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From Menarche to Menopause, Jenny Gregory, MD, Stays Close with Patients Baptist Health Medical Center OB/ GYN provides all aspects of women’s healthcare Jenny Gregory, MD, loves women’s health and the diversity that is Jenny Gregory involved in obstetrics and gynecology. Profile on page 3
Will the Boom in Out-of-State Telehealth Threaten In-State Providers? When the Hazelden Betty Ford Foundation began offering telehealth services in Montana in early February, the nation’s largest nonprofit addiction treatment provider promised quality care for far-flung residents without their even having to leave home. Article on page 6
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The Reserve at NEA to Provide Recreation and Solace
Haag Brown partnering with NEA Baptist for lifestyle medical development in Jonesboro By BECKY GILLETTE JONESBORO - A new outdoor campus and medical park under development by Haag Brown Commercial Real Estate for lease to NEA Baptist Health System allows the hospital to expand, providing more clinical space while retaining green space for outdoor enjoyment and exercise. “We are very thankful for our partnership with Haag Brown,” said NEA Baptist Chief Operating Officer Melanie Edens. “The lease option has allowed us continued growth without a large capital outlay. We are especially excited about The Reserve at NEA since it is adjacent to our main medical campus. This will allow our physicians close proximity to see patients in the hospital when needed. The green space and water feature will serve as a recreational area for all to enjoy.”
Edens said spending more time outdoors makes people feel better emotionally, and can also reduce blood pressure, heart rate and muscle tension. “We are hopeful that The Reserve will serve as a medical community promoting outdoor activities, health and well(CONTINUED ON PAGE 4)
A Fresh Perspective on Cancer Care Highlands Oncology Group’s Jeff Hunnicutt stays focused on value, innovation for patients in Northwest Arkansas By MELANIE KILGORE-HILL Jeff Hunnicutt is committed to bringing world-class cancer treatment to patients in Arkansas. As Highlands Oncology Group’s first CEO, the Washington native is focused
on delivering tech savvy, value-based care to more than 13,000 patients each year.
From IT to CEO “I had a very unorthodox transition into (CONTINUED ON PAGE 5)
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From Menarche to Menopause, Jenny Gregory, MD, Stays Close with Patients Baptist Health Medical Center OB/GYN provides all aspects of women’s healthcare By BECKY GILLETTE Jenny Gregory, MD, loves women’s health and the diversity that is involved in obstetrics and gynecology. “I take care of women from menarche through menopause,” said Gregory, who is affiliated with Baptist Health Medical Center in Little Rock. “I get to help women with gynecological wellness and cancer screening, as well as sexual, reproductive, and mental health. I enjoy the surgical aspect of my job and the variety of vaginal, laparoscopic, open, and robotic procedures. Delivering babies is certainly exciting and rewarding, but there are times where women are in lifethreatening emergencies which I must be prepared for.” Women sometimes prefer a female OB-GYN since a woman might have experienced similar issues and better understand the issues. Gregory empathizes with women who have experienced fetal loss. “I experienced a miscarriage before my first child and still grieve the loss,” she said. “I cannot imagine the pain of losing a fetus. Women are instantly bound to that baby from the first urine pregnancy test, and it is devastating to lose a baby, even in early miscarriages.” Gregory supports the charity Mamie’s Poppy Plate which provides memorial plates with footprints to families who have lost a baby. Gregory also knows what labor and delivery are like personally because she has experienced childbirth three times. She is the mother of girls 6, 8 and 10. In addition to fetal loss, the hardest part of her work is trying to help patients
who have cancer and those who are struggling to conceive. “I sympathize with women struggling with infertility,” Gregory said. “They desperately want a child, and it is very stressful.” What she loves the most about her job is her patients and appreciates getting to see and visit with them year after year. “I really have the best patients,” she said. Broadly, not much has changed with labor and delivery. Women have been delivering babies since the dawn of mankind. “However, we do have technology to better assess fetal and maternal health,” Gregory said. “We now can extract fetal chromosomes from maternal blood to screen for chromosomal anomalies. There are medications and instruments to better aid in stopping maternal hemorrhage, which is the leading cause of maternal death. Maternal fetal medicine specialists can even perform surgeries in utero on a fetus. Over the past decade, there has been a trend to decrease the Cesarean section rate across the country. We know that Cesarean sections are certainly necessary, but obstetricians are much more pro-
active in avoiding them, if possible.” Arkansas has one of the highest rates of infant mortality in the country. Gregory said this is related to the health of Arkansans in general. “The high obesity rate with its associated comorbidities affects a fetus even more than a woman,” she said. “Also, studies show that a lower socioeconomic status is directly related to a higher infant mortality rate. Providing more outreach to women, especially those in poverty, would lower this rate. Programs to educate people about exercise and nutrition would lower the rate. I read that the University of Arkansas for Medical Sciences (UAMS) has a new program in Northwest Arkansas focused on helping Marshallese women gain access to prenatal care. Programs like that can make a powerful difference in the fetal mortality rate.” One thing that has changed in women’s health in recent years is guidelines for screening mammography. Different societies have released guidelines with variance in the recommendations of the age to initiate and the frequency of imaging. “I counsel my patients on the various screening guidelines and personally recommend mammograms every one to two years starting at the age of 40 (unless they are high risk). Cervical cancer screening has evolved with the use of HPV cotesting. PAP smears begin at the age of 21 and are done every three years. HPV co-testing is added at the age of 30 and is done every three to five years. I always have to explain this to women, especially older women, who are accustomed to yearly PAP smears.” Birth control has also evolved. While oral contraceptives are still widely used, long-acting reversible contraceptives
(LARCs) like IUDs and Nexplanon are increasingly popular. “More younger women are choosing LARCs which is great because they have a higher efficacy and compliance rate,” Gregory said. “Not many college students can remember to take a pill the same time every day. They also have great insurance coverage and the pills are usually free, which is nice for young women.” Gregory grew up in North Little Rock, and her high school biology teacher, Mrs. Kirby, sparked her interest in science. Initially, in college, she planned to be a research microbiologist. However, in 1999, after volunteering at a free health medical clinic in Fayetteville, she realized that she loved the interaction between physicians and their patients. She then decided to pursue clinical medicine. After graduating from University of Arkansas at Fayetteville with a B.S. in microbiology, she attended UAMS for medical school and then for a residency in obstetrics and gynecology. After residency, she joined Little Rock Gynecology and Obstetrics in 2000. In March, she joined the Arkansas Women’s Center and is continuing to care for women at Baptist Health Medical Center-Little Rock. She has been on the OB/GYN department committee at Baptist Health Medical Center-Little Rock for 10 years and chaired the committee for two years. With three kids and a husband who is an emergency medicine physician, schedules can be difficult to manage. Most of her leisure time is spent running her children to activities. “I love watching them do what they love and creating bonds with their teammates,” Gregory said. “I love exercise and anything outdoors. I love hiking, camping, and canoeing. I love to travel, but COVID-19 has obviously stymied that.”
