ONCOLOGY • BEHAVIORAL HEALTH • CYBERSECURITY • TELEMEDICINE
March 2018 December 2009 >> $5 ON ROUNDS One Career Never Took Off, However A Notable One Did The career of Jamie Flerlage’s dreams never came true, but a remarkable – and valuable – one did as many at St. Jude Children’s Research Hospital will emphatically Jamie Flerlage confirm.
Profile on page 3.
Take a Close Look At Cyber Crime And Ransomware Cyber criminals today pose an immediate and major threat to health information privacy today. An expert discusses this danger and provides an update on Loretta Duncan Ransomware and cyber security.
Story on Page 4.
Mental Health Faces Many Barriers, But Can Be Overcome Hope and Healing for mental Illness is a huge challenge. The barriers – high costs, a dearth of providers, and unsuccessful treatment – are many, but they are surmountable when payers and purchasers work together.
Report on page 5.
ONLINE: MEMPHIS MEDICAL NEWS.COM
The Influence of Telemedicine Continues to Grow in Mid-South Baptist, Methodist Improving Outcomes With Technology By MADELINE PATTERSON SMITH
Telemedicine, or telehealth, is rapidly making an impact in the Mid-South, with the number of improving patient outcomes reportedly continuing to grow. Telemedicine, the use of interactive audio, video or other electronic technology by a healthcare provider to deliver care to a patient, is being employed at two of Memphis’ largest hospitals. Baptist Memorial Health Care is treating emergency neurological patients with telemedicine provider Patronus Neurology, while Methodist Le Bonheur Healthcare uses technology to connect in-demand specialists with pediatric patients. Kim Hallum-Stewart, Baptist’s system administrator for neurosciences, said emergency department physicians and neurologists across the tri-state region wanted
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Crestwyn’s Jep Stokes Takes Lead In Mental Health By JUDY OTTO
When Crestwyn Behavioral Health opened its doors in spring 2016, it represented a unique experiment in the form of collaboration between Nashville-based Acadia Healthcare – a leader in behavioral health services – and Saint Francis Hospital, Baptist Memorial Health Care and Delta Medical (CONTINUED ON PAGE 8)
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Physician’s Dream of Being an Astronaut Never Launched
Dr. Jamie Flerlage Stayed Grounded and Found Her Way to St. Jude It’s pretty safe in saying Jamie Flerlage is Memphis’ only physician who is also a hockey-playing mom and grew up wanting to be an astronaut. She dreamed of space suits and rocket ships. But that lasted only until she got to Vestal High School near her hometown of Apalachin, New York. Dan Bursch, an astronaut and Vestal alumnus, came back to speak to the students, and that is when Dr. Flerlage learned that only 1 percent of astronauts go into space. “That is the only thing I wanted to do was go to space,” she said. “He challenged me to think about some other things.” So she went to medical school instead, and Dr. Flerlage now is an oncologist at St. Jude Children’s Research Hospital and is the principal investigator in a genetic study of families with Hodgkin lymphoma. Her astronaut ambitions aside, Dr. Flerlage (pronounced fler-LAH-gee with a hard g) also had medicine in mind as a possible career from an early age. Two family members died of cancer, including her grandfather. “Our relationship with the oncologist was amazing,” she recalled. “He was much more than just a physician. He took care of our entire lives. I thought early on that I would like to be that.” In high school she was selected for a program called New Visions, and she chose the medicine track “because I thought a career in medicine would be exciting, but I knew little about it.” As a senior, she spent half of every day at a hospital. “I literally saw everything from birth to autopsies,” she said. “The whole point was complete exposure so that you knew definitively if you wanted that or not. I loved it.” She chose to do a combined eightyear program at Union College in Schenectady and Albany Medical College. Not only were those colleges relatively close to home, but, she said, “it was the only college that has Division I women’s hockey
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©2016 ST. JUDE CHILDRENS RESEARCH HOSPITAL; ALL RIGHTS RESERVED
By RON COBB
and a combined program, so that I could continue to play during undergrad and still be able to get into medical school. I got in ahead and was able to have time for all the workouts and ice time.” Dr. Flerlage played defense for the Dutchwomen, and now, some 13 years after her college career ended, she still plays hockey. She has played in the co-ed
half into her clinical trial to try to find out why Hodgkin lymphoma tends to run in families or happens to more than one person in the same family. With some help from the National Institutes of Health, families have been recruited to the study from across the United States and the world. “In families where there’s more than one person with Hodgkin, we believe there’s a genetic link within those families,” she said, “but nobody knows what it is. We’re trying to find the gene and find the link. We don’t know if it’ll be the same gene in each family or if it will be different genes in different families.” Dr. Flerlage says the hardest part of the trial is over, which consists of identifying families and collecting their samples. Now it’s on to analyzing the samples – “no small feat,” she said. “It will take more than two years to be able to analyze all that data for each family and compare the data from one family to another.” She believes that because Hodgkin lymphoma is relatively curable, the research world hasn’t focused its efforts on this disease as much as on other, more
Memphis Area Hockey League in Southhaven, although she is taking this season off after the birth of her daughter six months ago. The doctor did her internship and residency at Johns Hopkins, and as chief resident she co-authored the 20th edition of the Harriet Lane Handbook. Between finishing her residency and starting her chief year, she came to St. Jude to start her fellowship in oncology. She then was invited back to join the faculty. “Not everybody gets to stay,” she said, “but I was very thankful that I did.” “I actually came to St. Jude to do international oncology,” she added. “That’s always been my focus and passion. That first year, I would go every other month to Guatemala City at our partner site. “It’s part of why I picked a career in Hodgkin lymphoma and lymphoma in general because it’s very curable. So as we continue to grow our global pediatric medicine program, lymphoma will be one of the first diseases that we’ve opened protocols to treat internationally because of its curability.” Now in her sixth full year in Memphis, Dr. Flerlage is nearly a year and a
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Ransomware Attacks, Breach Notiﬁcation, Security, And Rule Compliance: What You Need to Know Now By LORETTA DUNCAN, FACMPE
The Breach Notification Rule was introduced to healthcare in the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009. Since that time, more than 2200 covered entities and business associates have reported breaches affecting 500 or more individuals, with the total number of individuals impacted by these breaches exceeding 170 million. The majority of these breaches involve electronic protected health information. Ransomware occurs when a cybercriminal obtains access to a covered entity’s ePHI and holds the data hostage until a ransom is paid. This type of attack on healthcare data is considered one of the “biggest current threats to health information privacy,” according to the Office of Civil Rights (OCR), the agency that enforces HIPAA Rules. A ransomware attack can virtually paralyze a medical practice’s operations. Following an attack, there will be a frenzy of activity to limit the damage and restore normal operations; however, there may be even more devastation and hardship
About the Writer Loretta Duncan, M.S., FACMPE, is a Senior Medical Practice Consultant with SVMIC and specializes in assisting policyholders with HIPAA compliance. She holds a Master of Science in Health Law and Policy from Samford University, Cumberland School of Law.
