Orlando Medical News October 2020 by Orlando Medical News

OCTOBER 2020

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BRING OUR CHILDREN HOME Talk with your staff, learn these resources

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CONTENTS || FEATURES

Drawing Inspiration at an Early Age Nemours’ Dr. Margaret Baldwin revels in helping kids be kids

PUBLISHER John Kelly jkelly@orlandomedicalnews.com ——————— AD SALES John Kelly, 407-701-7424

FEATURES

4 7

——————— EDITOR PL Jeter editor@orlandomedicalnews.com

COVER STORY Bring Our Children Home

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PHYSICIAN SPOTLIGHT Drawing Inspiration at an Early Age

CREATIVE DIRECTOR Katy Barrett-Alley kbarrettalley@gmail.com ———————

EOCC MEDICAL CITY The Great Debate over Minimum Wage & the Impact on Small Business

CONTRIBUTING WRITERS April Boykin Jay Cohen Mary Dort

Sex and Aging: Talking with Patients

Knowledge is Power

Jan Edwards Dorothy Hardee, Michael C. Patterson Jeff Ramos James M. Scicchitano

Is it Now Time for Patients to Return to Their In-person Out-Patient Appointments?

Renee Taylor

Medical Practices and Cloud Computing

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Use of Cannabis Prior to Bodily Trauma Limits Damage and Increases Recovery

——————— SOCIAL MEDIA DIRECTOR Jennifer Cerna ADVENT UNIVERSITY INTERN Noelle Kelly ——————— CIRCULATION jkelly@orlandomedicalnews.com ———————

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All editorial submissions and press releases should be emailed to editor@orlandomedicalnews.com ——————— Subscription requests or address changes should be emailed to jkelly@orlandomedicalnews.com

Orlando Medical News July 2020 is published monthly by K&J Kelly, LLC. ©2020 Orlando Medical News. All Rights Reserved. Reproduction in whole, or in part without written permission is prohibited. Orlando Medical News will assume no responsibility unsolicited materials.

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BRING OUR CHILDREN HOME Talk with your staff, learn these resources

BY JAN EDWARDS

easy to do and we help with the conversations. Now that you are educated on the signs to look for in both adults and children (if you need a review click here for last month’s article), you may be wondering what other resources are available. The Florida Department of Children and Family (DCF) services has created a brilliant human trafficking assessment tool. The assessment needs to be completed by a Child Protective Investigator or a Community-Based Care Agency representative, so if you suspect child trafficking, calling the Florida Abuse Hotline number is the wisest thing to do. That number again is 800-962-2873. You can find the DCF screening tool here. There is also a quick screening tool developed in tandem with Covenant House in New Jersey for teens and young people. You can access to the QYIT here. How you confirm a child is a possible victim is by asking very simple questions that can lead you to the conclusion to call DCF. It’s all in how you are being. The tone of voice, the words you use, your body language. Consider it similar to delivering news to a patient they don’t really want to hear but need to hear. Another really great tool is using ACE’s Quiz. Adverse Childhood Experiences have been sourced to chronic illnesses and diseases in many adults. The earlier we can discover the adversity and get the child taken care of, the longer and stronger life they get to live. You can use this assessment at any age and it offers a sense of what your patient is either dealing with or has in their past. Here is a link to the quiz and some terrific information about ACE Scores. The importance of using this tool is based on the fact that the CDC did a study in 2012 and estimated we spent over $124 Billion dollars on untreated childhood trauma. The long-term effects of abuse, neglect

Last month we talked about the realities of Human Trafficking right here in Central Florida. As shocking as it is, Florida is ranked 3rd in the nation for calls to the national trafficking hotline. The average age of entry is 11-14 and likelihood that a victim of human trafficking or child exploitation has crossed your doorway is high, in fact 85 percent of trafficking victims reported being in a medical setting for various concerns but did not feel safe enough to ask for help. I have a couple of questions for you? Did you put those numbers in your phone? If not, here they are again 888-373-7888 and Florida Abuse Hotline is 800-962-2873. Stop reading and do that now. Thank you. Did you have conversations with your staff yet? If not, well, maybe you’re dealing with all the unrest out in the world and unsure how to bring this topic up. Or maybe, this is still an uncomfortable topic to be with, let alone discuss it with someone else. It’s ok, I understand. In fact, it’s why we are so committed to getting the word out about this crime against our children. The more we shine a light in the darkness, the bigger impact we can have. We hear you concerns. We are trained to have those conversations with your team. Learn more about our nursing CEU Course here. This month we’re going to talk about tools and resources available to you and invite you to get involved in a statewide awareness campaign that’s

HELP LINES AVAILABLE 24/7 EVERYDAY. 888-373-8888 or text ‘Help’ to 233733. For minors, call the Abuse Hotline, 800-962-2873 4

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and suffering can actually be interrupted by asking a few simple questions as you engage with your patients. Here are a few non-threatening questions you can practice with talking with children: • “That’s an interesting place for a bruise – how’d you get that playing “superman/women’? – Watch their reaction. Do they look at the parent before speaking? Stumble with their words? If so, ask another simple question to verify. • “What was your favorite thing you learned in school this week? – Do they light up and share freely or again look to the parent for the answer and mumble something (and they are normally not a mumbler). • Watch the parent’s reaction – are they nervous? Do they stumble over words and were perfectly articulate moments ago? Fidgety? • Last question – “Have you been getting good sleep?” – watch the reaction – if it’s the same, looking for the answer, stumbling or mumbling – you can make a quick statement like – we’ll it’s been “hot, rainy, cold,” I’ve had a hard time sleeping too. It’s time to separate the parent and the child so you can ask the important key question. Take the child for an “x-ray or scan” or offer the parent coffee or water – bottom line, get a few minutes alone with the child and another nurse or doctor and you can ask the following questions: • “Sometimes, children find themselves in situations where they feel unsafe, threatened, controlled or even tricked into doing something they didn’t want to do. Is anyone at home doing

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VIDEO: Debunking Myths about Human Trafficking

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BRING OUR CHILDREN HOME something to you that makes you feel that way?” Pause and be quiet. Give the child a moment to think and respond.

