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FOCUS TOPICS CMO ROUNDTABLE • CARDIOVASCULAR CARE • LEGISLATIVE AGENDAS

February 2019 >> $5 ON ROUNDS The Wright Mix

Dr. Ted Wright finds himself in a different educational arena at West Tennessee Healthcare According to Dr. Theodore ‘Ted’ Wright’s mother, he first announced he would be a surgeon to her when she dropped him off at the playground at preschool, but he says that may be a bit of a stretch.

Profile on page 3.

Updated Cholesterol Guidelines Take a Personalized Approach The American Heart Association (AHA) and American College of Cardiology (ACC) last November released an update to the 2013 cholesterol guidelines, calling for more personalized risk assessments to guide primary and secondary cardiovascular disease prevention throughout a patient’s lifetime.

Story on page 6.

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THA Eyes Three Issues During Current Session Of General Assembly The Tennessee Hospital Association (THA) is working to bring three pieces of legislation to the Tennessee General Assembly in addition to focused advocacy on a number of other issues during the current session. The 111th Tennessee General Assembly convened its initial session last month. With more than 30 new legislators, a new governor and new members of leadership in each chamber, the session is attracting considerable attention from the healthcare community as well as the media. The session promises to be a busy time with several major priorities for hospitals on THA’s legislative agenda. According to

the THA, this year the organization will bring three pieces of legislation in addition to focused advocacy on a number of other issues. An item on the THA website reports that the three priorities are:

Hospital Assessment

• THA will bring legislation to continue to fund a shortfall in the TennCare budget through the voluntary hospital assessment • This maintains coverage for physical, speech and occupational therapies, physician office visits and other services, as well as avoidance of a significant provider rate reduction (CONTINUED ON PAGE 4)

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CMO’s in Rural Healthcare

Across West Tennessee, the role of CMO may take different names but they are a vital part of the changing healthcare scene By SUZANNE BOyD

One of the most important and challenging leadership roles within healthcare is the Chief Medical Officer. They have even been described as the Influencer in Chief, challenged to bridge the gap between administration and medical staff. Their role is no longer a luxury but has become a necessity for the successful functioning of today’s hospitals and healthcare organizations be they large or small. Over the past 20 years, the CMO role has evolved far beyond peer review and privileging, to include utilization review, program growth

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PhysicianSpotlight

The Wright Mix

Dr. Ted Wright finds himself in a different educational arena at West Tennessee Healthcare By SUZANNE BOYD

According to Dr. Theodore ‘Ted’ Wright’s mother, he first announced he would be a surgeon to her when she dropped him off at the playground at preschool, but he says that may be a bit of a stretch. Regardless of when he actually made the decision, Wright took it a few steps further than just surgery and specialized in cardiothoracic surgery, and even on the faculty at the University of Kentucky Medical Center. In early 2018, he switched from teaching fellows to patients when he joined the cardiothoracic surgeons at West Tennessee Healthcare. Wright grew up in Ashbury Park, New Jersey, graduated high school in 1987 and received his undergraduate degree from Princeton University. “I knew in college I wanted to pursue a profession that would allow me to mesh my affinities for social service and science,” said Wright. “Medicine was the perfect solution. Along my journey to this point, there were several individuals who I met that served as role models for me and helped guide me into medicine and greatly influenced how I approach patients and patient care today.” Wright attended the University of Virginia School of Medicine in Charlottesville, then returned close to home to complete his General Surgery Internship and his General Surgery Residency at Monmouth Medical Center/Newark Beth Israel Medical Center in Long Branch, New Jersey. It was during his residency that he became interested in heart surgery. “I loved anatomy and being able to make a difference with my hands led me to pursue surgery,” said Wright. “Then once I was exposed to cardiac surgery, valve replacement and bypasses in my residency, I got the bug to do cardiac and thoracic surgery.” Wright completed his fellowship training in cardiothoracic surgery at the University of Wisconsin Hospital in Madison. He then went to the University of California in San Francisco for a cardiopulmonary transplant fellowship. In 2005, Wright went into private practice and was Chief of Cardiothoracic Surgery at Saint Joseph Hospital in Lexington, Kentucky. After eight years he transitioned to academia serving as the Assistant Professor of Surgery, Clinical Title Series, at the University of Kentucky Medical Center. In this role he was not only the attending physician and treated patients, he also was responsible for overseeing and teaching medical residents. “One of the physicians I helped train, Dr. Hetal Patel, joined the group in Jackson after he completed his fellowship at Kentucky,” said Wright. “He contacted me about the opportunity here in Jackson. I was very impressed with what I found here; great people who have a can-do attitude when it comes to cardiac care. Drs. Sievers and Patel westtnmedicalnews

