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FOCUS TOPICS MEN’S HEALTH • HEALTHCARE DESIGN • AESTHETIC MEDICINE

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Healthcare Redesigned

PHYSICIAN SPOTLIGHT PAGE 5

ESa Architect, Designer Address Hottest Trends

Victor Wu,

COURTESY OF ESA/ © ATTIC FIRE PHOTOGRAPHY

By MELANIE KILGORE-HILL

MD, MPH

If the thought of hospitals and other healthcare spaces conjures up images of sterile white hallways and cheap vinyl furniture, think again. Today’s medical facilities are anything but boring, with evidence-based design bringing the outdoors in … and conveniences of the indoors out.

ON ROUNDS

Natural Beauty

“When it comes to healthcare interiors, we’re really seeing a lot of biophilic design, which is using materials that mimic elements found in nature,” said Alana Morris, IIDA, NICIDQ, EDAC, senior interior design manager for architectural firm ESa (Earl Swensson Associates). The Nashville firm is a national leader in healthcare construction and design, with in- and outpatient projects underway coast to coast. Green products are also on the top of today’s client lists, with moss-like carpet and living walls — panels of plants, grown vertically

USPSTF Issues Final Recommendation on PSA-Based Screening Last month, the U.S. Preventive Services Task Force published their final recommendation for screening men for prostate cancer. After reviewing the evidence, the task force issued a ‘C’ recommendation for men ages 55-69 with an emphasis on “informed, individual decision-making based on a man’s values and specific clinical circumstances.” ... 8

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McWhorter Society Luncheon Honors Healthcare Luminaries

Health Care Council Celebrates Latest Class of Fellows

Nominate a Nurse Nominations are open through June 30 for the March of Dimes 2018 Nurse of the Year Awards … 13

Dunn Recognized, Hall of Famers Announced

By CINDY SANDERS

PHOTOS COURTESY OF BELMONT UNIVERSITY

In late May, the Nashville Health Care Council celebrated the most recent group of healthcare executives to earn the designation of Council Fellow ... 9

This stunning medical office building in ONEC1TY makes use of biophilic design by bringing outdoor elements inside with the interplay of wood, stone and greenery.

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Gov. Winfield Dunn addresses attendees at the McWhorter Society Luncheon where he was honored for a lifetime of service.

During the 2018 McWhorter Society Luncheon held at Belmont University last month, The Honorable Winfield C. Dunn was presented with the Distinguished Service Award, and the seven inductees into the Tennessee Health Care Hall of Fame Class of 2018 were announced. McWhorter Society Chair Bill Gracey and Past Chair Harry Jacobson, MD, presented Gov. Dunn with the high honor for his lifetime of service and significant contributions to the health and healthcare-related academic programs at Belmont University, in addition to his work to improve the health of Tennesseans through his public service and advocacy. The nonagenarian, who earned his dental degree from the (CONTINUED ON PAGE 5)

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HEALTHCARE ENTERPRISE

Making Medical Devices Lighter, Stronger, Safer By LARRY MCCLAIN

If you open your cell phone, you won’t find screws holding things together. There are about a dozen tiny pieces of adhesive materials doing the job. It’s a manufacturing phenomenon known as “lightweighting” – making products ranging from automobiles to medical devices lighter, less expensive and more visually appealing. Adhesives are now widely used in medical products ranging from wheelchair cushions and surgical drapes to respirators and insulin pumps. The Medical Design & Manufacturing (MD&M) expos draw thousands of attendees each year. The next one is in New York City from June 12-14, and it brings together many industry experts in adhesives, coatings and sealants. In addition to familiar names like Medtronic, attendees will also include many newcomers to the medical product space like Google and Apple. Locally, Can-Do National Tape is a major supplier of adhesive solutions for the

medical field. The company, founded in 1972, gets large rolls of adhesive materials from manufacturers (like 3M, Bemis, Avery Dennison, Tesa and Berry), then slits and die-cuts the material to make a wide variety of products: bed coverings, curtains, sensors, gaskets for infusion pumps, and much more. The company is also laminating adhesive materials to be used in tiny boots that monitor newborn babies. Can-Do National Tape has about

70 employees in Nashville with a combined 200 years of adhesive tape experience. The company meets all the rigorous quality metrics required in the medical field, including ISO 9001:2008 certification. “Adhesives offer many advantages over screws and rivets for medical applications,” explained Rick Winkel, president of Can-Do. “They lower the cost of medical devices and make them easier to assemble. A typical medical device touch-screen is a lamination of film and adhesive. Our company works closely with design engineers at the medical device companies to achieve various objectives, like making a product waterproof or FDA-approved for direct skin contact.” Adhesives also make medical products stronger and safer. “Infusion pumps usually have electrically conducted tape or gasketing to keep them properly sealed,” said Winkel. Adhesive materials also enable manufacturers to securely adhere dissimilar materials that can’t be welded – such as lightweight aluminum and plastics.

Mazzetti+GBA Launches Tool for Healthcare Architects, Engineers By MELANIE KILGORE-HILL

A new app recently unveiled in Nashville is poised to be a game changer for healthcare architects and engineers. Mazzetti+GBA has developed an innovative healthcare technology and medical equipment planning web-based application that facilitates real-time, continuous project coordination between the design and project management team of a construction project, including owners, architects and engineers.

More Data in Real Time

M+Partner empowers project owners and design teams with 24/7 access to highly customizable, visual intel, optimized for any device. Unveiled at the American Society for Healthcare Engineering conference this spring, M+Partner provides a highly visual overview of a healthcare construction project, including medical equipment, as well as low voltage and active IT devices and systems all in a single database. Users have quick access to change reports by discipline, snapshots of the Revit model for each space, and can further examine item images, cut sheets, reports and space details. As the project advances or changes, the impact is immediately visible to the entire team. nashvillemedicalnews

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“M+Partner is a tool that allows everyone, from mechanical engineers and architects to plumbers and electricians, access to the exact cut sheet information they need,” said Jeff Looney, associate principal and technology division leader at Mazetti+GBA’s Brentwood office. “Whether someone’s installing an MRI or medical gas for Jeff Looney a piece of equipment, this assists them in outfitting.” Healthcare architects and engineers have traditionally been called on to piece details of each construction component together. Now, each individual has password-protected access to all information needed without a lengthy search. M+Partner is available to Mazzetti+GBA clients and their respective design and project management teams at no additional cost and is optimized for use on mobile, desktop or tablet devices. “We spent 18 months working with developers and getting feedback and wish lists from design firms so the healthcare community is very excited about this,” Looney said.

Tape converting companies like CanDo are known for their engineering precision. For example, the small piece of gauze in a wound care product doesn’t get there in some haphazard fashion. It’s carefully positioned in a procedure that tape converters call “island placement.” The size of the medical device market now exceeds $150 billion annually – and adhesives are a key part of that revenue. The Adhesive & Sealant Council hosted its “Tape Summit” last month in Minneapolis, which was heavily attended by medical device makers. Because medical device technology is changing so rapidly, the Medical Device Manufacturing Association – the industry’s advocacy group in Washington, D.C. – publishes nine magazines about the latest breakthroughs. Its publication Today’s Medical Developments features regular updates about how sealants and adhesives are revolutionizing device design. “We produce a lot of adhesive and non-adhesive products for multiple industries,” said Winkel. “But it’s especially gratifying to know that our solutions are helping make medical products safer, less expensive and easier to assemble.”

Keeping pace with an ever-changing industry

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NMGMA: 10 Minute Takeaway The Basic Principles in Medical Office Accounting The second Tuesday of each month, practice managers and healthcare industry service providers gather for the monthly Nashville Medical Group Management Association (NMGMA) meeting. As speaker for the May meeting, my presentation focused on the basic principles By LUCY CARTER and elements of medical office accounting.

You Can’t Manage What You Can’t Measure

The presentation centered on the importance of creating financial statements that are meaningful for the practice. Because financial statements tell a practice’s story, they serve a critical role in physician practice management. If designed appropriately, accounting programs can produce reports and subsidiary information that should eliminate the need to prepare separate schedules for management purposes like physician compensation. Strong accounting procedures can reduce the time a practice manager must spend generating additional reports

and increase accuracy of the information presented.

Presenting the Reports: Cash or Accrual?

Most physician practices prepare the financial statements on the cash basis of accounting where income is not recognized until it is received, and expenses are not deducted until they are paid. However, practices can also prepare financial statements on the accrual basis, recognizing income when it is earned (i.e., when the patient service is performed) and deducting expenses when they are incurred. The most significant estimate to determine when preparing financials on the accrual basis of accounting is the adjustment to accounts receivable for contractual adjustments (i.e., adjusting for third-party payer contractual adjustments) and bad debts. The revenue on accrualbased financials should reflect what the practice expects to collect for the services rendered after estimating the adjustments.

Deciphering the Reports

The balance sheet is a component of the financial statements that represents a snapshot of the practice’s assets, liabilities, and equity on a certain date (e.g., month end). It’s cleverly called a balance sheet, because assets = liabilities + equity.

Considered another way, equity represents the difference between the practice assets and practice liabilities (analogous to equity in a home). The income statement represents income less expenses over a period of time. (For example, an April 30 income statement for a calendar-year practice would reflect income and expenses for four months.) The income statement is a critical tool in practice management and can provide valuable information when compared to prior year results, budgeted amounts, and industry benchmarks. Areas of deviation can be identified and investigated through this analysis. The statement of cash flows assists the practice manager in answering the age-old question, “Why is income more than cash?” The statement identifies cash flow from operations (i.e., patient service collections less practice expenses) and other factors that increase or decrease cash but may not impact income (e.g., repayment of a practice debt principal).

If You Don’t Know Where You’re Going, How Do You Know if You’ve Arrived?

The budgeting process is an essential component for financial management in the medical practice as it helps the practice to translate its goals and objectives

into dollars. When compared to actual results, the budget can provide critical information alerting the practice to areas that need attention if financial goals are to be achieved. If the practice is adding providers, locations, or modalities, the budget is an essential tool because it helps estimates the financial impact of anticipated expansion.

