’s first-ever palliative care program, which will provide patients with an extra layer of support specifically targeted at relieving side effects of their treatment. This specialty will be delivered in tandem with other curative treatments. Most recently, she has served as a palliative medicine consultant at Baptist Health and Practice Plus in Little Rock, Arkansas. She completed her fellowship in hospice and palliative medicine and a residency in internal medicine at the University of Arkansas for Medical Science in Little Rock, Arkansas. She earned her medical degree from Louisiana State University Health Sciences Center in Shreveport, Louisiana, and a Bachelor of Science in Biology from Louisiana State University in Baton Rouge, Louisiana. She is board certified by the American Board of Internal Medicine.
Michael May, Jr., M.D., Radiation Oncologist Dr. May completed his residency in radiation oncology at the James Graham Brown Cancer Center at the University of Louisville College of Medicine in Louisville, Kentucky, where he was selected as chief resident. He earned his medical degree from the University of Tennessee Health Science Center in Memphis, Tennessee, a Masters of Science in Physiology and Bio-Physics from Georgetown University in Washington, D.C., and a Bachelor of Arts in Neuroscience from Vanderbilt University in Nashville, Tennessee.
Medical Center of South Arkansas Wound Care and Hyperbaric Center Welcomes Brandi Campbell, FNP-BC as New Nurse Practitioner EL DORADO - Brandi Campbell, FNP-BC, has joined Medical Center of South Arkansas as the new Nurse Practitioner at the MCSA Wound Care & Hyperbaric Center. Brandi will be joining a team of wound care specialists at the Center, which offers an Brandi Campbell evidence-based, systematic approach to advanced wound care. Treatment plans are developed and scheduled based on each individual patient’s needs. A patient’s personalized treatment plan may include specialized wound dressings, debridement, compression therapy, hyperbaric oxygen therapy, advanced cellular products and topical growth factors, edema management and/or non-invasive vascular assessment. Once treatment is complete, the patient will return to their primary physician to continue routine care. Brandi received her Master of Science, Family Nurse and Nursing Education from University of Arkansas, in Little Rock, AR and is a Board-Certified Family Nurse Practitioner with American Nurses Credentialing Center (ANCC). She is excited to return to her hometown of El Dorado and give back to patients in south Arkansas. In joining the Medical Center of South Arkansas Wound Care & Hyperbaric Center, as a member of the Healogics network, Mrs. Campbell will collaborate with a network of academic medical centers, hospitals and thousands of professionals committed to advancing wound healing by creating, sharing, and activating wound prevention and care expertise.
Bryan Williams Appointed Chief Nurse Executive for CHI St. Vincent LITTLE ROCK – CHI St. Vincent has appointed Bryan Williams, DNP, MBA, RN, NE-BC, as the system’s Chief Nurse Executive to provide leadership and coordination of nursing practice across the CHI St. Vincent system. Williams most re-
cently served as CHI St. Vincent’s Vice President for Patient Care Services and Chief Nursing Officer for CHI St. Vincent Hot Springs. Beginning his career as a staff nurse at Bryan Williams CHI St. Vincent, Williams went on to serve in various roles at the University of Alabama at Birmingham, aBaptist Health in Birmingham, CHRISTUS Health in Corpus Christi and Community Health Systems in the greater Nashville area. He returned to Arkansas in 2008 to serve as the Chief Nursing Officer for CHI St. Vincent North and later as the Executive Director of Nursing at the CHI St. Vincent Infirmary. Williams earned his Doctor of Nursing Practice-Nursing Administration from the University of South Alabama, his Master of Science in Nursing at Stanford University and his MBA from the University of Alabama at Birmingham. He completed his Bachelor of Science in Nursing from the University of Central Arkansas in Conway.
