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FOCUS TOPICS GASTROENTEROLOGY • PAIN MANAGEMENT • CFO ROUNDTABLE • STAND-ALONE ERS

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As a youngster Randelon Smith had to overcome several serious challenges, but a confidence boost from a doctor and his Randelon Smith skills on the tennis courts gave him the resolve to try medical school. And now look.

Profile on page 3.

Newly Enacted Law Should Help Tackle Opioid Epidemic Officials are hopeful that a new state law that lowers the supply and limits the prescriptions will help Tennessee improve what now are some of the most Mark Swanson embarrassing opioid statistics in the nation.

Story on page 5.

Blockchain Offers High Hopes For Future Outcomes Blockchain technology’s improved efficiency and communication offer healthcare great promise for improved outcomes in both a business and clinical setting.

Role of the Healthcare CFO Both Unique and Challenging Memphis Chief Financial Officers Reveal Strategies, Hurdles By BETH SIMKANIN

Creating strong business strategies and maintaining financial stability are important objectives for any chief financial officer at a corporation, but in the healthcare field, the role of a CFO goes beyond budgets. It’s unique, multi-faceted and involves face-to-face contact with patients and medical staff. As one of the highest-ranking positions in any healthcare organization, the CFO must understand critically the system’s operations in order to provide tools and processes to physicians so they can save lives, while at the same time ensuring the organization stays financially viable. It’s a tremendous responsibility. Last month, a group of five CFOs from various Mid-South healthcare

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Left to right: Kimberly Young, BMG; Tina Kovacs, Saint Francis Memphis; Pat Keel, St. Jude Children’s; Rick Wagers, Regional One; Brent Patterson, Semmes Murphey Clinic

While Debate Over ERs Continues, Baptist Proposes One for Arlington ‘‘

Emergency room visits continue to grow and grow and grow ...

– Zach Chandler

Article on page 6.

ONLINE: MEMPHIS MEDICAL NEWS.COM

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His Tennis Talent Led Him to Take A Swing at Medicine

HealthcareLeaders

‘‘

ON ROUNDS

By JAMES DOWD  

During the last decade, hundreds of freestanding emergency facilities have cropped up across the country, fueled by a building boom that began in Texas. In Tennessee, there are seven freestanding emergency rooms, which mirror those attached to hospitals and treat a wide variety of injuries and critical medical issues. But not in Memphis.

Or in Shelby County. Or in West Tennessee. But that could change if Memphis-based Baptist Memorial Health Care wins approval in a few weeks from the Tennessee Health Services and Development Agency (HSDA) for a proposed facility near the intersection of Interstate 40 and Airline Road near Arlington, one of the fastest-growing residential area in Shelby County. (CONTINUED ON PAGE 4)

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PhysicianSpotlight

Proficiency in Tennis Steered GI Doctor Randelon Smith Overcame Speech Impediment to Get to Med School By LAWRENCE BUSER

In a field as demanding and challenging as gastroenterology and hepatology, Randelon ‘Rande’ Smith followed a demanding and interesting path that led him to the staff at GI Specialists. Dr. Smith grew up in the small Mississippi Delta town of Indianola, hampered by a speech impediment and an accompanying lack of self-confidence until a local family-practice doctor noticed some potential in him that just needed a boost. “At that time, there was no speech therapist who could help me, so my local doctor helped me tremendously,” Dr. Smith recalled. “The impact he made on me made me want to have that impact on lives like this. I can’t say it was a straight path, but it was one that eventually got me there.” He went to Southern University and A&M College in Baton Rouge, La., where he was a member of the tennis team. Looking back now, Dr. Smith acknowledges that he may have spent more time on the courts than in the classroom, but he still had that goal of making an impact on lives. “I grew up playing tennis and had aspirations of maybe becoming a teaching pro,” he said. “But then I thought maybe that wouldn’t be as fulfilling as practicing medicine. So I decided on grad school.” After earning his degree in biology, Dr. Smith enrolled at the University

of Memphis in a microbiology masters degree program in which he accomplished several things. It made him a more focused student, gave him time to mature and created a very interesting resume. “I developed a relationship with one of my professors based on our mutual enjoyment of tennis, which we both played at a high level,” Dr. Smith said. “I needed a research project to complete graduation, and he made me an offer to join his team and I accepted. The focus was on research on catfish and voles.” His master’s degree in organismal

How Black Doctors Serve as Mentors

Dallas pulmonary and critical care specialist Dr. Dale Okorodudu created Black Men in White Coats because he knew the value of mentors. In April the University of Tennessee Health Science Center and Baptist College Health Sciences along with other partners hosted a Black Men in White Coats Youth Summit at the Dr. H. Edward Garrett Sr. Auditorium on the Baptist Hospital-Memphis campus. More than 30 black male medical doctors and 50 healthcare professionals from other disciplines turned out to greet more than 200 students from 99 colleges and high schools.  In 2015, the Association of Medical Colleges reported that the number of African-American males applying to and graduating from medical school was lower in 2014 than in 1978. In 2017, only 2.9 percent of the 6,711 students who applied to UTHSC were African-American males, 7.2 percent were African-American females, and 26.4 percent were white males.  For that same year, only 18 African-American males enrolled compared to 92 African-American females and 242 white males.  Dr. Smith has never forgotten his mentor back in Indianola, Mississippi – Dr. Neal Hurt – but he says it’s quite possible Dr. Hurt never actually knew he was a mentor.  “At the time, I don’t think he was aware of his role in my career choice, but he was pivotal in my desire to help others,” Dr. Smith said. “Unfortunately, I never had the opportunity to thank him.”  – Lawrence Buser  

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biology and ecology also included some toxicology and how it affected the environment and wildlife, and helped get him into medical school at the University of Tennessee Health Science Center. After residency and fellowship, Dr. Smith joined GI Specialists on Aug. 1, 2011. Since then, he has seen remarkable improvements in medicine, equipment and treatment protocol. For example, patients with hepatitis C have a much better outlook today than in years past. “It has always been curable, but it was more difficult because treatment was longer and included painful shots with significant side effects which sometimes limited treatment,” Dr. Smith said. “Cure rates were low in those who completed therapy and for those who discontinued treatment, usually because of the side effects. “Now the duration of therapy is shorter and it can involve a single pill taken at home with less patient monitoring and side effects. In addition, the cure rates are significantly higher, however, the new medications are very expensive and there remains the issue of navigating the insurance companies who determine who gets treated.” He also notes that doctors at GI Specialists are seeing more young people with colon cancer than in previous years. Dr. Smith recommends colon cancer screening with an initial colonoscopy at age 45 for African-Americans and at age 50 for non-African Americans. Dr. Smith said African-Americans are more likely to develop colon cancer at a younger age and to be at a more advanced stage when diagnosed, possibly related to diet, lack of exercise, rates of obesity and smoking. “Then for both groups repeat colonoscopies or surveillance based upon the findings and the patient’s family history if it applies,” he added. “The age to begin screening becomes more complicated if

there is a family history of colon cancer in first-degree relatives. “The traditional risk factors are obesity, smoking, alcohol, physical inactivity and diets high in fat or low in fiber. However, we are not seeing this in many of these cases. Why? That’s the milliondollar question. We don’t quite know, as of yet.” When not treating patients, Dr. Smith spends time mentoring and encouraging young minority students to pursue careers in medicine with a national organization called Black Men in White Coats. “Inner-city kids may not know what it takes in terms of getting into medical school,” he said. “We’re hoping to start early helping these kids prepare to be good medical school candidates, and even to expose them to things they may like after medical school, such as the different specialties of medicine and medical-field opportunities beyond patient care. “Also, we hopefully can help instill in them the responsibility to give back to the community as well as serving as positive role models.” He and his wife, Latreka, an accountant, have a son, Owen, who recently celebrated his 10th birthday with a group of friends camping in the family’s backyard, and a daughter, 5-year-old Olivia, who enjoys ballet and dance. “Owen is the cerebral kid,” he said and then added with a laugh that “Olivia, she’s the personality of the house.”