Reconcile, Reconcile, Reconcile

Establishing checks and balances in the accounting process for the medical practice is one of the most important steps in protecting the practice from financial fraud. From an income perspective, deposits should reconcile with payments posted to the practice management system and should agree with income reported on the financial statements (cash basis). Setting up a system to approve vendor additions to the accounts payable system can alert the practice to fraudulent vendors. And proper documentation and approval should always be provided for all patient refunds. Like an apple a day, proper processes can help keep the potential fraudster at bay! Lucy Carter is a member (owner) of KraftCPAs PLLC member and practice leader of the firm’s healthcare industry team. For more information, go to kraftcpas.com

Healthcare Redesigned, continued from page 1 using hydroponics — popping up in medical centers nationwide. “Bringing nature into an environment creates a calming space for patients as well as caregivers, and we’re incorporating that Alan Morris across the design of our buildings,” Morris said. It’s a far cry from the generic, massproduced artwork that once lined hospital walls, but experts say it’s a valuable change rooted in evidence-based design. “Bringing these elements indoors has been shown to improve patient outcomes, similar to how we now know incorporating windows and natural light into patient rooms increases a person’s chance of getting better,” Morris said. Designers also are seeing increased demand for hospitality style decor, which incorporates higher end design elements not traditionally found in hospitals. Glass mosaic wall tiles and custom digital imagery printed on cleanable resin are top choices for many facilities. “It’s a way to have that ‘wow’ factor in your project and engage in your environment,” said Morris, noting the popularity of natural landscapes and largescale artwork in various mediums.

well, as administrators re-envision the role of the hospital. “A lot of clients are now looking at hospitals as wellness centers for the entire community instead of a place where sick people are cared for,” said architect Jill Romano, AIA, project manager for ESa’s healthcare division. “We’re designing around the idea of community interaction, from walking Jill Ramono trails to showers, terraces, outdoor dining spaces and courtyards designed to bring the outside in.” Similarly, Romano said micro hospitals are the new buzzword in hospital design. “We’re seeing a new, robust outpatient component and integration of physician offices on the same campus, as opposed to building a bigger hospital,” she said. “It enforces that focus on wellness and reflects the push toward fewer inpatient stays that hospitals are trying to achieve.” While the need for inpatient beds will never go away, consolidation of health systems nationwide has led to frequent centralization of shared services rather than operating all departments (such as laundry and central processing) on all campuses.

A Fresh Take on Hospitals

Doctor-Friendly Designs

Construction design is evolving as

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Today’s healthcare facilities also

reflect an increased focus on physicians, who now play an integral role in the planning process. “It’s typical to have quite a few meetings with the end users who will be working in the space, and those conversations continue throughout construction,” Romano said. “There’s a big push for hospital owners to get staff buy-in early on.” She continued, “Employers want to create a nice workplace experience, from trails for those who want to bike to work to staff oasis rooms where a physician can focus and regroup before extremely tough cases. There’s a new focus on recognizing that this is a high-stress job and providing areas of respite for clinicians.”

Sustainability as a Standard

There’s no question expectations are shifting in healthcare design, and environmental impact is no exception. Once considered a sign of going ‘above and beyond,’ Leadership in Energy and Environmental Design (LEED) certification is now becoming a national standard in healthcare construction. The rating system devised by the United States Green Building Council evaluates the environmental performance of a building and encourages market transformation towards sustainable design. “As building codes evolve, some things that used to be exceptional are becoming the norm,” Romano said. “Hospital owners now recognize that they can be sustain-

able without the fees associated with LEED certification.”

Easy Fixes, Big Results

While not every employer can afford a complete design overhaul, experts say there are small steps organizations can take to create a healthier, more sustainable environment. Switching to LED fixtures can produce tremendous savings for a 24/7 medical center, while safer, low-VOC materials are now equally as effective as their higher risk counterparts. Clients also are paying attention to the “red list” of chemicals they want to avoid, including those applied to the tops of surfaces – hence the riddance of vinyl and PVC in countless waiting rooms.

A New View

Another remarkable shift in design planning is the role of virtual reality. Once used to produce a single design image, virtual reality is now instrumental in developing entire facilities users can explore room by room, with some clients even trading traditional building models for virtual reality goggles. While possibilities in healthcare design are endless, Romano said it could be challenging for clients to keep an open mind. “For architectural planning, there are so many times when people are stuck in the mindset of what they’ve always done,” she said. “It’s all about challenging them to find the best solution for their workflow.” nashvillemedicalnews

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Insights from Inside the Beltway A Conversation with Leslie Norwalk & Lynn Shapiro Snyder By CINDY SANDERS

Former CMS Acting Administrator Leslie Norwalk, who now serves as strategic counsel for Epstein Becker Green, and colleague Lynn Shapiro Snyder, a member of the EBG Board of Directors and a senior leader on the firm’s Health Care & Life Sciences practice, recently made the trip from D.C. to Nashville to celebrate the local Leslie Norwalk office’s first anniversary. While in town, the duo took time to speak with Nashville Medical News and offer their perspectives on federal issues impacting the healthcare industry.

Personnel is Policy

Norwalk, who served as deputy administrator with the Centers for Medicare & Medicaid Services for four years prior to being named acting administrator during the George W. Bush administration, said she learned a valuable lesson years earlier during the first Bush administration. Lynn Shapiro Snyder “Something I learned when I worked for George H.W. Bush in the late 80’s is personnel is policy,” noted Norwalk. “The appointment of Alex Azar as secretary of the Department of Health and Human Services is a prime example of that,” she continued. Norwalk added Azar’s prior work with HHS as general counsel and later as deputy secretary allowed him to hit the ground running. “I think it’s critical at this juncture in healthcare to have someone with that experience,” she stated. “It’s a huge benefit to the department to have a known quantity there.” While Azar’s predecessor Tom Price, MD, significantly reduced the focus on bundled payments, Norwalk said the new HHS administration has its own agenda priorities. Early in his tenure, Azar outlined four priorities: moving away from fee-for-service to a value-based payment structure, lowering prescription drug prices, addressing the opioid crisis, and increasing access to affordable healthcare. “There’s no question that Alex’s focus is on value-based payment. This is an example of the difference it makes of who is in the office,” Norwalk pointed out. In addition to his experience and expertise, Snyder pointed out another attraction of Azar was that he wasn’t a member of Congress. His appointment, she noted, didn’t trigger a special election in a Senate and House of Representatives with fairly tight majority margins. nashvillemedicalnews

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Legislation & Legal Interpretation

While there is clearly a national paradigm shift in moving from volume to value, Norwalk said providers continue to have a foot in both sides of the equation during this ongoing transition period. “There are a lot of things in government that impede that switch,” she noted. Because the Medicare program is designed by Congress in statute, she continued, “Those impediments are often best resolved by lawyers.” Norwalk pointed out specific laws and regulations that made sense in a fee-forservice system could hamper the move to value-based systems that call for coordination along the continuum. “There were good reasons when they passed,” she said of a number of laws including Stark, fraud and abuse, and privacy mandates, “but they need to be modernized to ensure we aren’t leaving legitimate opportunities on the table.” Interoperability in health technology is one of those areas where she said it’s important to make sure the regulations allow for information sharing, which is central to a value-based system. Norwalk added health information sharing between payers to providers could help accelerate the transition since the two groups “have seen all the claims data and EHR data meta-analytics to see what is working and what is not.” It’s also critical the information be able to flow between traditional provider silos to improve quality. It’s a discussion that was underway when she was with CMS. “Ten years later, I think we’re at a point where the ball is starting to roll downhill … the momentum is growing,” Norwalk said. “We have a long, long way to go with interoperability, but I think we’re slowly catching up with other (industry) sectors.” Of greater concern than the privacy piece, she continued, is security. “No one’s IT is secure … period,” she stated, adding it isn’t just information that can be hacked but machinery and medical devices. While technology is a core part of improving outcomes, Norwalk cautioned it also opens up new concerns. “How do you make sure it’s not a mechanism for mischief?” she questioned, noting this is an area that will undoubtedly attract growing regulatory attention.

Other Challenges

Having information and acting upon it are quite different, said Snyder. She pointed to the solid evidence around a number of preferred health behaviors that often goes ignored. “We see the challenge with adoption … some of it is generational, but some of it is also motivational,” Snyder said, adding she thinks there will be increasing attention on behavioral economics. “If we can motivate people, that affects social determinants.” Norwalk said another area that pres-

ents an ongoing challenge is paying for new treatments. “While we have all sorts of wonderful new therapies, the price tag has been exorbitant,” she said. CAR T-cell therapy, for example, has shown great promise but comes with an equally great financial burden. Norwalk said the appointment of FDA Commissioner Scott Gottlieb, MD, brings someone to the post with deep experience and a unique perspective that could help drive thoughtful policy. Not only does Gottlieb have prior experience with the FDA and CMS, but he is also a physician and cancer survivor. “He wants to increase competition by approving generics and biosimilars as quickly as pos-

sible,” Norwalk said. “On the other hand, he understands the incredible cost to bring new molecules to marketplace.” For every new solution suggested, every new regulation put forth, the healthcare industry will undoubtedly look to attorneys who specialize in the intricacies of the field for insights and legal interpretation. Being near the decision-makers and influencers was a driving factor in EBG establishing a presence in Nashville last year. “I call it the Triple Crown of healthcare law,” said Snyder. “We have 14 offices nationwide, but having an office in Nashville, Washington, D.C. and on Security Boulevard in Baltimore is the Triple Crown,” she concluded.