from a HIPAA standpoint. Guidance issued by the OCR states that a ransomware attack will be considered a breach unless it can be proven that the ePHI was not compromised. The sheer presence of ransomware indicates that a medical practice’s systems were compromised, and ePHI could have been at risk. The OCR states, “Whether or not the presence of ransomware would be a breach under the HIPAA rule is a fact specific determination.” Therefore, it is up to the organization to determine whether or not a breach occurred and to respond appropriately. This requires medical practices to perform a forensic investigation to uncover the underlying details of the attack and to ensure ePHI
was not compromised. The primary purpose of ransomware is to extort the victim for money - at least, that is how it appears on the surface. Ransomware works by encrypting computer files, thus making them unreadable by the computer system that holds the data. To complete the encryption process, the ransomware must access and process the data in question. One must assume that additional payloads (malicious intentions) could be present and executed on the system. For instance, did the perpetrator read, alter, or transfer the data offsite prior to encrypting? Did they leave a backdoor that provides future access? These are just some of the facts that will be uncovered during a forensic investiga-
tion. Organizations need a well-defined incident response plan to guide their actions in the event of an attack. HHS OCR references NIST SP800-61 Rev. 2, Computer Security Incident Handling Guide for those needing additional information. In general, incident response plans include the following phases (NIS SP800-61 Rev.2): Preparation – includes educating employees, conducting risk assessments, development of incident response plans, and implementation of preventative controls Detection and Analysis – identifies indicators of compromise plus preliminary analysis to understand the incident Containment, Eradication and Recovery – containment isolates the infected system and prevents propagation to other systems; eradication removes the ransomware; recovery restores encrypted data and returns systems to normal operations Post-Incident Analysis – examines the evidence to establish a detailed report of the incident; fulfills post breach (CONTINUED ON PAGE 7)
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Leaders in Women’s Healthcare Introducing the Next Decade of McDonald + Murrmann
The nationwide rate of current
1 IN 5
Mental illnesses are the leading cause of disability worldwide
American adults has a mental illness
1 in 10 full-time employees has an addiction
of employees with a mental illness take time off because of it— up to 10 days a year
more than 35% of managers feel they receive no formal support or resources to help employees
Ensuring return-to-work policies include accommodations and coworker education.
RESOURCES FOR EMPLOYERS:
• Addiction and mental health vs. physical health: Analyzing disparities in network use and provider reimbursement rates (Milliman report)
Accountable, Accessible, Affordable Care The easy step of removing arbitrary — and Costs Reduces Hardship limits has been taken. The harder Published with permission from the National steps of ensuring true overall parity, Alliance of Healthcare Purchaser Coalitions. appropriate in-network access, and dealing with the persistent issues “There is no health without related to payment, outcomes and stigma mental health; mental remain. Employers can take positive actions on their ownimportant to make it better health is too to but will also need to work together, uniting be left to the professionals thealone, purchaser voice and insisting and mental healththat is stakeholders deliver on the promise— everyone’s business.” and obligation—of effective mental — Dr. Vikram Patel health care for all.
It’s common knowledge that early detection and appropriate treatment of medical conditions can considerably reduce hardship and costs. Yet with mental health conditions, patients who seek help may wait months — even years — for a diagnosis, and even longer for an effective personalized care and medication management plan. Mental health conditions are the leading cause of disability worldwide. In the U.S., about one in five adults will experience mental illness in a given year, 60 percent of whom don’t get help. Many who do reach out face a daunting labyrinth of high costs, a dearth of providers, and unsuccessful treatment, leading to waning motivation, hopelessness, and progressively worse symptoms. Adding to the challenges, only 55 percent of the nation’s psychiatrists accept insurance, compared with 88 percent of physicians in other medical specialties. The difficulty in finding in-network mental health providers extends to other mental health professionals, too. It’s getting worse. The nation needs to add 10,000 providers to each of seven mental health professions by 2025 to meet the expected growth in demand. The lack of access has created a crisis throughout the healthcare system that is costly, harmful and frustrating — sometimes catastrophic — for patients, their families, and other healthcare providers. With unmet patient needs soaring, pressure on hospital emergency memphismedicalnews
About 10% of pregnant women
and 15% of postpartum women experience depression.
HR managers know the toll mental illness can take on the company. Yet, only 15% feel managers are training to recognize the problem and share support and resources
Hope and Healing for Mental Illness is Possible mental health in the workplace (e.g., Right Direction program, IWILLLISTEN, In Our Own Voice)
cigarette smoking among adults with past year any mental illness (AMI) is 31.6% vs. 18.7% without AMI.
• Moving Mountains for Mental Health departments is untenable quality and and Well-Being (Articleand by Michael satisfaction levels are alarmingly Thompson, National Alliance compromised. president and CEO)
Steps for Employers: •Action Working Well: Leading a Mentally The barriers to achieving the mental Healthy Business (a comprehensive health system we need are many, but they toolkit for employers, including are surmountable when payers and purchashealth programs the ersmental work together to drive for long-overdue workplace) change such as:
Anxiety disorders, the most
common mental health diagnosis, affects 18.1% (42 million) American adults. About 90% of people who die
by suicide—the 10th leading cause of death I the U.S.—have an underlying mental illness.
RESOURCES FOR EMPLOYEES: • National Alliance on Mental Illness • Mental Health First Aid at Work • Right Direction
BEAUTIFUL. MEDICINE. 360 0 TM
• Stamp Out Stigma
We know that forward progress creates powerful new beginnings.
ENDNOTES: 1. 2.