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While Debate Continues, continued from page 1 The healthcare behemoth has applied several times for – and each time been denied – permission to construct a freestanding emergency facility during the last few years. A year ago the HSDA voted 4-4 on a Baptist request to construct a $10 million freestanding emergency facility with eight treatment rooms in Arlington. The tie vote on the proposal – a joint agreement between Baptist and Regional One Health – meant that approval was denied. But hospital representatives are set to go before the HSDA board on August 20 to appeal that decision and this time they’re hopeful the votes will fall in their favor. “There’s a large growth in population in this area and a need for emergency room services, particularly from surrounding counties where there are no longer full-service regional hospitals,” said Zach Chandler, executive vice president and chief strategy officer for Baptist. “In emergencies, when minutes matter, having quick access to emergency care can mean the difference between life and death or permanent damage.” Access to nearby emergency care would benefit residents in rural eastern Shelby County, Chandler said, as well as patients in Fayette and Haywood counties. Brownsville’s Haywood Park Community Hospital closed in 2014 and Methodist Fayette Hospital in Somerville closed in 2015. And because the freestanding emer-

gency department would be affiliated with Baptist, the level of care would be the same as in a hospital. “This would be fully staffed, open 24/7 and offer the same services as any of our hospital emergency rooms,” Chandler said. “Emergency room visits continue to rise and we believe the need for freestanding emergency departments will continue to increase, too.” Dr. Lee Berkenstock, MD, a state delegate to the AMA and past president of the Memphis Medical Society, agreed. “From the 1950s through the 1970s, there was growth of regional hospitals in more rural areas, but today it’s just not viable to have full-service hospitals in many of these areas and many of those hospitals have closed,” Dr. Berkenstock said. “Healthcare has changed and improved and the business model is reflective of the times. We have to be smaller and more agile. No longer do you see someone going in for an appendectomy and staying in the hospital for a couple weeks. Hip replacement procedures have improved so much that hospital stays are measured in days, not weeks, followed by rehab and home.” There have been more than a dozen applications for freestanding emergency departments in Tennessee during the last decade, according to Jim Christoffersen, general counsel for HSDA, and more continue to file in. But, he believes, the state’s strict approval process and governance of (CONTINUED ON PAGE 12)

Emergency Care Facilities: There Are Differences The proliferation of freestanding emergency facilities built across the nation during the last decade – between 400 to 600, according to some industry experts – is changing the medical care landscape. But these emergency facilities differ from minor medical and urgent care clinics, both in location and in treatment options. Freestanding emergency departments must be affiliated with a hospital in Tennessee, but in states such as Texas they may be independently owned and operated. These facilities are staffed by physicians and emergency medical personnel 24/7 and are equipped to treat serious and life-threatening injuries. Urgent care facilities may be freestanding walk-in clinics or located inside pharmacies such as CVS or Walgreens, or in retailers such as Target. These facilities treat less severe conditions such as sore throat, runny nose and flu and typically offer more limited hours of operation. Patients at these clinics are seen by medical personnel, but not always treated by a physician. There are numerous minor medical and urgent care clinics throughout Shelby County that offer varying levels of treatment. Campbell Clinic Orthopaedics, for example, offers five walk-in centers that specialize in sports medicine and orthopedics. Most are open until 4 p.m., but two of the facilities are open during the evening and all treat breaks, sprains, strains and other conditions. Campbell Clinic employs more than 500 medical and support staff across its system, including about 50 physicians affiliated with the organization. “We offer full services, including X-rays and clinical diagnoses, and typically our walk-in clinics offer time savings with shorter waiting periods than at emergency rooms,” a Campbell Clinic spokesperson said. “Patients at our outpatient clinics receive outstanding quality care, but treatment usually results in less cost and lower insurance claims.” — James Dowd

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New Law on Opioids Spurs Optimism  

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Aim Is to Lower Supply, Limit Prescriptions    By MADELINE PATTERSON SMITH

Tennesseans alarmed over the state’s staggering opioid statistics are hopeful a new law that went into effect this month will have a positive impact on an epidemic that continues to intensify. Tennessee has the second-highest rate of opioid prescriptions in the nation, with more prescriptions than residents, according to local reports. But lawmakers and healthcare officials are optimistic about the new law that requires extra steps by physicians and patients before a prescription for opioid treatment can be filled. Dave Chaney, Vice President of the Tennessee Medical Association (TMA), worked with Gov. Bill Haslam’s office on SB 2257/HB 1831 to reach its current form. Earlier this year, TMA and physicians were concerned about the restrictions placed on dosing of opioids and worked with the governor’s office to create necessary exemptions. Mark Swanson, MD, ‎is Vice President, Baptist Physician Enterprise and President and CEO of Baptist Medical Group - ‎Baptist Memorial Health Care Corporation. He said Baptist is “supportive of the actions being taken within Tennessee to deal with the Mark Swanson opioid crisis. We have tried to be as proactive as possible and communicated to our physicians and nurse practitioners information about the new law as it was being developed.” Although the law is a significant change for prescribers, it’s a small piece in the large, multi-faceted puzzle of the epidemic.  The new law aims to lower the supply of opioids, with proponents of the bill counting on a reduced supply preventing patients from becoming addicted while at the same time making the drugs more difficult for addicts to abuse. This is the “medicine cabinet phenomenon” or “pass along” rate that targets the supply of prescribed opioids to the public. The law defines prescription limits (three-day prescriptions, followed by 10-day supply for acute pain and up to 30 days with medical exemption) for opioid naïve and acute pain patients. Additionally, the prescribing practitioner must obtain patient consent before dispensing the opioids, and check the controlled substance database to ensure a prescription has not been prescribed in the memphismedicalnews

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previous six months and that the patient has not been treated with an opioid 30 days prior (or 90 days for an “acute care patient”). There are four restrictions and six patient exceptions to the above restrictions, which makes the new law slightly complicated for prescribers. TMA has created a flow chart for members to help navigate the restrictions, such as limiting opioid naïve patients to a five-day supply, to trials of appropriate non-opioid treatment, and potential patient exceptions, such as palliative cancer or hospice care. Clint Cummins, Memphis Medical Society executive vice president, says this bill is administratively more challenging for physicians but agrees it was imperative to take action to help combat the crisis. In Memphis, however, Cummins worries about the shortage of pain management specialists who are equipped to help patients. Jeff Harris, MD, Medical Director at the Methodist University Hospital Emergency Department, agrees that the key is long-term pain management, not a quick fix. “This law itself represents common guidelines for ED practice, it won’t really change our practice that much from what we’ve been implementing because we try to use the full range of therapy available and try to solve the pain,” Dr. Harris said. “Some departments have talked about going to opioid-free departments, or put a ban on certain types of medications, and we have not taken that route. “We just try to tailor . . . often it’s [the treatment] not an opioid or not a medicine. There’s a full range of therapies, and that takes longer as a provider, but we try to sit down and make a connection to see what drives a person’s pain.” Patient education can go a long way toward preventing the spread of opioid abuse and addiction, but it requires a continuous care plan. Dr. Harris points to the available treatments for pain management that patients are often unaware of. “We [the medical society] have not done enough to date to provide the resources to people to use non-pharmacological agents for their pain. … We try to connect people with a pain clinic and here’s what our emergency plan is for treating your specific pain, but that has to be a warm hand-off to follow-up.” Not finding the diagnosis and taking the time to educate the patient on lifestyle and other changes for pain management can be a pitfall, Dr. Harris said. Jillian Foster administers the pharmacy service line at Baptist Memorial and says the hospital has “championed an ‘opioid light’ order set for our emergency (CONTINUED ON PAGE 14)

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Betting on Blockchain Its Technology, Efficiency Offer Great Promise for Healthcare By CINDY SANDERS

Blockchain has become a hot healthcare buzzword over the last several years. One key reason so many in the healthcare industry are working to unlock the technology’s potential is the promise it holds to revolutionize the field by creating a safer, more cost-efficient data sharing system with both clinical and back office application. Still in its infancy, there are numerous hurdles to clear to fully deploy blockchain throughout healthcare, but a number of companies have already begun utilizing the technology. “Three or four months of ‘blockchain time’ is like a year of regular time … so much is happening so fast,” said Kristen Johns, a partner at Waller in the firm’s Intellectual Property practice group. Considering Kristen Johns the regulatory and legal hurdles that come with any transformative change, it is perhaps not surprising that some of the earliest blockchain experts have come from the legal field.