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The Reserve at NEA to Provide Recreation and Solace, continued from page 1 ness,” Edens said. Haag Brown was also involved in the first lifestyle office park in the area, the Reserve at Hill Park. “When we outgrew our current office space, I approached my partner, Greg Haag, about considering a new office,” Brown said. “Greg said he didn’t have an interest in doing a new office unless it would be a great location where you could see trees and water outside the office. We drove a block from our office to look at some beautiful land in the middle of Jonesboro.” That quickly led to discussing the big plan. What about winter? Are there models of this in other parts of the country? There are models such as the headquarters for some of the largest companies in the world. the bank to do this type of project if it is What appealed to Haag, Brown and properly conceived and developed. others they work with is that they like na“The only way you can do a project ture and they enjoy outdoor exercise such like this is to purchase land at a price that as walking, running and biking. They allows preservation of a lot of the land,” created a one-mile walking trail through Brown said. “Two, you are also spending 20 acres of wood kept as green space and a lot more than in a typical built a three-acre pond bebudget to allow for landscaphind their offices. ing and sidewalks. We were “Nearly every day somefortunate in both instances. one is fishing out in our pond We followed the model of the or taking kids or grandkids out development of our current there,” Brown said. “When we reserve. We purchased the have meetings in our office, land locating our office on the visitors talk about how much back of the property, leaving they like the atmosphere. We the front with high traffic and love hosting meetings in our visibility for other developpresent setting.” ments. We are following the About half the portfolio Joshua Brown same model at The Reserve at the firm manages is medical NEA, working from the back of the land development. They build, develop and to make the front more valuable.” lease medical offices, and represent mediDesign considerations were made cal companies thinking of expanding into to make the green space appealing at all Arkansas. times of the year. The Reserve at NEA inLand in medical corridors is often cludes a pavilion with water on both sides very expensive. But it doesn’t have to bust 4
of it. Even when it is raining, hot or cold, people are likely to use the pavilion for picnics, taking calls or just relaxing. Most offices will have views of the outdoor spaces. “In general, this type of environment lightens the mood of most people,” Brown said. “People are more productive, creative, and are able to think more clearly. We love having geese, ducks and wildlife around our office. Everyone who visits our office has some level of interest in what we have done and how we have done it. We enjoy being here and our clients enjoy coming here. We try to design our buildings so you never have to flip the light switch. We have plenty of natural light.” Brown said you could see the excitement of employees at the ground-breaking ceremonies for The Reserve at NEA. And it is expected that this outdoor space will be particularly welcome for people who may drive a long way visiting loved ones for an extended period of time. “It will be great after visiting a sick
loved one to take a walk outside in a beautiful, natural setting rather than sitting in a waiting room,” Brown said. The discussion with NEA Baptist began because there were several specialty groups that wanted to join the integrated healthcare system. A pediatrician’s group, a pain management group and a dermatology group had interest in locating on the campus, but there was not room. “The project has moved a lot faster than expected,” Brown said. “We are already under construction. The street has been laid. The pediatrician and dermatology buildings are being framed. The pain management project will follow shortly. These buildings should be finished by the end of the year with employees ready to work.” He sees the potential for similar projects elsewhere in Arkansas, Mississippi and Tennessee. “Greg and I want to duplicate this natural working environment in multiple cities,” Brown said. “One thing we have heard throughout the pandemic is natural sunlight is good, may be preventive against acquiring the virus and may have health benefit if you do contract the virus. Health providers agree everyone should spend some time outside. Walking, getting some activity, and spending time in the sunlight is a very good medical recipe for overall better health. People were not meant to be inside away from the sun all day.” Landscape design including the renderings accompanying this article were by Martin Smith, Principal of EDG (https:// www.ecologicaldg.com). NEA Baptist Health System includes the NEA Baptist Clinic, the 228-bed NEA Baptist Memorial Hospital, and NEA Baptist Fowler Family Center for Cancer Care. arkansasmedicalnews
A Fresh Perspective on Cancer Care, continued from page 1 oncology,” said Hunnicutt, who joined Highlands in 2018. Originally from Port Orchard, Washington, he received his Bachelor of Science in information technology and organizational management from Washington’s Northwest University before working as a software developer and Webmaster. In 2005 he joined Tacoma’s Northwest Medical Specialties as director of technology – a position he filled until 2013 when he was named COO of the oncology practice. “I worked with a CEO who had a vision of integrating technology into their operational process,” he explained. “In IT you touch every area, and if you’re paying attention to how things work, you can think of tech solutions to operational problems, which was unorthodox but effective.”