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suicide-rate-surges-to-a-30-year-high.html • Requiring independent validation of • Out-of-Network, Out-of-Pocket, Out6. http://www.milliman.com/ mental health parity compliance. NQTLDisparityAnalysis/ of-Options: The and Unfulfilled • Evaluating dealingPromise with root 7. https://www.rwjf.org/en/library/research/2011/02/ The next decade of McDonald+Murrmann! of Parity mental-disorders-and-medical-comorbidity.html cause issues(NAMI relatedreport) to in-network access 8. https://www.ncbi.nlm.nih.gov/pmc/articles/ to mental health professionals. PMC3628173/ Dr. Mary McDonald, Dr. Heather Donato, Dr. Susan Murrmann • Promoting the Collaborative Care Model to improve mental health access and quality through primary care. • Supporting access to a full complement of mental health medication options to yield improved outcomes and lower overall costs.National Alliance would like to acknowledge the support it has • Developing innovative strategies received from APA Foundation Center for Workplace Mental to support, Health, engage Clearview and advocate for Quality Institute, and Takeda/Lundbeck Health employee mental health and well-being.
Pharmaceutical Alliance in the form of clinical expertise and funding to produce this Action Brief. Parity Compliance
It’s been nearly a decade since Congress passed the Mental Health Parity and Addiction Equity Act of 2008, which promised to make mental health and substance abuse treatment as easy to get as care for any other condition. But despite an opioid epidemic that is causing 91 deaths a day, and suicide rates that have surged to a 30-year high (with mounting disparities between rural and urban communities), accessing mental health care remains difficult for many, and impossible for some. Parity levels related to benefit levels are generally well understood and have generally been implemented by health plans, behavioral health organization and plan sponsors. However, parity requirements related to “non-quantitative treatment limitations” (e.g., utilization management, medication management, (CONTINUED ON PAGE 9)
Same Convenient Location MARCH 2018
St. Jude Children’s Research Hospital’s recently announced plans to develop a $412 million advanced research center is expected to not only “propel discovery” and scientific breakthroughs but also attract top scientists and clinicians in pediatric biomedical research to the Memphis facility. “The advanced research center will bring together a powerful combination of talent and technology in a space designed to propel discovery,” said James R. Downing, MD, St. Jude president and chief executive officer. “We are creating an environment where scientists and clinicians will have ready access to leading-edge resources and opportunities to pursue breakthroughs in hopes of accelerating progress in treating and curing catastrophic pediatric diseases.” Plans are to break ground on the center this spring and open in 2021. The approximately 625,000-square-foot center will comprise eight floors – six of research labs and two for future expansion and evolving technology. The labs will focus on immunology, neurobiology, cell and
© 2016 ST. JUDE CHILDREN’S RESEARCH HOSPITAL; ALL RIGHTS RESERVED
St. Jude’s Planned Research Tower Will Draw Talent, Propel Discovery
James R. Downing
molecular biology, gene editing, metabolomics, advanced microscopy, epigenetics, genomics, immunotherapy and RNA biology. The center, which is a major component of a $1 billion capital expansion of the St. Jude campus, was developed by The Crump Firm, lead architect on the project; and Jacobs Engineering, experts in lab design. Both are Memphis firms
The St. Jude Strategic Plan also calls for hiring 1,000 additional faculty and staff across scientific, clinical and administrative operations at St. Jude. Approximately 5,000 construction professionals and more than 125 vendors will be required to complete the advanced research center during the course of the three-year build-out. More than 75 percent of the positions and subcontractors
are expected to be hired from the Memphis area. In announcing its plans for the center, a statement from the hospital said, “The advanced research center builds on the St. Jude legacy of innovations for understanding and treating childhood cancer and other life-threatening diseases. Architecturally, it will be an interactive and interdisciplinary environment designed specifically for generating new ideas and teamwork. Its labs and spaces will enable researchers to collaborate openly and across departments. The center will stream natural light through open atriums and courtyards and will feature numerous interaction zones uniting key disciplines of science.” “Every aspect of the advanced research center has been customized to inspire and support researchers who seek to lead and collaborate,” said James I. Morgan, Ph.D., St. Jude scientific director and executive vice president. “We have committed critical resources to equip the brightest minds in science with the world’s most sophisticated technologies and equipment so that we can continue to speed discoveries that will save children.”Progress at St. Jude extends worldwide because of the organization’s global collaborations and rapid sharing of results and knowledge. “Through our international efforts, St. Jude is working to raise the survival rates of children with cancer worldwide by sharing knowledge, technology and organizational skills,” said Carlos RodriguezGalindo, M.D., St. Jude Global Pediatric Medicine chair and executive vice president. “The vital work that will occur in the advanced research center will help make improvements in the level and quality of care delivered around the globe.” memphismedicalnews
CONSOLIDATED MEDICAL PRACTICES OF MEMPHIS salutes Dr. Edward S. Muir, who is board certified by the American Board of Internal Medicine in hematology and internal medicine. Dr. Muir graduated with honors from University Of Mississippi School Of Medicine in 1986. Every patient hopes that their doctor can not only deliver excellent care but also be caring and compassionate. To coin an old adage, when you look up “bedside manner” in the dictionary, you might just see a photo of Dr. Edward Muir, whose patients often call him a “friend” as well as their “doctor.”
