FOCUS TOPICS ONCOLOGY • NEPHROLOGY • RURAL HEALTH • ADDICTION REHAB
March 2020 >> $5 ON ROUNDS MD on a Mission Oncologist Dr. Michael Ulm’s mission is not only to diagnose and treat cancer, but to prevent six types of cancer by raising awareness for HPV vaccination.
Story on page 3
Solving the Rural Health Puzzle
Taking the Initiative on Kidney Care
KHI, KidneyX, New Executive Order Create Collaborative Focus By CINDY SANDERS
Recent data from the Centers for Disease Control and Prevention shows more than 35 million Americans are affected by kidney diseases (CKD) … that’s one in every seven adults. Complicating the issue, it is estimated a staggering 96 percent of those with early kidney disease, when interventions are most effective, don’t realize they have CKD. Adding to the problem, the number of available treatment options have been limited for many years … although that is now beginning to change through the efforts of the Kidney Health Initiative, KidneyX and a new executive order from President Donald Trump. Prabir Roy-Chaudhury, MD, PhD, FASN, FRCP, serves as Councilor for the American Society of Nephrology (ASN), which has nearly 23,000 members across more than 130 countries. He noted the gallows humor in the field used to be that you could step away for 10 years, come back, and not have missed a thing. Despite the status quo, he said providers and (CONTINUED ON PAGE 5)
Hospital closures, alternative payment models, workforce issues and an older, sicker population have combined to create huge challenges in delivering rural care.
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Article on page 4
Parker Harris serves as CEO at Baptist Cancer Centers and Baptist-Tipton yet still makes time for family
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By LAWRENCE BUSER
ONLINE: MEMPHIS MEDICAL NEWS.COM
Parker Harris is not yet 30, yet he’s the CEO and administrator of Baptist Memorial Hospital-Tipton, he’s responsible for 11 Baptist Cancer Centers that stretch from Memphis to Union City, and he is president of Mid-South Healthcare Executives, a professional organization with nearly (CONTINUED ON PAGE 7)
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MD on a Mission
Dr. Michael Ulm’s mission is to not only treat cancer as an oncologist, but to prevent 6 types of cancer through an HPV initiative By SUZANNE BOYD
As a bright-eyed freshman at Rhodes College, Michael Ulm, MD, saw four years ahead of football, baseball, a political science degree and no idea what would come next. A volunteer opportunity during college showed him that while science was in his future, it wasn’t of the political kind. Much like a politician though, the gynecologic oncologist at the West Cancer Center and Research Institute does have an agenda, to provide the best care to his patients across Memphis and West Tennessee while also raising awareness of the importance of the HPV vaccine. Midway through his sophomore year, Ulm, a native of Lilburn, Georgia, was volunteering at Piedmont Hospital in Atlanta and had the opportunity to shadow various physicians and surgeons. “I found it to be interesting, stimulating and thought maybe this was something I would enjoy,” said Ulm. “While I was still a political science major, I took the MCAT my junior year knowing that I would have to complete additional course work after graduating.” Ulm headed to Tulane to pursue a Master of Science degree in Human Genetics. The one-year program allowed him to finish up some educational courses and be in the medical community doing research with a genetic counselor. The degree also provided a fall back option of science research should medical school not pan out. Medical school was an option and Ulm returned to Memphis, completing his medical degree at the University of Tennessee College of Medicine in 2011. “I initially thought pediatrics would be my specialty, but in my third-year rotations I discovered I really liked OB/GYN, despite the fact I said it was something I would never do,” said Ulm. “By the end of my third year, I knew it was for me and completed my internship and residency in Obstetrics and Gynecology at UT- Memphis.” During his residency, Ulm found inspiration and encouragement in oncology. “In obstetrics patients are usually healthy – oncology is the opposite – but I found that I really enjoyed that type of patient. They have had to face mortality in ways we haven’t and have a great memphismedicalnews
perspective on life,” he said. “Oncology offered a mix of basic science, chemistry, surgery and critical care. Oncology physicians are those who have to be comfortable in many realms, which was exactly what I wanted to be.” With oncology a relatively competitive arena, many residents apply to do an away rotation at one of only a handful of programs which allows them to be ranked and scored compared to other residents. As a Felix Rutledge Fellow in Gynecologic Oncology at the University of Texas MD Anderson Cancer Center, Ulm spent a month focused on the specialty. “It really solidified that this is what I wanted to do,” he said. “It was a mini-residency of sorts. We got to scrub in, operate, round and see patients in the clinic.” With his wife in her surgical residency in Memphis and their desire to start a family, Ulm knew Memphis was where he would do his fellowship training. At the time though, the West Cancer Center and Research Institute was in the process of developing a gynecologic oncology fellowship program with UT Health Science Center. To fill the gap and have an opportunity to hone his surgical skills, Ulm completed West’s one-year fellowship in female pelvic and reconstructive surgery. In 2019, he completed a fellowship in Gynecologic Oncology at West Cancer Center and Research Institute. After that fellowship, Ulm joined the West team as one of five gynecologic oncologists on staff. While he spends most of his time in the Germantown location, he sees patients in the Jackson office two days each month. “The West Cancer Center and Research Institute was the
right place for me, and one filled with the right people,” said Ulm. “Many of those were great mentors to me who take an interest in educating and molding doctors equipped to take care of our patients.” Ulm spearheads West’s human papillomavirus (HPV) initiative with an aim to prevent six different types of cancers with a series of vaccinations. HPV is the major cause of anal cancer, cervical cancer, oropharyngeal cancer, penile cancer, vaginal cancer, and vulvar cancer. With human HPV associated cancers on the rise in the United States, the counteraction to this growing epidemic is multi-faceted. Preventive measures available through HPV vaccinations as well as education around access to these vaccinations