“It’s simple from our point of view,” noted Chris Sloan, a shareholder with Baker Donelson who is chair of the firm’s Emerging Companies group and also leads the Blockchain & Cryptocurrency team. “We believe blockchain is going to become a very widespread and widely adopted technology across Chris Sloan almost all industries. It makes sense for us to get on board early to be able to advise our clients on it.”

Blockchain Basics

Sloan likened blockchain technology to the Internet in the late 1990s. “You’ve got a disruptive technology that has significant and diverse applications across all industries, and it’s colliding with existing legal and regulatory schemes,” he pointed out. Like the Internet, he anticipates those issues ultimately will be addressed to make way for broad deployment of the technology. “Blockchain works really well anytime you have an intermediary that’s necessary

to complete a transaction,” he added of the decentralized technology that lends itself to process automation. “The other area where blockchain works very well is where you need to preserve the integrity of the data.” Johns was immediately intrigued by the potential power of blockchain when she was first introduced to the concept a couple of years ago. There was a competition to write a white paper about blockchain for the National Institute of Standards and Technology (NIST) and the Office of the National Coordinator for Health Information Technology (ONC). “I flippantly said, ‘That’s a nobrainer,’ and then sat down and figured out how hard it was,” she said with a laugh. Although Johns didn’t win the competition, she did gain a great deal of insight into the new technology and now leads Waller’s Distributed Ledger/Blockchain practice. Recognizing the concept of blockchain can be difficult to grasp for experts and certainly for providers, Josh Ehrenfeld, Corporate and Tax partner at Burr & Forman and a member of the firm’s Blockchain, Cryptocurrency and Electronic Transactions group, suggested thinking of the technology as a baseline platform with cryptocurrency and various other

financial and clinical functions being related applications just as Excel and Word are programs under the Microsoft Office umbrella. “At the end of the day, it’s a databased platform,” Josh Ehrenfeld he continued. “It allows for a more efficient and locked-in transfer of information. It takes the blocks and locks them up … they’re immutable.” Ehrenfeld added that once information is put into the system, it cannot be changed so if an error is initially made or circumstances shift, a new block must be added to update the original information.

Back Office Functions

One of the benefits of having a decentralized permanent record is that it allows everyone to see the same information without having to re-input the data for each user . . . thus minimizing transcription errors and making it nearly impossible to surreptitiously alter data once its entered. However, Sloan pointed out, that doesn’t necessarily mean blockchain will (CONTINUED ON PAGE 7)

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Betting on Blockchain, continued from page 6 eliminate fraud. “Just like any system, it’s only as good as the data put into it. It won’t stop fraudulent data that was put in from the start but would be easily visible if manipulated once in.” All three legal experts agreed back office functions have seen the most blockchain activity thus far. “It’s a powerful tool to reduce transaction cost because most transactions can be replicated, and it allows you to replicate them in a more efficient and less costly manner,” said Ehrenfeld. Johns said some of the first functions utilizing blockchain technology are the ‘low hanging fruit’ applications that are easier to roll out with more complex uses to come as technology and legal hurdles are addressed. Still, she said, the movement is rapid. “The conversation is not so much about education now. It’s about use cases and where do we start and where do we go?” she noted of making the leap to the next level of deploying blockchain in healthcare.

Clinical Support

“The holy grail of blockchain is medical records,” stated Johns, who added a number of regulatory concerns must first be addressed. However, she said, the potential for improved communication … and, in turn, improved quality and safety … is too great to be ignored. “Is the promise of blockchain the ability to connect across the continuum of care? The answer is a resounding, ‘yes.’

How that happens, time will tell,” she said. Ehrenfeld noted one of the major upsides to using the technology with electronic health records is its decentralized nature, which allows participants across the chain to access information from different locations. Everyone from a patient’s internist to specialists to an urgent care provider seen while on vacation could potentially have access to the EHR and pertinent clinical information including medication allergies and co-occurring conditions. However, he noted, “Once you start putting someone’s health record on this chain, if someone hacks into it, you have a huge issue. Security becomes that much more critical.” Data is, of course, encrypted … and Ehrenfeld pointed out those using blockchain in a clinical setting face the same issues as an individual office with protected health information. In both cases, a strong cybersecurity plan should be in place that looks at processes, risk management and action plans in case of a breach. “The treatment you have from the protection and response side is similar to existing protocols but will ultimately have to be tailored and enhanced to account for blockchain technology.”

Barriers

Sloan said there are a number of barriers to broadly implementing blockchain ranging from regulatory concerns

with existing laws to inertia. “Historically, the healthcare industry has been one of the slowest adopters of technology,” he pointed out. “Is it better now than 20 years ago? Exponentially so, but I still think it’s going to take a little bit longer than people think.” Sloan noted it isn’t the young, nimble companies that are the issue in deploying blockchain. “It’s that you have to get so many disparate groups on board – providers, payers, regulators – it’s a lot of mouths to feed.” Johns said scalability is an issue and noted many potential applications aren’t readily available, as the underlying technology doesn’t currently exist. “We can see what is possible, but we’re just not there, yet,” she said. Ehrenfeld reiterated the barriers are different on the clinical front where there are more variables than with back office functions. “You are taking the art of medicine and trying to marry that with an executable and replicable set of activities,” he pointed out. Working through complicated medical scenarios and permissions are key reasons Ehrenfeld thinks it will take more thought and time before blockchain is widely deployed on the clinical front. “I have no doubt someone will figure it out, I just don’t know what that looks like, yet.”

Next Steps

While there are multiple hurdles to

overcome, blockchain is increasingly being considered as a way to innovate business functions. Johns, Ehrenfeld and Sloan all three said it was easy to see the allure of the technology in the healthcare setting. “It adds efficiency and integrity to any system that involves data moving back and forth between multiple parties,” Sloan pointed out. “Anyone in healthcare can probably think of a dozen areas where a blockchain network could save time, save money, reduce errors and add transparency … and that’s powerful for healthcare.” Ehrenfeld echoed those thoughts, saying, “It’s a powerful tool to achieve these results, but the devil is going to be in the details.” Johns noted, “Some entities are calling what they’re building a blockchain when it isn’t at all … but that’s okay. It’s still innovative and offers more efficiency, greater transparency and improved security.” She continued, “Even if blockchain isn’t your answer – and often, it isn’t – that’s okay. It has still forced you to look at your infrastructure, existing procedures and even policies in a fresh way. Blockchain technology can inspire those conversations.” Johns added, “I think it would be a mistake to ignore this. Even if you are a skeptic, you should pay attention. It would be naïve to say this is a passing fad. It’s not a matter of if … it’s a matter of when … and that answer will depend on the use case.”