Ransomware Attacks, continued from page 4 responsibilities; includes lessons learned for future improvement It is during the post-incident analysis phase that the forensic investigation will occur and subsequently determine if a breach took place. Investigators will be interested in the particular strain of ransomware infecting the system(s). Antivirus vendors and security researchers closely identify, follow, and analyze ransomware as well as other types of malware. Once the strain has been identified, the characteristics and behaviors will be known. This knowledge can be used to demonstrate whether or not the ransomware exhibits behavior that puts ePHI at risk. Known characteristics and key indicators of compromise include: • infection and propagation methods • types of targeted data such as banking, health, or personal information • if data exfiltrated to the Internet • if backdoors used to give perpetrators unauthorized, future access Log files produced by technical security controls hold valuable information and aid the forensic investigation. These logs are found on desktops, servers, firewalls, web filters, and intrusion detection systems. However, these devices must first be configured to collect the necessary information. It is important that medical practices talk with their information technology and security providers to ensure the appropriate controls are in place and properly configured. If an entire medical practice’s patient database has been compromised in a ransomware attack, the practice will usually be required to provide written notification to all patients, notice to the OCR through their online portal, and notice to local media. This notification must take place within 60 days of discovering the breach. A breach of this magnitude will also require the practice to be listed on the OCR’s publicly accessible website that displays all covered entities and business associates with breaches involving 500 or more individuals. More importantly, this type of breach will prompt an investigation by the OCR. Even though a ransomware attack is not necessarily an intentional breach of ePHI, it can still lead to substantial costs memphismedicalnews
to a medical practice. When the OCR investigates a breach of ePHI, whether due to a ransomware attack or the loss or theft of a device containing patient information, the dollar amount of a settlement or potential civil monetary penalty will be based on the covered entity’s level of compliance with the HIPAA Security Rule. Medical practices should review their compliance with the Security Rule, especially now, since cyber-crime is at an all-time high and healthcare information is so valuable. Steps that can be taken to help protect covered entities from a cyber-attack: • Conduct a risk analysis to identify threats and vulnerabilities to electronic protected health information (ePHI) and establish a plan to mitigate or remediate those identified risks • Implement procedures to safeguard against malicious software • Train authorized users on detecting malicious software and report such detections • Limit access to ePHI to only those persons or software programs requiring access • Maintain an overall contingency plan that includes disaster recovery, emergency operations, frequent data backups, and test restorations All of these steps are requirements of the Security Rule. Compliance with the Security Rule not only protects medical practices from a potential breach and a large potential settlement with the OCR, it also protects patients. If ePHI is held for ransom, corrupted or lost due to a computer malfunction, patients may not receive the care they need in a timely fashion. It is imperative that medical practices take the time and allocate the financial resources to ensure the security of all ePHI that is created, received, maintained or transmitted. Copyright 2018 SVMIC. Reprinted with permission. This article is intended for educational/informational purposes only and is not intended to constitute legal advice.
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New Payment Opportunity for Remote Patient Monitoring By Denise Burke In January, Medicare began providing monthly reimbursement to providers for remote patient monitoring (RPM), promoting a powerful new tool to manage patient care between provider visits. RPM services are not classified by Medicare as telehealth services, therefore, RPM reimbursement is not subject to many of the restrictions that currently prevent widespread use of telehealth for Medicare patients. For example, unlike telehealth services, RPM services do not require the use of interactive audio-video, nor must the patient be located in a rural area. Instead, RPM services involve the interpretation of medical information without a direct interaction between the practitioner and beneficiary, thus allowing RPM services to be provided in a patient’s home. This code is payable in both non-facility and facility settings. Medicare will reimburse RPM services under CPT code 99091 which is used for the “collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time.” It is not a new code, which means it does not perfectly describe current technology, but CMS chose to proceed with reimbursement while the AMA’s CPT Editorial Panel develops new codes to describe remote monitoring more accurately. The Author: While not an exhaustive list, core elements of CPT 99091 entail: • A requirement for a face-to-face office visit prior to initiation of RPM for new patients or patients not seen by the practitioner within one year prior to billing RPM • The inclusion of physician or other qualified healthcare professional time involved with data accession, review and interpretation, modification of care plan as necessary (including communication to patient and/or caregiver), and associated Denise Burke documentation, and • Documnentation in the patient’s medical record of patient consent for RPM services . CPT 99091 can only be reported for a patient once in a 30-day period. Additionally, CPT 99091 can be billed with certain other chronic care management and behavioral health service codes, however, time spent furnishing the service cannot be double counted. Reimbursement for RPM finally provides a mechanism for providers to be paid for the time needed to remotely monitor patients between visits and is a long overdue development in the quest to keep patients healthier and provide timely interventions to prevent avoidable hospitalizations.
Crestwyn’s Jep Stokes Takes Lead In Mental Health, continued from page 1 Center. The opportunity to embrace the leadership role at Crestwyn was one of the factors that brought CEO Jep Stokes to Memphis, where today he confirms the success of that experiment. “Crestwyn is a new type of hospital, combining not-for-profit hospitals and their service lines with a mental health company like Acadia; and this is the way I believe the future of mental health is going,” Stokes said, “really wrapping your arms around the community’s needs in a full circle and having continuity of care. Being the CEO of such a joint venture is hands-down my biggest career accomplishment.” As Acadia’s appointed CEO, Stokes took over Crestwyn’s day-to-day operations from current Delta Medical CEO Phil Willcoxson just 22 days after they coopened the center together. Debuting as a 60-bed, 61,000-square-foot psychiatric hospital, Crestwyn was recently granted a 10 percent increase in bed capacity and is now a 66-bed hospital. Stokes began his healthcare career as a community liaison at Emerald Coast Behavioral Hospital in his hometown, Panama City, Fla. Intrigued by its mission, he rose through the ranks to become director of business development. With the help of a mentor, Stokes achieved an upward transfer to become chief operating officer at a Houston facility, and was later accepted into Acadia’s CEO-in-training program, which ultimately brought him to Memphis to help open Crestwyn’s doors. The greatest challenge he faced as the “new kid on the block” was the difficulty of attracting patients — and providers — to Crestwyn from the many other well-established facilities in Memphis. “Just getting the word out that people have another choice in Memphis — the same services provided in a new, smaller, state-of-the-art hospital, which provides a more intimate level of care — was a challenge,” he said. “We have an absolutely amazing family here,” he added, “but the reality is we haven’t been able to keep up with our growth.” With five privileged psychiatrists and two privileged internists, Stokes is looking for one or two more psychiatrists and adding other layers of specialty, including a trauma specialist. “We’re staffed exactly where we want to be, but we’re always trying to add more talent,” he said. The depth of the current opioid crisis is something neither Stokes nor Acadia anticipated when he arrived in Memphis. “We’re seeing patients from Arkansas, Mississippi, Kentucky, even Alabama, as well as Tennessee, and from many different walks of life. I don’t think we truly anticipated exactly how much we were going to see.” But although opioids are the No. 1 reason people go to Crestwyn seeking
help for detox services, it is not the center’s primary focus. Its most in-demand services involve acute psychiatric issues. “People coming to us with severe depression and anxiety and suicidal thoughts of harming themselves or others is still at the top of that list,” he said. Stokes sees a growing trend toward improved awareness, however, that creates less of a negative stigma for people who have mental illness — making it less difficult for them to reach the decision to seek care. “Now you hear factoids that one in four people suffer from depression; 10 years ago, it was one of those things that nobody talked about — until it was so much of a problem that you’d lost a family member or a loved one,” he said. Although the problem affects all ages, Crestwyn is seeing adolescents between ages 13 and 17 who are dealing with more significant issues regarding depression, revolving around traumatic experiences often the result of bullying or cyber-bullying. “Now,” he added, “a bully can follow you (even at home) on Twitter or Facebook or Instagram. There’s no escape, and that’s increasing the issues with our youth at an alarming rate.” Identifying the symptoms and signs of bullying, and educating kids regarding the ramifications of their bullying actions can make a difference, he advises. “If we do a better job coaching our kids not to pick on people for being different … I think that will go a long way to at least decreasing the crisis that we’re in with the youth epidemic of suicide.” “Ultimately,” Stokes said, “we want to be the No. 1 choice for care in mental health in Memphis. We want to be known for having the best practices in the industry, and we want to be able to coach other facilities on how to duplicate our successes. Because at the end of the day, it doesn’t matter where you get help, we just want people to be helped.” To that end, Crestwyn offers free assessments to walk-in patients. “Anybody can come to us in crisis at any time,” he said. “We’re open 24-7.” But perhaps the key to Stokes’ success is his determination to help both Crestwyn’s patients and its staff to reach their goals. “I have this huge push in my life to organically grow new leadership and have them reach every goal that they look toward, because someone helped me do the same,” he said. “I really strive to be a mentor more than a boss. I want my staff to know that I’m there for them, and the more people that I can get to their ultimate career goal, the more satisfied I’ll be.” The things he prizes most are his faith and his family — wife Brooke and two sons ages 4 and 8 — whose support is his greatest blessing. He is passionate about college sports and committed to staying active, fit and healthy.