are one part. The Centers for Disease Control predicts HPV infections will cause more than 30,700 cancers in men and women every year. Both boys and girls between the ages of 9 and 14 years old should receive the vaccination series against HPV, but it can be administered up to age 45 and after patients become sexually active. Ulm’s interest in HPV and promoting the importance of vaccinating for it came from an encounter during his fellowship. “I had a patient who was 25 and had five children who had been diagnosed with cervical cancer,” he said. “All I could think was how is this happening? The vaccine for HPV had been out 10 years at that time. Had this patient been vaccinated she would not be dealing with cervical cancer.” This caused Ulm to pause and ask, “As a medical community, where are we going wrong? If there were a vaccine to prevent breast cancer, people would be lining up at the door. Why is that not the case with this vaccine to prevent cervical (CONTINUED ON PAGE 8)
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Solving the Rural Health Puzzle
Industry Panel Brings Different Perspectives to the Discussion Last month, the Nashville Health Care Council and Bipartisan Policy Center (BPC) brought together an expert panel to discuss issues and opportunities facing rural health providers. “Solving the Rural Health Care Puzzle: National, State and Provider Perspectives” attracted a sold-out crowd to learn more about the challenges disproportionately impacting rural communities as the nation moves to value-based care. Bill Hoagland, senior vice president of the BPC, offered opening remarks and noted there have been more than 107 rural hospital closures across the country since 2010. Today, he continued, another 650 hospitals have been identified as ‘at risk’ of facing a similar fate. He added Tennessee is second only to Texas in the number of hospitals that have closed in recent years. The BPC plans to have a report ready late next month that focuses on four key areas: closures, payment reforms, workforce and technology.
(L-R) Panelist Stuart McWhorter, Nashville Health Care Council President Hayley Hovious, Moderator Dr. Bill Frist, and Panelists Dr. Sarah Chouinard and Alan Levine
Hoagland then turned the program over to moderator William Frist, MD, former U.S. Senate Majority Leader and a member of the BPC Rural Health Task
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We need boots-on-the-ground people who are addressing issues like behavioral health and addiction.” Yet, she said, attracting a skilled workforce to rural communities remains a major challenge. Ballad Health serves 1.2 million people across 29 communities, taking a regional approach to rural care delivery. Levine said he was appreciative for partnerships with state agencies and the leadership they provided to address critical areas of need. For rural hospitals, he said there was a three-pronged problem that had to be addressed: 1) the movement toward valuebased care, which drives down utilization, 2) population decline in rural communities that comes from lower birth rates and the outmigration of young adults, and 3) social determinants of health. “When you combine population decline with the movement towards alternative payment models that decrease the volumes, you now have a business model that’s in decline,” Levine said. He added, rural hospitals won’t survive unless a bridge is built to a different model of care. He added the need to address problems stemming from poverty is at a critical level and said the emerging science surrounding the lifelong impact of adverse childhood events underscores the need to improve early childhood resources. “There is the obvious problem of people who can’t afford their medications, don’t have transportation or food security,” said Levine. “The data shows the best solution for healthcare costs is to reduce poverty, which will close the racial and income disparity gaps and reduce the cost of healthcare long-term. Whatever we’re going to do to solve these issues will require patience, commitment to the effort and time.” He continued, “If you’re going to solve these problems, you have to deal with both social determinant issues at the same time … bail the boat out and plug the leak.” All three panelists agreed early intervention and pioneering initiatives are key to maintaining the health and well-being of rural communities. Levine cited plans Ballad Health is developing to focus on residential support for pregnant women who suffer from homelessness or addiction - providing treatment, prenatal care, parenting skills and other supports to help improve the likelihood for a healthy mom and baby. Chouinard referenced Community Care of West Virginia’s partnership to educate teachers about how to support students who have encountered adverse childhood experiences. McWhorter added PHOTO: © 2020, DONN JONES
By CINDY SANDERS
Force, who introduced the day’s panelists: Sarah Chouinard, MD, chief medical officer of Community Care of West Virginia; Alan Levine, executive chairman, president and CEO of Ballad Health; and Stuart C. McWhorter, commissioner of the Tennessee Department of Finance & Administration. Frist pointed out 93 percent of Tennessee is rural … and health is influenced greatly by place. He added 60 million Americans living in rural areas are at greater risk of dying from chronic conditions like heart disease, cancer, stroke and respiratory diseases. “Much of health and well-being turns on the social determinants, the non-medical determinants. We’ve got to address those,” he said. “The residents of rural communities continue to face huge, huge disparities that in this century and in this great country really should not occur.” Representing the local community perspective that comes from working with a Federally Qualified Health Center, Chouinard said, “When you look at rural America, you see patients who are a lot sicker and older than those in urban areas. As a result, we have chronic illnesses that are less controlled, more severe.” She continued, “Layered on top of that now is the opioid epidemic. It really reaches every corner of everything we’re doing in the office. We have 6,900 kids who are in foster care – double what it was a decade ago – and state officials estimate that about 80 percent of those kids are impacted by the opioid epidemic.” She said what beautiful communities filled with great people are now faced with is addressing an issue that is new to them. “I don’t think the solutions are hard,” Chouinard noted, “We don’t need expensive technology to solve this problem.