Coming to Arkansas While working as COO, Hunnicutt served as executive director of the Quality Cancer Care Alliance, where he crossed paths with leaders from Highlands Oncology Group. In 2018, the family of six became Arkansans after a surprising visit to Northwest Arkansas. “They invited us out to take a look, and it blew our socks off,” Hunnicutt said of his first visit to the Natural State. “We were shocked at how nice it was here.” Two weeks after his arrival, Hunnicutt joined in the groundbreaking for Highlands’ 125,000 square-foot center along I-49 in Springdale. The facility opened in 2020, marking a halfway point between Highlands’ cancer centers in Rogers and Fayetteville. The spacious
Springdale facility now houses clinical and administrative services, business offices, physical therapy and other support services, with room to grow.
Meeting challenges 2020 brought unprecedented healthcare challenges, and Highlands was no exception. Fortunately, Hunnicutt took lessons from Washington colleagues, among the first nationally to combat COVID-19. “Arkansas was a little later in the process, so it was nice to have an educational pipeline to give us a leg up and a faster way of getting processes, policies and procedures in place,” he said. Highlands also had introduced limited telehealth services at the end of 2019 – a fortuitous decision that would be rolled out system wide months later. Hunnicutt also relied on relationships with the QCCA, which was quick to share best practices among cancer centers nationwide. “When they looked at the impact, they saw that it came down to three main areas: Geographical location of the practice, the time at which COVID hit and the number of services available within your own walls,” he said. “At Highlands, many surgeries and scans are performed inhouse, so we didn’t see the 40 percent dip that other centers did.” A growing footprint In 2021, Highlands announced a formal partnership with Baxter Regional Medical Center in Mountain Home – their first venture outside Northwest Arkansas.
While a new cancer center is expected in 2022, Hunnicutt said additional statewide expansion isn’t on the radar. “The organic growth we’ve experienced in Northwest Arkansas has made a lot of sense,” he said. “We’re home grown, and people here in Northwest Arkansas still need high quality cancer care.” Highlands also relies on longstanding relationships with local hospitals and UAMS, and in 2021 will launch a spiritual care partnership with John Brown University in Siloam Springs.
Leadership Hunnicutt, who oversees a team of 500, cites staff engagement as a crucial piece of his leadership style. “It’s important to create an environment where people feel cared for, valued and supported,” he said, noting a recent staff retention improvement of 40 percent. “Highlands already had that, but we’ve been able to improve on it by distinguishing between satisfaction and engagement. Satisfaction will bring people in the door, but engagement is what keeps them from walking back out.” The IT veteran also is committed to innovative technology for patients and staff. “In Washington, my practice gained a reputation for being the first to work with vendors on cutting edge technology and software, and I was energized to continue that type of work at Highlands,” he said. The Arkansas practice was recently among the first in the nation to offer Electronic Patient Reported Outcomes – a mobile app facilitating communication between patients and providers. Hunnicutt also has prioritized value-based care, demon-
strating high quality practices while reducing the financial burden on patients. In 2021, 50 percent of Highlands patients participated in a value-based care program, typically from Humana or Medicare’s Oncology Care Model – the largest value-based care initiative in the US for oncology patients.
Patients first Today, Highlands ranks among the top 10 percent of oncology practices in the nation – an accomplishment Hunnicutt credits to the group’s physicians. “This is a great group of doctors, and it’s more of a partnership than in any other place I’ve been,” he said. “Any physician will say they put patients first, and that’s true at different levels, but I’ve never seen a practice own that statement more. As an administrator I have to focus on the business side of things, but the physicians won’t allow business to be put first. What’s best for patients truly comes first, and business second.” Looking forward Going forward, Hunnicutt hopes to continue fostering an environment where employees love to work, while bringing world-class care to Northwest Arkansas. “Long term, I want to be part of building that on a larger scale,” he explained. “That means building more partnerships with local hospitals and educational facilities with a common goal of innovating our local healthcare system and transforming healthcare by keeping people here at home.”
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Will the Boom in Out-of-State Telehealth Threaten In-State Providers? By Matt Volz, Kaiser Health News
HELENA, Mont. — When the Hazelden Betty Ford Foundation began offering telehealth services in Montana in early February, the nation’s largest nonprofit addiction treatment provider promised quality care for far-flung residents without their even having to leave home. That promise was what Montana and more than 40 other states had in mind when they temporarily relaxed rules restricting telehealth services and allowed out-of-state providers to hold remote patient visits for the duration of the covid-19 pandemic. A year into the pandemic, telehealth has become widely accepted. Some states are now looking to make permanent the measures that have fueled its growth. But with it have come some unintended consequences, such as a rise in fraud, potential access problems for vulnerable groups and conflicts between out-of-state and in-state health providers. In Montana, for example, not everybody cheered the virtual arrival of the Minnesota-based Hazelden Betty Ford Foundation. The head of Montana’s largest behavioral health provider, Billingsbased Rimrock, worried that an influx of out-of-state providers could lead to Rimrock’s losing a significant number of its privately insured patients. Rimrock patients with private insurance subsidize patients who are on Medicaid, CEO Lenette Kosovich said. The difference in insurance reimbursement rates between the two is so great that the loss of those privately insured patients would hamper Rimrock’s operations, she said. “I’m all for competition, as long as it’s fair competition,” Kosovich said. She added that she would like to see rules in place ensuring that out-of-state providers that enter Montana via the relaxed regulations of the pandemic meet the same licensing requirements as in-state providers. “They don’t take Medicaid, so they don’t have to go through the same rigors,” she said. “We’ve been really very vocal that we want more legislation that speaks to that. Even the playing field.” Hazelden Betty Ford is not out to poach anybody else’s patients, said Bob Poznanovich, the foundation’s vice president of business development. Instead, it’s targeting patients who aren’t receiving care and can’t go to one of its 15 drug and alcohol rehabilitation centers, he said. “We think it’s important that a national brand like ours is able to provide care nationally,” Poznanovich said. “That becomes important to our patients, who come from all over the country. It’s also important, I think, for people who can’t 6