McWhorter Society Luncheon Honors Luminaries, continued from page 1 University of Tennessee College of Dentistry in 1955, also spent several years working as an executive with Hospital Corporation of America and later with Memphis-based MedShares. He and his wife, Betty, have been previously honored for their hands-on work with the Nashville Heart Association, and the Dunns have also worked tirelessly for the Nashville chapter of the American Cancer Society. Dunn has served on a number of healthcare boards including Phycor, Total eMed, and Behavioral Healthcare Corporation. He is the sixth individual to receive the McWhorter Society Distinguished Service Award. The event was also highlighted by the announcement of the 2018 Inductee Class for the Tennessee Health Care Hall of Fame, which was established in 2015 to recognize healthcare luminaries with ties to the state. Craig Becker, president and CEO of the Tennessee Hospital Association and a member of the Hall of Fame selection committee, announced the newest honorees: Monroe Carell, Jr.: The former CEO of Nashville-based Central Parking Corporation and prominent philanthropist led efforts to fund the Monroe Carell, Jr. Children’s Hospital at Vanderbilt. Carol Etherington, MSN, RN, FAAN: The chair of the Metro Nashville Board of Health is well known for her work advocating on behalf of those in need including initiating the Victim Intervention for the Davidson County Police Department, establishing coalitions that led to the founding of the Nashville Prevention Partnership, volunteering medical services across the globe and serving as associate professor emerita of Nursing at Vanderbilt Institute for Global Health. John Henry Hale, MD, & Millie Hale, RN: The brave and innovative practitioners paved the way for healthcare justice and equality by opening their home to become the Millie

E. Hale Hospital when African Americans couldn’t be treated at ‘white’ institutions. The dynamic duo also created a holistic community center. In addition, Dr. Hale was professor of Clinical Medicine and Surgery at Meharry, and Millie Hale created a training center for nurses across the South. Lynn Massingale, MD: The founder and chairman of TeamHealth, one of the largest integrated care providers in the country, is widely hailed as a major influencer on emergency medicine nationwide. He has been previously recognized as a ‘Hero of Emergency Medicine’ by the American College of Emergency Physicians and as one of the Modern Healthcare’s “Top 100 Most Influential People in Healthcare.” William Schaffner, MD: The professor of Preventive Medicine in the Department of Health Policy and professor of Medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine is one of the nation’s pioneers of rigorous infection control in hospitals. His Nashville standard became the standard of excellence nationwide. He is widely seen as a national leader on adult immunizations and is the longest serving member of the CDC’s Advisory Committee on Immunization Practices. Matthew Walker, Sr., MD, FACS: Founder of the Matthew Walker Comprehensive Health Center, which is celebrating its golden anniversary in 2018, Walker was one of the first African Americans voted into the Nashville Academy of Medicine and became the first African American Fellow of the American College of Surgeons. Serving as a professor at Meharry for four decades, he was credited with training half of the African American physicians in the United States at the time of his death. The induction ceremony for this latest class of luminaries is set for Oct. 16 at Belmont University. JUNE 2018

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PHYSICIAN SPOTLIGHT

TennCare CMO Victor Wu Coming Home to Care for the Most Vulnerable By MELANIE KILGORE-HILL

Sometimes, you can come home again. Such was the case for TennCare’s Chief Medical Officer Victor Wu, MD, MPH, an East Tennessee native who returned to his home state to oversee care for Tennessee’s 1.4 million Medicaid recipients.

To Nashville & Back

After receiving a bachelor’s degree in biomedical engineering from Vanderbilt University, Wu headed to Atlanta where he received a joint medical degree from Emory University School of Medicine and a Master’s of Public Health in health management and policy at Emory’s Rollins School of Public Health. He completed his internal medicine residency at Emory University and served as chief medical resident at Grady Memorial Hospital, Atlanta’s

publicly funded safety net hospital. “Growing up in rural East Tennessee and then training in urban Atlanta, I saw a wide spectrum of underinsured care, which gave me a perspective on the experiences of folks across different portions of society,” said Wu. “I was exposed to how social determinants of health, such as a lack of education, unemployment, and low literacy, can have an outsized impact on a person’s physical and mental health.” After practicing in Atlanta, Wu spent a year as a White House Fellow for the U.S. Department of Health and Human Services and practiced clinically in Washington, D.C., as an assistant professor of medicine at the Veteran’s Affairs Medical Center. After leaving the White House, he transitioned to work at Evolent Health as vice president of clinical transformation

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and of Medicaid strategies, leading large health systems in transforming care delivery to a population health approach. “Working in D.C. was an eye-opening experience. I quickly learned there’s such a need for physicians to be engaged in health policy conversations, within their own institution and at the community, state and federal level,” Wu said. “Physicians have to be at the table and part of the solution to translate clinical medicine into meaningful policy that can be implemented with both the patient and provider perspectives.” In 2016 he returned to Tennessee to work in public service. “I looked at my own upbringing and wondered how different my life and health would have been without having parents who stressed the value of an education and a community who helped support my professional development,” said Wu, noting that a quarter of Tennesseans receive Medicaid. “It’s inspiring to me to come back to my home state and work with a program aimed at improving the health of some of our most medically fragile citizens.”

Men’s Health Initiatives

In an ongoing quest to improve men’s health, Wu said the state has seen steady progress through preventative measures including smoking cessation programs. The department is also working alongside Gov. Bill Haslam’s office to help curb opioid addiction, which affects a disproportionately high number of men statewide. Three Tennesseans a day die from opioidrelated overdose, and the state ranks in the top 15 for overdose-related deaths. The state’s multi-faceted Tennessee Together plan is comprised of legislation and executive actions and is backed by $30 million (state and federal funds) through Gov. Haslam’s proposed 2018-19 budget to attack the opioid epidemic through prevention, treatment and law enforcement. “At TennCare, we’re looking to strengthen both prevention and treatment. We want to reduce the level of opioid overexposure for first-time users,” said Wu, noting evidence demonstrating significant negative downstream health impact for those initially exposed to high doses and long-courses of opioids. “Additionally, we recognize the need to reduce the stigma around individuals seeking treatment and broaden access to high-quality addiction and recovery treatment services.”

Primary Care Transformation

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Wu also is committed to the state’s Primary Care Transformation initiative, which includes a three-part strategy aimed at transforming the delivery of healthcare in Tennessee. “Primary care is the backbone of a healthy healthcare system, and we have to make sure we’ve equipped our primary care providers with the right resources and

team members to get patients engaged in their care as early as possible,” Wu said. “One goal we have is to recognize that patient and provider experiences are equally important. If the patient feels engaged and has a healthcare home, he or she will feel more empowered and connected. Similarly, a provider must feel prepared and supported with the right resources to meet the growing demands we place on our primary care teams.”

PCMH

Nationwide, patient-centered medical homes are recognized as a model of care that puts patients at the forefront. Designed to build better relationships between patients and their clinical care teams, patient-centered medical homes have been shown to improve quality, patient experience and staff satisfaction, all while reducing healthcare costs. “Successful primary care requires so many linkages to the community. I’m eager to support innovative links allowing providers to broaden their reach and support members in their homes, schools, places of worship and communities,” said Wu, stressing the importance of engaging patients outside the walls of a doctor’s office. TennCare is working with the Tennessee Hospital Association to increase communication through cloud-based care coordination tools, which allow for more data insight than ever before. “It’s necessary to have a strong medical home, but how do we support a patient once the patient comes home?” Wu asked. “Being able to connect to different resources and extend care outside of the standard doctor’s visit is ultimately what makes patientcentered medical homes come to life.” Wu also is focused on mental health transformation through Tennessee Health Link, which connects more than 70,000 members to behavioral health resources statewide. The response has been overwhelmingly positive and has resulted in improved data and resources to better connect practices to patients in their neighborhoods and communities, as well as foster more partnerships. “Today we ask more and more of primary care providers who have less and less time with a patient, so we want to give actionable data and help build capabilities and reach of broader interdisciplinary care teams,” Wu said, noting that 68 primary care groups in Tennessee already participate in PCMH models. “By engaging patients and providers to transform the connection between primary care and the community, we’ll improve the patient and provider experience, and maximize the value of every dollar we spend by generating better health outcomes. I’m really excited about 2018 and plans we have to continue supporting primary care and primary mental health transformation.” NASHVILLEMEDICALNEWS

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Making the Grade

Men’s Health Report Card Reflects Highs & Lows By MELANIE KILGORE-HILL

Eight years after the launch of the state’s first Men’s Health Report Card, males in Tennessee are making notable strides in key markers including cardiac health. Released bi-annually, the Tennessee Men’s Health Report Card monitors the health and well being of men in Tennessee and provides strategies to improve the health of men in the state. Sponsored by Vanderbilt University, Meharry Medical College, the Tennessee Men’s Health Network and the Tennessee Department of Health, the project represents months of teamwork to present data from the Tennessee Department of Health and the U.S. Census Bureau. First released in 2010, this fourth edition of the Men’s Health Report Card continues to distinguish Tennessee as the only state in the U.S. that has regularly published a report card to guide the planning, implementation and evaluation of programs and policies to improve men’s health. The team also produced a six-minute video for their website that provides diverse perspectives on the state of men’s health and examples of statewide initiatives aimed at improvement.

Healthier Hearts

“The general patterns were what we expected, but it was really good to see heart disease mortality rates finally improving,” said report chair Derek M. Griffith, PhD, director of the Center for Research on Men’s Health and professor of Medicine, Health, & Society at Vanderbilt University. “We’re excited to see a lot of the initiatives within Dr. Derek Griffith the state seeming to bear some fruit.” Griffith also attributes success to secondary factors including economic improvements, improved high school graduation rates, and better access to community colleges and post-secondary education. “While it’s difficult to make a direct link, these things do have an affect on health when you consider the financial and job stressors related to opportunities,” he said. “As a state, we’re doing pretty well, and that’s contributing to why we’re seeing improvements.” Overall and for black and white men, heart disease, cancer (overall and colorectal, lung and prostate), stroke, motor vehicle accidents, and AIDS mortality rates

improved between 2005 and 2015 but did not meet or exceed the national Healthy People 2020 goal. However, death rates from heart attacks in Tennessee improved and were lower (better) than the national Healthy People 2020 goal. Griffith credits improvements to advances in distribution of access to care. “Initiatives have been undertaken by the state health department and related partners to increase awareness around men’s health initiatives including signs and symptoms, prevention and education around healthier lifestyles,” Griffith said. “We’re teaching men to pay attention to things like hypertension, diet, sleep patterns and stress, all of which can affect heart disease.” While heart disease and cancer remain leading causes of death among Tennessee men, overall improvements were seen in both groups. Deaths attributed to suicide, homicide and chronic liver disease remained consistent, while those linked to unintentional injuries (not including motor vehicle accidents) and accidental poisoning from drug overdose and other biological substances were worse.