born or the ‘boyfriend/girlfriend’? Those three things right there are red flags and call for a moment of separation to dive a little deeper into the situation. Once alone – these simple questions can guide you to the next move. I will warn you, much like DV Victims, most trafficking victims do not self-identify, they may not want to leave or even feel they can leave. Trauma bonding is real. So are the threats, manipulation and coercion. I invite you to bring some patience, love and compassion to the conversation along with keen listening and paying attention to body language. Trust your gut – if something feels off. Stop the action. Separate the patient from their controller as gently as possible and ask a few of these questions:

• “I know this may be a little scary. Maybe no one has asked you about this before or maybe you shared it with someone and they didn’t believe you, it’s ok. It’s not your fault. You haven’t done anything wrong, we want you to know you are safe, and we will make sure to keep you and your (mom, sister, brother) safe.” • From there, one of the staff members must call DCF. They will instruct you what to do. You can also call One More Child, they support child trafficking victims ages 10-21. Their number is 407-799-8719. Now what does all of this have to do with disrupting child trafficking and exploitation? Here are some frightening statistics:

• That’s an unusual tattoo? Does it have a special meaning to you? • Have you ever been afraid to leave or quit a work situation due to fears of violence or threats of harm to yourself or your family?

• 80.3 percent of childhood abusers were parents, 6.1 percent were relatives other than parents.1

• Has anyone ever threatened you if you didn’t do something you didn’t want to do?

• 75 percent of teenage child trafficking victims have been sexually abused. 2

Depending upon the answers, trusting your gut, call the national trafficking hotline, 888373-7888. They’ll guide you from there. Please try not to get discouraged if they do not want to be “rescued.” Trauma bonding is very strong and sometimes it takes several times for victims to even think about leaving the life. A word of caution, giving them the hotline number can put them at risk. Be creative on how you do that. For example, you can write the number on their foot or leave a paper and pen in the restroom they can say if they want help. The one thing I’ve learned over time, victims choose when they leave. They are not rescued – they decide to leave the life or not. Trauma centered care and compassionate conversation can make the difference for them to even contemplate leaving and stay out. Depending upon the situation, if law

• 65 percent of child trafficking victims are exploited by a family member. 3 The math is clear – our children are at the highest risk of being victimized and exploited.

Know the signs. Ask the questions. Make the call. For more insights watch our interview here with Principal Jordan Rodriquez: https://youtu.be/kCbSes72DWY For adult victims the journey is similar because many were abused as children, ran away, came out of foster care or were recruited into this nightmare. Like children, they are controlled by their ‘boyfriend’ pimp, trafficker or bottom girl. A bottom girl is the traffickers “top girl” – she helps recruit and maintain the ‘stable’ of girls. It’s her job to keep them in line, take them to get their health checkups, hair and nails done, shopping, etc. She may even get a small percentage of the girls take to keep her loyal. She may be the one that brings the victim to your office for her checkup. The same rules of engagement apply – the questions are slightly different. There are however, clear things to look for, starting with the front desk team. Does the patient have his/her own wallet and ID or does someone else control it? Do they never leave the patient alone? Does the patient answer the questions about address, age and where they were

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enforcement is called in, they will bring a victim advocate to assist the survivor and ensure they get the assistance they need. They will manage the care and getting the survivor to the place they need to be safe, reduce the fear and begin their journey of hope. Some local resources for adults are: • United Abolitionists • Aspire Healthcare • One to One Hope • Selah Freedom • Lifeboat Project • The Shelter • Samaritan Village Modern Day Slavery is a travesty against humanity. Women and children represent over 60 percent of the victims, while men make up the rest. There is no socio-eco-demographic boundary for human trafficking. There is a solution and you are an important part of it. By being aware, educating your staff and taking appropriate action to save people from a life that one can only imagine. We invite you to participate in a simple event in November to raise awareness – Lights on For Children! November 20, is Universal Children’s Day. Go buy a blue lightbulb, then on 11/20/20 at dusk, turn on your porch light blue and let’s light up the night, shining the brightness of hope. You can learn more here on how to participate and shine a light on child trafficking. https:// www.pavingthewayfoundation.org/lightsonforchildren.html SOURCES: 1. https://www.cdc.gov/violenceprevention/pdf/ childmaltreatment-facts-at-a-glance.pdf 2. https://www.taalk.org/resources/statistics 3. https://www.iom.int/sites/default/files/our_work/ DMM/MAD/Counter trafficking%20Data%20

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PHYSICIAN || SPOTLIGHT

Drawing Inspiration at an Early Age Nemours’ Dr. Margaret Baldwin revels in helping kids be kids Most people probably recall very few memories of being two years old, let alone making a major career decision at that age.

exactly what I was looking for, so I can collaborate with everyone I did fellowship training with for surgeries and research ideas. I look forward to serving my new communities of Orlando and Lakeland at Nemours.” Only six percent of board-certified orthopedic surgeons are female. While some women report facing barriers and discrimination in professions that are largely male dominated, Baldwin said she was lucky to have a great mentor during medical school. “Even though he was male, he believed in me and encouraged me to do what I loved,” she said. “I did have many other people make comments that I was not strong enough/large enough/or that orthopedics just wasn’t suited for females. Those are misconceptions that I am hoping to change and through volunteering with the Perry Initiative and various medical school interest groups, I am a huge advocate for females going into orthopedic surgery.” Baldwin said she is excited to be a trail blazer by being the first female orthopedic surgeon for Nemours in Florida. She will treat children with a wide variety of orthopedic issues, including spine and neurodevelopmental disorders, spina bifida, and spinal muscular atrophy. She especially looks forward to continuing her work with patients with CP, a subspecialty in which she has done important research. The thing she most enjoys about her work is when she can help children get back to being children and young adults.