(CONTINUED ON PAGE 8)
Taking the Initiative on Kidney Care, continued from page 1 researchers have long been keenly aware of the desperate need for improved care options. “If you have 100 people starting off on hemodialysis, at the end of three years only 50 of them would be alive. That is a mortality (rate) that is worse than most every form of cancer,” he said. Yet, there have been 153 new U.S. Food and Drug Prabir Roy-Chaudhury Administration (FDA) approvals for cancer drugs over the last two decades compared to 23 for kidney diseases according to statistics from CenterWatch. “Kidney disease is common. It kills people, and quality of life is poor,” said Roy-Chaudhury, who serves as professor of Medicine and co-director of the University of North Carolina Kidney Center. “Despite this terrible triad, we’ve really had very little innovation in kidney disease treatment.” However, he continued, that began to change in 2012 with a memorandum of understanding between ASN and the FDA for a unique public-private partnership, which was signed by both organization’s leadership at the time, Ron Falk, MD, FASN, and Commissioner Margaret Hamburg, MD. To marshal resources, support ongoing research, advance clinical trials and spur innovation in the development of patient-centered therapies, the ASN joined forces with the FDA to create the Kidney Health Initiative (KHI). RoyChaudhury, founding ASN co-chair of the KHI, noted the partnership has been a game-changer in creating a roadmap for innovation. He added KHI – which is currently led by Ray Harris, MD, PhD, of Vanderbilt University Medical Center and supported by ASN staff – is a true team effort. From 2000 through 2011, there were eight FDA drug approvals for kidney disease. There have been 15 since 2012. Although excited about the progress, RoyChaudhury said, “We should be having a lot more biologics, new devices and new drugs coming in for kidney patients.” Still, he continued, “We’re really moving in the right direction.” Recognizing the need to create a proper foundation for future innovation, Roy-Chaudhury noted, “We’ve done a lot of tangible things within the Kidney Health Initiative, but by far the most important thing is the Kidney Health Initiative has created a platform for diverse stakeholders meeting and coming together.” He added the KHI connects health professional organizations, patient organizations, large pharma, small biotech and a range of federal agencies including the National Institutes of Health, Centers for Medicare and Medicaid Services, and the Centers for Disease Control and Prevention, in addition to the FDA. “In the long run, this will have the most impact,” memphismedicalnews
he noted of the open dialogue between stakeholders. Other large-scale projects to date include hosting workshops, setting data standards, publishing white papers, establishing clinical trial endpoints and creating an overall plan for patient-centered kidney disease management and treatment. “All of these outputs created a substrate, which is going to facilitate the passage of drugs, devices and biologics in kidney disease,” he said. Just as there is collaboration within KHI, Roy-Chaudhury is equally encouraged by the establishment of other kidneyfocused cooperative efforts. The kidney innovation accelerator KidneyX, led by John Sedor, MD, of the Cleveland Clinic, is another ASN public-private partnership. Working with the U.S. Department of Health and Human Services (HHS), KidneyX hosts prize competitions around specific kidney needs with funding going to winning ideas. “I think this can really change how we care for people in the next 10 years,” said Roy-Chaudhury. He also expressed great excitement over the “Advancing American Kidney Health” executive order signed last summer. CMS has proposed new reimbursement models to encourage preventive care, home dialysis and transplantation, and HHS has outlined three primary goals to improve kidney health. The first is to reduce the number of Americans developing end-stage renal disease (ESRD) by 25 percent by 2030. “It’s an audacious goal,” said Roy-Chaudhury, “but I think it’s going to push us to develop new therapies that will prevent the progression of kidney disease.” The second goal is to have 80 percent of new ESRD patients in 2025 either utilize home dialysis or receive a transplant. While recognizing there are different views on timing among stakeholders, he noted, “I think we all recognize the status quo that has gone on for such a long time has to change.” The third goal is to double the number of kidneys available for transplant by 2030. To meet that target, the executive order calls for HHS to expand support for living donors, look at reforms in organ procurement and management, and encourage development of wearable or implantable artificial kidneys. Additionally, Roy-Chaudhury said the relevant groups also are focused on public awareness and education, as well as primary and secondary prevention. “It’s a nice example of how government and the kidney community have come together to synergize development of new therapies, and I think that’s going to have exponential impact on patients,” Roy-Chaudhury said of the growing momentum among the collaborative efforts. “Above all, I strongly believe that if you can get smart and committed people and organizations together and get them to focus on a problem they are all interested in, then good things can happen … and sometimes it’s like magic!”