access quality care, who are in some health care deserts where there just isn’t good care.” A federal government survey estimated that a shortage of mental health providers exist in 5,800 geographic areas, populations or facilities — such as prisons — across the U.S., with 6,450 practitioners needed to fill the gaps. For primary care, the need is even greater, with nearly 7,300 areas short of health professionals. For patients nationwide, telehealth can make getting medical care much easier. Ayanna Miller, a 24-year-old student at Northeastern University in Boston, is among those embracing the technology. “Sometimes you don’t really need to go into the office. You really just need, like, a quick conversation with your doctor,” she said. “I’ve also done telehealth for therapy. You don’t necessarily need to be in the same room with your therapist.” As the stresses of the pandemic have strained mental health and addiction recovery, the need for help has increased. Hazelden Betty Ford has accelerated its pre-covid plans for expansion and expects to offer telehealth services in all 50 states within two years. Next on deck: Arizona and New Mexico. “We’ve heard grumblings, like ‘Why are you coming into our state?’” Poznanovich said. But, he added, “More people have welcomed the entry into the marketplace because they think that we will help create a bigger marketplace.” Before covid, remote doctor visits by computer or phone were rare: Just 2.4% of enrollees in large-employer health plans used a telehealth service in 2018, according to KFF. That was due in part to different policies among states and federal rules that limited where and to whom telehealth services could be offered. But now, states are waiving patient copays and coinsurance, reimbursing telehealth services at the same rate as in-person services, waiving licensure requirements and allowing audio-only visits, among other measures.
In the first months of the pandemic, with lockdowns the norm throughout the country, telehealth visits surged to about 7 in 10 medical appointments, according to the Epic Health Research Network. That had tapered off to about 1 in 5 visits as of summer. Existing and startup services are flourishing. Poznanovich compared the surge to the dot-com boom of the early part of the century, noting that the foundation’s internal studies show that hundreds of telehealth companies have received financing. “There is a land-grab mentality right now,” he said. “We’re seeing some really crazy market valuations because of the potential number of clients.” Today’s rush will lead to permanent changes in health care, said Florida radiologist Dr. Ashley Maru, who invested in three telehealth companies. More innovative virtual providers entering the field may come at the expense of physicians who see patients in brick-and-mortar offices. But it also presents a solution to the national shortage of doctors, he said. “You’re going to see a national change in the landscape of medicine,” Maru said. “They’re going to be able to cross state lines and really uproot and disrupt everything.” The prospect of unfettered interstate virtual health care worries some health industry officials. Blue Cross and Blue Shield of Montana spokesperson John Doran said he shares Kosovich’s concerns that local providers could suffer or be driven out of business, particularly in smaller states. “The future of medicine has to include connecting a Montana patient to a Montana provider,” Doran said. Poznanovich said that, besides providing services to people who weren’t receiving them before, Hazelden Betty Ford Foundation forms partnerships with local providers in some markets and offers education and resources to providers where it expands. Some states are forging ahead with plans to make their telehealth changes
permanent. A Montana bill passed the state House of Representatives unanimously Feb. 9 and is pending in the Senate. “We were forced to use technologies in ways that we maybe thought we weren’t ready for and it turns out that we were,” Jackie Jones, government affairs director for the state’s securities and insurance commissioner, recently told state lawmakers in supporting the bill. Certain patients may be left out of the telehealth revolution. The rapid, wide-scale implementation of telemedicine could leave behind people with limited internet access or tech literacy, including the elderly, poor and non-English speakers, according to a New England Journal of Medicine article. Meanwhile, telehealth fraud cases have “gone through the roof,” said Mike Cohen, an operations officer with the Office of Investigations of the Department of Health and Human Services’ inspector general’s office. Telehealth in general is a good thing, he said, but with any popular medical advancement, “there’s going to be rats on the ship.” Many fraudsters are trying to steal patients’ identities and sell them on the black market, he said. Some providers are overcharging for appointments, are billing for services that weren’t given, or are not registered or licensed in the U.S. Some scammers offer to put a patient at the front of the line for a covid vaccine in exchange for payment. “Our sense is that it’s more widespread than we envisioned,” Cohen said. “If we’re going to make this permanent, we need to make sure there’s guardrails to ensure programmatic integrity and also patient safety.” Even when working optimally, telehealth can have its limits. Miller, the Northeastern University student, said she was diagnosed with covid in January and had mild symptoms. By early February, she felt better and wanted to schedule an in-person physical with her doctor to find out if the virus had affected her in other ways. The doctor was taking only virtual appointments, and Miller was left feeling unsatisfied just answering the doctor’s questions by video call. “The scariest thing about covid is you just don’t know how it’s going to impact you,” Miller said. “I can say how I feel, but I don’t know if there’s anything that I’m not catching because I’m not trained.” KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation. arkansasmedicalnews
GrandRounds CHI St Vincent Establishes Unique, New Addiction Recovery Program LITTLE ROCK – CHI St. Vincent, in partnership with Bradford Health Services, announces the first Addiction Recovery Program in the state of Arkansas that offers the full continuum of care through an integrated approach that includes both outpatient and hospital inpatient components. The new program, located at CHI St. Vincent Infirmary in Little Rock, marks a significant step forward for the hospital system’s 133 year healing ministry and recognizes the growing need for integrated, compassionate care programs that offer recovery support for addictive diseases in Arkansas. In addition to both outpatient and inpatient services, the new Addiction Recovery Program at CHI St. Vincent Infirmary includes a private entrance to help ensure patient confidentiality. The dedicated space includes inpatient suites for 30 residential patients, 10 detox spaces and staff trained in Bradford Health Services’ proven addiction treatment methodology in order to help anyone suffering from addiction to find the support and healing they need. Whether suffering from drug, alcohol, food or other substance abuse challenges, the new program incorporates a model designed to provide the necessary help patients need to overcome addiction.