But pediatric orthopedic surgeon Margaret Baldwin, MD, has had her eyes set on a career in medicine ever since she was a toddler. “I think it was because I really looked up to my pediatrician and thought what she did was amazing,” said Baldwin, who recently joined the staff Nemours Children’s Specialty Care in Lakeland, as well as at Nemours Children’s Hospital in Lake Nona. “I was really fascinated by the idea of making kids feel better.” She also wanted to be an astronaut when she was younger. As she advanced in school, she became very interested in math and science and considered doing engineering, especially prosthetic design, while in college. But she continued to be drawn toward a career in medicine. “It just felt like a natural career choice for me,” Baldwin said. “I knew I wanted to do orthopedics my first year of medical school at the University of Texas School of Medicine at San Antonio. I was able to spend some time with the current residents and really enjoyed the idea of restoring function to people and being able to fix what was wrong.” She became interested in pediatric orthopedics during the beginning of her residency at the University of Oklahoma Health Science Center. “In my residency, I really enjoyed working with children and families to offer excellent care and make a difference in someone’s life,” she said. “We were able to rotate on the pediatric service during intern year and I really enjoyed that patient population and being able to work with families. I also loved that I would be able to take care of children their entire lives with the goal of allowing them to be a kid.” Baldwin completed her fellowship in pediatric orthopedics at A.I. duPont Hospital for Children/ Nemours. She found that experience so positive that she was inspired to find a permanent position with the children’s health system. When an opening was posted in Florida, she applied, saying the opportunity to stay within Nemours was too good to pass up. “The Nemours hospital in Delaware is one of the top centers in the country for work in cerebral palsy (CP), and I learned from the best doctors in that area,” Baldwin said. “In my residency, I really enjoyed working with children and families to offer excellent care and make a difference in someone’s life. The opportunity to stay with Nemours is

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“I love to see them going back to playing with friends or to the sports they love,” she said. “I really enjoy building a relationship with the children and their families and being able to care for the children from a young age to adulthood. It is also amazing to help be part of a team that helps kids keep or restore their mobility.” She said an important trend is doing single event multi-level surgery (SELMS). This allows the children to undergo one large operation with one recovery/rehab period. Baldwin said it allows them to rehab better and retain more of their function. There have been major advancements made over the past 10 to 15 years treating areas of focus in orthopedics including spine and neurodevelopmental disorders, spina bifida, and spinal muscular atrophy. “There has been further understanding of the genetics and basic science aspect of these diseases which has brought forth medications to help slow the progression of some of these diseases,” Baldwin said. “We have also developed better implants which allow us to accomplish more with surgery and obtain better outcomes.” Outside of work, Baldwin loves outdoor activities, including running, and enjoys trying out new restaurants. She looks forward to introducing her parents and siblings, who all live in different states, to all that Florida has to offer. In addition to Nemours internationally-recognized children’s health system that owns and operates two free-standing children’s hospitals, Nemours also powers the world’s most-visited website for information on the health of children and teens, KidsHealth.org, and offers on-demand, online video patient visits through Nemours CareConnect. Nemours ReadingBrightstart.org is a program dedicated to preventing reading failure in young children, grounded in Nemours’ understanding that child health and learning are inextricably linked, and that reading level is a strong predictor of adult health. The not-for-profit Lakeland Regional Health reaches beyond its hospital walls to promote wellness, education and discovery in new places and new ways, providing a wide range of inpatient and outpatient healthcare services at its Medical Center, Hollis Cancer Center and ambulatory care locations.

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EAST ORLANDO CHAMBER OF COMMERCE

EOCC || MEDICAL CITY

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CALENDAR:

The Great Debate over Minimum Wage & the Impact on Small Business

Healthcare Council Collaborative Virtual Peer-to-Peer Referral Forum & Breakout THURSDAY, OCTOBER 8, 2020 8:00 – 9:00 AM Powered by Powernet Free to Healthcare professionals

BY DOROTHY HARDEE

For years, there has been a national debate over whether to raise the minimum wage to $15 per hour and in November, Floridians will be able to cast their ballot on the issue.

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Established in 1938 as part of the Fair Labor Standards Act (FLSA), FLSA not only determined a minimum wage to ensure employees would have a fair wage as well as decent quality of life but also, prohibited child labor and mandated the 40-hour workweek. It was also supposed to ensure regular increases to ensure the lowest-paid workers could benefit improving their standard of living. In 2015, David Cooper with The Economic Policy Institute addressed the fact that adjustments have been infrequent and inadequate eroding buying power, making “the value of the federal minimum wage in 2014, 24 percent below its peak value in 1968.” The decline meant that employees had to work longer hours to achieve a standard of living considered the bare minimum almost half a century ago. He went on to say that “raising the federal minimum wage to $12 by 2020 (the goal in 2015) would restore its value to a level that ensures full-time work is a means to escape poverty and would provide tens of millions of America’s lowest paid workers with a small yet long overdue improvement in their standard of living”. Fast forward to 2020 and a pandemic situation. Our frontline workers (20 percent of which are doctors and nurses) are risking their lives during COVID. However, the other 80 percent are low paid, undervalued essential workers such as housekeepers in acute nursing facilities, maintenance, dietary, nursing assistants, patient care techs, administration, and others. The median pay is $13.48 an hour, well short of a living wage. In fact, 20 percent of care workers live in poverty and more than 40 percent rely on some type of public assistance. Florida last voted on a minimum wage ballot measure in 2004. Voters approved Florida Amendment 5 approving a $6.15 per hour minimum wage set to increase each year on changes in the Consumer Price Index for Urban Wage Earners (CPI-W). Ballotpedia shared that, as of 2020, seven states have passed a $15 minimum wage bill,

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WEDNESDAY, OCTOBER 21, 2020 11:30 AM – 1:00 PM The Pavilion at Avalon Park 13401 Tanja King Blvd. Orlando, FL 32828 Registration Required: Hybrid Event

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Please visit EOCC.org for a complete listing of October events

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The Great Debate over Minimum Wage & the Impact on Small Business effective incrementally. If Florida approves Amendment 2, it will become the first state to increase the minimum wage through a ballot measure, implementing the highest minimum wage rate of any ballot measure as of 2020. The passage of Amendment 2 will incrementally raise the minimum wage reaching $15 per hour in 2026. Starting September 20, 2027, the state would have an annual adjustment to the state minimum wage based on increases to the Consumer Price Index for Urban Wage Earners and Clerical Workers. Florida For a Fair Wage is leading the campaign to support the Amendment sharing that “The living wage is the minimum cost that covers the basic needs of an individual and family without government assistance.” However, opponents to the Amendment including The Florida Restaurant and Lodging Association consider the increase disastrous for businesses and individuals alike. Business owners will have to find solutions to control costs. Solutions may include reducing employees, hours and seeking automation as an alternative to labor. They suggest that the measure would create a 75 percent salary increase that would suffocate small businesses. Florida Today detailed that the current minimum wage in Florida is $8.56 per hour, less than $1,400 per month or $17,600 a year. A livable wage in Brevard County, for a household with two working adults and two children is $15.57 per hour and $16.14 in Florida based on the Living Wage Calculator. Today’s low-skill workers earn comparatively less per hour than their counterparts 50 years ago, despite economic growth, according to Florida for a Fair Wage. Taxpayers cover the bill for low wages. Nearly half of those on the Nutrition Program for Women, Infants and Children, as well the free school lunch program is living in low wage working families. Economists are unable to agree on the impact of a higher minimum wage. Different studies reach different conclusions. The University of Washington found in 2017 that as wages increased, hours worked decreased along with pay. However, a follow-up study concluded it was not the case for all workers and those with experience earned more. Another study by the University of California concluded that wage hikes have not led to job losses. Given the information, how do you feel Amendment 2 would impact your practice or small business? Dr. Colin Bartoe (Functional Neurology Chiropractic Center) said, “A $15 an hour minimum wage would affect us, but not as much as larger companies with many minimum wage employees. We are a smaller office with employees who are paid competitively and above minimum wage. We would want to maintain the financial incentive above minimum wage for our employees, however, that may mean a reduction in hours based on the available budget for payroll until growth can be achieved.” Join us for the next East Orlando Chamber Healthcare Council Collaborative Virtual Meet & Greet Thursday, October 8, 2020 at 8:00 AM.