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No time? No Problem! continued from page 1 300 members. No time anymore for his favorite hobbies of hunting and fishing? No problem. “I also juggle a 9-month-old and a 3-year-old with my wife, Amanda, so I have four or five fulltime jobs on any given day,” Harris said with a laugh. “It takes a team to get through most days. I have 500 folks who report up through the Tipton channels and it’s a never-ending job. It’s a job where you’re on call 24 hours a day, but it’s probably the most rewarding thing I think you could do.” After a brief career as a tax accountant, Harris gravitated to the world of healthcare. As an undergraduate in accounting, he had an internship with an accounting firm that involved working with medical professionals, including Baptist executives Dana Dye, Derick Ziegler and Skip Steward among others. “They influence me to push out of comfort zones, to always question, to always ask why, to always get to the root cause and to always be challenging,” said Harris, who earned a master’s in healthcare administration from the University of Memphis. “As an early careerist you’re nervous and you don’t want to push the envelope, so it was very encouraging to have mentors who pushed you to break out of that zone and who challenged your thinking.” In January of 2019, he was named CEO of Baptist Tipton, a 100-bed facility in Covington about 35 miles north of Memphis. He found out quickly that the challenges are many and that there is no time for a comfort zone. Running a hospital is a bit like being the mayor of a small town. “Healthcare is literally the most complex business sector you can enter into,” Harris said. “One of the things that surprised me is the impact a community hospital has at every level of county politics and at every level of county involvement and interaction. That’s been kind of special to me to know that we have the support of the community and the community expects our support, too. “This is a group of 220 employees who live in this community and they get to come to work and take care of their community every day. I’m one of those community members, so it’s rewarding to see all the care and compassion of these folks as they take care of their peers in the community. A lot of times, if we weren’t here, people would die. So yes, there always are new problems to solve and it’s extremely fast-paced, but I’m rooted and grounded everyday by the fact that this team I get to work with is able to save lives.” Rural hospitals, however, have been facing hard times over the past decade as nearly 120 facilities have closed across the country, including 13 in Tennessee. Only Texas has closed more. Special problems include small patient populations, shrinking reimbursements from insurance companies, and difficulty recruiting specialists.
“We tend to have some trouble recruiting specialty physicians like surgeons and subspecialists such as those in infectious disease, so one of the things we’re doing to combat that is really growing our telemedicine programs,” Harris said. “We actually just went live (in February) with tele-infectious disease. We completed our first consult and that was really rewarding. That patient historically would have been transferred to our Memphis hospital, but now we’re able to use a computer, push a button and have a physician lay eyes on that patient right here in Covington. “There are always things that we’re going to have to send people to Memphis for – issues involving the heart or brain or things like that – but for the minor stuff why can’t we keep them here? That’s one of our goals to help grow our patient volume. We’ve got to be really strategic in what we do, what services we have, what money we spend each month.” The Baptist cancer operations, 60 percent of which report to Harris and his Tipton team, includes a genetic testing, nutrition, radiation therapy and thoracic lung programs. The top leadership of the Baptist system also has set an ambitious goal for its centers to reduce the lung cancer mortality rate in the region. “Throughout the United States, lung cancer mortality is decreasing, fewer people are getting it and fewer people are smoking, so we want to monitor that downward trend and we want to beat that downward trend by 25 percent over the next 10 years,” Harris said. “The death rate nationally is around 40 per 100,000 folks impacted by lung cancer mortality. Currently, in our market it’s closer to 60 folks per 100,000. We want to beat the national reduction rate, whatever it is, by 25 percent. “We’ve got 4.2 million people in our Baptist system area and 800,000 of them are active smokers. The reduction goal is a huge task, but we’ve got the financial and grant support, we’ve got the clinical leadership with Dr. Raymond Osarogiagbon, and we’ve got the administrative power to really work with our 22-hospital system and to work with the community and get out the education they need.” The reduction program will include enrollment in annual screening studies, enhancing multi-disciplinary clinic programs as well as incidental-nodule finding programs. So medical personnel will be paying extra attention to possible lung-cancer indicators even though a patient may be coming for an unrelated issue. “We’re going to use our electronic tools through our electronic medical records to really try to identify the extremely high-risk population and get them enrolled in appropriate programs, whether it be to educate or to properly screen those patients,” said Harris. “The key to lung cancer mortality is catching it early. If we can catch it early, there’s an extremely high rate of remission.”