Mental Health

The report also saw a slight improvement in mental health, although numbers

still prove concerning overall. Statewide, men claim to experience bad mental health an average of 12.2 days out of 30, down from 14-plus days in earlier studies. Griffith encouraged clinicians to be more proactive in identifying signs of depression in men, whose symptoms often differ from women’s. “If you’re expecting a man to say, ‘Yes, I’m sad and depressed,’ it’s not going to happen,” said Griffith. “Talk to those close to them and find out if they’re more on edge, grumpy or quick to outbursts, as those can be important signs of depression we don’t tend to focus on as much.”

Focus on Prevention

Deputy Medical Director Michelle Fiscus, MD, FAAP, of the Tennessee Department of Health Division of Family Health and Wellness, said the state has seen positive results from programs designed to help patients manage diabetes and other chronic diseases, with a focus on prevention. “Our hope is Dr. Michelle Fiscus to engage everyone, including men, in being more proactive (CONTINUED ON PAGE 8)

Vanderbilt Plays Major Role in Nationwide “All of Us” Research Program Last month, Vanderbilt University Medical Center participated in the national launch of the National Institutes of Health’s All of Us Research Program, a momentous effort to advance individualized prevention, treatment and care for people of all backgrounds. In July 2016, VUMC was selected to lead the program’s Data and Research Center with Joshua Denny, MD, MS, professor of Biomedical Informatics and Medicine and VUMC’s vice president for Personalized Medicine, serving as the Center’s director. Participants within the All of Us Research Program will consist of volunteers who, by sharing their health data, will help accelerate discoveries in understanding, treating and preventing a host of diseases. Enrollment centers active across the U.S. are responsible for collecting participant data. While enrollment centers expand, participants can easily enroll online, using a smartphone or computer. The Data and Research Center is responsible for storing, organizing and providing secure access to the program’s data set in a format useful to researchers around the world. Secunashvillemedicalnews

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rity, privacy and accelerating innovative research are its driving tenets. The goal of All of Us is to support research to better understand genetic, demographic, environmental and lifestyle factors that affect wellness. All of Us research ultimately may lead to more effective treatments with fewer side effects, improved prevention strategies and better overall health – for everyone. “No more one-size-fits-all, but optimized for each particular person—that’s a

concept we now call precision medicine,” said Francis Collins, MD, PhD, director of the National Institutes of Health (NIH), which supports and officially launched the public enrollment phase of the program on May 6. Researchers from academic medical centers as well as the pharmaceutical, computer science and biotech industries will be able to request access to data collected through All of Us to answer scientific questions. Independent citizen-

scientists are also welcome. “We want to leverage modern data science techniques so leading computer scientists can leverage machine learning and natural language processing, the things that are in vogue in computer science, and apply those to health and make health better,” explained Denny. Volunteers are essential to the program’s success. “We’re seeking adults of all ages, races, ethnicities, sexual orientations, socioeconomic and health statuses to join us in this unprecedented effort,” said All of Us Chief Engagement Officer Dara Richardson-Heron, MD. Participants ages 18 and older can sign up at the All of Us website – joinallofus.org – and will be asked to complete a series of online health surveys. They will also be asked to authorize access to their EHRs. Some will be asked to go to a collection site, such as a healthcare provider organization or clinic, to provide physical measurements and blood and urine samples. Going forward, some participants might also be invited to share device information that tracks their activity level throughout the day or measures their blood pressure at home. JUNE 2018

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USPSTF Issues Final Recommendation on PSA-Based Screening By CINDY SANDERS

Last month, the U.S. Preventive Services Task Force published their final recommendation for screening men for prostate cancer. After reviewing the evidence, the task force issued a ‘C’ recommendation for men ages 55-69 with an emphasis on “informed, individual decision-making based on a man’s values and specific clinical circumstances.” For men aged 70 and older, the task force issued a ‘D’ recommendation, noting such screening would not routinely be advised as potential benefits do not outweigh harms. The recommendation applies to all adult men who have no signs or symptoms of prostate cancer and who have not previously been diagnosed with the disease – including men at increased risk for the cancer. However, the recommendation statement incorporates specific sections to address higher risk populations with additional information for these men and their clinicians to consider during the decisionmaking process. While the final recommendation letter grades didn’t change from the draft report issued last year, USPSTF Vice Chair Alex Krist, MD, MPH, said some of the wording was refined after reviewing the feedback submitted from various Dr. Alex Krist stakeholders during the public comment period. “It’s a little bit more clear that we’re trying to cue patients and clinicians in the factors that might lead a man to be screened or not be screened,” he said, adding there is an increased focus on this being an individual decision. “Prostate cancer is one of the most common cancers to affect men, and the decision whether to be screened is complex,” Krist noted. “Men should discuss the benefits and harms of screening with their doctor so they can make the best choice for themselves based on their values and individual circumstances.” While the routine use of prostatespecific antigen (PSA) screening elicits strong opinions both for and against, Krist pointed out the evidence-based USPSTF recommendation aligns with a number of other organizations, including the American Urological Association (AUA). While specific screening recommendations from the AUA, American Cancer Society, National Comprehensive Cancer Network, and USPSTF are somewhat varied in the details, all stress a shared decision-

making component between patient and clinician. Krist – who is a professor of Family Medicine and Population Health at Virginia Commonwealth University, an active clinician, and director of community-engaged research at the Center for Clinical and Translational Research – said it is important for a physician and patient to talk about the clinical implications of screening in the context of that patient’s particular circumstances. “For some men, it may not even need a discussion,” he noted of patients facing competing health concerns that would significantly reduce or eliminate the need to worry about prostate cancer, which is typically slow growing. For others, who are at higher risk for the disease and expected to live more than 10 years, the decision should be weighed in terms of benefits versus harms. There are three major concerns tied to PSA screening, said Krist. The first is the number of false positives as a result of testing. Krist noted, “240 men out of 1,000 will have a high PSA … and approximately 140 of those are false positives.” There are a number of reasons why a man’s PSA level might be elevated from cancer to an enlarged prostate or inflammation of the prostate. Krist said many of those with elevated PSA levels will go on to have a biopsy for a definitive diagnosis. In addition to stress, there are other potential side effects with biopsy including pain, bleeding and infection. The second concern, he continued, is overdiagnosis. “Of those screened, 100 out of 1,000 men will be diagnosed at some point in their lifetime (with prostate cancer), but 20 to 50 percent of them will be overdiagnosed,” Krist said. “That’s a

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really hard concept for people to grasp because there is fear with cancer, but it won’t cause any signs or even symptoms ever in their lifetime,” he explained of those in the overdiagnosed group who have prostate cancer that never grows, spreads or harms them. The third issue is that the majority of men, once they’ve received a prostate cancer diagnosis, will go on to have surgery or radiation treatment. Data cited by the USPSTF shows 80 of the 100 diagnosed undergo one of the two treatments initially or after a period of active surveillance. Yet, Krist said, there are harms that could result from either treatment option. Estimates based on observed benefits in the ERSPC trial for men 55 to 69 years of age and on harms derived from pooled absolute rates from three treatment trials

found 50 of the 80 who choose surgery or radiation treatment will experience erectile dysfunction and 15 will have urinary incontinence. Further, the USPSTF estimates three men will avoid cancer spreading to other organs, 1.3 will avoid death from prostate cancer, and five will die from the cancer even after surgery or treatment. Krist said the Task Force didn’t make any recommendation for men younger than 55 due to a lack of clinical data. “I certainly think we need more research on men under 55 at higher risk – AfricanAmerican men and those with a family history,” he said. Krist added this call for additional research was part of the group’s report to Congress. On the other end of the age spectrum, he said there were quite a few comments about extending screening. “In the draft, many folks criticized us and said men are living longer so we should be screening longer,” Krist noted. However, he continued, “There is good data that there are more false positives, more overdiagnosed prostate cancers, and more harms for biopsies and treatments. We had good confidence that over (age) 70, men are more likely to be harmed than would benefit from screening.” Krist pointed out these recommendations pertain to routine screenings across the broad population and reiterated individual circumstances at any age could influence screening decisions. At the heart of the recommendations, Krist concluded, “We want men and their doctors to talk about the benefits and the harms. We want men to make informed decisions about what’s right for them.”

Making the Grade, continued from page 7 about their health,” said Fiscus. “We want to make access to those programs more readily available to prevent or slow the development of chronic disease and improve outcomes.” State initiatives include Tennessee’s Tobacco QuitLine, which provides support to Tennesseans who want to kick the habit. The free service has historically reported quit rates that outpace the national average. According to the report, Tennessee saw a five percent reduction in smokers, although smokeless tobacco users increased nearly two percent. Fiscus said the report also addressed the tendency of men to wait until a problem is intolerable to seek medical attention – an ongoing struggle for physicians nationwide. “This study confirmed a lot of what we intuitively know, as far as men not actively seeking out healthcare,” she said. “That’s a difficult thing to try to change because it’s the culture that’s developed over time.” Fiscus said that men - particularly those in a disparate population - are more

likely to seek out preventative care when family members and physicians engage in intentional conversations. “Doctors might need to say, ‘If you’re not going to do it for yourself, do it for your family,’” Fiscus said. She encouraged clinicians to make an intentional effort to engage men in conversation and to speak to family members when necessary. “For some men, having someone to give them a nudge and take that initiative on their behalf may be very helpful,” she said. “We have to get the message out that men’s health is important and not let men ignore screenings because they may be afraid of discomfort or results. We know the best choice is early detection and prevention, and that can add a significant amount of time to their lives.” International Men’s health Week 2018 is June 11-17. For a list of global activities, visit Global Action on Men’s Health at gamh.org.