Economists are unable to agree on the impact of a higher minimum wage. Different studies reach different conclusions. The East Orlando Chamber Healthcare Council Collaborative is focused on the entire landscape with special attention to offering focused peer-topeer networking to increase referral sources. During our breakout we want to hear your thoughts on Amendment 2 and the impact on your business. Join us to meet your neighboring physicians, learn more about the Healthcare Collaborative and how the EOCC is helping grow your practice through referrals, community outreach and new opportunities with increased revenue potential. If you are a physician or healthcare professional, register today. RSVP is requested. Want to know how else the Chamber can work with you to elevate your business? Let us meet to discuss your business objectives and how the EOCC helps drive results making you a longterm member of one of the oldest established chambers in Central Florida. As we reach half a year of the COVID-19 nightmare, many businesses are teetering on the

brink, trying to decide which expenditures make sense to continue. So, you ask yourself why you should consider membership in the East Orlando Chamber. As businesses are looking at ways to save money, they also seek ways to retain and attract employees. Not only does the chamber offer networking opportunities and great costsaving benefits, but it now provides a direct primary care plan and health benefits program, with a group rate with pricing individuals would find hard to beat. The chamber partnered with Joe Filice, president of Avalon Insurance Services, to provide members some of the most unique benefits around. In fact, this move makes our organization the first chamber in the state to offer an affordable package for any size business. Have we piqued your interest? Give us a call to find out more at (407) 277-5951 or visit our website at eocc.org. The East Orlando Chamber of Commerce everywhere East of I-4.

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Sex and Aging:

Talking with Patients BY APRIL BOYKIN, MSW, LCSW, AND RENEE TAYLOR, MSW, LCSW, CERTIFIED SEX THERAPIST

This gives permission and opens the door for a great

overall health and well-being. For some older patients,

conversation.

the physician’s office might be the only opportunity to

3. Props - Not what you think! Use posters on the

If you’ve made it past the title, then you’re ahead of the game. Research tells us that medical providers (and everyone else) have great difficulty raising questions about sexuality with our older patients. Instead, we focus on medical problems or ask physiological questions. Always staying in the safe zone: side effects of medications, pain, exercise or diet, bowel movements, and maybe even emotions. But never SEX. Sexuality is central to being human. We are living longer and sexual functioning among older adults is more important than ever for leading a healthy and fulfilling life. According to Indiana University’s Center for Sexual Health, in the 1970s only 10 percent of men and women reported being sexually active into their 70’s. Today, 60 percent of men and 34 percent of women are reporting being sexually active into their 80s. That change is something to celebrate. Sex has so many benefits, including improving the immune system, lessening pain, improving sleep, managing stress, boosting self-esteem, improving connections and quality of life, and so much more. So, let’s encourage their oxytocin to start flowing. What gets in the way of SEX talk? Time constraints, discomfort, not enough privacy, insufficient training in sexual function in old age, and even socio-cultural factors. Most of us are uncomfortable with conducting a sexual history with our older patients. But it’s not just us, it’s them too. Older adults usually have greater difficulty talking about sex in general. They are reluctant because they buy into myths about sex and aging. They think they shouldn’t be interested, or it’s undignified, worry they will be judged, or have a lifetime of being reserved about this topic. For many, sexed was a one-time event and they never think of talking about the changes that are happening to their bodies sexually because they are assumed to be normal and unavoidable. But we can fix that.

wall, rack cards, a flyer, or something that promotes

discuss their current sexual experiences. 2. Sexual Cycle: If a patient reports sexual issues,

talking about sex. This is a non-threatening way to

a physician can help them identify which area of the

let patients know you are comfortable with this topic

sexual cycle they are experiencing distress; desire,

and encourages the conversation.

arousal, orgasm, or resolution. When we are young

4. Annual Wellness Visit - Make sexuality a part of the annual health questionnaire. 5. Open-Ended Questions - Or just “go for it” with questions that get them talking such as, “In what ways has your sexual relationship changed with your partner as you have aged?” or “Tell me about how you are expressing your sexuality now?” or “Is there anything getting in the way of a fulfilling sex life?”

What older patients would benefit from knowing:

desire happens before we become aroused, but as we age and hormones change, often desire happens after arousal. Helping patients understand this shift can help them stay engaged. 3. Disruptions due to Body Changes: It is not uncommon for men to have erectile issues or women to have vaginal dryness, these changes occur due to natural hormonal changes. But bodies also change because parts are removed, prolapsing, thinning, or changing in other ways. It is important to include in sexual information when you educate patients about dealing with these changes.