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Solving the Rural Health Puzzle, continued from page 4 Tennessee Gov. Bill Lee’s proposed K-12 Mental Health Trust Fund will place behavioral health support services in schools. Addressing workforce and population erosion is an area where McWhorter said statewide economic development efforts could make a difference. “The opportunity we’re seeing is we have to bring new jobs and support existing industries in the rural parts of our state, and to do that we have to create more incentive,” said McWhorter. “You can’t draw people to these areas of the state unless there are
benefits, and we have to make the investments in areas like healthcare, education and more. These foundational investments will change the trajectory for economic development.” Panelists agreed that broader industry efforts to reform payment models are valid, but they often are designed targeting urban healthcare cost centers and end up squeezing already challenged rural healthcare providers. Chouinard and Levine said the unique challenges of rural healthcare call for solutions that are specifically tailored to those communities.
Despite the many problems facing rural health, Frist asked if there were optimistic notes, as well? McWhorter pointed out the governor is very focused on rural Tennessee and committed to improving communities. Chouinard pointed to grassroots efforts springing up to address issues like addition and recovery. “I don’t think these are problems that don’t have solutions,” she pointed out, “I just think we’re just at the tip of the iceberg in getting there.” For Levine, he said the national attention now focused on the dynamics
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causing rural hospitals to close is encouraging. He said there is a growing recognition of the issues that exist coupled with a growing will to find unique solutions. “I’m optimistic for the first time in a long time,” he concluded.
MD on a Mission, continued from page 3
cancer? I found myself asking, ‘What can I do to get the message out that this is a safe and effective means to prevent cervical cancer.’” Cervical cancer is the fourth most frequent cancer in women, and the World Health Organization estimated that there were over 500,000 cases in 2018. In England, the National Health Service (NHS) instituted a universal HPV vaccination program that offers all boys and girls ages 12-13 the HPV vaccine in school. In 2008, the year the vaccination program launched, 15 percent of young women in England were infected with HPV. A decade later, Public Health England (PHE) released a report showing the infection rate dropped to 2 percent in ages 16-18 years between 2014 and 2018, and in a sample of 600 young women tested in 2018, zero infections were found. This data indicates the vaccination program is successful for the reduction of HPV infections, and thereby reducing the risk of cervical cancer. England is not the only country to experience huge success from an HPV vaccination program. Scotland’s HPV vaccine program has seen similar success and Australia is on track to becoming the very first country to eradicate cervical cancer within the next two decades. Ulm is married with two girls under the age of two. He met his wife, also a Rhodes graduate and a surgical resident while applying to medical school. Balancing practice, residency and kids keeps the Ulms busy, but they do find time to enjoy the many great eating establishments Memphis is famous for and time with friends and family. Ulm is also an avid runner.
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GrandRounds UTHSC Launches Website with COVID-19 Information, Resources MEMPHIS – As Tennessee’s public academic health care institution, the University of Tennessee Health Science Center has launched a website to provide the public with information and resources about Coronavirus (COVID-19). The site, uthsc.edu/coronavirus , is designed to be a one-stop resource for the public that includes the best available information about Coronavirus, as well as frequently asked questions and links to global, national, and local organizations monitoring the virus. There is also an interactive option that allows the public to ask the experts at UTHSC questions about the virus and receive answers. Visitors to the site will find links to information from the World Health Organization, the Centers for Disease Control and Prevention, the Tennessee Department of Health, and the Shelby County Health Department.
Memphis Among Unhealthiest Cities in America – WalletHub Study With health care costs rising and U.S. life expectancy declining for three consecutive years, the personal-finance website WalletHub has released its report on 2020’s Healthiest & Unhealthiest Cities in America as well as accompanying videos. To identify the places where health is a priority, WalletHub compared more than 170 of the largest U.S. cities across 43 key metrics. The data set ranges from cost of medical visit to fruit and vegetable consumption to fitness clubs per capita. Memphis ranked 170th on the list. To view the full report visit: https:// wallethub.com/edu/healthiest-cities/31072/
Together includes expert information, stories and experiences from families of childhood cancer patients, and practical suggestions from specialists. The site also offers resources that address a range of cancer experiences, including long-term survivorship and bereavement. In the coming months, St. Jude will make the website available in multiple languages to bring this information to families worldwide. The English version of the site has attracted visitors from over 175 countries. The information on the Together website is generated from the latest research and best practices in pediatric oncology. Content, which includes articles, animations, illustrations and video features, has been developed and vetted by staff at St. Jude. Members of the St. Jude Patient Family Advisory Council, a group of parents or patients who are at least 18 years or older, also review the site and offer their perspective on how families of diagnosed children look for information.