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are some of the best cardiac and thoracic surgeons I have seen and fact that all are very focused on providing the best patientcentered care made the program here at Jackson Madison County General Hospital a great fit for me.” One of the things Wright liked the most was the collaborative nature of the physicians in the group. “It is the leading cardiothoracic surgery team in the region that provides some of the most advanced care available to our patients,” he said. “Our team includes surgeons from some of the top heart programs in the country who provide state-of-the-art services and expertise. We are the only group in the area with surgeons who provide open heart procedures. Outside of transplants, we have all the tools to provide the services and care patients need right here in Jackson.” The biggest challenge Wright has faced since coming to West Tennessee has not been in the operating room but at home. “Moving to Jackson meant moving away from my wife Saskia’s family,” he said. “I came initially, then my wife, twin sons and 88-year-old mother moved here about six months ago so we have been reconnecting and enjoying as much time together as a family as we can.” Since he came from a university hospital, one might think Wright would have had to adjust to being in a smaller hospital but that was not the case. “Actually, it is as big as any hospital I have ever worked in,” he said. “The job and the opportunities here are what attracted me the most. This area is known as the coronary valley because of the high rates of obesity, diabetes, hypertension and the issues that those conditions cause. There are so many people here that need help and unfortunately, they often times do not seek help until quite late in the game. All these factors are helping this program to grow. Our hope is to have more advanced practice providers and nurses to help mature the program and provide the care needed. The data shows we are providing excellent care here in Jackson and that is what we want to continue to grow.”

TMA Hopes to Serve as Resource as State Lawmakers Meet Officials of the Tennessee Medical Association (TMA), the state’s largest professional organization for doctors, say it will intentionally limit its list of issues it plans to support while meeting with members of the new-look state legislature while the lawmakers are deliberating in Nashville. Dr. Matthew L. Mancini, TMA President for 2018-2019, said as the 111 th Tennessee General Assembly convened on Capitol Hill, the most important item on the organization’s to-do list was perhaps “building relationships.” TMA is considered one of the Matthew Mancini most influential healthcare advocacy groups on Capitol Hill. “With a third of the men and women in the General Assembly being brand new this session – along with a new governor – we expect to devote a lot of time building relationships and serving as a resource on important healthcare matters,” said Dr. Mancini, a Knoxville surgeon, ‘The General Assembly first created TMA for this purpose,” Dr. Mancini continued. “More than 180 years later, we are still the most effective voice representing physicians’ interests, promoting public policies and stopping or improving laws, rules and regulations that may threaten patient safety or quality of care. That core mission has not changed and will not change, regardless of the specific issues.” TMA’s 2019 legislative priorities are improving opioid prescribing laws, defending scope of practice and pursuing a reasonable compromise on payment issues. Taking a closer look at each one: Balance Billing – As lawmakers continue to look for ways to address the issue of patients receiving “surprise medical bills,” TMA wants to protect physicians’ rights to get fairly compensated for services they provide out of a health plan network while remaining fair to patients who are caught between their health plan and their physician. TMA has led previous efforts to find a reasonable solution and will continue to defend physicians’ rights if legislation is filed by other stakeholders this session. Opioid Epidemic – While TMA was able to make significant improvements to Gov. Haslam’s “TN Together” legislation in 2018, some of the unintended consequences doctors initially feared the new law would create are manifesting across the state. New restric-