Hope and Healing for Mental Illness is Possible, continued from page 5 etc.) are much more com-
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on can also mitigate the access compliance. igh-quality, cost-effective, Evaluate that Network -based solutions are approManagement r the patientâ€™s condition across From a quality and perspective, nuum ofaffordability acute and chronic care issues related to access to able. Employers bridging in-networkare mental health services can gowith beyond the s by working closely their parity requirements. Among ans andthe other vendors to offer findings in a November mote things EAPs, telemen2017like report published by Milliman Inc.: h, pharmacogenomics, online â€˘ In 2015, behavioral e behavioral therapy care was four (CBT), to six times more reduction likely to be training, provided y and stress out-of-network than medical pinion services, or surgical and care.more.
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Collaborative Care Model
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The Influence of Telemedicine Continues to Grow in Mid-South, continued from page 1 a teleneurology program to treat patients who present with stroke and other neurological disorder symptoms at times when a neurologist is unavailable. They identified Patronus NeuKim Hallum-Stewart rology, a national provider of teleneurology services, as a partner to meet the needs of patients and fully integrate into the Baptist system. The relationship has grown over the past two years, and successful incorporation into the patient treatment experience has led to growth from five hospitals to 10 hospitals in the Baptist system across Tennessee and Mississippi. Plans are underway to spread this platform across the 21-hospital system. The importance of teleneurology has increased simply because of numbers. According to Baptist’s stroke medical director, Lucas Elijovich, MD, there are not enough neuroloLucas Elijovich gists equally spread
out across the region, and telemedicine became the answer to deliver a uniform standard of care regardless of the patient’s location. “Some of these hospitals are in smaller communities that might not have a neurologist available 24 hours a day. But through this technology, these patients can be treated by worldclass neurologists in minutes,” said Baptist President and CEO Jason Little. Jason Little Because minutes really matter in stroke treatment especially, Elijovich said telemedicine is the best way to connect patients at any time of the day to a specialist so they can receive IV-tPA or tissue plasminogen activator, a common treatment used to dissolve clots in the brain. Patients in less urban areas are able to seek treatment at their hometown hospital and receive care close to home where they have the support of family and friends. Patronus Neurology provides a fellowship-trained vascular neurologist within four minutes to evaluate the patient and prescribe treatment. According to Elijovich, last year 13 percent of Baptist stroke patients received IV-tPA treatment, compared with the national average of 5 percent. Studying the patient timeline – from presenting symptoms to thrombectomy – is where telemedicine can improve outcomes. In concert with the Patient Placement Center, teleneurologists can diagnose patients, who can then be transferred for treatment quickly without having to wait for a neurologist in the emergency room, improving treatment time and saving lives. For easy communication between care providers in the Baptist system, the teleneurologists record their consults in the same electronic health record. At Le Bonheur, the vision for telemedicine is to provide care for children any time, any place and on any device. There are three telehealth models at Le Bonheur – synchronous scheduled
Is the missing
telemedicine visits (being offered by eight specialties currently), synchronous unscheduled care for acutely ill patients being transferred to Le Bonheur, and nonpatient care activities like distant diabetes education, lactation consultation, educational seminars and conducting remote team meetings. Integrating telehealth at Le Bonheur has enhanced quality of patient care by improving access while keeping care family-centered. Jay Pershad, MD, medical director of Le Bonheur’s telehealth program, said “about 15 percent of our patients reside in rural counties, and telemedicine is a unique way to leverage technology to improve access to our specialists.” Virtual visits can save families time, Jay Pershad inconvenience and expenses that come with traveling to Memphis. One example is connecting a patient with chronic asthma at Le Bonheur’s Tupelo clinic with a pediatric pulmonologist or allergy-immunology specialist in Memphis via a fully equipped telehealth cart, with a digital stethoscope and a highresolution camera plus otoscope. Another scenario could be a follow-up evaluation for a patient with seizures or a complex medical condition like tuberous sclerosis at home by connecting him or her with subspecialists at Le Bonheur. Prior to telehealth, a patient and/or physician would have to invest considerable time and resources in traveling long distances. Pershad would like to dispel five common myths associated with telemedicine in the medical community. First, telemedicine is not replacing in-person visits but rather complementing them when the face-to-face visit does not warrant a detailed physical examination. Second, telemedicine does not compromise on quality of care. Pershad sees telehealth as improving the patient experience, therefore creating value and convenience for families and increasing compliance. Third, telemedicine is expensive
• • • • • •
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to implement. While there are start-up costs associated with the video conferencing software and hardware, the ability to increase capacity, enhance physician productivity, generate savings from lower windshield time for patients and specialists, and cost avoidance associated with better management of chronic diseases can offset these expenses over time. Fourthly, there is the myth that reimbursement is low. While there continues to be conversations with insurance companies, reimbursements have improved as there is more evidence showing the benefits of telehealth. Tennessee, Mississippi and Arkansas parity laws protect telehealth practitioners by requiring payers to reimburse telehealth visits on par with in-person encounters (not the case in every state). The fifth and final myth is that medical malpractice exposure is higher. Insurers like SVMIC cover telemedicine visits the same as in-person care, and Pershad adds that virtual visits may actually decrease exposure by permitting better evaluation of acuity of illness, when compared to traditional phone consultations. After all, “if a picture is worth a thousand words, a video can be priceless,” Pershad said. As healthcare continues to evolve and move away from the fee-for-service model, telemedicine will continue to grow in popularity. “Telemedicine offers a unique opportunity to address issues like readmission, ED overcrowding, chronic disease management through remote patient monitoring and improved population health by keeping patients outside the hospital,” Pershad added.