Yaun Elected Vice President of Tennessee Chapter of the American Academy of Pediatrics Jason Yaun, MD, FAAP, associate professor in the Department of Pediatrics in the College of Medicine at the University of Tennessee Health Science Center and Le Bonheur Children’s Hospital, has been elected vice president of the Tennessee Chapter of Jason Yaun the American Academy of Pediatrics (TNAAP). He will serve a two-year term. The organization, which is based
in Nashville, is comprised of physicians and specializes in pediatric advocacy for the state of Tennessee. TNAAP members work with legislators and policy makers to ensure the physical, mental, and social welfare of children, their families, and the pediatricians who care for them. Dr. Yaun has been a member of the TNAAP since 2009. Before being elected vice president, he previously served as a West Tennessee Fellow AtLarge (2013-2017) and secretary/treasurer (2018-2019). He has also been the Legislative Committee co-chair since 2016. After his term as vice president, Dr. Yaun will serve a two-year term as president beginning in 2022. For more information on the TNAAP, visit www.tnaap. org.
AMA Supports Passage of Supplemental Appropriations Package to Combat COVID-19 Patrice A. Harris M.D., M.A., president of the American Medical Association said, “We are pleased that Congress quickly approved this critical bipartisan supplemental appropriations package in response to COVID-19. It is particularly important that it will lift Medicare restrictions on the use of telehealth during this public health emer-
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New St. Jude Website Informs Families Facing Childhood Cancer St. Jude Children’s Research Hospital, a leader in the way the world understands, treats and defeats childhood cancer, has launched Together, https:// together.StJude.org, an online resource for anyone affected by childhood cancer. Together offers information about diseases, diagnosis and treatment options, as well as supportive care resources and shared stories of hope, healing and experience. The Together website launched in fall 2018 and has won several awards, including the Cancer Patient Education Network’s Excellence in Cancer Patient Education award, the ClearMark Award from the Center for Plain Language, and an eHealthcare Leadership award. The site was recognized for making complex and difficult information on childhood cancer approachable and easy for patients and their families to understand. memphismedicalnews
gency – something that will limit further exposure and help stop the spread of the virus in the health care setting. Funding for vaccines, therapeutics, diagnostics and medical supplies is necessary to bolster the health care response to COVID-19. In addition, we were pleased to see funding for health departments as they are a critical partner in helping us understand the scope of the outbreak through surveillance and laboratory testing, as well as implementing mitigation strategies to prevent additional cases.” Since the beginning of the COVID-19 outbreak, the AMA has been providing physicians with the latest clinical guidance from the Centers for Disease Control and Prevention (CDC) to help them evaluate, test and care for patients under investigation for COVID-19, as well as guidance to help protect physicians and other health care clinicians from illness. The AMA will continue to keep physicians informed of the CDC’s resources and updates, including on the AMA’s COVID-19 online resource center, via social media, and through direct communications to physicians. Additionally, the AMA’s JAMA Network has a comprehensive overview of the coronavirus – including epidemiology, infection control and prevention recommendations – available for free on its JN Learning website.
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GrandRounds Ram Velamuri, MD, Named Associate Medical Director at Regional One Health’s Firefighters Burn Center MEMPHIS – Ram Velamuri, MD, has been named associate medical director of Regional One Health’s Firefighters Burn Center, where he’ll help lead a growing team using his clinical experience and passion for helping patients lead full, rewarding Ram Velamuri lives. Velamuri joins medical director and fellow plastic surgeon William Hickerson, MD, FACS in overseeing the only burn center in the region that is verified by the American Burn Association and American College of Plastic Surgeons. Velamuri joined the Firefighters Burn Center and University Clinical Health in 2016. He is board-certified in plastic surgery and serves as an assistant professor and program director for plastic surgery at University of Tennessee Health Science Center. Velamuri earned his medical degree and completed a general surgery residency in India, then moved to the United States to pursue training in plastic surgery. He completed residencies in general surgery and plastic and reconstructive surgery at Saint Louis University School of Medicine and a fellowship in burn and reconstructive plastic surgery at Johns Hopkins University. Currently, he helps lead a burn center team at Regional One Health that includes physicians, advanced practitioners, nurses, therapists, pharmacists and other medical professionals. Velamuri said he admires his colleagues for both their skill and compassion.