tions on prescribing and dispensing are no doubt reducing overall initial supply, but are also unreasonably obstructing some patients from accessing legitimate, effective pain management. TMA will work with the legislature to amend the law to address specific issues raised by doctors and patients. TMA has developed a number of proprietary resources to help educate doctors and other prescribers on Tennessee’s opioid prescribing laws at tnmed.org/opioids. Scope of Practice – TMA is on alert to continue defending against any proposals that would threaten patient safety and quality of care by removing physician oversight for nurses, physician assistants or any other midlevel providers. TMA for years has led doctors’ opposition to nurse independent practice in Tennessee and in 2016 reached an agreement with the Tennessee Nurses Association that included a three-year moratorium on all independent practice bills. The moratorium expires at the end of the 2019 session, but doctors expect the debate to resurface in 2019, particularly around expanding access to care in rural areas. TMA will continue promoting physician-led, team-based care as the safest, most efficient and effective healthcare delivery model in Tennessee. MAT Parity – TMA will ask the General Assembly to consider a resolution encouraging health insurance companies to include Medication-Assisted Treatment therapies in patients’ health plans and reimburse specialists who provide MAT services at rates comparable to other treatments. TMA has long advocated for more accessible and well-funded treatment options for patients struggling with substance abuse. Using medications in combination with counseling and behavioral therapies is a necessary strategy in the ongoing fight against Tennessee’s opioid abuse epidemic. TMA is a nonprofit advocacy organization, serving more than 9,600 members with legislative, legal/regulatory and insurance advocacy, physician leadership training and other programs. TMA’s biggest advocacy event of the year, Day on the Hill, is scheduled for Tuesday, March 26. Last March more than 300 physicians descended upon Nashville’s Cordell Hull Building for the annual event and TMA expects another large crowd this year as doctors from around the state visit Nashville to meet with lawmakers, attend committee hearings, and advocate for their profession and patients. Those interested in learning more about more about TMA’s legislative advocacy at tnmed.org/legislative and follow TMA @ tnmed and @tnmedonthehill.

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THA Eyes Three Issues During Current Session, continued from page 1 Modify Nurse Practice Act

• An update to the Nurse Practice Act is needed to address issues identified by the Centers for Medicare & Medicaid Services (CMS) related to EMTALA requirements for OB and psychiatric patients • THA will bring legislation to clarify in statute that patient assessments performed by a registered nurse to determine if an emergency medical condition exists do not constitute a diagnosis • Such clarification is consistent with longstanding practice in hospitals between nurses and physicians

Billing Clean-up

• THA members have identified the need to clarify several elements of 2018’s

out-of-network notice legislation, which often has been referred to as Public Chapter 840 • This year’s legislation does not seek to change the intent of the law, but rather clarify elements of the law to ease implementation and ensure patients receive relevant and useful information about healthcare services as it relates to insurance benefits and cost-sharing

Certificate of Need

• Americans for Prosperity (AFP) Tennessee, the state level arm of the national conservative political organization of the same name, has identified elimination of certificate of need (CON) as one of its 2019 priorities

• Arguments that introducing free market principles to the healthcare system in Tennessee by eliminating CON would help reduce cost and improve access to care fail to understand the unique financial model of hospitals and other providers or the precarious financial situation experienced my many rural hospitals in the state • Hospitals support continuation of the CON program and worked closely with legislators in 2016 to significantly overhaul and modernize the law, with an agreement to no additional changes for three years • Given this action and 2018’s extension of the Health Services and Development Agency (HSDA) for three years,

THA believes it is premature to reexamine the CON law and elimination would run counter to last year’s action by the General Assembly

Patient Transport

• Legislation is expected in 2019 to remove sheriffs from state law that requires law enforcement to transport mental health patients • THA is working with the Tennessee Department of Mental Health and Substance Abuse Services and other stakeholders to identify alternative means and processes for transporting affected patients, as well as funding for such a solution, to present to the legislature for consideration