1. Sex is Good for You: Older patients need to know that they are entitled to a healthy and happy sex life at any age, and that sex and intimacy play a vital role in

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more comfortable you are in discussing sex the more comfortable patients will be. 2. Patient Comfort - Acknowledge the discomfort patients may experience at the start of the

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Sex and Aging: Let’s Talk! 4. Disruptions due to Medication Side Effects/ Health Conditions: Sexual issues can also be a symptom of a health issue or side effect of a medication. Some sexual issues can be remedied by changes to medication, suggesting using lubricants, prescribing an erectile enhancer, or hormone therapy. It is important to include information related to sexual disruptions when prescribing a new mediation or addressing a new diagnosis. 5. Outercourse or intercourse: For patients not able to have penetrative sex, you can let them know that they can still have an enjoyable sex life without penetration. Penetration or intercourse is only a part of sexual activity, outercourse can also provide pleasure and enhance intimacy. Outercourse can include, massage, sensual touching, kissing, hugging, oral stimulation, and masturbation. Two great techniques that patients can use to guide them in outercourse is Sensate Focus and Tantric Sex. 6. STIs and Aging: Another reason to talk to older patients about sex is that they might not think about using protection as pregnancy is no longer an issue. According to the CDC in 2018, 17 percent of new HIV diagnoses were people 50 and older; and Athenahealth reported between 2014 and 2017, STIs rose 23 percent amongst patients 60 and older. The physician’s office can be a great space to normalize sex and sexuality for older patients, as well as provide education, resources, and guidance on having healthy sexual relations with themselves or with a partner. Counselors are great partners in this discussion. We are skilled at addressing all aspects of a persons’ physical, behavior, or emotional functioning, including sex. April Boykin is a Licensed Clinical Social Worker and cofounder of Counseling Resource Services (CRS). Established in 2013, CRS is a communitybased in-home integrated behavioral health agency serving the aged and disabled population in Central Florida. As a mental health counselor, she has provided individual, family and caregiver counseling to children, teens and adults. She can be reached at april@counselingresourceservices.com

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Knowledge is Power How would you want to be tested? present. Viral tests are recommended to diagnose acute infection of both symptomatic and asymptomatic individuals, to guide contact tracing, treatment options, and isolation requirements.

BY MARY DORT, RN

COVID-19 by the CDC numbers: • 7,059,087 total cases of COVID-19 in the U.S, to date. • 204,033 deaths in the US, to date. • 2,133 cases per 100,00 people, to date

• Culture-based testing: Culture based testing is the standard in the industry which relies on growing cultures in a petri dish of a suspect sample. While this has been the norm for the industry for decades, it has limitations of accuracy and specificity as well as can take 4-7 days for results versus molecular based testing in the market today.

These numbers represent People. We have not stopped this pandemic and have only slowed it. Now we are faced with FLU season, in addition to COVID-19, which will complicate the detection and understanding. Since grade school, we have been taught that testing shows us how we are learning and progressing in school. Similarly, COVID-19 testing is used and must be continued to give us the baseline information needed to track progress, in addition to knowing how to properly treat our patients.

• PCR testing: This molecular based COVID-19 test detects the genetic material of the virus using a lab technique called polymerase chain reaction (PCR). Also called a molecular test, a health care worker collects fluid from a nasal or throat swab or from saliva. Results may

COVID Viral Testing per Mayo Clinic: • Authorized assays for viral testing include those that detect SARS-CoV-2 nucleic acid or antigen. Viral (nucleic acid or antigen) tests check samples from the respiratory system (such as nasal or oral swabs or saliva) to determine whether an infection with SARSCoV-2, the virus that causes COVID-19, is

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be available in minutes if analyzed onsite or 48 hrs. or less if sent to an outside lab. PCR tests are faster, more accurate, with improved reliability and increased sensitivity versus culture testing when properly performed by a health care professional. So, you are sick, and you think you may have COVID or maybe the FLU. Which test are you going to want done? As a person with medical knowledge, I have made my decision on how I wish to be treated as a patient. If I am sick, I will be having the PCR testing done. As Thomas Jefferson said, knowledge is power. Mary Dort has been a Registered Nurse for 35 years. She is currently co-owner of an Rx2Live Franchise in Cape Coral and serves as a Medical Business Consultant to medical practices, elder care facilities, dental practices and businesses interested in implementing Health and Wellness programs. Prior to her current role, Mary served as a Chronic Care RN for the Bay Pines VA health care facility in Cape Coral. Prior to this role, she served in a similar capacity at the VA in Salisbury, NC as well as in Wichita, KS. Mary received her RN degree from Olney Central College in Olney, IL.

Is it Now Time for Patients to Return to Their In-person Out-patient Appointments? • Well defined, comprehensive, procedures and training provided to all staff, with special emphasis placed on disinfecting frequently contacted surfaces.

BY JAMES M. SCICCHITANO

The COVID-19 pandemic has drastically altered a patient’s perception of even the most routine outpatient medical visits. With every appointment reminder from their providers comes a lingering thought that persists throughout a patient’s mind: “should I keep this appointment?” The pandemic has forever transformed how healthcare services are delivered; telehealth appoints are the new norm, PPE and social distancing are compulsory, and even controlled medications can now be phoned in or e-prescribed to your pharmacy. However, are virtual appointments sufficient to address all of a patient’s health concerns? How do patients with greater health needs weigh the risks of delaying much-needed care against potential exposure to the deadly virus? Can physicians even uphold the same standard of care conducting a virtual appointment compared to in-person visits? To quote one of my physicians: “we are equipped to deal with this virus and keep our patients safe, but our diagnostic and interventional effectiveness can only be maximized when we are face-to-face with our patients.” As a healthcare administrator for Orlando Heart & Vascular Center and Orlando Endocrinology, part of my job entails communicating with local physicians and the surrounding community the various endeavors that our organization is undertaking. This includes the steps that we are taking to protect our patients and reduce the risk of transmitting COVID-19. In addition to the national standards mandating everyone wear a mask, maintain social distancing, and frequently use hand sanitizer, our organization provides care for an older demographic of patients and, as such, dictates that we are held to a higher standard. To protect our patients and provide a diverse range of options to accommodate their needs, Orlando Heart & Vascular Center and Orlando Endocrinology have implemented the following protocols:

• Social distancing training merged with our customer service standards, after all, we should be courteous when reminding patients to social distance. • Occupancy limitations which not only focus on the buildings as a whole but also limits the number of patients or personnel in a particular room or gathering area. • Temperature checks and screening questionnaires requiring patients to report any symptoms, potential contact with someone exhibiting symptoms, and any recent COVID-19 testing. • Staff, particularly medical assistants must instruct patients to be mindful and avoid frequently contacted surfaces and apply hand sanitizer at our several newly installed hand sanitizer stations. • Of course, we offer telehealth appointments, contactless payment options, and have waived all late/no show fees. We do not believe our patients should have to pay for exercising caution during these difficult times. Though this is not an exhaustive list of the numerous safeguards we have put in place to ensure the protection of our patients and staff alike, it lends credence to steps that we believe to be necessary to reinforce the confidence of our patients whose health needs are better served by face-toface appointments. From a diagnostic standpoint, it is extremely difficult to effectively assess and treat patients from a virtual or telehealth platform. Using our organizational specialties as examples, an arrhythmia is best diagnosed with an EKG and an assessment by our cardiologists with their stethoscope; screening a diabetic’s foot for loss of protective sensation is best diagnosed by our endocrinologist using monofilament. Many media outlets and data-driven healthcare institutions report dramatic increases in the number of patients who are delaying care due to fears of contracting COVID-19 and spreading it