Unity Psychiatric Care Names Robert Edwards Administrator in Memphis MEMPHIS – Unity Psychiatric Care, a division of Franklin, Tennessee-based American Health Partners, has named Robert Edwards administrator of its Memphis, Tennessee location. Edwards oversees operations for the psychiatric hospital, which pro- Robert Edwards vides compassionate and stabilizing care for seniors dealing with an acute mental health crisis, as well as behavioral complications from dementia. Treatment services include a comprehensive health and psychiatric evaluation, medication assessment, nutrition evaluation, pain assessment, therapeutic activities and educational support. Edwards joins Unity Psychiatric Care from Lakeside Behavioral Health in Memphis, where he served as chief nursing officer for the 345-bed psychiatric facility. His responsibilities included clinical and financial oversight of the nursing practice, which offered residential treatment, partial hospitalization and electroconvulsive therapy/transcranial mag-
netic stimulation, among other inpatient stabilization services. With more than 30 years’ experience, Edwards has held many leadership roles in hospitals and healthcare facilities, including chief operating officer and chief nursing officer of Delta Medical Center in Memphis. Edwards earned his Bachelor of Nursing from the University of Memphis, a Master of Business Administration in Technology/Project Management, as well as a Master of Science in Nursing from the University of Phoenix. He also holds undergraduate degrees from Christian Brothers University and LeMoyne Owen College. In addition to his clinical and operational experience, he has expertise in electronic medical records applications and is trained as a Six Sigma Black Belt in process design. A life-long learner, he’s now working on a doctorate in nursing practice and expects to be get his certification in geriatric nursing later this year. To learn more about the Memphis location and services or to set up a tour, please visit unitypsych.com/memphis
Memphis Entrepreneur Secures Investment to Fund Fourth Health Care Venture MEMPHIS — Companies will soon have access to medications at cost for employees on their health plans, thanks to a new venture by Phil Baker, PharmD, a Memphis-based entrepreneur. Baker’s newest venture, HaloScrips, has secured a private investment of $480,000 from the Christian Capital Network, a voluntary network of Christian business owners, entrepreneurs and investors. Prescription drug spending represents health plans’ third-largest health care expense, behind only hospital care and physician services. And although the national average puts drug spending at about 10 percent of health care costs, the share is much higher – 20 to 25 percent – for working-age adults with low rates of hospitalization. While this leads many organizations to adjust coverage to incentivize less prescription use, that trend hurts patients most in need of regular medications. HaloScrips aims to change that. This investment will jumpstart the company by allowing it to expand its licensed mail-order pharmacy services nationwide through pharmacy automation. Baker’s experience also played a role in the investors’ decision. HaloScrips marks his fourth health care venture. Along with partner Ayile’ Arnett, Baker is also behind the nonprofit Good Shepherd Pharmacy; the blockchain company RemediChain, which runs a national oral chemotherapy reclamation program and heads a consortium of organizations working to track surplus medication; and GoodWheel, a blockchain app that pairs volunteer drivers with charities in need of deliveries and which started by delivering prescriptions for Good Shepherd Pharmacy. Baker and Arnett were named
one of Inside Memphis Business’ Innovators of the Year in 2019.
Dorothy Robinson and Shana Young Join HealthChoice Dorothy Robinson has joined HealthChoice as a certified medical assistant for the organization’s Population Health Services team, which works collaboratively with patients and their physicians to improve their health status. Prior to her new role, Robin- Dorothy Robinson son served as a certified medical assistant for Le Bonheur Healthcare, mobile phlebotomist for several insurance companies, and registered medical assistant for Moffit Cancer Center in Tampa. Robinson earned her bachelor’s degree from Everest University. In addition to being certified as a medical assistant, she also holds certifications as a registered medical assistant and clinical medical assistant. Shana Young has joined HealthChoice as a care manager for the organization’s Complex Care Management program, which provides customized support for patients faced with multiple chronic conditions, frequent hospitalizations, or limited ability to perShana Young form basic daily functions due to physical and psychosocial challenges. With 25 years of experience as a registered nurse, Young has served in a variety of roles including 10+ years as a medical surgical nurse, 10+ years as a care plan coordinator for skilled nursing facilities, and 5 years in home health. Prior to her new role, she served as a registered nurse at Methodist LeBonheur Hospital. Young earned her B.S.N. degree from Western Governor’s University and is licensed as a registered nurse.
Second Wind Dreams’ Virtual Dementia Tour® Gets Funding for Tennessee Nursing Homes The Tennessee Department of Health announced that Second Wind Dreams® (SWD®) has been approved by the Centers for Medicare and Medicaid Services (CMS) to use Civil Money Penalty (CMP) funding in 100 Tennessee skilled nursing homes. The two-year project will assist nursing home staff to improve care for dementia residents by providing hands-on, experiential training using the patented Virtual Dementia Tour® (VDT®). The VDT has been scientifically proven to build a greater understanding of dementia using sensory tools and instructions. A Second Wind Dreams Certified VDT Trainer will conduct the training at participating nursing homes and supervise the implementation of the VDT and related assessments that measure person-centered care outcomes.
P.K. Beville, the founder of Second Wind Dreams and creator of the Virtual Dementia Tour, is a psychologist specializing in geriatric care and a leading expert in dementia and aging issues. She believes that until we can experience what it might be like to have dementia, we are unable to provide person-centered care. The Virtual Dementia Tour enables caregivers to experience the physical and mental challenges those living with dementia face. This helps to provide practical ways to create an environment that supports the disease and increases understanding. More than three million people in 20 countries have experienced the VDT.
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A HOLISTIC APPROACH TO TREATING ADDICTION, DRIVEN BY CARING by Dr. David Stern
and individuals who choose to pay directly with their own funds.