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Role of the Healthcare CFO Both Unique and Challenging, continued from page 1 Pat Keel Title, organizations – Chief Financial Officer and Senior Vice President, St. Jude Children’s Research Hospital. Birthplace – Landstuhl, Germany. Education – Bachelor of Science in Accounting from Arkansas State University and a Master’s Degree in Healthcare Administration from Trinity University in San Antonio. Experience –With more than 25 years of experience in healthcare, Keel leads the financial strategy and management at St. Jude. She came to the hospital in 2016 to help launch a six-year strategic plan to expand clinical care and research programs worldwide.  Prior to joining St. Jude, she served as CFO and senior vice president for University Health in Louisiana, and also served on Governor John Bell Edwards’ Healthcare Transition Team. In 2015, 2016, and 2017 she was selected for Becker’s Hospital Review list of “130 Women Hospital and Health System Leaders to Know.”  She has held leadership roles in operations and finance at Good Shepherd Health System in Texas and at CHRISTUS Health in Louisiana.            

organizations with drastically different financial structures sat down with Pamela Harris, publisher of Memphis Medical News, and discussed the budgeting challenges they face to ensure that their organizations run smoothly, as well as how their decisions directly affect patient care and medical staff. According to all five CFOs, their roles aren’t about saying “no” to department budgets, but about coming up with creative strategies so all medical staff can perform their jobs to their maximum potential while achieving patient satisfaction, especially during financially lean times. Participants in the roundtable discussion were: • Pat Keel, senior vice president, CFO, St. Jude Children’s Research Hospital • Tina Kovacs, Memphis market CFO, Saint Francis Hospital • Brent Patterson, CFO, Semmes Murphey Clinic • Rick Wagers, executive vice president, CFO, Regional One Health • Kimberly Young, CFO, Baptist Medical Group  

Impact on Patient Care

All five CFOs agreed that direct interaction with patients makes a difference in how financial decisions are made in regard to patient care. In order to make informed decisions, many MidSouth hospital CFOs round with hospital staff regularly to get direct feedback from both patients and staff. “You live and die by your budget,” said Saint Francis’ Kovacs. “You have to keep in mind your community’s needs. It’s important to make clinical rounds 8

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with patients and staff on a consistent basis, so you can make sure they have what they need. I do patient rounds on a daily basis and follow up with the same patients on off-shift times. This has improved our patient satisfaction.” According to Young, CFO with Baptist Medical Group, rounding is especially important for the CFO to observe how patients’ needs are being met. She said the CFO must see how everything affects the patient so hospital leadership can keep in mind the ramifications of every financial decision, especially when budgets are tight.

“Making clinical rounds changes your perspective,” Young said. “You physically see patients fighting for their lives. It makes an impact emotionally. It’s especially imperative during those times when budgets are tight and there’s no more money.” Additionally, Patterson, at Semmes Murphey, said it’s important for the CFO to plan ahead for financial scenarios years in advance. “It’s the clinician’s job to fight for the patient; it’s my job to create the structure so they can continue that fight,” he said. “You must always be forward thinking and not just budget ‘what’s good for now.’ You always have to be thinking five years down the road to be able to provide good patient care.” Regional One’s Wagers agreed. “At the end of the day, it’s all about the patient and doing what’s right for them,” he said. “We want to make decisions to be here today and tomorrow for patients. It’s important to be an enabler for the patient and create sustainability.”  All five CFOs said their organizations have formal submission processes for planning budgets, but they agree that one-on-one direct contact with physicians and medical staff is critical to understanding their processes and procedures. “In addition to formal budget planning, we get real-time feedback when we do rounds and walk the corridors and hallways,” Wagers said. “Physicians need what they need to perform their job in the operating room. It’s imperative to enable them to be successful in saving lives.” Patterson said he encourages physicians to become involved in making budget decisions and finding alternate solutions to problems. “My goal is to achieve the clinic’s

Title, organizations – Market Chief Financial Officer, Saint Francis Healthcare. Birthplace – Houma, Louisiana. Education – Bachelors of Accountancy from Loyola University, New Orleans; Masters in Business Administration Experience – In November 2017, Tina assumed the role of Market Chief Financial Officer for Saint Francis Healthcare. Prior to that, she had joined Saint Francis Hospital-Bartlett as CFO in 2010. Previous experience includes serving as Assistant Chief Financial Officer at Sierra Medical Center in El Paso, Texas. She also has worked in financial leadership roles at hospitals in Indiana and Louisiana.    

Title, organizations– Rick Wagers, Senior Ex Vice President and Chief Financial Officer, Re One Health. Birthplace – Indianapolis, Indiana.  

Education – BS with a major in accounting a State University; MBA, with a concentration Finance at Middle Tennessee University.

Experience – Wagers has been involved in h finance a total 44 years. He began his caree as Assistant Controller for 4 years at Ball Mem Hospital in Muncie, Indiana, before joining V University Medical Center, where he worked including serving as CFO during the last 10. the past 8 years he has been CFO at Regiona Health.   

Medical Staff Input

Tina Kovacs

Rick Wagers

objectives with limited funds,” said the Semmes Murphey CFO. “I try to teach others to become problem solvers. It’s the CFO’s job to say no, but it’s also my job to encourage others to think about the problem and solution another way.” According to Kovacs, Saint Francis establishes a five-year business plan before the budgeting process begins. The plan includes a list of what items the hospital needs, such as hospital equipment and service programs. The hospital employs hospital liaisons who directly interact with physicians to find out their needs. They relay those needs to the hospital system. “It’s the liaison’s job to find out what the physicians need, whether it’s new equipment or new procedural tools,” Kovacs said. “It’s all funneled to the CFO to build a business plan. After the plan is created, a budget is built.” Additionally, Saint Francis has hospital committees that give feedback on budget requests. Kovacs said they consist of a mix of physicians and hospital staff. Individuals discuss whether the requested budget items are needed for the hospital system. BMG’s Young said that even if a CFO has to say no to a “wish list” budgeting item, it’s important for him or her to respond directly to the physician or department leader. This helps establish reliable relationships. “Ultimately, there isn’t a drawer full of money,” she said. “You must respond to clinicians and medical staff even when you have to say no. You have to explain why certain priorities are the way they are.” St. Jude’s Keel said the hospital has a different budgeting scenario due to its six-year strategic plan for operational growth and research acceleration, which has support from the hospital CEO. memphismedicalnews

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Brent Patterson Title, organizations– Chief Financial Officer Semmes Murphey Clinic.

xecutive egional

Birthplace – Huntsville, Alabama. Education – BBA in Accounting, Harding University.

at Ball n in

Experience – Brent began his healthcare career at Semmes Murphey Clinic in 2003 and has served in both the Controller and Chief Financial Officer roles for the past 15 years. Prior to arriving at Semmes Murphey, Brent’s work was primarily focused on the manufacturing industry, as a Senior Accountant providing audit services for Ernst & Young before moving into a corporate finance role at Mueller Industries.

healthcare er serving morial Vanderbilt 32 years, During al One

“At St. Jude, it’s a little different,” she said. “The strategic plan helps prioritize needs and gives us a long-term road map. We meet quarterly to make sure everything is on track. Every department has a vested interest in maintaining a balance.”