The Addiction Recovery Program is part of CHI St. Vincent’s commitment to help protect all Arkansans, regardless of race, gender or socioeconomic background, as this healing ministry works to create healthier communities. The program was made possible with the generous support of donors, including Bradford Health Services. To learn more about resources available through the CHI St. Vincent Addiction Recovery Program in partnership with Bradford Health Services, visit: chistvincent.com/ addictionrecovery
Arkansas Surgical Hospital Expands Operating Room Capabilities NORTH LITTLE ROCK – In our continued effort to meet the healthcare needs of Arkansas residents, physicianowned Arkansas Surgical Hospital announced a construction project that will add two additional operating rooms to the hospital’s facility. The project will add 4,590 square feet to the current campus and bring the total number of operating rooms to 13. Additionally, renovations will be made in the Post Anesthesia Care Unit, adding three more recovery beds. This project which began in February should be completed by the end of 2021. With the addition of five surgeons in 2020, more operating and recovery
space was needed, and this growth will allow the center to continue to serve the communities throughout Arkansas.
$8 Million Expansion at Jefferson Regional Cancer Center PINE BLUFF - Jefferson Regional is pleased to announce it is expanding access to local cancer care for residents of Southeast Arkansas. The health system is making an $8 million investment to develop a fully integrated Cancer Center, which will be located on campus in the Jefferson Professional Center 1 building (JPC 1). Construction will consist of two phases - the first being an expanded medical oncology clinic with an infusion center capable of treating 27 patients, which will be open in June 2021. The second phase will include the construction of a radiation oncology suite that will be complete near the end of 2021. The Cancer Center is the health system’s latest investment in building a comprehensive cancer program designed to meet the unique needs of residents in Pine Bluff and throughout Southeast Arkansas. Arkansas ranks among the states with the highest incidences of new cancers in the U.S., and the Jefferson Regional Cancer Center is a direct reflection of the organization’s continued commitment to ensuring local residents have access to exceptional cancer care when
and where they need it. Jefferson Regional provides southeast Arkansas with the largest physician network, consisting of more than seventy providers and twenty specialties, ready to meet the needs of patients with cancer. Furthermore, Jefferson Regional’s network of specialists are in the region, available 24 hours a day, 7 days a week. The Jefferson Regional Cancer Center will offer seamless access to services including physician visits, an infusion center, a Breast Center, imaging services, radiation oncology, care coordination and financial navigation. Through the new Cancer Center, Jefferson Regional will be able to coordinate care more easily for patients – from screening and diagnosis to therapy and beyond. For more information, please visit jrmc.org/cancer.
CHI St. Vincent Infirmary Cardiovascular Surgeons Receive Highest Quality Rating for Cardiac Procedure LITTLE ROCK – Cardiovascular surgeons with the CHI St. Vincent Heart Institute at the Infirmary in Little Rock earned a distinguished three-star rating for patient care and outcomes in mitral valve replacement and repair (continued on page 9)
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GrandRounds (MVRR) surgery with coronary artery bypass grafting (CABG) from The Society of Thoracic Surgeons (STS). The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care and the three-star rating denotes the highest category of quality the system bestows. Cardiologists and cardiac surgeons at the CHI St. Vincent Heart Institute provide access to the latest technology, advanced techniques and treatments to ensure patients benefit from the highest standard of heart care. In August, CHI St. Vincent Infirmary was also recognized as the best hospital in Arkansas for cardiology and heart surgery in the 2020–21 Best Hospital Rankings from U.S. News & World Report. The latest analysis of data for MVRR+CABG surgery covers a threeyear period from July 2017 to June 2020 and includes 3,800 participants. STS benchmarks outcomes of cardiothoracic surgery programs using a combination of quality measures for specific procedures performed by database participants. The STS National Database was established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons and gathers information from more than 3,800 participating physicians, including surgeons and anesthesiologists from more than 90% of hospitals that perform heart surgery in the United States. In February, CHI St. Vincent Heart Institute was one of only two institutions recognized as a center of excellence for both Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Edge-to-Edge Repair (MitraClip™) (TEER) heart procedures across the 142 hospital and 21 state CommonSpirit Health system. In 2019, the CHI St. Vincent Heart Institute also announced a seven-year collaboration with Philadelphia, Pennsylvania-based Penn Medicine to accelerate high-priority clinical research efforts related to heart surgery and implement novel approaches into surgical practice. To learn more about the CHI St. Vincent Heart Institute or schedule an appointment, visit: chistvincent.com/heartC
Washington Regional Offering ROSA® Knee System Technology FAYETTEVILLE — Washington Regional now offers Zimmer Biomet’s ROSA® Knee System, state-of-theart robotic technology that helps surgeons personalize surgical procedures for their patients. Washington Regional is the first hospital in Northwest Arkansas to use the system. ROSA Knee is a robotically-assisted surgical system designed to help perform total knee replacement surgery. Data provided by ROSA Knee enables surgeons to use computer and software technology to control and move surgical instruments, allowing for greater accuracy. According to Kris Hanby, MD, medarkansasmedicalnews
ical director of Washington Regional Total Joint Center, the system facilitates more precise implant positioning, which leads to better patient outcomes. For everyone involved – surgeons, medical staff and, most importantly, patients – ROSA Knee has the potential to offer several key benefits and advantages according to Hanby. The decision to have joint replacement is often a difficult one for patients to make, and robotically-assisted technologies have the potential to make it an easier decision moving forward he said. Total joint replacement is one of the most commonly performed elective surgical procedures in the United States, and this system will lead to better outcomes for patients. Since installation in October, almost 50 procedures have been completed using the ROSA Knee System. To learn more, visit wregional.com/rosaknee.