ANPA Annual Conference Cancelled for Virtual Meeting Thank you for being a part of the Arkansas Nurse Practitioner Association (ANPA). Due to continued concerns regarding COVID-19 and large gatherings, our board decided to cancel our Annual conference scheduled for August 21st and 22nd. Our conference and education committees are finalizing details for a virtual conference to offer CEs and support our annual membership meeting. We will send this information when we have further details. Our 2021 legislative agenda includes running a Full Practice Authority bill, supporting a Medicaid PCP bill, and other Nurse Practitioner issues that may arise (such as opposing bills that adversely effect NP practice). ANPA legislative committee is working with a Legislator to run the Full Practice Authority Bill. We plan to hire our first ANPA Lobbyist. Unfortunately, the decision to cancel our Annual Conference has an enormous impact on our ability to pay a lobbyist for our 2021 legislative agenda. Since we are a 501(c)3 tax exempt association, we can use 20% of our gross revenue for lobbying. The Annual Conference (although expensive for ANPA) is our largest source of revenue. We are asking, if you are able, to donate your full or partial conference registration fee to help support ANPA’s 2021 Legislative Agenda/Lobbyist. We understand many of our members are financially effected by the virus and cannot make this contribution. Be assured your full registration will be returned if you choose not to donate it. All contributions are greatly appreciated. Email conference@anpassociation. org to donate your registration and firstname.lastname@example.org for a refund.
GrandRounds Conway Regional Health System, Central Baptist College, Hendrix College, and the University of Central Arkansas Announce COVID-19 Partnership CONWAY - Conway Regional Health System, along with Central Baptist College, Hendrix College, and the University of Central Arkansas, announce a partnership for testing and health services related to COVID-19. Conway Regional Health System and Conway’s three institutions of higher education have been collaborating for several weeks to implement protocols and practices to help ensure the health and safety of students, faculty, and staff. During this unprecedented time, this partnership brings together innovation, collaboration, and teamwork to build on and expand upon long-established working relationships. As a community, the administration at the campuses felt the need to pursue a local health care partnership to help address COVID-19 this fall. A college consortia with regard to COVID-19 screening and testing in the ‘City of Colleges’ is ideal because it allows speaking with one voice to the thousands of employees and students on campuses of higher education according to Sancy Faulk, Vice President for Institutional Advancement at Central Baptist College. The partnership focuses on recommended best practices for each campus to keep their communities safe and healthy. The infection prevention team at Conway Regional has worked with the campus medical providers to understand their needs and provide guidance on prevention and testing, as well as operational recommendations, which are based on the health system’s management of COVID-19 since its appearance in Conway in March. The partnership is another innovative way the campuses are coming together to build on existing relationships to address the needs of each of the campus communities. Additionally, this partnership enables robust testing for all college students in the city of Conway. Testing will occur with a provider order and will be facilitated by Conway Regional Laboratory Services. This critical partnership will have an immediate impact in addressing COVID-19 on campuses and will help with surge testing when and if it’s needed said Necie Reed, APRN at the Conway Regional Hendrix Medical Clinic. For UCA, it’s about ensuring a sustainable approach for managing COVID-19, including testing and mitigation of potential spread of the virus. All three institutions of higher education plan to resume face-to-face instruction for the fall semester on Thursday, August 20, 2020.