Budgeting Challenges

Each healthcare system and/or clinic faces a variety of budgeting challenges, but all five CFOs said the challenges differ based on their organization’s finance model. Regional One Health depends heavily on government assistance to operate its entire system. Wagers said the healthcare entity breaks even on its operational budget. Additionally, he said that since Regional One is the only level one trauma center within 150 miles, it must operate no matter the financial situation. “We exist on a shoestring budget for our level of indigent care,” Wagers said. “Only 20 percent of our patients pay under contract or by health insurance. We wouldn’t exist if not for the support from county, state and federal government. This situation creates a defined sum of money, and we must make ends meet with it.” Wagers said that although there is no “rainy day fund” – the system operates with only about 100 days of cash on hand – Regional One is one of the few hospitals in the country without debt. On the flip side, Wagers acknowledged that Regional One has one of the oldest campuses in the downtown area and needs renovation. “Our campus is in need of an upgrade,” he said. “We need community buy-in to replace and upgrade buildings. Currently, we have a development plan, but although we don’t have any debt, we lack the funding for an upgrade.”

Patterson said Semmes Murphey is focusing on cyber security due to the adoption of electronic medical heath records in the healthcare field. “There has been an explosion of healthcare data, and we must protect it,” he said. “It’s our job to protect this patient data. Environments and threats change on a daily basis in the technology world. We must balance the treatment of that data in the budgeting process.” Kovacs said that since Tenet Healthcare, which owns Saint Francis’ two area hospitals, is a national, for-profit corporation, shareholders influence the budgeting process. “We must take care of both consumers and shareholders, so our numbers look nothing like they do when we start

Kimberly Young Title, organizations – Chief Financial Officer, Baptist Medical Group. Birthplace – Memphis. Education – BBA, MBA in Finance, University of Memphis (formerly Memphis State University). Experience – 27.5 years Healthcare Finance experience all with Baptist Memorial Health Care Corporation. Her experience spans Corporate Finance, Managed Care Finance, CFO for 5 Hospitals and CFO for Baptist Medical Group (approx. 780 providers).

the budgeting process,” she said. “There is so much input from the outside.” The polar opposite of Saint Francis’ financial structure is St. Jude. The hospital heavily relies on private donors. “Our budget is dependent on our 10 million donors, and we have no contracts with them,” Keel said. “There is no funding model. We balance that with grants and insurance. There isn’t an unlimited bank. We have to always think, ‘Would a donor approve of how we spend our money?’” Additionally, Keel said St. Jude treats children from 48 states with different Medicaid plans, so the hospital accepts every payer network in the U.S. “The work that is done to keep that current is massive,” she said.

Fundraising and Donations

There are only a select number of hospitals in the Mid-South where donations and fundraising efforts directly impact the hospital’s bottom line. One of the most nationally known Mid-South hospitals is St. Jude. Keel said that donations make up such a large portion of the hospital’s budget that her staff must plan for unplanned scenarios in case they don’t meet their fundraising objectives. According to St. Jude’s website, 75 percent of the funds necessary to sustain and grow the hospital must be raised each year from donors. “Donors are huge for us,” Keel said. “It’s imperative that we have a contingency plan. We must always have cash on hand and be prepared if donation goals aren’t met. We rely heavily on donations and that funding model can be taken away at any time. We have 1,500 children who must receive treatment no matter the financial situation.” Additionally, Keel said that St. Jude has to prepare financially for situations that she never envisioned before in her long-standing career in healthcare. “You have to make sure donations and fundraisers don’t create a conflict of interest,” Keel said. “Also, we have 55,000 people visit our facility each year and you have to plan financially for the security. It’s mind boggling sometimes.”

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Linking Clinical and Financial Data The Key to Real Quality and Cost Outcomes I have a book on my desk that tends to scare people, but its thesis is a great way to introduce the importance of linking clinical and financial data to improve healthcare. The book is called Show Me the Money by Jack and Patricia Phillips.The book isn’t there to scare people, of course. It’s there because I’m a finance person, By BOBBIE BROWN and I love the Health Catalyst book’s discussion Senior Vice President about achieving high-value results because it’s applicable to today’s new healthcare environment. Health systems didn’t need to concern themselves with achieving high-value care until accountable care took the healthcare industry by a storm in 2010. That’s because health systems had a predictable revenue stream from the fee-for-service payment model, and to account for their revenue, they were primarily interested in the financial data they acquired from patient volumes. The days of only tracking volume with the fee-for-service model, however, are

now long gone. Nowadays health systems are tasked with providing high-value or value-based care along with a new focus on improving the quality of care based on clinical data.

falls occurred in the hospital? How many hospital-acquired infections? If hospitals don’t report their quality metrics, they’ll receive a penalty, further impacting their bottom line.

Operational Metrics

Readmissions.

While the switch to value-based purchasing will ultimately improve both quality and cost outcomes, health systems now need the capability of tracking and analyzing many other metrics before they can comply with the government’s new mandates. These metrics include the following:

Throughput

The time it takes to complete a process, such as shortening the average wait time in the ER or reducing the time between cases in the OR, now translates directly into money and greatly affects quality. Improving throughput will benefit the organization by reducing cost and increasing patient satisfaction.

Quality

With value-based purchasing, hospitals are required to assess and report measures of quality relative to defined benchmarks. Were patients given discharge instructions? Did the care manager schedule follow-up visits? How many

Quality will also be assessed based on the rates of readmissions for all causes within a certain time period for specific patient populations. For example, what are the rates of heart failure, pneumonia and AMI readmissions within a 30- and 90-day period? Mortality rates. What are the hospital’s mortality rates for pneumonia, heart failure and acute myocardial infarction (AMI) among its patient populations? High mortality rates in pneumonia, health failure and AMI will result in loss of incentives beginning in 2014. Patient satisfaction. Patient satisfaction is now tied directly to payment models. How satisfied are patients with their care experience? Was the room satisfactory? Was the family comfortable? Would they recommend the hospital? Cost per episode of care. Containing costs is now more important than ever as value-based purchasing systems strive to keep treatment consistent and expenditures appropriate and predictable. Reduc-

ing clinical process with variations will improve the cost structure. As though health systems weren’t already dealing with enough concerns with all of the new metrics they need to capture and analyze, there’s one more challenge they’re dealing with — accessing linked clinical and financial data from within their systems to provide the right metrics in this new world of value-based reimbursement. Traditionally, health systems housed their financial and clinical data in separate systems. The original systems were designed this way because financial data needed to be available to certain teams tasked with specific functions such as cost and payments. Clinical data was housed in systems that would allow clinical teams to focus specifically on readmissions, hospital acquired conditions, and core measures for clinical processes. But the two data systems were not integrated because there wasn’t a need. There is now, however, a need to access the data from both clinical and financial systems because the data can be leveraged to drive concrete, timely quality improvements. The kind of quality improvements necessary to survive in this new world of accountable care, quality (CONTINUED ON PAGE 11)

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Linking Clinical and Financial Data,

CONSOLIDATED MEDICAL PRACTICES OF MEMPHIS

continued from page 10

measures, shared savings, and bundled payments while also lowering costs.

A Winnable Challenge

Achieving high value results for health systems is a winnable challenge, provided the organization approaches the task with a thorough understanding of where it stands relative to clinical quality measures and the financial costs associated with delivering care. But the right tools and teams are necessary to liberate clinical and financial data to link it together to provide a full picture of trends and opportunities. An enterprise data warehouse (EDW) provides the ability to aggregate data from a wide variety of sources, such as clinical, financial, supply-chain, and HR source systems, in such a way that a sophisticated analytics system can then leverage the data to drive concrete, timely quality improvements. However, traditional data warehousing, which solved some of these problems, is no longer good enough. As Gartner recently reported, traditional data warehousing will be outdated and replaced by new architectures by the end of 2018. And current applications are no longer sufficient to manage these burgeoning healthcare issues. The technology is now available to change the digital trajectory of healthcare. The Health Catalyst® Data Operating System (DOS™) is a breakthrough engineering approach that combines the features of data warehousing, clinical data repositories, and health information exchanges in a single, common-sense technology platform. In addition to the EDW and DOS, permanent multi-disciplinary teams of frontline staff (for example, clinicians, quality personnel, analysts, a financial representative, and technologists) can help drive sustainable improvement initiatives by analyzing the data to determine what to target and how best to realize improvement. The team then sets goals that they constantly monitor to ensure they’re focused on sustaining quality and financial improvements as well as clinical and operational outcomes. Once they discover an improvement based on the data and best practices, then they work to gain buy-in from the clinicians to adopt the improvement.