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PHOTOS BY STEVE LOWRY AND NICK COURY

Health Care Council Celebrates Latest Class of Fellows In late May, the Nashville Health Care Council celebrated the most recent group of healthcare executives to earn the designation of Council Fellow. The 31 executives completing the challenging curriculum explored strategies and collaborated on solutions to address some of today’s most complex and pressing healthcare issues during eight day-long sessions that kicked off with a retreat in late January and culminated with a May commencement ceremony. Co-directed by former U.S. Senate Majority Leader Bill Frist, MD, and Larry Van Horn, professor of Healthcare Management and Economics at Vanderbilt’s Owen Graduate School of Management, Council Fellows provides an exclusive opportunity for top healthcare leaders to engage in dialogue, share unique perspectives and enhance the skills needed to carry the industry forward. “In the program’s sixth year, we continue to see how convening the brightest healthcare minds under one roof can drive meaningful change in our industry,” Frist said. “With the passion these Fellows have for innovation combined with the collaborative dialogue and ideas explored, I am confident this diverse group of individuals will shape the future of healthcare across the country.” The 2018 Fellows class focused on advancing healthcare entrepreneurship and innovation. Topics included the opioid epidemic, disruptive technologies, innovative care delivery models, the role of nutrition in maintaining health and preventing disease, social determinants of health, shifting reimbursement models, state and federal policy reform and more. Jonathan Bush, CEO of athenahealth; George Barrett, executive chairman of Cardinal Health; Sen. Bob Corker; and Donato Tramuto, CEO of Tivity Health were among the guest faculty to address the 2018 Fellows Class. Todd Park – co-founder and executive chairman of Devoted Health, previous co-founder of athenahealth and Castlight Health, and former U.S. chief technology officer – gave the keynote address at the 2018 Fellows graduation ceremony. Park nashvillemedicalnews

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provided some firsthand lessons from his 25-year career in healthcare and expressed expectations for this class. “I really believe this class of Fellows is a national resource and that you’re each national treasures,” he told the class inside Nashville’s Noah Liff Opera Center. “Fellows brings together a group of people who are both incredibly accomplished, yet still on the upswing of their careers. The notion of getting them all together and exposing them to these experiences and lessons, to discuss the key issues in healthcare so that they’re that much better equipped to be change agents, is incredibly exciting. And it’s fantastic and fitting that Nashville is the host of this kind of program.”

2018 Fellows Graduates

Gene Boerger: COO, Preverity, Inc. Devin Carty: CEO, Martin Ventures Ravi S. Chari, MD: President, West Florida Division, HCA James Corbett: Principal, Initium Health Jonathan Dhillon: Enterprise Securities and Corporate Governance Counsel, Envision Healthcare Corporation Mary S. Flipse: Chief Legal and Administrative Officer, Tivity Health, Inc. Chuck Girard: Director, Government Relations, HCA Chris Harber: Vice President, Health Plan Operations, Availity Jim Jamieson: COO, EvidenceCare Bryan Kaegi: Senior Vice

President, Government Relations, Acadia Healthcare Kevin Klauer, DO: CMO– Emergency Medicine and Chief Risk Officer, TeamHealth Shaheed Koury, MD: Senior Vice President and Chief Medical Officer, Quorum Health Corporation Ryan M. Kreinbring: Vice President and General Manager, Cerner Corporation Dusty Lieb: Partner, Echo Health Ventures Veronica T. Mallett, MD: Senior Vice President of Health Affairs and Dean School of Medicine, Meharry Medical College (CONTINUED ON PAGE 12)

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Financing the Deal PHOTO BY DONN JONES

On May 22, more than 300 tering technology innovation. “It healthcare executives gathered to would be a shame for Nashville to hear from top financial executives not be a hub of healthcare IT given Matt Carroll, general partner of the depth of knowledge where WestView Capital Partners; Anna it really matters — the provider Haghgooie, healthcare managing space,” he said. “Nashville needs director of Sandbox Industries; to recruit and build tech talent and and Paul Wallace, managing rally around its deep provider legdirector of the Heritage Group, as acy. If it can do this, Nashville can part of the Nashville Health Care be a real leader on the technology Council’s signature “Financing side of the industry.” the Deal” panel discussion. The city’s collegial attitude Tom Wylly, senior partner toward helping the next generaof Brentwood Capital Advisors, (L-R) Moderator Tom Wylly discusses the deal landscape with healthcare investment experts Paul Wallace, Anna Haghgooie, and Matt Carroll. tion of innovators is well known moderated the panel as industry and attractive to those with capifinancial experts gave insider perspectives tal. “There is such a great mentorship public attention to healthcare costs. This to have a different relationship with each on the state of the market, healthcare community here in Nashville helping transformation has created a desire for a other,” said Haghgooie. “There is often a transactions and the outlook for funding young entrepreneurs create companies,” consumer-friendly marketplace and addidesire from the C-suite, but the barrier is Nashville’s $84 billion healthcare industry said Haghgooie. “Here, entrepreneurs are tional opportunity for innovation. in the existing infrastructure.” growth. able to surround themselves with people “I would advise early stage entrepreRegardless of the complexities of Despite overall deal activity being who’ve been there and done that, which neurs to prioritize finding a customer over today’s industry, panelists said the chaldown in 2018, the panelists pointed out shows a lot of credibility to investors.” capital,” said Wallace, a Nashville native. lenges actually encourage increased innocompetition within the market has driven “As was expressed during today’s event, “Once you find the customer, capital will vation and entrepreneurship. “Because increasing multiples in sectors including Nashville has an incredible opportunity to find you.” payment and reimbursement rules and healthcare technology, behavioral health, come together to address issues facing the There was a consensus by all panelmethods are ever-changing, it presents clinical supply, post-acute care, Medicare healthcare industry, particularly when it ists that collaboration is imperative when it continual challenges for providers,” said Advantage and companies helping procomes to healthcare IT,” concluded Councomes to financing the deal. “You’ve got to Carroll, who has nearly 15 years of expeviders shift from volume to value-based cil President Hayley Hovious. “The Council develop a relationship with the strategic buyrience in the revenue cycle technology reimbursements. looks forward to its role in bringing healthers,” said Wylly. “There’s a huge relational and services space. “As a result, it presents Panelists also mentioned the sigcare leaders together with innovative entreelement.” great opportunities for innovative companificant role consumerism has played in preneurs in the technology space in order Panelists also referenced the increasnies to solve these challenges.”  recent deal activity, noting the shift to highto meet these critical needs and to establish ing desire for collaboration among payers Carroll added the city has the oppordeductible health plans and the increased Nashville as the leader in healthcare IT.” and providers. “Payers and providers want tunity to take the lead when it comes to fos-

Wang Vision Debuts Ellex Laser for Floater Removal New In-Office Option for Many with Visual Floaters By MING WANG, MD, PHD

detachment generally occurs without incident, in some cirThe first laser floater cumstances, it can lead to the removal (LFR) in Nashville using development of a wrinkle on the the new state-of-the-art Ellex retina called an epiretinal memlaser was performed successfully brane. This condition can cause at Wang Vision 3D Cataract & blurred vision and sometimes LASIK Center – an Aier-USA require surgery. In rare circumeye clinic – on May 26, 2018. stances, it can lead to retinal Tony Ashley, 73, of Lebanon, tears or detachments, which can Tenn., had suffered for many years cause permanent vision loss if not from visually debilitating floaters. treated. Any patients with new “They are like spider webs, very onset of floaters, flashes of light, annoying,” Ashley shared. “They a curtain effect, or loss of vision float around, always interfere with should see an eye doctor immemy vision and get in the way of diately to ensure that the eye is things that I really want to see.” healthy. Since the successful surgery, Laser floater removal is an Ashley has been very pleased in-office, minimally invasive with the outcome. A few weeks procedure that can reduce the after treatment, Ashley reported Dr. Ming Wang with Tony Ashley, Nashville’s first patient to receive laser floater appearance of floaters. A surremoval with the Ellex laser. a 90 percent improvement in the geon uses a precise laser to focus appearance of his floaters. on the floaters in the gel in the back of the Floaters are a common condition that back of the eye. Aging changes cause eye. Nanosecond light pulses then evapocan affect people of all ages but generally the vitreous gel to become more liquid rate collagen and hyaluronan molecules in become more predominant later in life. and shrink. During this process, it forms the floater, converting them to a gas. The Floaters can appear as dots, cobwebs, clumps and eventually separates from the gas then dissolves and reabsorbs into the squiggly lines, rings, or a combination of back of the eye in a process called a vitvitreous. The final result is that the floaters these, which temporarily obscure vision. reous detachment, which typically occurs are removed or reduced in size. Floaters occur from structural for most people after the age of 50. The only other option for floaters is a changes to the vitreous gel that fills the While this process of a vitreous more invasive surgery called a vitrectomy 10

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in which a portion or all of the vitreous is removed and replaced with a balanced electrolyte solution. This surgery needs to be performed in an operating room setting and does present more risk than laser treatment, as a surgeon must physically enter the eye with instruments. The recently introduced Ellex laser is specifically designed for treatment of vitreous floaters. Features of this instrument include precise focusing capability, target illumination, and a superior energy beam profile. These features allow a surgeon to accurately visualize floaters relative to the structures in front and behind the lens and the retina. This combination of features, developed particularly for this purpose, allows the surgeon to safely target floaters without risk to other eye structures. Ming Wang, MD, PhD, (Harvard MD, magna cum laude; MIT PhD in laser physics), is the CEO of Aier-USA and director of Wang Vision 3D Cataract & LASIK Center – an Aier-USA eye clinic. He has performed more than 55,000 procedures, including on over 4,000 on doctors. Wang also founded a 501c(3) non-profit charity, which to date has helped patients from over 40 states in the U.S. and 55 countries with sight restoration surgeries performed free-ofcharge. For more information, email drwang@ wangvisioninstitute.com or go online to wangcataractLASIK.com.