Physician’s Dream, continued from page 3
deadly diseases. But for Hodgkin lymphoma, she said, “there is not a good understanding of the genetics and the biology behind what creates a Reed Sternberg cell, why they’re there and how we might be better able to get rid of them.” Her husband, Dr. Tim Flerlage, is finishing a combined fellowship in infectious disease and ICU for pediatrics at St. Jude and Le Bonheur. In their spare time, they enjoy the outdoors, hiking, running and golf. They also enjoy the warmer weather, which has allowed Dr. Flerlage to ditch her snow shovel, “which is a good thing,” she said, “although I’m the person to drive everyone around when it snows.” She feels very fortunate to be at St. Jude. “I had really great mentorship along the way to help me find my path, but I also have continued to find really great mentorship here at St. Jude,” she said. “In the department, I’m one of the younger faculty, and there are incredible world leaders and experts in leukemia and lymphoma who I get to work with on a daily basis, for which I’m very grateful.” memphismedicalnews
Hope and Healing, continued from page 9 other mental health professionals. Working with vendors, employers can ensure that employees and their covered family members benefit from this Model. Innovation can also mitigate the access issues. High-quality, cost-effective, evidence-based solutions that are appropriate for the patient’s condition across the continuum of acute and chronic care are available. Employers are bridging care gaps by working closely with their health plans and other vendors to offer and promote things like EAPs, telemental health, pharmacogenomics, online cognitive behavioral therapy (CBT), resiliency and stress reduction training, second opinion services, and more.
By their nature, medications for mental health do not work consistently for all patients like statins do for people with high cholesterol. Mental health treatment is complex, and studies show that medications in the same class for the treatment of mental illness are not interchangeable the way medications in other classes may be. Policies that include overly restrictive formularies (e.g., excluding newer medicines), prohibit clinical exemptions based on cost rather than science, or institute onerous prior authorization or step therapy requirements can fail to achieve their intended purpose of reducing overall healthcare costs. These practices can potentially delay or hinder full recovery, lead to longer periods of disability and lower productivity, and contribute to additional medical visits and even hospitalizations. When it comes to mental health and substance abuse, the standard of treatment today is that physicians and patients work together to define individualized treatment decisions consistent with medical guidelines and personalized circumstances. There are emerging trends showing promise for improving first-time prescribing success and medication compliance. For example, pharmacogenomics uses information about a person’s genetic makeup to choose the drugs and drug doses that are likely to work best. While relatively new, the potential to avoid multiple initial and subsequent therapy fails and incorrect diagnoses can be mitigated. In addition, not complying with mental health medication therapy can lead to serious consequences such as relapse, hospitalization, incarceration, suicide, and poor quality of life. With today’s technology, we have “smart” pill bottles, mobile apps, multi-dose delivery, and newly FDA-approved ingestible pill sensors to aid compliance.
Support, Engage, Advocate
Progressive employers understand that in a workplace culture where mental illness isn’t stigmatized — and seeking help is encouraged and supported — employees are more likely to be aware of and use available resources such as EAPs, so they can start treatment sooner and recover more quickly. And treatment works, effectively reducing symptoms for 75 percent of memphismedicalnews
those with common mental health conditions like depression and anxiety. Just as with physical medical conditions, mental health outcomes improve when illness is caught early in the most treatable stage, and patients receive the care and support they need to get well. In addition to ensuring compliance and access to high-quality mental health services, employers can take a number of steps to identify, engage and support employees with mental illness such as: • Including mental health questions related to stress, depression and substance abuse on health risk appraisals. • Training supervisors, managers and other leaders to identify and compassionately address the signs of mental illness. • Educating employees about things like preventive care, overall well-being, EAPs and other complimentary programmatic resources addressing mental health in the workplace (e.g., Right Direction program, IWILLLISTEN, In Our Own Voice) • Ensuring return-to-work policies include accommodations and co-worker education. • The easy step of removing arbitrary limits has been taken. The harder steps of ensuring true overall parity, appropriate in-network access, and dealing with the persistent issues related to payment, outcomes and stigma remain. Employers can take positive actions on their own to make it better but will also need to work together, uniting the purchaser voice and insisting that stakeholders deliver on the promise — and obligation — of effective mental health care for all.
Resources for Employers
• Addiction and mental health vs. physical health: Analyzing disparities in network use and provider reimbursement rates (Milliman report). • Moving Mountains for Mental Health and Well-Being (Article by Michael Thompson, National Alliance president and CEO). • Working Well: Leading a Mentally Healthy Business (a comprehensive toolkit for employers, including mental health programs for the workplace) • Out-of-Network, Out-of-Pocket, Out-of-Options: The Unfulfilled Promise of Parity (NAMI report).
Resources for Employees: ness
• National Alliance on Mental Ill• Make it OK • Right Direction • Stamp Out Stigma
Published with permission from the National Alliance of Healthcare Purchaser Coalitions which represents approximately 50 employee/purchaser-led coalitions whose membership collectively provides health coverage to over 45 million Americans. The National Alliance helps to drive improvements in health, well-being and value for our companies and communities across the country. The Memphis Business Group on Health is a member and serves on the Board of Governors of the National Alliance.
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Rev. Dr. Albert Mosley, an ordained Elder in the United Methodist Church and a nationally-recognized religious leader, has been selected as Methodist Le Bonheur Healthcare’s new senior vice president for Faith and Health. He will join the leadership team in April, replacing Rev. Harry Durbin who retired last fall. Mosley has about 20 years of experience in faith-based leadership roles. He currently serves as Executive Vice President at United Methodistrelated Bethune-Cookman University in Daytona Beach, Florida, and is involved in a variety of nonprofit and church-related entities. Prior to serving at Bethune-Cookman University, he served as the president and dean of Gammon Theological Seminary, a United Methodist-related graduate school of theology that specializes in training pastoral leaders for the church and society. Mosley has also held posts at Johns Hopkins University as university chaplain and director of the Interfaith and Community Service Center, and held similar positions at Duke University. Mosley earned his EdD at the University of Georgia and a Doctor of Divinity from Liberia Baptist Theological Seminary. In addition, he earned a Master of Sacred Theology from Yale, a Master of Divinity from Duke and a Bachelor of Science from Millsaps College.