The “Aha!” Moment

It’s important to educate clinicians so they buy in to the improvement and understand the financial implications. In working with health systems for many years, I’ve discovered that if education and financial results are tied to real, demonstrable clinical improvements, clinical teams will become excited about the change. By using easy-to-use dashboards along with DOS, clinicians can visualize their own progress. The “Aha!” moment comes when they can see how the clinical decision they made two days ago affected the bottom line today. Here’s a quick example of how a client I worked with memphismedicalnews

.com

benefitted by gaining buy-in from their frontline teams. One of our client hospitals targeted length of stay following an appendectomy as a key opportunity for quality and financial improvement. The frontline team looked at the data in their EDW and discovered that clinicians were prescribing a wide range of antibiotics after an appendectomy. Based on the outcomes data for each antibiotic, the team decided on a protocol for the entire facility and started encouraging clinicians to prescribe one particular antibiotic following surgery. The antibiotic turned out to be expensive, so any clinician who knew that the hospital was trying to cut costs might simply suggest using a lower-cost medication. But because we had linked the clinical and financial data in the data warehouse and made it available via dashboards, clinicians could see that while pharmacy costs rose, a parallel drop in length of stay (LOS) more than made up the difference. Once clinicians saw these results and caught the vision, they began requesting further refinements to the system. They began asking the team questions like, “Are we giving patients the antibiotic at the correct time after surgery?” Clearly, these clinicians became willing and proactive participants in the process. This is what data-driven quality improvement is all about. In short, quality and cost improvements require intelligent use of linked financial and clinical data coupled with education for multi-disciplinary teams who are driving process improvements. DOS offers the ideal type of analytics platform for healthcare because of its flexibility. DOS is a vendor-agnostic digital backbone for healthcare. Using DOS, teams will be able to populate workflow information systems with critical point-ofdecision insights and give the organization access to the most recent clinical and financial data. This, in turn, provides the organization with the best way to identify quality and cost improvements and ultimately to achieve high-value results. Health Catalyst was formed by a group of healthcare veterans with vast data warehousing and quality improvement experience. Itsfounders and executives collaborated for nearly a decade with Dr. David A. Burton, known for revolutionizing clinical process models using analytics. During development, they faced numerous hurdles in the quest to develop a data warehouse that could handle the complexities unique to healthcare data.

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GrandRounds UTHSC Names New Executive Dean of College of Medicine Scott Strome, MD, FACS, an internationally recognized head and neck surgeon, has been named Robert Kaplan Executive Dean of the College of Medicine and vice chancellor for Health Affairs at the University of Tennessee Health Science Center (UTHSC) effective on or before Scott Strome October 1. Dr. Strome comes to UTHSC from the University of Maryland School of Medicine (UMSM) where he served as professor and chair of the Department of Otorhinolaryngology – Head and Neck Surgery (OTO-HNS) for 13 years. A respected cancer surgeon and investigator, he brings both research and clinical expertise to UTHSC. “For me, this is a really tremendous opportunity to help shape the research, educational, and clinical missions of the school,” Dr. Strome said. “I was looking for a place that already had many strengths, but also had room for someone to build.” At UTHSC, Dr. Strome said he plans to focus on all of the university’s missions. In education, he plans to develop new ways to help students learn the vast

amount of knowledge they need to obtain during medical school and to teach them in ways that will be useful in their career. “We have to think about how we really teach our students to be lifelong learners,” he said. “And we have to teach them about how to give back to the community.” Dr. Strome said he is passionate about finding ways to reduce the cost of medical education. “I want to make certain that everybody within the state and outside the state as well, if they want to be a doctor and they have the requirements, they have the opportunity,” he said. Dr. Strome has been a mentor for students and championed efforts to reduce medical student debt at UMSOM. As a clinician, Dr. Strome has particular expertise in the treatment of head and neck tumors, thyroid cancer, and diseases of the anterior skull base. He spends one day a week in the clinical setting and one day a week in the surgical setting. His plan is to expand the UTHSC clinical operation, while focusing on quality patient outcomes and cutting-edge advancements and technologies As a researcher, he is the founder and former co-leader of the program in tumor immunology and immunotherapy in the University of Maryland’s comprehensive cancer center. He has been a National Institutes of Health-funded researcher and is the co-founder of Gliknik Inc., a biotechnology company developing novel therapeutics to treat cancer and autoimmunity. Highlights of Dr. Strome’s research career include his roles in helping to define the translational potential of manipulating PDL1: PD-1 interactions for the treatment of cancer – discoveries that are being employed for the treatment of patients with malignant disease – as well as the development of a new class of drugs for the treatment of autoimmune/inflammatory diseases. “I’m really excited to grow the research portfolio of the school, to expand the entrepreneurial opportunities within the school, to refine the educa-

Is the missing

tional activities of the students, and to partner with the community to ensure that we are addressing their health care needs,” Dr. Strome said. Dr. Strome received his bachelor’s degree in liberal arts from Dartmouth College in Hanover, New Hampshire, and his medical degree from Harvard Medical School in Boston. He completed his internship and residency at University of Michigan Medical Center in Ann Arbor, and a fellowship in OTOHNS reconstruction at Alleghany Health Education and Research Foundation in Philadelphia. He has been an associate consultant of otorhinolaryngology at the Mayo Clinic, and an assistant professor of OTO-HNS and an associate professor of OTO-HNS at Mayo Medical School. Dr. Strome joined University of Maryland Medical School in 2005, and in addition to serving as professor and chair of the Department Otorhinolaryngology – Head and Neck Surgery, he has held a secondary appointment as a professor of immunology and microbiology. He was interim chair of both the Department of Ophthalmology and Visual Sciences and the Department of Dermatology.

Methodist South Hospital Now Offering 3D Mammography Methodist South Hospital in Whitehaven has begun offering 3D mammography for breast cancer diagnostic screening exams using the Selenia 3D Dimensions Mammography System. The 3D exam provides more accurate detection and earlier diagnosis of breast cancer compared to 2D alone. 3D mammography already has been available at Methodist Diagnostic Center in Southaven, Margaret West Comprehensive Breast Center, Midtown Diagnostic Center and Methodist North Hospital. “Greater accuracy means better breast cancer detection and a reduced chance of additional screenings,” said Cherie Heard, director of radiology at Methodist South.  

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“Rather than taking a single picture of the entire thickness of the breast, 3D mammography involves taking multiple low-dose images of the breast from different angles,” said Heard. “These images are then used to produce a series of one millimeter slices or layers that can be viewed as a 3D reconstruction of the breast. We have the ability to evaluate each individual layer in much greater detail.”