• Unique departmental mandates for employee PPE, ranging from face masks for receptionists to full, head to toe, PPE attire for our Cardiac Catherization Lab personnel.

to their loved ones. In their abundance of caution, however, patients who have chronic conditions, or conditions yet to be diagnosed, suffer from the progression of those symptoms. This can further complicate their condition, potentially irrevocably, and lead to an increasingly bleak prognosis. It is not uncommon for a patient’s symptoms, left untreated, to advance to the point of requiring admission to the emergency department and suffer life-altering progression of their symptoms. The situation is not without hope, because patients can take steps to assume greater control over both their personal health needs and their environmental risks associated with COVID-19. Patients are encouraged to take the initiative to reach out and inquire with their health care provider(s) asking, “what steps has your organization taken to protect me and my family’s well-being from COVID-19?” Are they going above and beyond the call of duty? Or simply maintaining the minimum standards mandated by local and state governments? The answer could be telling and paint a picture of the physicians who you trust with your health and well-being. In our experience, the minimum standards are insufficient and unacceptable when assuming responsibility for the health needs of a vast patient population with conditions that increase their vulnerability to the deadly COVID-19 virus. As healthcare providers, we also find it unacceptable for patients who are forced into delaying care out of fear of risking exposure to the virus and even futile if their condition, left untreated, produces the same result of being admitted to the hospital. With that in mind, our recommendation as healthcare professionals, is to keep your in-person appointments for serious conditions or concerns. There are two ways a patient discovers they have a serious health condition: either they are evaluated and informed by a healthcare provider, who can then begin immediate treatment, or the health condition is left undiagnosed and untreated and they find out in the emergency department. A patient retains control of their health by leveraging the power of information. Information on how their providers are coping with the pandemic, and information regarding their health gained from a face-to-face visit with their physician.

James M. Scicchitano graduated from both the MHA and MPA programs at UCF. He is the healthcare administrator at Orlando Heart & Vascular Center.

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Medical Practices and Cloud Computing BY JAY COHEN

guaranteed response times. As a healthcare provider, you are likely serving patients around the clock, 365 days a year, so you will need an MSP who can respond to your needs accordingly.

Cloud computing is impacting healthcare in several powerful ways, including lowered computer resources costs, easier data integration throughout the healthcare system, access to highpowered healthcare data analytics, higher patient control of their medical data, and a more extensive array of telemedicine options. However, while taking advantage of cloud computing to boost convenience and efficiency, medical practitioners must comply with the Health Insurance Portability and Accountability Act, known as HIPAA, which ensures the security and privacy of protected health information.

• Provide single-interface access to all IT systems. To work effectively, you need to have easy, dynamic access to your full IT infrastructure. A professional MSP is supposed to offer you a single interface that enables you to access all of your IT resources. • Employ strict security measures. Your ideal MSP should work with top-notch, HIPAA-compliant security functions, and be transparent with you regarding what their practices are. This includes physical server security, identity-based security, and data encryption, among other things.

How does HIPAA Impact IT for Medical Practices? Keeping PHI (protected health information) secure and private is crucial to maintain a trusting relationship between the patient and the healthcare provider. A HIPAA violation, even if it is unintentional, might not only lead a healthcare provider to lose patients but may also result in fines as high as $1.5 million. Therefore, when choosing options of patient data storage, network security, and communication, a healthcare provider must be extra careful to make HIPAA-compliant choices. The network used to transmit patient data must operate at the highest possible level of protection, and any emails must be delivered securely to the recipient. There are several data storage options compliant with HIPAA, including cloudbased technologies and on-premise storage. When necessary, data needs to be HIPAA-encrypted for absolute transmission security. Because of the gravity of a possible HIPAA breach, hiring an IT expert specializing in data security for HIPAA compliance may be a wise choice for health organizations. Also, medical staff with access to patient databases should receive suitable training in HIPAA practices.

• Have a solid emergency backup plan. A healthcare provider is committed to acting upon the best medical practices, even in the face of emergencies like a natural disaster, a power outage, or a database failure. A trustworthy managed services provider should come up with a reliable emergency backup response that will enable your practice to function—and comply with HIPAA—no matter what happens.

10 Common HIPAA Violations for IT Due to the complexity of HIPAA regulations, many medical practices unknowingly violate the rules of working with PHI, risking negative publicity, and hefty fines. You should be aware of these ten common HIPAA violations. 1. Unsecured records. All PHI documents must be kept secure at all times. Physical files should be safely locked away, while digital data must only be accessible with a password and, whenever possible, encrypted.

How to Pick a Good Managed Services Provider for Your Practice

2. Lack of staff training. For proper record security, all medical staff must be trained in HIPAA-compliance practices in general and their implementation by your organization in particular.

When choosing a managed services provider for your health practice, you want to make sure you pick someone who knows all about HIPAA and working with protected health information. A competent Managed Services Provider should:

3. Sharing PHI. Medical staff must be extra careful to discuss sensitive patient information only with authorized staff members, in private. 4. Employee deception. When an unauthorized employee attempts to access PHI, they violate HIPAA practices. Staff training must be very clear on who can access patient data.

• Be active in managing and reporting on application performance. This includes databases, networks, computing, and any proactive measures.

5. Third-Party PHI disclosure. Staff with access to PHI must beware of discussing it with people who do not have lawful access to this information.

• Offer reliable, predictable, and clearly defined response times. Any MSP contract should include a detailed agreement specifying

6. Unauthorized information release. The most common occurrence of this is when medical information about celebrities leaks to the media. 14

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7. Lack of data encryption. Encryption protects the data even if the device storing it is stolen, lost, or hacked. While HIPAA does not explicitly stipulate for data encryption, it is a strongly recommended practice. 8. Hacking. All devices used to store PHI must have updated and active antivirus software, use firewalls, and employ the protection of unique, regularly changed passwords. 9. Device loss or theft. All devices used to store PHI must be stored in a secure location, in addition to being password protected. 10. Improper Record Disposal. PHI records disposal is an essential part of HIPAA compliance. All diagnoses, social security numbers, etc., must be physically destroyed or deleted from the hard drive when no longer needed.