Dr. David Stern is a senior member of Integrated Addiction Care (IAC) Associates (www.integratedaddictioncare.com), a physician practice dedicated to helping people with addictions to drugs and/or alcohol. He is also the founder of the Center for Addiction Science, a designated “Center of Excellence” by the Addiction Medicine Foundation.
The collaborative relationship of IAC with Baptist Memorial Health Care, resulting in the formation of the Center of Excellence in Addiction Medicine, has been a catalyst for providing addiction care for a wider group of patients. Our goal is for this service to spread to the 22 hospitals comprising the Baptist system throughout the Mid-South. IAC and Baptist have integrated their services so expert addiction care can be delivered virtually immediately in the emergency rooms, as well as inpatient and outpatient areas at Baptist’s Tennessee hospitals and Baptist Medical Group physician offices. The on-call service IAC provides at Baptist involves either in-person or telemedicine consultation and occurs in real time. We are working to provide continuity of care so patients in the emergency room who remain in the community after discharge have follow-up appointments at IAC the same or next day. Patients who are admitted to the hospital are followed by the hospitalist and an IAC addiction medicine specialist until discharge. Patients receive in-person consultations, as well as telemedicine appointments for their convenience.
Integrated Addiction Care (IAC) opened its doors just about one year ago and has had the privilege of serving more than 400 patients with substance or alcohol use disorder (SUD/ AUD). We thank those patients who have entrusted their care to us and look forward to continuing to serve them and others who contact us for assistance. We believe addictions are a chronic, relapsing brain disease and long-term care, as for other chronic disorders, is necessary for control and eventual cure. For treatment to be effective and allow patients to achieve durable recovery, it needs to be multi-dimensional, where treatment of the addiction is accompanied by therapy for physical and mental health issues, as well as intensive case management to address social determinants of health (transportation, employment, housing, family, financial and legal issues, etc.). Our holistic approach embraces patients in totality and supports them as they develop “capital” during treatment. This strategy provides a foundation for recovery where patients are on the path to realizing their objectives. Recovery is all about giving patients control over their lives again. IAC was founded by three physicians dedicated to helping people with a range of addictive behaviors with the goal of providing optimal, evidence-base care. Our care is delivered by an interprofessional team. When an individual seeks care for cancer, the care team often consists of a medical, surgical and radiation oncologist. Similarly, in addiction, there is a team approach to providing optimal care for patients. At IAC, the interprofessional team consists of fellowship-trained and boarded addiction medicine physicians who are also boarded in family medicine, a licensed therapist, nurse care manager and case manager-peer recovery support specialist. The team creates treatment plans in collaboration with the patient that have the goal of achieving the objectives that patients have for themselves. All members of the team are in the same place at the same time. It is a “one-stop” shop. This type of care coordination is called integrated care and is on the leading edge of addiction treatment. IAC cares for patients with a range of addictions (alcohol, opioids, benzodiazepines, crack/cocaine, methamphetamines, marijuana, other tranquilizers/sedatives, etc.) using medication-assisted treatment and intensive outpatient programs. We welcome patients with co-occurring mental and physical health problems, as well as pregnant women with addiction. Appointments are available the same or next day, and IAC accepts TennCare, Medicare, most commercial insurance
Baptist is the only health system in the region at the front lines in meeting the challenge of the opioid epidemic and overall addiction problem. The Center of Excellence in Addiction Medicine integrates addiction care into every level of the Baptist system to meet the needs of our patients. Baptist emergency rooms have instituted an “opioid light” program, which emphasizes non-opioid approaches to treating pain to minimize the risk of addiction in patients. The ACGME-accredited fellowship in addiction medicine at Baptist, staffed by IAC faculty, focuses on training future addiction medicine specialists for our region. The Center of Excellence in Addiction Medicine has a focus on helping vulnerable populations, especially women with substance-exposed pregnancies. These services are available to all patients at Baptist Memorial Hospital for Women, as well as women who come to IAC. This 24/7/365 on-call service for women with addiction issues supports stable pregnancies that minimize neonatal abstinence syndrome and maximize the health of mother and baby. As in all aspects of our practice, we meet patients where they are and understand that the treatment protocol and pathway to recovery is different for each person. IAC and the Center of Excellence in Addiction Medicine at Baptist are dedicated to helping every patient in our region with addiction. We offer advanced, evidence-based care that embraces mental and physical health, as well as the social needs of our patients. Our approach to holistic care is designed to be optimally supportive of our patients as they achieve durable recovery. Too often, patients with addictions say, “I don’t know where to go to get care.” Physicians have their own version of this approach, “Why should I screen for addictions if there are no programs in addiction in the region?” We can supply the answer to that question…send the patients to IAC and Baptist. We are ready!
Integrated Addiction Care Associates Monday-Friday 8 AM to 5 PM | Walk-ins welcome Monday-Friday 8-10 AM 6630 Summer Knoll Circle, Suite 101, Bartlett TN 38134 | For appointments, call 901-746-9438. Medical Office Building, 4th floor, 700 West Forest Avenue, Jackson TN 38301 | For appointments, call 731-234-8736.
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