Mercy and Humana Team Up to Expand Access to Virtual Health Services and Coordinated Care FORT SMITH/ROGERS – Mercy and leading health and well-being company Humana Inc. (NYSE: HUM) have signed an agreement to expand patient access to virtual health resources as part of a broader, joint effort to provide more holistic care to Humana Medicare Advantage members. These goals are especially vital given the challenges presented by the COVID-19 pandemic. The new initiative offers convenient care options for Humana Medicare Advantage members who are patients of Mercy’s more than 4,000 integrated primary and specialty care clinicians in Arkansas, Kansas, Missouri and Oklahoma. Now in effect, the value-based agreement expands upon Mercy and Humana’s existing network contract, which continues to provide in-network access at all Mercy hospitals, outpatient facilities and physician practices. Key features of the collaboration include: Mercy Virtual: Humana Medicare Advantage members now have in-network access to this comprehensive virtual resource, often called a “hospital without beds.”Staffed with more than 300 clinicians, it offers 24/7 care, such as virtual primary care in the home. Mercy Virtual’s services are an innovative, patient-centric model that provides care to patients when and where they require it. Value-Based Care: Mercy and Humanahave entered into a contract to provide care that addresses the health of the whole patient. Payment to Mercy physicians by Humana is linked to providing quality care in order to improve the patient experience and health outcomes. This differs from traditional “feefor-service” models by which payment is based on the quantity of services. Humana has an extensive and growing value-based care presence. As of Dec. 31, Humana has more than 2.7
million individual Medicare Advantage and commercial members who are cared for by more than 67,000 primary care physicians in more than 1,000 valuebased relationships across 43 states and Puerto Rico. As of January, Humana’s total Medicare Advantage membership
is more than 4.8 million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings. For more information, visit www.humana.com/ valuebasedcare.
UAMS Opens Satellite Transplant Clinic in Jonesboro JONESBORO - A satellite clinic for UAMS Health’s kidney and liver transplant patients living in northeast Arkansas has opened at UAMS’ Northeast Regional Campus in Jonesboro. Post-transplant follow-up care will be provided at the clinic, located inside the existing UAMS Family Medical Center at 311 E. Matthews St., on the second Friday of every month. Scott Dickson, MD, director, said the clinic would provide greater accessibility to patients who live in Northeast Arkansas, and will promote stronger relationships and collaboration between UAMS and the health care providers in the area. In March, UAMS also opened a satellite clinic for transplant patients inside the UAMS Family Medicine Clinic on the Southwest Regional Campus in Texarkana. The clinics in Jonesboro and Texarkana join a satellite clinic for transplant patients that has been operating at UAMS’ Northwest Regional Campus in Fayetteville since early 2019. UAMS physicians will travel to the Fayetteville clinic on the first Friday of every month, to Jonesboro on the second Friday and to Texarkana on the fourth Friday. In addition to transplant care, the clinics provide dialysis access evaluation; liver, pancreatic and cancer evaluation and care; management of disorders of the bile ducts; and care for liver failure and liver dysfunction. Eventually, UAMS hopes to offer pre-transplant care, such as testing to determine whether a patient is medically suitable for a transplant, at the satellite clinics. UAMS is the home of the only adult liver and kidney transplant programs in the state.
Pictured (L to R): Julie Wylie, ANPA President; Kerry Murphree, Outstanding NP Award Winner; Candi Guinn, colleague who nominated Kerry.
2021 Arkansas Nurse Practitioner Association Outstanding Nurse Practitioner Award EL DORADO - Congratulations to Kerry Murphree, FNP, from El Dorado on being selected the 2021 Arkansas Nurse Practitioner Association Outstanding Nurse Practitioner. Kerry demonstrates excellence in clinical practice and service to her community, ensuring barriers to care for her patients are overcome. She is compassionate, generous, and courageous, serving as a mentor and teacher to nurses and nurse practitioners in El Dorado. Congratulations to the other nurse practitioners nominated for this award: Cassie Gonzales, Hillary Creech, Jeanie Finley, JoAnn Clark, Lynn Wilkerson, Stacie Hipp, Tammy Hawkins, and Whitney Franklin. Being nominated shows these amazing nurse practitioners are held in great esteem by their colleagues. MARCH/APRIL/MAY 2021
GrandRounds Governor Acts on Controversial Healthcare Bills
Gov. Asa Hutchinson has vetoed HB1570, an anti-transgender healthcare bill that would have prohibited physicians in the state from providing genderaffirming “procedures” for trans people under age 18, but has quickly seen that veto overidden. He called the bill “a vast government overreach” that would have created “new standards of legislative interference with physicians and parents as they deal with some of the most complex and sensitive matters involving young people. “I am hopeful, though, that my action will cause conservative Republican legislators to think through the issue again and hopefully come up with a more restrained approach that allows a thoughtful study of the science and ethics surrounding the issue before acting,” he said. Days earlier, the governor did sign Senate Bill 289 known as the Medical Ethics and Diversity Act, which allows healthcare professionals to deny any non-emergency services to patients according to “conscience-based-objections.” The bill also serves to protect healthcare organizations from “discrimination, punishment, or retaliation as a result of any instance of conscientious medical objection.” The bill passed the General Assembly in the face of fierce opposition from LGBT advocacy groups, including the American Civil Liberties Union, which argued it was blatantly discriminatory. The governor, who objected to the bill in 2017, said he weighed the provisions carefully. “The bill was changed to ensure that
the exercise of the right of conscience is limited to ‘conscience-based objections to a particular health care service.’ I support this right of conscience so long as emergency care is exempted and conscience objection cannot be used to deny general health service to any class of people. Most importantly, the federal laws that prohibit discrimination on the basis of race, sex, gender, and national origin continue to apply to the delivery of health care services,” said Hutchinson. The measure goes into effect this summer. Also signed by the governor was HB1258, that creates a pathway for certified nurse practitioners meeting certain requirements to practice free from a collaborative agreement and creates a full independent practice credentialing committee to create an independent practice. The bill is designed to help Arkansas close the shortage gap in primary care.