Arkansas Children’s, UAMS Announce Perkins as Chief of Pediatric Neurology LITTLE ROCK – Arkansas Children’s and the University of Arkansas for Medical Sciences (UAMS) have named Freedom F. “Fred” Perkins Jr., MD, as chief of Pediatric Neurology for both health systems. Dr. Perkins, who also serves as an associate professor of Pediatrics Fred Perkins, Jr. in the UAMS College of Medicine will lead the world-class Neuroscience Center at Arkansas Children’s, where he will also see patients, delivering comprehensive pediatric care for neurological disorders, brain, nervous system and neuromuscular disorders. Dr. Perkins will serve as the director of the MEG laboratory at Arkansas Children’s Hospital, leading state-of-the-art brain mapping efforts for epilepsy, neurosurgery and research. He most recently was the interim leader of the epilepsy program at Dell Children’s Medical Center in Austin, Texas, where he focused on children with epilepsy, autism, and developmental disorders. He also served as the director of the magnetoencephalography (MEG) laboratory at Dell Children’s Medical Center. Perkins succeeds Greg Sharp, MD, who was appointed to chief medical officer of Arkansas Children’s Hospital in 2019. Sharp is also a professor of Pediatrics at UAMS. Dr. Perkins was led to neuroscience through a combination of his own aspirations and environmental influences. His younger brother sustained a severe hypoxic brain injury as the result of a viral illness at 10 months old, which led to subsequent developmental difficulties and seizures. This personal experience drove Dr. Perkins to pursue a career that might help his brother or others like him. Dr. Perkins was previously an assistant professor of pediatrics and neurology at the University of Texas Dell Medical School. He is a graduate of the University of Texas Medical Branch at Galveston and did his residency training at the University of Texas at Houston. He then completed his fellowship in clinical neurophysiology/epilepsy at the University of Texas at Houston and went on to be program director at the University of Tennessee Health Science Center at Memphis Pediatric Neurology Residency Program. Dr. Perkins joined Dell Children’s Medical Center in 2013 and has been practicing there since.
Christy Hockaday Named VP of Provider Network Innovation & Strategy at Arkansas Blue Cross LITTLE ROCK – Christy Hockaday, FACHE, a Morrilton native with more
than 20 years of experience in healthcare administration in Arkansas and Louisiana, has joined Arkansas Blue Cross and Blue Shield as Vice President of Provider Network InChristy Hockaday novation & Strategy. She will succeed Dan Bloodworth, who is retiring in December after more than 32 years with the company. Hockaday will oversee initiatives to maximize relationships with healthcare providers and achieve mutually beneficial results for Arkansas Blue Cross, its covered members and the providers who care for them. Her recent healthcare management experience in Louisiana includes eight years with Franciscan Missionaries of Our Lady Health System, where she served as Chief Executive Officer of Assumption Community Hospital (an affiliate of Our Lady of the Lake Regional Medical Center in Baton Rouge), Administrator of Shared Services for collaborating partners for the Franciscan system and Administrator and Chief Operating Officer of the Heart Hospital of Lafayette. In Arkansas, she formerly served as Chief Executive Officer of CHI St. Vincent Morrilton and held key administrative positions with Conway Regional Health System and Sparks Health System in Fort Smith. Hockaday earned a bachelor’s degree from the University of Arkansas for Medical Sciences in Little Rock and a master’s degree in health services administration from the University of Arkansas at Little Rock. She is a Fellow of the American College of Healthcare Executives®.
New NEA Baptist Clinic Locations Announced JONESBORO - NEA Baptist announces plans to begin work on a new location for Pediatrics and Dermatology. Both service lines will soon be offered at the first building project at The Reserve at NEA. The development is an extension of the largest master-planned integrated health care campus in our trade area. A partnership between NEA Baptist and Haag Brown Commercial Real Estate, The Reserve at NEA will become a lifestyle focused medical development that is a virtual extension of the NEA Baptist Medical Campus. Plans for the new clinic space include nearly 12,000 sq. ft. The new site will house pediatricians Dr. MaryJoanne Umeora, Dr. Camille Chan, Tomorrow Potter, APRN, and Priscilla Fortner, APRN. NEA Baptist recently signed Dr. Enid Burnett to lead the NEA Baptist Dermatology Clinic. Access to the new location will be available through hospital drive, directly connecting to NEA Baptist Medical Campus, and is the first building in a multi-phase project which will continue to change the landscape at hilltop. A ground-breaking was held July 13.