While Debate Continues, continued from page 4 these facilities means that it is unlikely Tennessee will experience the same kind of explosive growth in freestanding emergency departments as in states like Texas. “In Texas, there is no requirement that a freestanding emergency department be affiliated with a hospital like we have in Tennessee,” Christoffersen said. “There is a very detailed structure about the process in Tennessee to ensure that these facilities meet the needs of the communities where they’re located.” The Texas boom began after a state ruling in 2009 that allowed freestanding emergency departments to be built and operated independent of hospital affiliation. The result was what some medical professionals have described as a “Wild West” surge in healthcare entrepreneurship that saw the rise of hundreds of independent freestanding emergency departments in less than a decade. Rob Morris is CEO and cofounder of Complete Care, which operates about two dozen freestanding emergency departments in Texas and Colorado. They treat more than 100,000 patients each year. He is also board chairman of the Texas Association of Freestanding Emergency Centers and on the board of the National Association of Freestanding Emergency Centers. He acknowledges that there were some bumps along the way in Texas, but believes that his company is the face of the future. “I think we’re starting to see the free market at work. We offer the same services as a full-service hospital emergency department, but with a smaller footprint, excellent specialized care and much lower wait times,” Morris said. “Some operators made poor site selections and eventually closed, but I think we’re starting to see a course correction and I’m optimistic that this industry will emerge stronger because of it.” Baptist officials remain optimistic that state officials will agree the time has come for a freestanding emergency department in Shelby County. And they plan to present a compelling appeal at their hearing next month. “Emergency room visits continue to grow and grow and grow and this facility would help us decompress the ER at our East Memphis campus,” Chandler said. “We want to provide excellent, specialized care to those who need it. This is right for patients and right for the community.” memphismedicalnews

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GrandRounds Internationally-Known Transplant Surgeon Joins UT/Methodist Institute

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Internationally known transplant surgeon and researcher Daniel G. Maluf, MD, has been named professor of surgery, surgical director of liver transplantation, and director of live donor transplantation for the UT/Methodist Transplant Institute. He will also hold the Transplant Institute Endowed Professorship in Liver Transplantation at the University of Tennessee Health Science Center. “This is a transformational change in the direction and future of the transplant institute, clinically by expanding live donor liver transplantation, as well as being able to perform groundbreaking transplant research,” said James D. Eason, MD, founder and program director of the UT/Methodist Transplant Institute and professor and chief of the Transplant Division in the College of Medicine at UTHSC. Dr. Eason holds the Endowed Chair of Excellence in Transplant Surgery at UTHSC. Over roughly a dozen years, he has built the transplant institute into one of the top liver transplant programs in the country. It performs approxi-

PATIENT-CENTERED

mately 260 to 280 transplants a year, totaling more than 2,500 transplants since he began. The institute recently added live donor liver transplants. “We are especially excited to have Dr. Maluf join our team,” Dr. Eason said. “He is internationally known for his work in live donor liver transplantation, as well as his research in genomics, proteomics, and molecular pathways of rejection.” Dr. Maluf comes to UTHSC from the University of Virginia, where he has served as a tenured professor of surgery, surgical co-director of liver transplantation, director of living donor transplantation, and director of the abdominal transplant fellowship program. He received his MD degree from the Universidad Nacional de Cordoba in Argentina, and did his general surgery internship and residency at Catholic University of Cordoba in Argentina. He did postgraduate work in advanced robotics in transplantation at the University of Illinois at Chicago, robotic surgery training at Eastern Carolina University, transplant surgery fellowship and a transplant research fellowship at Virginia Commonwealth University Medical Center in Richmond.

Conditions we treat include:

Our treatments include:

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• Epidural Steroid Injections • Facet Injections/Medial Branch Nerve Blocks • Radio Frequency Ablation Therapy • Genicular Nerve Blocks • Sacroiliac Joint Injections • Sympathetic Nerve Blocks • Management of Medications • Spinal Cord Stimulator Therapy • Botox Treatment for Chronic Migraines

Chronic Refractory Migraines Facial Pain Neck Pain Shoulder Pain Thoracic Spine Pain Lower Back/Lumbar Pain Hip and Knee Pain Post-Surgical Back Pain CRPS/RSD Fibromyalgia

Earvin “Magic” Johnson and Michael Ugwueke, president and CEO of Methodist Le Bonheur Healthcare, share a moment with Cato Johnson, the hospital’s senior vice president during the Party of the Century to celebrate 100 years of the health system.

Methodist Le Bonheur Healthcare Celebrates 100 Years To commemorate its 100-year anniversary Methodist Le Bonheur Healthcare hosted what it called “The Party of the Century” at the FedEx Event Center at Shelby Farms Park last month. “For the last one hundred years, Methodist Le Bonheur Healthcare has served as a beacon of expertise and care in our community and region,” said Michael Ugwueke, CEO and president of the Methodist Healthcare system. “Our centennial is more than an anniversary. It’s a celebration of our commitment to the future of medicine.” A century ago, John Sherard, a Mississippi farmer hoped one day to help open a hospital that would provide high-quality care for everyone regardless of their ability to pay. Sherard was committed to this mission after his minister received care in a charity ward at another Memphis hospital. His dream became what today is Methodist Le Bonheur Healthcare. “To this day, we stay true to our founder as we continue to be a mission-driven organization committed to providing high-quality care to everyone regardless of their ability to pay,” said Ugwueke. The elegant evening featured special guest Magic Johnson, Los Angeles Lakers president and former NBA star, live musical entertainment, a silent disco, gourmet food, cocktails and special indoor and outdoor activities, all overlooking beautiful Hyde Lake at Shelby Farms Park. Sponsors included AutoZone, Cigna and FedEx. memphismedicalnews

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New Law, continued from page 5   departments. It outlines some non-opioid options for treating pain not related to trauma. We have metrics showing significant reduction in opioid administrations in our emergency departments.” Medicare evaluates hospital and physician performance on pain management, so working with patients to help them understand their pain management options is critical for satisfaction. The July 1 start was a challenge for quickly communicating the intricacies to physicians and nurses, but Foster said Baptist has entered the ICD10 codes for automatic adding during prescribing, which will hopefully alleviate any learning curve for prescribers. The governor’s TN Together plan includes funding and other programming to address the opioid epidemic. Shelby County has a disposal program, Count It! Lock It! Drop It!, and the joint city-county Opioid Task Force has unveiled their multi-faceted plan. All are efforts to attack the problem from multiple angles. Still, Dr. Harris points to the shortage of primary care physicians as one piece of the issue, preventing patients from having a point of contact for regular care and building trust. Cummins agrees, adding there is a shortage in Memphis of pain specialists and pain clinics. The University of Tennessee Health Science Center’s Center for Addiction Science was recognized in 2016 as the first addiction medicine center of excellence in the country, but there is concern that patients will turn to illicit drugs like heroin if their pain is not managed. Often, it takes several rounds of rehab for patients to stay opioid-free. Autry Parker Jr., MD, President of the Memphis Medical Society, addressed the issue in a Memphis Medical News article last month, saying the rapid-release nature of opioids is what makes them so addictive, and the illicit opiates like fentanyl so deadly. What’s next in the fight against opioid addiction? Starting January 1, 2019, a partial fill requirement for pharmacies will begin. This requires the pharmacist to fill only  half of the first opioid prescription, and if patients require the second half of the dose, they must come back.

GrandRounds UTHSC Collaboration Publishes Research on Diabetes Drug Researchers from the University of Tennessee Health Science Center (UTHSC) have discovered a chemical compound that could lower sugar levels as effectively as the diabetes drug Metformin but with a lower dose. This new approach to diabetes drug discovery has been published in PLOS One, a peer-reviewed open access scientific journal. The research team includes scientists from the University of Tennessee, Knoxville (UTK) and Oak Ridge National Laboratory (ORNL). Along with his research team, Darryl Quarles, MD, University of Tennessee Medical Group (UTMG) Endowed Professor of Nephrology, director of the Division of Nephrology, and associate dean for Research in the College of Medicine at UTHSC, has been working with a specific protein called GPRC6A, which Darryl Quarles regulates sugar levels by simultaneously correcting multiple metabolic derangements that underlie Type 2 diabetes function. These derangements include abnormalities in pancreatic β-cell proliferation and insulin secretion, glucose uptake into skeletal muscle, and liver regulation of glucose and fat metabolism.