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Finding the Sweet Spot in Aesthetic Medicine By CINDY SANDERS

I want to look natural. Steven Dayan, MD, noted Chicago facial plastic surgeon and keynote speaker at the recent Symposium for Cosmetic Advancement & Laser Education (SCALE) conference held in Nashville, said the biggest fear patients have with cosmetic procedures is that they will wind up looking like they’ve had a cosmetic procedure. “It’s our number one barrier to getting patients in the office,” he said. “It’s the reason we don’t have more people getting aesthetic treatments … it’s because they’re afraid of looking unnatural.” Dayan pointed out, “Cosmetic treatments cannot equal natural results. It’s a flawed logic.” In fact, he added, when he was asked to write a paper defining ‘natural,’ he quickly recognized he couldn’t do it. The realization led Dayan to think about beauty in a different way. Based on the theory of relativity, he created a different platform to encapsulate what people mean when they strive for natural beauty. “It’s a four-dimensional model … not a two-dimensional model … to explain what is natural, which is really just an interpretation because you can’t define it,” he said. A New York Times bestsell-

Dr. Steven Dayan

ing author, Dayan is a researcher who has published five books and more than 110 articles in medical journals, as well as an adjunct professor at the University of Illinois. He noted, “Beauty works at a subconscious level because we are pre-wired to know what beauty is whether it’s a pea-

cock’s feathers, a flower or a human.” While naturalness cannot be defined, Dayan said the same isn’t true of beauty. “It’s mathematically definable,” he said, adding that he was taught the figures and formulas of what makes a face beautiful during his training as a plastic surgeon. “I believe now that beauty is not our aim. I think when we put beauty out there as our target, we fail,” Dayan continued. He pointed out there was a time when everyone believed the world was flat. That same fallacy comes, he said, from confusing beauty with the genuine attractiveness that most patients really desire. “Beauty is flat. Beauty is one-dimensional,” he stated. “If we increase cosmetic interventions, yes, we can make someone more mathematically beautiful.” However, he continued, much like a bell curve, there is a peak after which more treatments actually diminish beauty rather than add to it. Dayan noted that a flat, one-dimensional scale is also how the FDA approves products and the field measures outcomes in the United States. “I need to show a two-point improvement in the crow’s feet or nasolabial folds,” he said of defining success. However, what hits the mark on paper doesn’t necessarily hold up in practical application.

“Cosmetic treatments cannot make people more natural. It’s logically flawed,” he reiterated. “But the problem is when we teach beauty, what we teach is unnatural. We say, ‘Yes, we got a two-point improvement.’ We think we’re making people more beautiful on a flat scale, but the reality is when they are in animation, they look less beautiful … and they look unnatural.” Instead of frozen perfection, Dayan called on clinicians to recognize that four dimensions are required to create the results patients want – beauty, genuineness, self-esteem/confidence, and attractiveness. He noted genuineness actually is definable and identifiable. Using pictures of two Hollywood stars smiling, one had mouth corners that slightly turned up and no other movement. The other had broader lip movement and crow’s feet around the eyes – the very definition of the Duchenne smile, which involves contraction of both the zygomaticus major muscle to raise the mouth corners and the orbicularis muscle to raise the cheeks and form the crow’s feet. “If someone smiles, and they have no crow’s feet, they don’t look genuine, and you don’t trust them,” (CONTINUED ON PAGE 12)

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Record Attendance at 2018 SCALE Conference Symposium Featured Latest in Aesthetic Medicine By MELANIE KILGORE-HILL

More than 800 cosmetic surgeons, clinicians and industry professionals descended on the Music City Center May 10-12 for the 13th annual SCALE conference. Hosted by the Tennessee Society for Laser Medicine and Surgery (TSLMS), the Symposium for Cosmetic Advances and Laser Surgery (SCALE) is an annual educational event focused on lasers and energy-based devices, injectables for cosmetic concerns, skin care, research updates, practice management and medical dermatology. The conference was founded by Nashville-based cosmetic surgeons Brian Biesman, MD, and Michael Gold, MD, and has grown to become one of the largest and most respected industry events nationwide. Attendees received 21 hours of continuing medical education over three days and learned from some of the most respected leaders in the field. Guest faculty included experts from UCLA, Cornell, Harvard, NYU, Yale, the University of California and numerous other cutting edge programs in the United States and abroad. “We had an all-star faculty this year with phenomenal guests, and it was really helpful for attendees to hear from the top physicians in the field,” Biesman said.

was a really neat addition and was well received by attendees,” Biesman said. “Our goal was to demonstrate those structures that are considered danger zones, which we want to avoid during injectable treatments and surgery.” Following the cadaver demonstration, the workshop’s 80 attendees continued injectables training on live models. Founders Gold and Biesman also hosted presentations and moderated panels with live patient demos, including seminars on treating facial acne scars, injectables and body contouring. The conference included special symposiums devoted to acne, psoriasis, scar and wound healing, and atopic dermatitis and chronic skin disease. Dr. Brian Biesman (Center R) leads a session at the recent SCALE conference that included live demonstrations to enhance education for the attending clinicians.

In addition, more than 120 vendors were on hand to showcase the latest products, answer questions, and discuss industry needs with SCALE attendees. “Besides looking at existing approaches, attendees learned a lot about new treatments from injectables, topicals, and devices that aren’t yet on the market,” said Biesman. “It’s really a glimpse into the future and very interesting to get insight from the

people working on those new products.”

Breaking Ground

A highlight of the May event was the first-ever facial dissection cadaver lab. Led by John Moore, MD, and Jason Pozner, MD, the full-face surgical anatomy and injection course was designed to improve the safety of neurotoxin and dermal filler injections for clinicians. “The workshop

Looking Ahead

Plans are already underway for the 2019 event. Biesman said the conference’s high energy combined with the upbeat atmosphere of the Music City Center create a positive, unparalleled environment in which to mingle, network and learn. “SCALE is a phenomenal experience for physicians and anyone interested in either aesthetics or medical dermatology,” Biesman said. “You can’t find a better or more efficient way to get that amount of quality education, faculty and presentations in such a short period of time.”

Finding the Sweet Spot in Aesthetic Medicine, continued from page 11 said Dayan. Yet, he continued, physicians remove them with 12 units of FDAapproved neurotoxin all the time. While beauty can be improved to a point before there are diminishing returns, he said the second dimension of genuineness begins to slip the minute any procedure is done. “We can’t make people more genuine. You’re born 100 percent genuine. All I can do is make you less genuine,” Dayan said. The goal, therefore, is to find the sweet spot where beauty and genuineness cross. Even then, sometimes people aren’t attractive. Why? “This is the third dimension – self-esteem and most importantly, confidence,” he stated. “Confidence is the most attractive feature on anyone.” While confidence often trumps physical beauty, studies have shown that 70 percent of self-esteem and confidence is wrapped up in beauty. Research has also found that after receiving fillers and neurotoxins people feel more confident, and a new study found an increase in actual happiness. “We know our products can improve the way people feel about themselves,” Dayan said. He added aesthetic medicine has the power to impact expression, emotions, selfesteem and confidence. “We’re doing so much more than just making people beautiful,” he said. “We’re making them more attractive.” Taking into consideration physical 12

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beauty, genuineness and confidence, he said, “Now I’m seeing that what we’re doing is creating attractiveness by bringing these three dimensions together.” So what does that mean? Dayan said it means a forehead that still moves when you cry. It means fine lines around the eyes that crinkle with laughter. It means maximizing the first three dimensions. “If I provide all of that, that to me is the interpretive point where natural falls in place. Everything comes to a max point. Too much cosmetic intervention – I

reduce physical beauty; I reduce genuineness; I reduce self-esteem and confidence; and they look unnatural … and that’s where patients don’t want to be.” Dayan added the fourth dimension of attractiveness is variable. Different people find different things attractive, and it’s relative to time and space. He said it’s critical to understand the math and science behind beauty but also to recognize the need for genuineness so that procedures aren’t overdone and to recognize there is a psychological component to treatments.

The most challenging factor is the fourth dimension, which he said isn’t intuitive, that calls upon physicians to try to understand where the patient is in space as it relates to others. “Our mission is so much deeper and more meaningful than just making people beautiful,” he concluded. “We’re evolving beyond beauty to form and function, beyond form and function to improving the mind, mood and attractiveness of our patients … and that, to me, is where the future lies.”

Health Care Council Celebrates, continued from page 9 Gregory C. Marotta: President and CEO, CleanSlate Centers Karen D. McKeown: State Health Officer and Administrator, Division of Public Health, Wisconsin Department of Health Services Jameson Norton: CEO at Vanderbilt Psychiatric Hospital and Clinics, Vanderbilt University Medical Center Lisa Piercey, MD: Executive Vice President, West Tennessee Healthcare Justin Pitt: Senior Vice President and Chief Litigation Counsel, Community Health Systems Christopher Rehm, MD: Chief Medical Informatics Officer, LifePoint Health

Stephani J. Ryan: Director, Long Term Services and Support, BlueCare Tennessee Kevon Saber: CEO, GoCheck Kids Puneet Singh: Chief Development Officer, Aspire Health Elizabeth Ann Stringer: Chief Science Officer, axialHealthcare Emily Tyson Kyle Wailes Michael D. Warren, MD: Deputy Commissioner for Population Health, Tennessee Department of Health Sam Weinstein, MD: CEO, SpecialtyCare, Inc. Edna Willingham: President, Amerigroup Tennessee

Michael Wood: Senior Vice President, Product Development and Technology, Change Healthcare 2019 Fellows Recruitment As one Fellows year winds down, preparations begin to welcome the next class of leaders. Applications for the class of 2019 will open in September. To apply, candidates must submit information and statements of interest, professional bio, resume and letters of recommendation from his or her CEO and a fellow healthcare leader. The 2019 class will be selected by the Council Fellows Advisory Committee and announced in December. For more information, go online to HealthCareCouncilFellows.com. nashvillemedicalnews

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Nominate an Inspiring Nurse March of Dimes Gears Up for 2018 Nurse of the Year Awards By FORD SANDERS

A breakfast held in late May at the Monroe Carell Jr. Children’s Hospital at Vanderbilt officially kicked off the Ninth Annual March of Dimes Nurse of the Year Awards and outlined the process to nominate an inspiring nurse for 2018. Kathie Krause, MSN, RN, chief nursing officer at Monroe Carell and 2018 Nurse of the Year event chair, said the nomination process is open online at nurseoftheyear.org/musiccity through June 30. Nurses can be nominated in 17 different categories ranging from advanced practice and administration to women’s health and undergraduate student nurse. Patients, colleagues, supervisors, instructors, family and friends are all eligible to nominate an outstanding nurse. “If you know of someone that you think fits that category and deserves to be recognized for his or her work, then all

you need to do is to choose the category and write a couple of sentences about why you believe this nurse is deserving of this honor,” said Krause. While the nomination process is quite simple, it is the glue of the event. Krause said the hope is to hit 200 nominations this year. Once nurses are nominated, the selec-

tion committee will reach out to each nurse to complete an application process that requests additional details on the nurse’s practice. She encouraged nominators to give their nurse nominees a head’s up on the application, which is due by the end of July. From the large and talented pool of nominees, the selection committee will have the tough job of narrowing to one winner from each category, which is kept secret until the gala luncheon event scheduled for Nov. 1, 2018 at Belmont University’s Maddox Grand Atrium. In 2017 the event was attended by more than 300 people and raised over $115,000 in support of the March of Dimes mission. Krause said the goal in 2018 is to raise at least $120,000 to maintain and grow March of Dimes programming activities. “It’s very clear the March of Dimes is committed to nursing, and nursing is very committed to the March of Dimes,” said Krause.