Arkansas Surgical Hospital Announces Installation of ROSA(R)️ Knee System for Total Knee Replacement NORTH LITTLE ROCK — Doctors at Arkansas Surgical Hospital have a new helping hand for knee replacement surgery with the arrival of the Zimmer Biomet ROSA®️ Knee System. The ROSA knee system brings together robotic technology with industry-leading surgeons to help personalize surgical procedures. ROSA Knee is a robotically-assisted surgical system designed to help perform total knee replacement surgery. The system is scheduled to be installed at Arkansas Surgical Hospital in August with surgeries anticipated to start in early September. Real-time data provided by ROSA Knee alerts surgeons to minuscule movement a patient’s leg may make during the operation. In addition, ad(continued on page 11)
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GrandRounds vanced modeling technology provides a way for surgeons to create three-dimensional models of a patient’s joint using images obtained by x-rays. The robotic assistant also includes features to assist with bone resections, assessing the state of soft tissues, and controlling and moving surgical instruments, which allows for precision and flexibility for the surgeon during procedures.
Jose Echavarria Named Assistant CEO for Northwest Health SPRINGDALE — Jose A. Echavarria has accepted the position of Assistant Chief Executive Officer (ACEO) for Northwest Health, according to Denten Park, Chief Executive Officer for the Northwest Health market. Echavarria comes to Northwest Health Jose A. from Steward HealthEchavarria care in Texas where he had served in executive leadership positions at several hospitals since 2016. Echavarria began his career in San Antonio, TX, as an Administrative Intern at Christus Santa Rosa Health System. He moved up to Administrative Resident at Southwest General Hospital, and then into an Associate Administrator position at St. Joseph Medical Center, a 790-bed facility with a Level III Trauma Center located in Downtown Houston. Echavarria was then promoted to Administrator of St. Joseph Medical Center in the Heights in Houston, where provided daily oversight of hospital operations, facilitated development opportunities and strengthened community, staff and physician relations. He was then promoted to Administrator of St. Joseph Medical Center and held this position prior to joining Northwest Health. He earned his undergraduate degree, a B.S. in psychology, from Texas A&M University in College Station, TX, and his master’s degree in health care administration from Trinity University in San Antonio, TX, where he also earned a Black Belt in Lean Six Sigma. He is a member of the American College of Healthcare Executives and the Association of Hispanic Healthcare Executives. His civic club involvement has included serving as a board member for the South San Antonio Chamber of Commerce and the Houston Heights Chamber of Commerce as well as a member of Central Houston Inc. Millennial Enterprise Group, which focused on promoting and revitalizing the Downtown Houston community.
UAMS Health Women’s Center Opens, Brings Lifelong Care Under One Roof
the University of Arkansas for Medical Sciences (UAMS) to one convenient Midtown location. The new location is at 6119 Midtown Ave., just off Interstate 630 and University Avenue near Target. All women’s health services previously at UAMS Health’s Financial Center Parkway, Freeway Medical Tower and 8th and Cedar clinics have moved to this location. Services include care for routine pregnancies and high-risk pregnancy care from the only maternal-fetal medicine specialists in Central Arkansas. The center offers Arkansas’ only Centering-
Pregnancy Program, in which groups of women with similar due dates gather for extra prenatal care, education and support. Gynecology services include routine checkups, labs, ultrasounds and a uterine fibroid clinic. Menopause treatment services are all inclusive and tailored to the individual. Genetic and nutritional counseling, along with behavioral health services and prenatal classes compliment care. The Women’s Center also houses the Arkansas Fetal Diagnosis and Management Program, which provides coordinated, compassionate, and evi-
denced-based care for pregnancy and newborn cases complicated by congenital birth defects or genetic disease. The center includes the UAMS Health Gender Clinic, which provides hormonal and surgical treatment to transgender and gender-nonconforming patients, and the UAMS Vulvar Clinic, where women with vulvar and vaginal disorders are provided the latest treatments. The Women’s Center building features 46 exam rooms, eight ultrasound rooms, and a dedicated patient education space. The center also offers virtual visits according to patient preference.
The physician team of father and sons from Koppel Dermatology have trusted LAMMICO for their medical malpractice insurance for decades. Pictured: Robert Koppel, M.D., René Koppel, M.D. and Douglas Koppel, M.D.
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