CMO’s in Rural Healthcare, continued from page 1 and development, practice acquisition, integrating health systems, and aligning and coordinating ambulatory and inpatient care, technology acquisition and implementation, process improvement, and regulatory compliance, among others. Whether a hospital is a part of a healthcare system or stands alone, the impact a CMO can have is evident but how they are utilized can be dependent upon the size of the organization. “The necessity and role of a CMO in a hospital is dependent upon multiple parameters. The utilization of CMOs varies from the role of the CMO being performed by the medical staff’s chief of staff or members of the medical staff, to part-time roles and full-time roles,” said Nick Lewis, CEO of Hardin County Nick Lewis Medical Center. “The question of need for a CMO isn’t size dependent as much as it is how an organization answers the following question, ‘What is significant and yet to be accomplished for the benefit of the whole community which could be accomplished or impacted with a physician leader?’ The CMO is a pivotal role as a liaison for both the medical staff and the hospital.” “The role, and even if there is a CMO, can depend on the size of the hospital,” said Bob Pryor, MD, Chief Physician Executive for West Tennessee Healthcare. “While a smaller hospital may not have a designated/ defined CMO position because its medical staff is small, they will have chief of staff Bob Pryor or some sort of physician leader that does that role in that facility.” “Large facility CMOs’ responsibilities vary greatly as they have a larger pool of 4

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physicians in which to ensure that they are practicing appropriately. In a smaller rural hospital, I think there is a greater opportunity for the CMO to collaborate with all entities in the healthcare arena and ensure that we deliver a more patient-focused care delivery model. Our ability to meet our patients needs and provide patientcentered care is contingent on our ability to work effectively as a team,” said Wendy Trickey, CNO, Hardin County Medical Center. “In order to collaborate better with all members, having the CMO in our facility is pivotal. He has the ability to communicate effectively with all team members, as well as works well with others to imWendy Trickey plement change in our organization. It is important to have buy in for change implementation from all that will be impacted by the change. He assists us in ensuring that we look at all aspects of our care that the change we are implementing will impact to ensure that we make the best possible decision for all involved.” “Physicians spend a significant portion of their lifetime preparing for the practice of medicine. Their training is intense and demanding of perfection with a focus of providing for the patient,” said Lewis. “A leadership role for the CMO physician on the management side of an organization isn’t necessarily backed with years of education and training.  Physicians learn quickly because of an acquisition for knowledge he/she possesses.  My experience has been physicians step up to the challenge of a role, which requires them to think and act somewhat outside of the career for which they have been trained.  What they don’t know, they will learn.” Jackie Taylor, MD, has recently taken over as CMO for Jackson Madison County Hospital, the flagship of West Tennessee Healthcare (WTH), after serving as acting CMO for six months. Prior

to that, he was the assistant CMO for the past four years. As WTH continues to grow as a system, Taylor sees the CMO role growing and evolving with it. “As CMO of JackJackie Taylor son General, I work with all the other hospitals in the WTH system. In our smaller hospitals it is often the chief of staff that will fulfill the role as the demands of a small staff do not require a physician be dedicated to it full-time. In working with the other hospitals in our system, I hope to be a resource for them since we can all learn from each other.” Taylor, who is phasing out of practicing medicine because his role as CMO requires more of his time, sees the CMO role as a go between administration and the medical staff, who is there to help both sides. “My first step into formal administration was when I became medical director of the ER, which allowed me to see more of what administrators do. It intrigued me and I found there was so much about that side of healthcare that I liked and was challenging,” he said. “With over 300 physicians on our medical staff, this role is demanding of my time. I still work a few shifts in the ER but do see me phasing out of practice and into full-time administration at some point. As CMO, I actually can have a greater impact on more people than I do as a physician.” “In our hospital, the CMO role is only part of the role for a full-time practicing physician. If a physician was designated as full-time in a facility our size (less than 80 beds), the physician might lack credibility. Some members of the medical staff might think, and some would say, ‘You’ve forgotten what it’s like to be a doctor,’” said Lewis. “A CMO is more likely to be acknowledged and accepted by the medical staff if they are actively engaged with providing care. The medical staff needs to recognize the need in order for the CMO role to be accepted in any organization.” “Nationwide, the CMO position has