Medical Center of South Arkansas Welcomes New Orthopaedic Surgeon
EL DORADO - Medical Center of South Arkansas (MCSA) Chief Executive Officer Scott Street announced that Samuel Agnew, MD has joined the Medical Staff at MCSA. Agnew is a boardcertified orthopaedic surgeon and traumatologist with more than Samuel Agnew 30 years of experience. He specializes in the repair of musculoskeletal injuries caused by trauma, as well as general musculoskeletal care. Agnew attended medical school at
UAMS Winthrop P. Rockefeller Cancer Institute Unveils New Breast Center
Tulane University School of Medicine in New Orleans, Louisiana and completed his residency at Medical University of South Carolina in Charleston, South Carolina. Agnew’s Orthopaedic Traumatology Fellowship was completed at Harborview Medical Center, University of Washington in Seattle, Washington. Prior to his employment at MCSA, Agnew has served as Orthopaedic Department Chairman and Chief of Trauma at various institutions around the southern region. Agnew specializes in revitalizing orthopaedic programs with the intent of creating a culture focused around patient care and surgical excellence. Agnew’s practice will specialize in a variety of surgical and medical treatments including: musculoskeletal injuries and infections, comprehensive fracture care, elbow surgery, foot and ankle surgery, workers compensation, bone health and osteoporosis/osteoarthritis care, nonoperative spine care and interventional pain management. Agnew’s goal is to restore as much physical activity as possible to help his patients return to maximum function and activity. Agnew is accepting new patients at his clinic; Orthopaedics of South Arkansas, which is located at 620 West Grove Street, Suite 201, El Dorado. For more information visit our website at southarkansasphysicians.com
Arkansas-based Rural Healthcare System ARcare Joins Hazelden Betty Ford’s National Addiction Treatment Network
AUGUSTA – ARcare, a federally qualified healthcare center with primary care and behavioral health clinics in rural
LITTLE ROCK — A spacious new center offering comprehensive breast imaging services has opened in the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS). The Breast Center is located on the third floor of the Cancer Institute and offers a complete array of services, including mammography, ultrasound and image-guided biopsy. An MRI dedicated exclusively to breast imaging is scheduled be installed in the center later this year. The center, which was previously housed in the UAMS Outpatient Center, encompasses about 12,000 square feet and includes five mammography rooms, five ultrasound rooms, space for image-guided biopsies, Gwendolyn Bryant-Smith, M.D., (left) shows off the new UAMS Breast Center to large patient dressing rooms and a waiting area filled Chancellor Cam Patterson, M.D., MBA; Ronda Henry-Tillman, M.D.; Michael Birrer, M.D., Ph.D.; and other staff at the Winthrop P. Rockefeller Cancer Institute. with natural light. Original artwork by female Arkansas artists will be featured throughout the center, adding to the relaxing environment. By increasing the number of mammography and ultrasound rooms offered, the center increases capacity to serve more women each day according to Gwendolyn Bryant-Smith, M.D., director of the Breast Center who also is division chief of breast imaging at UAMS and director of the mobile mammography program. The center will continue to offer same-day results for all screening and diagnostic mammograms, as well as the ability to follow up immediately with additional imaging and procedures for women who require more testing. Radiologists at the Breast Center are part of the UAMS Breast Cancer Team, a group of specialists from various areas who work together to offer personalized treatment for each patient. In recognition of the Breast Center’s high standards, the facility was named a Breast Center of Excellence by the American College of Radiology. This prestigious recognition includes a mandatory accreditation in mammography and voluntary accreditations in stereotactic core biopsy, ultrasound, ultrasound-guided biopsy and breast MRI. In addition to Bryant-Smith, the Breast Center’s physicians include Scott Harter, M.D., and breast fellow Patrick Jennings, M.D., who will remain at UAMS upon completing his fellowship in July. Also that month, radiologist Rachel Taylor, M.D., is slated to join the Breast Center. 10
Arkansas, Mississippi and Kentucky, is the newest member of the Hazelden Betty Ford Foundation’s national network of addiction treatment providers. As a federally qualified health center (FQHC), ARcare utilizes government funds to provide quality services in underserved areas regardless of patients’ ability to pay. It has been operating for 35 years, employs 800 people, and has six behavioral health clinics in addition to more than four dozen primary care clinics. In recent years, Hazelden Betty Ford has supported ARcare’s implementation of new opioid addiction treatment protocols and its integration of peer recovery specialists at primary care sites to support patients’ recovery management. Headquartered in Augusta, Ark., ARcare is the second FQHC to join the Hazelden Betty Ford Patient Care Network, a growing group of organizations from across the nation working together to share knowledge and best practices, extend the continuum of care, and improve quality and outcomes for their patients.
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GrandRounds OrthoArkansas Expands Bryant Clinic to Offer Physical and Occupational Therapy BRYANT - OrthoArkansas, which specializes in head-to-toe comprehensive orthopedic care, is now offering Saline County residents physical and occupational therapy with the expansion of its Bryant clinic. The clinic is located in the Springhill Crossing office park near I-30 and Springhill Road in Bryant. Practicing at the Bryant clinic are David A. Black, MD, Adam R. Smith, MD, Rod Cayme, MD and Jonathan D. Wyatt, MD, along with licensed physical and occupational therapists. The expansion doubles the size of its existing clinic. OrthoArkansas is the largest practice of its kind in Arkansas with nine locations.