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UTHSC’s Julio CorderoMorales Receives $1.5 Million Grant Julio Cordero-Morales, PhD, an assistant professor in the Department of Physiology in the College of Medicine at the University of Tennessee Health Science Center (UTHSC), has been awarded $1,520,000 to study the molecular basis by which dietary fatty acids — such as omega-3 and omega-6 — regulate the function of membrane proteins present in the vascular system, called transient receptor potential channels (TRP channels). Awarded by the National Institutes
of Health (NIH), the grant paves the way for five years of funding to continue Cordero-Morales’ research project entitled, “The Role of Bioactive Lipids in Transient Receptor Potential Channels Gating.” In preliminary research using Caenorhabditis elegans, an animal model that can be genetically deprived of fatty acids, Cordero-Morales and his team discovered that a class of omega-3 fatty acids played important roles in protein function. “Once we discovered that omega-3 fatty acids were important, we moved to the second phase and studied the effect of fatty acids on TRPV4 channels present in human vascular endothelial cells.” Understanding the mechanism by which fatty acids regulate TRPV4 in these cells is key in generating novel therapeutics strategies to target this protein.
UTHSC Announces CORNETClinical Award Winners The University of Tennessee Health Science Center (UTHSC)’s Collaborative Research Network (CORNET) has announced the four research teams that have won the 2018 Clinical Awards. Nearly two years since its inception, the CORNET Awards have been the seed of more than $1.3 million in funding to support new collaborative research teams and their groundbreaking initiatives. The winning teams will receive a combined total of $200,000, divided evenly amongst each group, to foster their novel research projects. The CORNET-Clinical Awards are a mechanism for stimulating new research initiatives amongst UTHSC clinical faculty members (physicians, dentists, clinical psychologists, RNs, physical and occupational therapists, clinical pharmacists, etc.). While the main targets for this award were junior, new, or young investigators, established UTHSC faculty members who were new to research or had plans to enter a new field of research were also considered. The awardees and their project titles: Athena S. Davenport, PhD, Patricia Adams-Graves, MD – “Investigation of miR-29 as a Novel Fetal Hemoglobin Inducer and Treatment for Patients with Sickle Cell Disease” Maria Carrillo-Marquez, MD; James Lewis, PhD; Asim Choudri, MD; John DeVincenzo, MD; Heather Smallwood, PhD; Roozbeh Rezaie, PhD – “Defining and Predicting Outcomes of Congenital Cytomegalovirus Infection.” Khyobeni Mozhui, PhD; Jeffrey H. Brooks, DMD – “Epigenomic Study of Short-Term Prescription Opioid Use.” Manish Tripathi, PhD; David Shibata, MD; Meena Jaggi, PhD – “Role of LncRNA-MALAT1 in Colorectal Cancer Health Disparity.”
GrandRounds UTHSC Pair Awarded $1.9 Million Grant to Study Orthotic Function Researchers Phyllis Richey, PhD, professor in the Departments of Preventive Medicine, Physical Therapy and Pediatrics, and Kunal Singhal, PhD, PT, assistant professor in the Department of Physical Therapy, at the University of Tennessee Health Science Center (UTHSC), have been Phyllis Richey awarded $1,998,325 to study the effectiveness of a new robotic exoskeletal technology for use by military service members and veterans that have limited mobility due to a neurologic injury. Kunal Singhal Funded by the U.S. Army Medical Research Acquisition Activity, the Department of Defense grant will allow Richey and Singhal to conduct the “Veterans and Active Duty Service Members Leading Orthotic Research” (VALOR II) clinical study at UTHSC. The aim of the study is to determine if a Powered Ankle-Foot Orthosis (PAFO), in addition to a traditionally prescribed fixed ankle-foot orthosis (AFO), will improve walking ef-
ficiency, safety and quality of life for the typical service member or veteran who has suffered a neurologic injury resulting in lower extremity impairment. The study will receive funding for three years. Advancements in technology utilizing powered exoskeletons are being developed to help soldiers carry heavy loads and facilitate walking longer distances. Although these recent orthotic innovations are groundbreaking, the traditional AFO often prescribed for people who have lower limb impairment resulting from a neurologic injury has not had any major innovation for more than 30 years.
Two Memphis Healthcare Providers Included on Prestigious List Two Memphis healthcare organizations – St. Jude Children’s Hospital and Methodist Le Bonheur Healthcare (MLH) – have been named to the 2018 Fortune 100 Best Companies to Work For. It is the second year in a row the healthcare system has made the list, which is based on employee ratings of their workplace culture, including the level of trust they feel towards leaders, the pride they take in their jobs, and the camaraderie they experience with coworkers. The Fortune 100 Best Companies to Work For list has recognized excellence
for 21 years. Great Place to Work based its ranking on a data-driven methodology applied to anonymous Trust Index™ survey responses from more than 310,000 employees at Great Place to Work-Certified organizations with more than 1,000 employees. To learn more about Great Place to Work Certification, visit Greatplacetowork.com.
Eating Disorders Treatment Providers Form Organization A group of professional treatment providers have announced the formation of the Mid-South Eating Disorders Association (MSEDA) to serve as a community resource dedicated to the education, treatment and networking for all eating disorders treatment providers. Teri McCann, PhD, CEDS, and MSEDA, a co-founder and board member said, “We are pleased to have a dedicated professional organization to build community among treatment professionals in the Mid-South, which will improve our ability to provide comprehensive solutions for those struggling with this devastating illness.” McCann is the founder and executive clinical director of Fairhaven Treatment Center for Eating Disorders. She is a licensed psychologist, certified rehabilitation counselor and certified eating disorders specialist.
In addition to McCann, the board will include Michelle Bowden, MD, an assistant professor at University of Tennessee Health Science Center and adolescent medicine physician at Le Bonheur Children’s Hospital; and Angie Wallick, MS, RDN, CSR, LDN, a nutrition therapist with Memphis Nutrition Group. MSEDA will be open to all behavioral health counselors, nutrition specialists, medical professionals, school/college counselors and interested treatment providers. Those interested in more information about MSEDA should contact Suzanne Horsley at shorsley@fairhaventc. com.