been evolving,” said Pryor. “It used to be the VP medical affairs was a retired physician that had a good clinical career who helped manage the medical staff and handled complaints. Today the CMO is truly an executive position that brings the clinical focus and business focus together. Many have acquired their MBA degrees because they are now involved in mergers and acquisitions, contract negotiations, budgets, safety issues and often have departments that report directly to them.” “The role of the CMO is not to be the peacekeeper but rather the interpreter and collaborator for all parties. The role of the CMO is membership on the executive leadership committee/team. A CMO is a “must have” for any executive committee/team,” said Lewis. “The knowledge a CMO gains from being a member of an organization’s executive leadership team helps to interpret the activities and direction of management for physicians and other clinical personnel; while it also serves to educate and create an understanding of the medical staff’s view or perspective for management.” “Physicians are part of the patient care team and must be included as much in organizational planning and change management/implementation as possible in order for hospitals to be able to meet organizational goals,” said Trickey. “The CMO role assists us in getting everyone within the organization working toward common goals and assisting us in staying on track. I could not imagine trying to accomplish these things and being effective without a CMO.”

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Updated Cholesterol Guidelines Take a Personalized Approach By CINDY SANDERS

The American Heart Association (AHA) and American College of Cardiology (ACC) last November released an update to the 2013 cholesterol guidelines, calling for more personalized risk assessments to guide primary and secondary cardiovascular disease prevention throughout a patient’s lifetime. “Both guidelines were heavily based on evidence that has developed in terms of what can benefit patients,” said Neil Stone, MD, MACP, FAHA, FACC, who worked on the 2018 guideline update and served as vice chair of the writing committee. Stone, a ChicagoNeil Stone based cardiologist and AHA national spokesperson added, “Both begin with emphasizing that lifestyle change is most important.” In fact, he continued, the new guidelines focus on adopting a heart-healthy lifestyle from a young age and build upon the 2013 emphasis on identifying and addressing lifetime risks to prevent cardiovascular disease (CVD). The update also provides additional guidance for physicians to help them drill down for a more robust and personalized risk assessment that considers multiple factors and treatment paths. The need for personalized risk stratification and intervention is great in the United States. Stone pointed out we live in a country where one of every three people dies of heart disease or stroke annually and nearly six in 10 people develop heart disease during their lifetime. Additionally, he said, one-third of American adults have high levels of low-density lipoprotein cholesterol (LDL-C), known as the ‘bad’ cholesterol that contributes to plaque buildup and narrowed arteries. Key highlights from the updated cholesterol clinical practice guidelines statement, which was released this past November during the AHA’s 2018 Scientific Sessions conference in Chicago, include: • High cholesterol, at any age, can increase a person’s lifetime risk for heart disease and stroke. A healthy lifestyle is the first step in prevention and treatment to lower that risk. • The 2018 guidelines recommend more detailed risk assessments to help healthcare providers better determine a person’s individualized risk and treatment options. • In some cases, a coronary artery calcium score can help determine a person’s need for cholesterol-lowering treatment, if their risk status is uncertain or if the treatment decision isn’t clear. • While statins are still the first choice 6

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of medication for lowering cholesterol, new drug options are available for people who have already had a heart attack or stroke and are at highest risk of having another. For those people, medication should be prescribed in a stepped approach, first with a maximum intensity statin treatment, adding ezetimibe if desired LDL cholesterol levels aren’t met and then adding a PCSK9 inhibitor if further cholesterol reduction is needed. Stone, who is a professor of medicine at Northwestern University’s Feinberg School of Medicine and the medical director of the Vascular Center of the Bluhm Cardiovascular Institute of Northwestern Memorial Hospital, noted the personalized risk stratification results in a score to help inform next steps for primary prevention and additional treatment options for secondary prevention.