Why Remote Monitoring is Important Remote patient monitoring is vital to keep track of a patient’s condition outside a clinical setting. Remote monitoring is highly costeffective, improves efficiency, enables patients to receive timely medical care without having to physically visit a clinic, and allows medical practitioners to keep in touch with their patients more frequently, facilitating proactive care. Various studies have shown that telemedicine may help reduce hospital readmission rates, which means both better outcomes for the patients and significantly reduced operational costs. While remote monitoring is rapidly becoming a vital and mainstream part of medical practice, it does bring some concerns, data privacy among them. Therefore, healthcare organizations practicing remote patient monitoring must adhere to HIPAA guidelines to ensure PHI is kept secure and for patients to continue to feel comfortable disclosing sensitive information through a digital channel. Thorough staff training, comprehensive HIPAA-compliance guidelines, a sufficient cybersecurity budget, and choosing a trustworthy managed services provider all contribute to the protection of sensitive patient data. Jay Cohen is a successful IT strategist, CEO, International Author and Speaker with over 25 years of experience in technical and customer support industries. Cohen has led large and small development and deployment robust technical solutions. He has expertise working in technology, financial, real estate, healthcare, government contracting and telecommunication services. Offering a unique combination of strategic technology vision, business acumen, and tactical leadership to consistently deliver to plan and bring value to the organization. Visit www.jaycollc.com or email him at jay.cohen@jaycollc.com

Use of Cannabis Prior to Bodily Trauma Limits Damage and Increases Recovery but did not have any other prescription or illegal drugs in their system. The patients who were THC positive were typically younger and made up of more males than females. Also, the THC positive patients were more likely injured by a penetrating mechanism than the patients who did not have THC in their system. The results found that THC positive patients had a shorter median length of stay in the trauma center (P<0.001) and intensive care unit (P<0.001). Patients who were THC positive had a lower mortality rate (4.3 percent) compared to the patients without THC in their system (7.6 percent). Furthermore, THC positive patients with traumatic brain injury had a shorter length of stay in the hospital (P= 0.025) and shorter ventilator days (P= 0.033) than non-THC positive patients. With patients who had an Injury Severity Score >16, THC positive patients had significantly lower ICU length of stay (P= 0.009) and lower mortality (19.3% versus 25.0%) (P= 0.038) than patients who did not have THC in their system.

BY MICHAEL C. PATTERSON

A recent study published in the August 2020 edition of Journal of Surgical Research demonstrates patients who arrive into a hospital trauma center suffering from bodily trauma, and have THC detected in their blood stream upon admission to the trauma center, recover faster and have less permanent bodily damage. The link to the study is below. https://www.journalofsurgicalresearch.com/article/ S0022-4804(20)30468-6/abstract The study was conducted by Dr. Sharven Taghavi and Dr. Danielle Tatum of Tulane University School of Medicine Critical Care Department Surgery Division of Trauma in New Orleans, Louisiana and Dr. Danielle Tatum, Research Director, and Saul Ramirez, Trauma Specialist at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana. The goal of the study was to determine the relationship between use of cannabis containing THC and recovery from bodily trauma. The study was performed at two large trauma centers in Louisiana between 2014 and 2018. All participants were adults (18 years or older) who presented to the trauma centers. A total of 4849 patients were included in the study and 1372 (28.3 percent) of all patients tested positive for THC in their bloodstream

Analysis This study confirms previous studies from Israel which show patients who are admitted to hospitals suffering from trauma, and have THC in their system, demonstrate a faster recovery than patients without THC in their system. This could be due to the antiinflammatory effects of cannabis as well as its neuroprotectant qualities.

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With more research on this topic, we could one day have cannabis or THC protocol within trauma centers that specify that all patients be checked upon admission for THC (or other cannabinoids) present in the body. Patients who do not have any cannabinoids in the body may be given cannabis or THC (in some form) as a course of treatment to increase recovery from trauma. As healthcare practitioners it is important for us to be led by the science of cannabis and not by previous ideology of being something bad for the body. If we can use a natural plant to aide in recovery from extremely traumatic and life-threatening situations, we can potentially increase survival rates of trauma, increase quality of life for trauma victims, and save billions in healthcare costs from decreased use of medical services. Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com

ORLANDO || GRAND ROUNDS

Digestive and Liver Center of Florida Welcomes Douglas Weissman, MD Dr. Harinath Sheela and Dr. Srinivas Seela are pleased to announce Interventional Gastroenterologist Douglas Weissman, MD, has joined their practice and will be seeing patients at Orlando Health in the newly expanded western Orlando service area of Digestive and Liver Center of Florida. Dr. Weissman will see patients at both at Health Central Hospital located at 10000 W. Colonial Drive in Ocoee and at Dr. P. Phillips Hospital at 9400 Turkey Lake Road in Orlando. Weissman is a Board-Certified Gastroenterologist as well as an advanced Endoscopist. He completed his postgraduate training at Mount Sinai Hospital in New York.

Weissman completed a biliary endoscopic fellowship in Santiago, Chile under the auspices of Dr. Jerome Waye, and with Dr. Claudio Navarette, a well-known and highly regarded biliary endoscopist at Mount Sinai Hospital. Following his Fellowships, Weissman served his community of Coral Springs, FL in private practice for more than 20 years with distinction. During his time in private practice, Weissman completed an advanced endosonography fellowship in Montreal, Canada under the guidance of Drs. Anand Sahai and Sarto Paquin - both world

renowned endosonographers. Following the sale of his practice, he was recruited to the state of Indiana by a leading tertiary care trauma center and comprehensive cancer center. There Dr. Weissman was afforded the opportunity to work with exemplary gastroenterologists, and medical and surgical oncologists where he was introduced to the most complex cases in the state. For more information on the practice or to schedule an appointment with Dr. Douglas Weissman, please contact (407) 384-7388.

No-Cost Drive-thru Flu Shot Event Roll in, Roll up a sleeve, and Roll out!