Saint Francis Volunteers Collect 92,180 Servings of Cereal

Saint Francis Healthcare volunteers collected 92,180 servings of cereal donated during its annual “Healthy Over Hungry Cereal Drive.” Both Saint Francis Healthcare operations — Saint Francis Hospital-Memphis and Saint Francis Hospital-Bartlett — participated in last month’s week-long event by collecting boxes of cereal and monetary donations and by hosting various fundraisers and contests. The cereal will benefit the Mid-South Food Bank. The event will help provide Memphis-area youngsters and adults with a healthy breakfast during the summer.

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University Clinical Health Promises Same-Week Rheumatology Appointments

University Clinical Health (UCH), an independent, physician-led faculty clinical practice plan of the University of Tennessee Health Science Center (UTHSC), has announced a commitment to provide appointments within a week or less of a request – at two UT Rheumatology locations in the Memphis area. UT Rheumatology also offers telehealth services to the Tipton County communities through its partnership with UT Family Medicine. A UCH spokesperson said the average wait times for rheumatology appointments in the Memphis area can edge close to six months. UCH through its UT Rheumatology service line has asserted its commitment to improving that statistic and providing rapid access to care throughout the Mid-South. UT Rheumatology is made up of Vaishnavi Pulusani, MD, who served as Chief Rheumatology resident during her tenure at UTHSC and currently serves as an assistant professor, and Bradley Postlethwaite, MD, who also serves as an assistant professor at UTHSC.

Saint Francis-Memphis Receives CARF Accreditation

Saint Francis Hospital-Memphis received a three-year accreditation, the highest level available, from CARF International (Commission of Accreditation for Rehabilitation Facilities) for its adult Inpatient Rehabilitation Unit. CARF is an independent, nonprofit accrediting body whose mission is to promote the quality, value and optimal outcomes of services through a consultative accreditation process and continuous improvement services that center on enhancing the lives of persons served.

UTHSC’s Yallapu Receives Grant for Breast Cancer Drug Development

Murali Yallapu, PhD, assistant professor in the College of Pharmacy at the University of Tennessee Health Science Center, has received a $439,818 grant from the National Institutes of Health (NIH) to continue his research on developing a drug therapy to combat aggressive and late-stage Murali Yallapu breast cancer, especially triple negative breast cancer. While there are therapies that are widely used for breast cancer, there is currently no effective target for triple negative breast cancer cells; this is attributed to suboptimal drug delivery systems as well as cellular resistance to therapies. In his project entitled, “Targeted NanoChemosensitization of Breast Cancers,” Yallapu is using a novel delivery system to deliver a natural compound called curcumin – which has been shown to have potent effects on cells but lacks strong movement within the body – for cancer therapeutic applications. Through this grant, Yallapu and his

research team (Prashanth Kumar, PhD, Pallabita Chowdhury, and Elham Hatami) will be funded for three years to investigate how to best sensitize resistant cells using his novel magnetic nanoparticle delivery system to specifically target tumor cells demonstrating drug resistant properties. Yallapu and his team collaborated with the research teams of Meena Jaggi, PhD, and Subhash Chauhan, PhD , who are also faculty of the UTHSC College of Pharmacy, for successful implementation of this research – which is significant because the FDA has yet to approve a targeted based therapy, placing Yallapu at the front lines of this novel research. This grant has more than just a research element to its benefits. It also includes training for doctoral students, improving infrastructure and other facilities within the College of Pharmacy.

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Subscription requests can be mailed to the address below or emailed to pamela@memphismedicalnews.com. Memphis Medical News is now privately and locally owned by Ziggy Productions, LLC. P O Box 1842 Memphis, TN 38101- 1842 President: Pamela Z. Harris Vice President: Patrick Rains Reproduction in whole or in part without written permission is prohibited. Memphis Medical News will assume no responsibility for unsolicited materials. All letters sent to Memphis Medical News will be considered the newspaper’s property and unconditionally assigned to Memphis Medical News for publication and copyright purposes.

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GrandRounds Baptist Ambulance Names GM, Communications Director Baptist Ambulance, which serves a three-state area, has named Greg Schowen general manager and Jeff Waid Communications Director. The EMS industry veterans bring a combined 55 years of EMS experience in operations management and communications center Greg Schowen supervision and design to the company’s leadership team. Schowen brings 25 years of experience in overseeing operations of high-performance 9-1-1 service areas, as Jeff Waid well as in business development interfacing with facilities and communities to create lasting, beneficial relationships. Waid will oversee the Baptist Ambulance Dispatch Center, which handles more than 45,000 calls for service annually. He has more than 30 years of experience in operating advanced communications and dispatch centers for public safety services. With a fleet of 40 ambulances Baptist Ambulance serves more than 30,000 patients in Arkansas, Mississippi and Tennessee annually. A member of the Priority Ambulance family of companies, Baptist Ambulance serves 10 Baptist Memorial Health Care facilities.

Sharonda Bealer Joins HealthChoice’s Care Team Sharonda Bealer, NCMA, NPT, CPhT, has joined HealthChoice’s care management team as a certified medical assistant. Bealer will assist HealthChoice’s members with finding the right place for care, gathering clinical information to optimize care coordination, and help- Sharonda Bealer ing close gaps in care. Prior to joining HealthChoice, Bealer was a certified medical assistant for Comprehensive Pain Specialists. HealthChoice, a Memphis physician hospital organization, is a joint venture between Methodist Le Bonheur Healthcare and MetroCare Physicians.

Hamilton Eye Institute Names Penny Asbell Director Penny A. Asbell, MD, FACS, MBA, FARVO, has been named chair of the Department of Ophthalmology in the College of Medicine and Director of the Hamilton Eye Institute at the University of Tennessee Health Science Center (UTHSC). Dr. Asbell comes to UTHSC from the Icahn School of Medicine at Mount Sinai (ISMMS) in New York, where she is

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a professor of ophthalmology and director of the Cornea Service and of the Cornea Clinical and Research Fellowships, which she initiated. She is the vice chair of the ISMMS Appointment and Promotion Committee, medical director of the Faculty Practice for Ophthalmology, and system vice chair for Academic Affairs for the Department of Ophthalmology. She received her bachelor’s degree from the University of Chicago and her MBA as valedictorian from the Zicklin School of Business at Baruch College in New York. She obtained her medical

degree from the State University of New York. Dr. Asbell completed her postdoctoral training at Yale New Haven She founded the Ocular Inflammatory Biomarker Laboratory at Mount Sinai.

St. Jude CEO Ranked Fifth of Glassdoor’s Top 100 CEOs James R. Downing, M.D., president and CEO of St. Jude Children’s Research Hospital, is the No. 5 ranked CEO in the large company category of Glassdoor’s Top CEOs. Glassdoor is a website where employees and former employees anony-

mously review companies and their management. Winning CEOs are determined by feedback from their employees who review their performance on Glassdoor. com. Under Downing’s leadership, St. Jude has increased employee feedback channels and forums, resulting in more innovation and connectivity across the Memphis-based campus. Downing leads monthly Town Hall and Blueprint Series all-employee meeting opportunities that encourage employees to share ideas and connect with leadership.

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Stroke Survivor

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Stroke Survivor

66 Years Old Loves to Run

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What they have in common is uncommon care. No matter who you are, at Methodist Le Bonheur Healthcare, we’ll meet your unique health needs with expert care for your one-of-a-kind life. Come experience healthcare that’s tailored to you. See our difference, visit methodisthealth.org/uncommon

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