Primary Prevention

For those who have not yet had a heart attack or stroke, Stone said the updated guidelines call for patients with a very high LDL – 190 or more – to be on a high intensity statin. For those with diabetes between the ages of 40 and 75, no matter what the LDL number, the updated guidelines continue the 2013 recommendation for them to be on a statin, as well. He added, “Those who have long-standing diabetes or are older than 50 may do better on a higher intensity of statin.” The new guidelines call for a more nuanced approach to statin use in the largest group – those 40 to 75 without diabetes or the highest LDL-C. Stone said by virtue of four different clinical trials assessing 10year risk, individuals with a score of 7.519.9 percent should at least be considered for statin therapy. He added, those with a score of 5 percent or less typically don’t need statins, and those with a score of 20 percent or higher on the risk calculator should automatically be on statin therapy. “The previous guidelines recommended a clinician-patient risk discussion before a statin was given,” he said of the borderline group. “The new guidelines also recommend a clinician-patient discussion, but they give more details of what that should be. The idea is to provide a way for doctors to give patients, who aren’t sure whether to take a statin, factors to show a patient what their personal risks are.” In addition to traditional risk factors like smoking and high blood pressure, the new guidelines outline a number of other risk-enhancing factors to consider, including: family history and ethnicity, LDL≥160, triglycerides persistently above 175, premature menopause or pre-eclampsia, chronic inflammatory conditions such as rheumatoid arthritis, metabolic syndrome, and chronic kidney disease. A coronary artery calcium (CAC) score can also help tip the scale on whether or not to start statin treatment immediately. A CAC of zero has typically indicated a low

risk of CVD, which has been borne out by two large-scale studies. “We are not recommending calcium scores as a screening test,” Stone stressed. “We’re using it as a tie-breaker … it can be the decider,” he added. “Someone with a (risk assessment) score of 9 percent, few other risk factors, and a coronary calcium score of zero may wish to postpone statin use for five to 10 years because their risk is relatively low,” Stone continued of using the personalized approach at the heart of the new guidelines. For everyone, no matter where their risk assessment percentage falls, he stressed the importance of lifestyle modification to either delay or prevent the need for statins or to enhance the work of statins in maintaining heart health. “We point out even if you’re on a statin, you need to focus on lifestyle because the lower you can get your number on a statin, the lower your risk,” stated Stone.

high cholesterol over a lifetime. In most children, an initial test could be administered between the ages of 9 and 11. For some children with a strong family history of heart disease and high cholesterol, selective cholesterol testing might be appropriate as young as age two. While most children won’t need medication, physicians should use the test to discuss the positive impact healthy behaviors have on lifetime CVD risk. The updated guidelines offer a more individualized method to controlling cholesterol. “Before, it wasn’t a one-size-fits-all approach, but everybody thought if you had a score of 7.5 percent or more, you automatically go on statin therapy. The new guidelines really make it clear how to use enhancers to personalize the risk discussion,” Stone concluded. For a link to the new guidelines, please go online to WestTNMedicalNews.com.

Secondary Prevention

For individuals who have already suffered a heart attack or stroke, the new guidelines call for additional intervention when LDL-C is not well controlled. “We have three trials showing if the LDL is above 70 in people who are very high risk, they might benefit from not just a maximally tolerated statin but also the non-statin ezetimibe or PCSK9 shot,” explained Stone. He added the recommendation is for a stepwise approach. Stone said the addition of ezetimibe would get a significant portion of high-risk patients under the 70 LDL benchmark. Available as a generic, ezetimibe is typically affordable and well tolerated by patients. For those who cannot achieve the desired goals with a combination of statin and ezetimibe, a PCSK9 inhibitor could be added. The new guidelines also note a PCSK9 inhibitor might be added as a primary prevention tool for individuals who have a genetic condition that causes high LDL-C. However, Stone noted, the shot is considerably more expensive. Some insurers have been slow to cover the treatment, although there has been movement in recent months to lower the cost. The AHA and ACC are bringing together stakeholders to further discuss financial barriers to achieving optimal primary and secondary prevention of heart disease and stroke.