The strong link between nursing and the March of Dimes runs deep and traces its roots back to 1954 when 40,000 nurses cooperated on the Salk Polio Trials. The vaccine field trials were sponsored by the National Foundation for Infantile Paralysis … now the March of Dimes. Today, the organization’s mission is to ensure every child has a fighting chance by addressing prematurity and other issues that threaten children and families. “At each step, nurses have been an integral part of helping March of Dimes achieve their mission,” said Krause. The Nurse of the Year celebration shines a light on nurses across Middle Tennessee and recognizes the hard work of all the nominees.

Schuck Takes on CMO Role for Two TriStar Hospitals

DigiScript, Inforum, com, and Medibuy.

was the first to identify a high frequency of PIK3CA mutations in breast cancer and then discovered their contributions towards oncogenic phenotypes. His work, including the generation of genetically modified cell lines, has been widely cited and requests for his cell lines have led to important discoveries by other investigators. Park, who will assume his new VICC post Sept. 1, succeeds Carlos L. Arteaga, MD, who accepted a position at the University of Texas Southwestern Medical Center last year.

Kathie Krause

Nurse of the Year Nominations are open through June 30. Go online to nurseoftheyear.org/musiccity

GRAND ROUNDS Mark Your Calendars

NMGMA June Meeting • June 12 • Saint Thomas West Steve Dickens will share “Effective Communication: Physicians, Staff & Patients” at the luncheon event held 11:30 am-1 pm in the hospital’s Medical Learning Center.

Mental Health America Annual Conference • June 14-16 • Washington, DC With a theme of ‘Fit for the Future,’ the 2018 MHA conference will focus on the link between nutrition, fitness, overall wellbeing and mental health. Expert panelists and speakers will look at cutting-edge technologies, integrated health and collaborative practice, and 21st century policy solutions. For more information and registration, go online to mentalhealthamerica.net.

Tee Off for ALS • June 18 • Vanderbilt Legends Club Register a team to enjoy a fun golf tournament will helping the ALS Association of Tennessee provide critical services to those living with ALS in our community. The tournament runs 11:30 am-7 pm with a shotgun start at 1 pm. Go to webtn.alsa.org, click on ‘Get Involved’ and then ‘Events’ to register.

Health:Further • Aug. 27-29 • Music City Center The annual summit focused on the future of healthcare returns in August. The three-day event features a host of expert speakers addressing clinical, business, and technology issues impacting the accessibility and sustainability of the healthcare industry with a focus on innovation. Health:Further has partnered with TN HIMSS and includes the 10th TN HIMSS Summit of the Southeast as part of the programing. For tickets or info, go online to healthfurther.com. nashvillemedicalnews

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Eric Schuck, MD, has been appointed chief medical officer of TriStar Southern Hills Medical Center and TriStar StoneCrest Medical Center effective Aug. 6, 2018. In this role, he will serve as a business and clinical strategist responsible for the overall direction and coordi- Dr. Eric Schuck nation of medical affairs. Schuck currently serves as medical director of the emergency department at Fort Walton Beach Medical Center in Fort Walton Beach, Fla. Previously, he served as medical director of the emergency departments at West Florida Hospital in Pensacola and Capital Regional Medical Center in Tallahassee. Schuck brings over 20 years of clinical experience to his new role. He received his medical degree from Emory University School of Medicine and completed his residency in pediatrics at Wright Patterson Air Force Base/Wright State School of Medicine.

Pearson Adds to Responsibilities at HealthStream In mid-May, HealthStream announced Chief Operating Officer Eddie Pearson had been promoted to president, effective immediately. Pearson will remain as COO as he concurrently assumes the new role of president. A 12-year veteran of HealthStream, Pearson has served as its Eddie Pearson COO since 2011. Previously, he held executive positions with

empactHealtth.

Park Named to VICC Breast Cancer Leadership Internationally renowned breast cancer expert Ben Ho Park, MD, PhD, has been named coleader of the Breast Cancer Research Program, director of Precision Oncology, and associate director for Translational Research at VanderbiltIngram Cancer Center. In Dr. Ben Ho Park his academic role, he will serve as professor of Medicine.       Park currently serves as professor of Oncology in the Breast and Ovarian Cancer Program, associate director for Research Training and Education and member of the Executive Oversight Committee at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. He also is associate dean for Postdoctoral Affairs for the Johns Hopkins School of Medicine where he has been on faculty since 2002. Park received his undergraduate degree from the University of Chicago, followed by a dual MD and PhD at the University of Pennsylvania School of Medicine. He trained in Internal Medicine and Hematology/Oncology at The Hospital of the University of Pennsylvania where he was named chief fellow, then completed a post-doctoral fellowship in cancer genetics at Johns Hopkins where he trained in the laboratory of Bert Vogelstein, MD, the first scientist to explain the molecular basis for the development of colorectal cancer. Park is a leader in the field of PIK3CA gene mutations and their relevance to breast cancer. In 2004, he

NIH Awards Second $1 Million Grant to IQuity Nashville data science company IQuity announced last month that the company has received a second $1 million Phase 2 grant from the National Institutes of Health’s (NIH) Small Business Innovation Research (SBIR) program. The grant, which will be dispersed over two years, will help IQuity expand its research efforts studying fibromyalgia syndrome and its place in the spectrum of rheumatic diseases and conditions. IQuity recently announced the release of its IsolateFibromyalgia™ blood test, which uses RNA analysis to help healthcare providers detect fibromyalgia syndrome quickly and accurately. Results are 94 percent accurate and are delivered to providers within seven days of receiving the sample in the laboratory. The company is working to further develop RNA-based technologies to detect fibromyalgia syndrome and monitor patient responses to treatment. IQuity has received a total of $2.3 million from the NIH’s SBIR program and is one of just three Tennessee companies receiving funding in the research project grant division in 2018.

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GRAND ROUNDS Let’s Give Them Something to Talk About!

Awards, Honors, Achievements

Finn Partners’ Health Practice has been named 2018 Healthcare Agency of the Year by The Holmes Report. The FINN Health Practice is among the agency’s largest and fastest growing, with clients spanning patient groups, payers,  product innovators, policymakers and provider organizations. The prestigious Holmes Report’s Agency of the Year honors are considered the ultimate benchmark of PR firm performance with Holmes Report editors selecting finalists based on the performance of more than 400 firms worldwide. On April 27, Meharry Medical College unveiled a portrait of its 10th president, Wayne J. Riley, MD, and named an auditorium in his honor at The Cal Turner Family Center for Student Education. Alive Hospice has won the 2018 Hospice Honors Elite Award. Established by HEALTHCAREfirst, this prestigious annual review recognizes hospices nationally that continuously provide the highest level of quality as measured from the caregiver’s point of view.  South College has again earned the Military Friendly® School designation for 2018-2019. South College, which first earned the designation in 2016, has been a longtime advocate for veterans and supporter of the U.S. military. The South College Military Grant program provides tuition benefits to veterans and spouses of veterans with honorable discharge status; active duty military and spouses; and dependents who are eligible for U.S. Department of Veterans Affairs educational benefits. Leapfrog Hospital Safety Grades were released in late April and several area hospitals are jumping for joy. TriStar Centennial Medical Center earned an A, giving the facility straight A’s for the last six years. In Middle Tennessee, Maury Regional, NorthCrest Medical Center, Saint Thomas Midtown, Sumner Regional Medical Center, TriStar Hendersonville, TriStar Horizon, TriStar Southern Hills, TriStar Skyline, Vanderbilt University Hospital and Williamson Medical Center also received A’s. Mental Health America (MHA) will honor an impressive group of professionals and innovative programs at its 2018 Annual Conference, being held in Washington, DC on June 14-16, including two award recipients from Middle Tennessee. MHA’s “George Goodman and Ruth P. Brudney Social Work Award” this year goes to Marie Williams, Commissioner of the Tennessee Department of Mental Health & Substance Abuse Servic- Marie Williams

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es. MHA of Middle Tennessee (MHAMT) is one of two affiliates nationwide being recognized with the “Innovation in Programming Award.” MHAMT is being honored for the Tennessee Suicide Prevention Network (TSPN), a private-public partnership that is a national model for suicide prevention networks. PhyMed has been named to the Becker’s Healthcare “150 Top Places to Work in Healthcare 2018” list. The annual accolade highlights hospitals, health systems and healthcare companies that promote diversity within the workforce, employee engagement and professional growth.

Places to Work in Healthcare. This is the firm’s sixth consecutive year on the prestigious list, which identifies and recognizes outstanding employers in the healthcare industry based on employee survey results. Other area companies making the list include axialHealthcare, Experian Health, Pivot Point Consulting, Santa Rosa Consulting, and Southern Tennessee Regional Health System – Pulaski. Nashville-headquartered CGS Administrators, LLC — a provider of administrative and business services for the Medicare and Medicaid communities, commercial health plans, healthcare providers and medical equipment suppliers — earned ISO (International Organization for Standardization) 9001:2015 certification after an rigorous independent audit, which found GCS earned nine best practices and no ‘opportunities for improvement.’

LifePoint Appoints New VPs

Jason & Scotty Falk celebrate franchisee recognition.