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EATING DISORDERS HIDE IN PLAIN SIGHT. Eating disorders are serious and can be life-threatening. The mortality rate for people with eating disorders is 12 times higher than for people without them. The U.S. Department of Health & Human Services recommends evidence-based treatment – including medical stabilization, nutritional rehabilitation, pharmacotherapy, and psychosocial therapy – from a coordinated team of eating disorders specialists. For more information, or if you or someone you know may be at risk, contact Fairhaven Treatment Center for Eating Disorders. 901-757-7979 WWW.FAIRHAVENTC.COM
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GrandRounds Zhongjie Sun Named UTHSC Physiology Department Chair Zhongjie Sun, MD, PhD, FAHA, has been named chair of the Department of Physiology in the College of Medicine at the University of Tennessee Health Science Center (UTHSC) and deputy director of the Zhongjie Sun UT-Methodist Cardiovascular Institute. He
will assume his new role in April. Dr. Sun comes to UTHSC from the University of Oklahoma College of Medicine, where he was a professor of physiology, vice chair of research and chair of the research committee. In addition, he was the director of the Robert & Mary Cade Laboratory. A renowned cardiovascular investigator, Dr. Sun received his medical degree from Jining Medical College in Jining, China, in 1983, and completed his Master of Science degree in physiology at Tongji Medical University. He
received his PhD in physiology from Shanghai Medical University, and completed his postdoctoral training at the University of Florida. His research areas of interest include integrative cardiovascular physiology, endocrinology, and neuroscience.
UTHSC Names Interim Associate Vice Chancellor of Student Affairs Darrylinn Todd, EdD, has been named interim associate vice chancellor
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of Student Affairs and Enrollment Services at the University of Tennessee Health Science Center (UTHSC). In this role, she will provide executive leadership for and Darrylinn Todd oversee several administrative units that provide centralized campus support activities and services to students, including the Offices of Admissions, Financial Aid, Registrar, Student Life, Student Affairs, and the One-Stop Shop. She will also manage campus outreach programs, including K-12 outreach activities, and will represent UTHSC as the chief student affairs officer. Todd will continue to serve as an executive administrator in the Office of Academic, Faculty and Student Affairs, where she provides professional direction for strategic initiatives and uses her knowledge of academic and student affairs programs, policies, and culture to communicate information to the UTHSC faculty, staff, students, and administration. Todd brings more than 20 years of higher education experience. She has held a number of academic leadership positions and previously served as the senior director of Online Learning at DePaul University and vice president of Academic and Student Affairs at Malcolm X College - City Colleges of Chicago.
Methodist Le Bonheur Names President of Its University Hospital Roland Cruickshank, who has more than 20 years of experience in healthcare administration, has been selected new president of Methodist University Hospital (MUH). Previously he served as president of Vintage Hospital Roland Northwest Houston, Cruickshank part of the CHI St. Luke’s Health System. Prior to that role Cruickshank served for five years as vice president of operations at Houston Methodist Hospital, Texas Medical Center, a 1,119-bed academic medical center considered one of the top hospitals in Texas. Additionally, he had operational oversight for pharmacy and laboratory of eight hospitals in the Houston Methodist system. He earned a Masters of Health Administration from the Medical University of South Carolina, a Masters of Public Affairs from the University of South Carolina and a Bachelor of Arts from the College of Charleston. Cruickshank, who is joining Methodist as the organization marks its Centennial year, plans to begin his role at MUH late this month.
GrandRounds Regional One Names Imad Abdullah Chief Legal Officer Regional One Health has named Imad Abdullah chief legal officer. As the principal attorney and general counsel for the health system, he is responsible for managing all aspects of legal affairs and risk management. Abdullah joined Regional One Health Imad Abdullah in 2014. Prior to joining Regional One Health he was a Shareholder at Ogletree, Deakins, Nash & Smoak and spent nearly a decade at Baker, Donelson, Bearman, Caldwell & Berkowitz, handling civil cases in the areas of health care, employment and
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commercial litigation. Abdullah earned his Juris Doctor from the University of Minnesota Law School and his B.A., also from the University of Minnesota. Imad is active in the Memphis community, serving on the board of Bodine School, which specializes in educating and remediating dyslexic learners, and he previously served on the board of Pleasant View School.
Deadlines Near for MIPS Performance Period Reporting Deadlines are fast approaching for submitting data for the 2017 Meritbased Incentive Payment System (MIPS) performance period. The key dates are: • March 1 if you plan to submit 2017 data for the Quality performance category via claims, • March 16 at 8 pm EST for group reporting via the CMS web interface, • March 31 for all other MIPS reporting, including via qpp.cms.gov Those who are not sure if they are required to report for MIPS should enter their National Provider Identifier (NPI) in the MIPS Lookup Tool https://qpp.cms. gov/participation-lookup. Those who are in a MIPS APM or Advanced APM can use the APM Lookup Tool https:// data.cms.gov/qplookup. Those who need free assistance should call 844-205-5540 or email firstname.lastname@example.org.
BlueCross Selects Woods as Memphis Market President BlueCross BlueShield of Tennessee has named Kevin Woods as Memphis market president. He will be responsible for building and supporting key relationships with west Tennessee businesses and serve as the face of BlueCross leadership Kevin Woods in the Memphis community. Before joining BlueCross, Woods served as executive director of Memphis’ Workforce Investment Network, which assists city and county organizations with improving employment opportunities for area residents. He also serves on the Shelby County School Board and is a member of the Bridges Board of Trustees, REACH Memphis and the tnAchieves Advisory Council. Woods earned a Bachelor of Science in computer engineering and a Master of Science in business administration from the University of Memphis. He is a New Memphis Fellow, a member of the Leadership Memphis Executive Class of 2014 and the 2017 class of Leadership Tennessee. He has been recognized as one of Memphis Business Journal’s “40 Under 40.”
Bluff City Medical Society’s 2018 Officers Announced Persico Wofford, MD, was introduced as the new president of the Bluff City Medical Society during a Executive Committee dinner last month. The new slate of officers for 2018 and the organization’s Calendar of Events were introduced. All officers shown above include: Walter Rayford, MD, Past-President, Cathy Chapman, MD, Chaplain, Latonya Washington, MD, President-Elect, Lanetta Anderson, Immediate Past-President, Corbi Milligan,MD, Vice-President and Persico Wofford, President.
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Published on Mar 9, 2018