For All

Once treatment has started, whether lifestyle modification only or modification with medication, physicians should schedule a follow-up appointment within four to 12 weeks to assess adherence and effectiveness with a fasting lipid test. The guidelines then call for retesting every three to 12 months, depending on determined needs. Stone said the new guidelines recognize and address the cumulative effects of

PUBLISHER Pamela Z. Haskins pamela@memphismedicalnews.com EDITOR Pepper Jeter editor@westtnmedicalnews.com CREATIVE DIRECTOR Susan Graham sgraham@nashvillemedicalnews.com GRAPHIC DESIGNERS Susan Graham Katy Barrett-Alley CONTRIBUTING WRITERS Suzanne Boyd Cindy Sanders All editorial submissions and press releases should be sent to pamela@memphismedicalnews.com Subscription requests can be mailed to the address below or emailed to pamela@memphismedicalnews.com. West TN Medical News is now privately and locally owned by Ziggy Productions, LLC. P O Box 1842 Memphis, TN 38101- 1842 President: Pamela Z. Haskins Vice President: Patrick Rains Reproduction in whole or in part without written permission is prohibited. West TN Medical News will assume no responsibility for unsolicited materials. All letters sent to West TN Medical News will be considered the newspaper’s property and unconditionally assigned to West TN Medical News for publication and copyright purposes.

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GrandRounds West Tennessee Healthcare Announces Multiple Promotions

James Ross, President and CEO of West Tennessee Healthcare, announced multiple promotions within the health system this week. Tina Prescott will assume the role of Executive Vice-President and Chief Operating Officer/Chief Nursing Officer for the James Ross health system. Dr. Jackie Taylor, will assume the role of Vice President and Chief Medical Officer for Jackson-Madison County General Hospital (JMCGH). Additional promotions at JMCGH include Deann Thelen’s move into the position of Vice President and Hospital Chief Executive Officer at JMCGH, and Teresa Freeman’s promotion to Vice President and Chief Nursing Officer at JMCGH. Tina Prescott has been a registered nurse with West Tennessee Healthcare since 1996, and since joining the organization has served in many roles, including Director of the Surgical Intensive Care Unit and Administrator at Camden General Hospital, while most recently Tina Prescott serving as the Chief Nursing Officer at JMCGH for 11 years. She is a graduate of Union University where she received her BSN and MBA, and she is board certified as an Advanced Nurse Executive with the American Nurses Credentialing Center. Dr. Jackie Taylor has been serving patients in West Tennessee since 1990. In 2003, he joined the emergency medicine team at JMCGH, and most recently served as the Chief Quality Officer Jackie Taylor

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and Assistant Chief Medical Officer. He attended medical school at University of Tennessee Center for Health Sciences and holds a board certification in family medicine. He is also a Fellow of the American Academy of Family Physicians. Deann Thelen joined West Tennessee Healthcare in 2012 as Vice President of Hospital Services after serving as Chief of Operations at University of Iowa’s Heart and Vascular Center. She worked Deann Thelen clinically as an RN in SICU

and Cardiac Cath Labs prior to working in healthcare administration. She has an MBA with a Healthcare Management focus from University of Phoenix and a BSN and RN from the University of Iowa. She has more than 30 years of experience in nursing and healthcare. Teresa Freeman has been a registered nurse with West Tennessee Healthcare since 1987. She is a graduate of Union University where she received her ASN, BSN and Teresa MBA degrees. She also Freeman completed a Master’s de-

gree in Nursing from the University of Memphis with an emphasis in Executive Leadership. Previously held positions in the organization include: Director of CCU/MICU, Director of Clinical Informatics & Process Management, Executive Director of Clinical Development & Staffing, Assistant Chief Nursing Officer & Chief Clinical Informatics Officer. She is also part time nursing faculty for the University of Memphis. Teresa is board certified as an Advanced Nurse Executive with the American Nurses Credentialing Center.

The Jackson Clinic Welcomes Our Newest Physician

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