Susan Smyth, MD, PhD, Named Dean of the UAMS College of Medicine LITTLE ROCK — Susan S. Smyth, MD, PhD, has been named executive vice chancellor and dean of the College of Medicine at the University of Arkansas for Medical Sciences (UAMS), effective June 1. She is succeeding Christopher Westfall, Susan S. Smyth MD, who retires Aug. 1, 2021, after 24 years at UAMS. Smyth joins UAMS from the University of Kentucky College of Medicine, where she is the chief of the Division of Cardiovascular Medicine and the director of the Gill Heart and Vascular Institute, a position in which she developed and implemented an operating structure that emphasized the integration and translation across research, education, and clinical care. A nationally known cardiologist and translational scientist, Smyth is an elected member of the American Society for Clinical Investigation, immediate past-president of the Association of University Cardiologists, and has served on the CTSA Steering Committee for the National Center for Advancing Translational Science. At the University of Kentucky, she is Senior Associate Director of the Kentucky Center for Clinical and Translational Science and has a part-time appointment as a physician and research investigator at the Lexington VA Health Care System. Smyth graduated from Mount Holyoke College in South Hadley, Massachusetts, with a bachelor of arts in biology before earning both a medical degree and a doctorate of pharmacology at the University of North Carolina in Chapel Hill, North Carolina. She completed an internal medicine residency, including a year as chief resident, at University Medical Center in Stony Brook, New York, and cardiology fellowships at Mount Sinai Medical School in New York, New York, and The University of North Carolina,
where she joined the institution’s faculty in 2001. Smyth’s husband, Andrew J. Morris, Ph.D., is internationally known for research in lipid metabolism and signaling. They have two children — Edward, a junior at Washington University in St. Louis, and William, a high school senior.
Razorbacks Partner with UAMS to Serve Razorback Student-athletes FAYETTEVILLE – Razorback Athletics has partnered with the University of Arkansas for Medical Sciences (UAMS) to provide comprehensive care for 465+ Razorback student-athletes. As part of the medical services agreement, UAMS will provide daily medical coverage to all 19 Razorback sport programs. The four-year agreement was activated on January 1, 2021 and runs through December 31, 2024. As part of the partnership, UAMS will provide advanced care from sports medicine trained primary care physicians and sports medicine trained orthopedic physicians as well as first-class hospital and surgical services. The UAMS team will work in conjunction with the Razorback Athletics Sports Medicine staff on a daily basis. UAMS currently has two Orthopaedics & Sports Medicine clinics in northwest Arkansas dedicated to treating athletes and community patients alike. Dr. Ramon Ylanan and Dr. Larry Balle serve as the primary care physicians as part of the partnership. Dr. Shea Brennan, Dr. Tyler CarlLee, Dr. Wes Cox, Dr. Navin Kilambi, Dr. Rob Martin, Dr. Chad Songy and sports medicine fellow Dr. Ryan Sorrell will also be part of the medical team. Physician Assistant Valerie Whitson will serve Razorback student-athletes in the on-campus clinic.
Baptist Health Hires System’s First Value Based Care Officer LITTLE ROCK – Dr. Cliff Fullerton recently joined Baptist Health as the health care organization’s first chief value based care officer. In this newly created role, Dr. Fullerton leads Baptist Health’s efforts to improve the quality and cost of health care for Arkansans and leads the Population Health Services Office for Baptist Health. This office will unify the organization’s efforts to work with patients, physicians, health plans and employees in agreements that bring more value to stakeholders. Dr. Fullerton comes to Baptist Health from the Baylor Scott and White Health system where he has held numerous leadership roles. Most recently, he served as senior vice president and chief population health officer as well as president of the Baylor Scott and White Quality Alliance. Dr. Fullerton is board-certified in Family Medicine and holds a master’s degree in Healthcare Management.
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Introducing the new UAMS Health Aortic Center UAMS Health Aortic Center Team
Mohammed Moursi, M.D.
Kyla Shelton, M.D.
Kalenda Kasangana, M.D.
Christian Simmons, M.D., Ph.D.
Jay Bhama, M.D.
Chief of Vascular and Endovascular Surgery, Vascular Surgeon
Aortic Center Director, Vascular Surgeon
Chief of Cardiovascular Surgery, Cardiovascular Surgeon
The new Aortic Center at UAMS Health brings together comprehensive, multidisciplinary treatment of the full range of aortic diseases and conditions for patients of any age.
24/7 Emergency Response Just one call to the Physician’s Call Center, 501-686-6080, will enable referring doctors to speak to a vascular surgeon and arrange an immediate transfer via an “aortic pathway” designation.
Learn more at UAMS.Health/AorticCenter
Located on the Little Rock campus, the center includes an expanded team of board-certiﬁed surgeons and offers the most advanced vascular surgical options in the state. The center offers early and complete diagnosis, appropriate medical and/or surgical management, and long-term follow up. We care for critical conditions such as aortic dissections and ruptures requiring emergency care as well as elective procedures. In addition to four vascular surgeons, the center’s specialists include cardio-thoracic surgeons, medical geneticists, cardiovascular anesthesiologists in the operating room, board-certiﬁed critical care surgeons in the ICU as well as multidisciplinary post-surgical care in the ICU and on regular ﬂoors. The UAMS Health Aortic Center provides state-of-theart complex open and endovascular surgery. UAMS is the state leader in endovascular, minimally-invasive procedures and our vascular surgeons are the only ones in the state performing fenestrated endovascular aortic operations used to treat patients with complex aneurysms.
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