FirstLight Home Care, a national provider of non-medical in-home care, recently named the company’s Nashville Franklin team 2018 “Franchisee of the Year” for providing outstanding service to the local community. Owners Jason and Scotty Falk were selected from more than 160 FirstLight franchisees. Change Healthcare President & CEO Neil de Crescenzo has been announced as chair of the 2018 Healthy for Good™ Heart Walk, scheduled for Sept. 5. In his role, he will lead 30 local executives serving the community to tackle Neil de Crescenzo heart disease and stroke. E. Berry Holt, a partner in Bradley Arant Boult Cummings Nashville office, has been inducted into the Seton Society of Saint Thomas Health of Tennessee. The Seton Society recognizes and pays tribute to physicians, nurses, healthcare workers and community E. Berry Holt volunteers who demonstrate excellence in their professions and in their service to Saint Thomas Health and the greater Nashville community. Sumner Regional Medical Center has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Cumberland Consulting Group, a leading healthcare consulting and services firm, has been selected by Modern Healthcare as one of the 2018 Best

Brentwood-based LifePoint Health has appointed three leaders to vice president posts within the organization. Tracy (Maurice) Abney has been promoted to vice president, clinical informatics officer. In this role, Abney will provide strategic oversight for the development of LifePoint’s comprehensive clinical informatics program and guide the organization’s approach Maurice Abney to clinical technology. Abney previously served as senior director, acute clinical systems and director, evidence-based medicine.

Prior to joining LifePoint Health in 2012, Abney worked in informatics leadership at Hospital Corporation of America. Barbara Olson has been promoted to vice president, clinical improvement and healthcare safety were she will lead the company’s efforts to enhance the safety of patients and healthcare workers in its facilities. Olson Barbaro Olson also oversees the LifePoint Patient Safety Organization and spearheads the company’s enterprisewide culture of safety and engagement survey process. She will also continue to be deeply involved with supporting LifePoint’s hospitals as part of the National Quality Program Leadership Team. Olson most recently was senior patient safety officer for the company and has been with LifePoint since 2013. Mark Pickett has been hired as vice president, physician services, Eastern Group. Previously, he served as senior director, physician practice operations at Tenet Healthcare. In his new role with LifePoint, Pickett will be responsible for leading and Mark Pickett directing all aspects of physician services operations the company’s Eastern Group of facilities, which include Michigan, North Carolina, Pennsylvania, South Carolina and Virginia. Prior to Tenet, Pickett served in a number of roles as vice president during his 10-year tenure with Hospital Corporation of America.

Wishes Granted

Sirtex Medical Ltd. has renewed a grant award to Dan Brown, MD, FSIR, professor of Radiology and Radiological Sciences and chief of Interventional Oncology, and his Vanderbilt Health colleagues, for a research program designed to treat patients with liver tumors that cannot be addressed with surgery. Brown has served as the principal investigator of the Vanderbilt-led research registry that tracks cancer patients whose tumors are treated with a radioactive isotope known as Yttrium-90 (Y-90). The research agreement renewal from Sirtex will provide $2.64 million over three years to support the patient registry. Saint Thomas Medical Partners (STMP) has received a $75,000 grant for the Our Mission in Motion (OMIM) program from Susan G. Komen® Central Tennessee. The grant award will provide screening mammography through a mobile health unit within 11 of the 42-county Susan G. Komen Central Tennessee service area. OMIM brings screening mammography to 2,550 women annually within the service area. nashvillemedicalnews

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GRAND ROUNDS Y O U R M I D D L E T N S O U R C E F O R P R O F E S S I O N A L H E A LT H C A R E N E W S

PUBLISHED BY: Graham | Sanders Publishing, LLC PUBLISHERS Susan Graham & Cindy Sanders SALES 615.397.2836 Cindy Sanders Maggie Bond Pam Harris Jennifer Trsinar MANAGING EDITOR Cindy Sanders csanders@nashvillemedicalnews.com CREATIVE DIRECTOR Susan Graham sgraham@nashvillemedicalnews.com CONTRIBUTING WRITERS Lucy Carter, Melanie Kilgore-Hill Larry McClain, Cindy Sanders Dr. Ming Wang CIRCULATION subscribe@nashvillemedicalnews.com —— All editorial submissions and press releases should be emailed to: editor@nashvillemedicalnews.com —— Subscription requests or address changes should be mailed to: Nashville Medical News 105 Spring Ridge Lane Nashville, TN 37221 615.646.3916 (FAX) 615.673.8819 or e-mailed to: subscribe@nashvillemedicalnews.com Nashville Medical News is published monthly by Graham | Sanders Publishing, LLC. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Nashville Medical News will assume no responsibilities for unsolicited materials.        All letters sent to Nashville Medical News will be considered the newspaper’s property and therefore unconditionally assigned to Nashville Medical News for publication and copyright purposes.

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Nguyen Joins TriStar Cardiovascular Surgery Duc Q. Nguyen, MD has joined TriStar Medical Group Cardiovascular Surgery. Nguyen is an expert in left ventricular assist devices (LVAD), heart transplantation, and extracorporeal membrane oxygenation (ECMO) therapy. He also specializes in the treatDr. Duc Q. Nguyen ment of coronary artery disease, aortic disease, aneurysms and valvular heart disease. Previously, Nguyen worked as a Cardiothoracic Surgeon at Emory University School of Medicine. He earned his medical degree from the Boston University School of Medicine and completed his general surgery residency at the University of Minnesota in Minneapolis, followed by cardiothoracic surgery residency at Emory. Nguyen received his fellowship training in mechanical assist devices and heart and lung transplantation at the Heart, Lung and Esophageal Surgery Institute at the University of Pittsburgh Medical Center.

TMA Names Word Director of Regional Development

Last month, the Tennessee Medical Association announced Doug Word as director of Regional Development. At TMA, the state’s largest professional organization for physicians, he will be responsible for managing county and regional medical society activiDoug Word ties in designated areas in Middle and West Tennessee. As the staff liaison to TMA-chartered county and regional medical societies, Word will help drive and support physicians’ efforts to increase medical society activities, improve member engagement, and build and retain physician membership. Word joined TMA in 2014 as marketing manager with an emphasis on membership recruitment and retention. He will remain based in the association’s Nashville headquarters.

Health, a Weber Shandwick full-service agency devoted to the healthcare industry. She has spent the majority of her career in healthcare communications, including at Ogilvy CommonHealth Worldwide where she supported pharmaceutical clients with FDA approval processes. Werner earned a music industry bachelor’s degree with a minor in business administration from Northeastern University.

Stepping Down

Last month, Quorum Health President and CEO Tom Miller left the hospital company, which he had led since it spun out from Community Health Systems in 2016. Bob Fish, a former CEO of Skilled Healthcare and current chair of Genesis Healthcare, is stepping in on an interim basis to lead Quorum. Additionally, Launch Tennessee CEO Charlie Brock announced he would be returning to the private sector. Brock will continue to lead Launch Tennessee until October.

Precera Bioscience Builds Leadership Team

Earlier this year, Franklin-based Precera Bioscience (formerly Sano) appointed Pamela Weir as president and CEO. Weir brings 30 years of pharmaceutical experience across diverse functions of commercial, R&D, operations, business development and general management. She has led the development and launch of multiple brands and franchises in the U.S. and global markets across numerous therapeutic areas. She has worked with large pharma companies including Sanofi and biotechs including ContraMed and Medicines360. J. Scott Daniels, PhD, is leading all R&D functions including the laboratory team as chief scientific officer. During tenures with DuPont, Millennium and Pfizer, Daniels advanced the fields of biotransformation and drug metabolism, and published multiple scientific papers. Prior to joining Precera, he was a faculty member and director of Drug

Metabolism and Pharmacokinetics in the Department of Pharmacology at Vanderbilt. Betty Hawkins recently joined the company as senior vice president of Business Development & Operations. She has extensive diagnostic and pharmaceutical experience leading teams and launching products. Previously, Hawkins was vice president of Strategic Initiatives with Diatherix and has also held senior commercial positions with AstraZeneca.

Business Briefs

In late May, Anthem, Inc. announced the company had entered into an agreement to acquire Nashvillebased Aspire Health, the nation’s largest non-hospice, community-based palliative care provider. Aspire currently provides services under contracts with more than 20 health plans to consumers in 25 states. Aspire was founded in 2013 by Senator Bill Frist, MD and Brad Smith, who serves as CEO. The transaction is expected to close in the third quarter of 2018. Healthcare Management Partners (HMP) recently led the successful sale of nine senior care facilities through “stalking horse” auctions. Acting as the courtappointed receiver, HMP partnered with Waller to execute simultaneous successful auctions of Southeast-based senior living facilities, resulting in nearly $27 million recouped for bondholders. A stalking horse auction involves a purchaser (the stalking horse) who is willing to publicly submit their bid ahead of a formal auction. The stalking horse purchaser’s bid effectively establishes a floor for bids at the auction and ensures that there will be at least one party who will bid at the auction. Nashville-based Montecito Medical Real Estate has acquired the Pinnacle Orthopaedics Center, a Class A medical office and surgery center from a leading orthopaedic provider in the Atlanta metropolitan area.

emids Appoints Strategic Healthcare Marketer

Last month, emids, a leading global provider of healthcare technology expertise and consulting services, announced the appointment of Libby Werner as director of Marketing Operations to fuel the company’s sales and marketing efforts. Werner brings nearly a Libby Werner decade of experience developing and implementing integrated marketing communications campaigns and measuring success against company business goals through robust data and analytics strategies. She will lead efforts in collaboration with Mike Hollis, president, Strategic Business. Prior to emids, Werner served as a client relationship manager at Revive-

Hannah Dennison Butterfly Garden at Monroe Carell In late May, legendary country music singer-songwriter Dolly Parton and her niece Hannah Dennison were honored at the dedication of the newly named Hannah Dennison Butterfly Garden at Monroe Carell Jr. Children’s Hospital at Vanderbilt. The dedication came after Parton announced a $1 million gift to Children’s Hospital’s Pediatric Cancer Program last October while visiting patients with her niece, Dennison, who was treated for leukemia as a child at Children’s Hospital for four years. JUNE 2018

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