Siemens Healthineers Announces First U.S. Installation of SOMATOM X.cite Premium CT Scanner Florida’s Orlando Health Orlando Regional Medical Center (ORMC) recently became the first healthcare institution in the United States to install the SOMATOM X.cite, a premium singlesource computed tomography (CT) scanner from Siemens Healthineers that offers advanced imaging capabilities with a focus on the patient experience. The SOMATOM X.cite is the first CT scanner to feature the new myExam Companion intelligent user interface, which guides the radiologic technologist through the exam workflow with precise questions regarding the patient. Combining available patient data (gender, age, etc.) with other patient-specific information, myExam Companion identifies optimal acquisition and reconstruction techniques for each patient, increasing the efficiency and consistency of the imaging process. Other features of the SOMATOM X.cite include a large, 82 cm gantry bore, a powerful Vectron X-ray tube, and spectral imaging with TwinBeam Dual Energy. Together with the StellarInfinity detector, the Vectron X-ray tube enables visualization of even the smallest details with 0.30 mm precision resolution. Additionally, a Patient Observation Camera allows the technologist to closely monitor the patient while inside the gan-

try. A detachable, gantry-mounted tablet allows the technologist to complete nearly the entire exam workflow from within the scan room while maintaining focus on the patient. An optional FAST 3D Camera collects additional anatomical information and automatically positions the patient at isocenter. “This new technology provides many benefits for patients and clinicians,” said Frans van Dijk, MD, Radiology Department Chairman, Orlando Health ORMC. “With a bore that’s nearly 3 feet in diameter, patients will be more comfortable, and the added space will make it easier to perform additional diagnostic procedures while the patient is being scanned. The unit’s tablet will allow the clinician to preview the scanned images while staying close to the patient at all times.” “The large bore and mobile workflow of the SOMATOM X.cite, which also features MyExam Companion to provide optimal acquisition and reconstruction techniques for each patient based on artificial intelligence, will help enable consistency and optimal utilization of scanner technologies at Orlando Health ORMC,” said Douglas Ryan, Vice President of Computed Tomography at Siemens Healthineers North America.

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The Florida Department of Health in Orange County (DOH-Orange) will host a FREE Drive-thru Flu Shot event on Saturday, October 17, 2020. The event will be held at Freedom High School, 2500 West Taft Vineland Road in Orlando. It will be open to the general public from 9am until 3pm, and the flu shots are free for everyone six months and older. First come, first served. While supplies last. Getting the flu shot each year is important, but reducing illness and hospitalization from flu is even more critical this year to protect frontline health care workers and hospital systems who will continue to care for people with COVID-19 and other illnesses. The Drive-thru Flu Shot event will make it possible for residents to roll in, roll up a sleeve and receive a flu shot safely and quickly while remaining in their vehicles, and roll out. Masks will be required while getting services. Residents should wear clothing that is loose around the arm so the public health nurse can administer the flu shot in the upper arm, without requiring residents to leave the comfort and convenience of their vehicle. For more information, please call DOHOrange’s Call Center at 407-723-5004. WHAT: FREE Drive-Thru Flu Shot (Point of Dispensing) event WHERE: Freedom High School, 2500 W. Taft Vineland Road, Orlando, FL 32837 WHEN: Saturday, October 17 9am until 3pm WHO: Orange County residents 6 months & older

ORLANDO || GRAND ROUNDS

AdventHealth Announces Global Orthopedics Partner and Tower Orlando Campus almost 40 offices in Pennsylvania, New Jersey and New York. Clinical teams at Rothman, which is celebrating its 50th anniversary in 2020, focus on sub-specialized orthopedic care including sports medicine; joint replacement; spine; shoulder & elbow; foot & ankle; hand & wrist; orthopedic oncology, trauma and fracture; and physical medicine and rehabilitation. Rothman Orthopaedics has repeatedly been ranked as one of the nation’s best orthopedic providers, thanks to its superior and affordable care. “This is a major step outside of our traditional geographic footprint,” said Mike West, CEO of Rothman Orthopaedic Institute. “We have always believed in bringing care to where the patients are, and we can’t wait to bring that same passion for excellence that makes us the preferred providers among referring physicians and professional athletes, to Central Florida.” Rothman Orthopaedics are the official team

A new landmark in the downtown skyline is set to rise on the greater AdventHealth Orlando campus, bringing a range of new and expanded services to Central Florida. Leading the way is a center for world-class orthopedic care, part of a long-term partnership with Rothman Orthopaedic Institute. Rothman is an internationally recognized leader in high-quality orthopedic research, treatment and associated services. Rothman’s Orlando headquarters will be based out of a 12-story, 300,000-square-foot building AdventHealth will build adjacent to Interstate 4 at Rollins Street and Dade Avenue. Rothman Orthopaedics will begin seeing patients in the greater Orlando area in late 2020. As believers in community care, Rothman intends to launch in Central Florida with multiple locations in the suburban areas of Orlando. For Rothman, AdventHealth was a natural fit for growth. Headquartered in Philadelphia, Rothman has

physicians for the Philadelphia Eagles, Phillies, 76ers, and the iconic Radio City Rockettes, as well as over 40 college and high school teams. Rothman Orthopaedics evaluates more than 300,000 patients and performs 65,000 surgeries each year. The tower that will house Rothman’s operations will also include space for neuroscience, imaging, rehabilitation and research. The building and expanded services are a major step forward in the evolution of the 172-acre Health Village campus. Health Village — the home of AdventHealth Orlando, AdventHealth for Women and AdventHealth for Children — also includes centers of innovation and medical research, as well as residential, retail, dining and lodging options. The project will include a 10-story, 1,600-space parking garage. The new tower is expected to open in late 2022.

Availity, Jacksonville University Collaborate on Nurse Practitioner Education Jacksonville-based Availity, the nation’s largest real-time health information network, announced a new partnership with Jacksonville University, northeast Florida’s leader in healthcare education, to expand access to primary care for millions of Floridians. With a $100,000 donation from Availity to establish the Availity Nurse Practitioner Scholars Fund at Jacksonville University, qualified nurse practitioners (NPs) may begin to earn the educational credits needed to offer independent primary care without an attending doctor, as outlined under a new state law. “Florida has the largest shortage of primary care health professionals in the country. Aging patients, retiring physicians, and the current pandemic are creating a perfect storm for access to care, and change needs to happen now,” said Russ Thomas, CEO of Availity. “Since philanthropy is a big part of who we are at Availity, we believe that change starts with us.” “At Jacksonville University, we’re working every day to transform the health of our communities by educating and training exceptional healthcare professionals,” said Jacksonville University President Tim Cost. “With Availity’s generous support, we can help up to 1,000 nurse practitioners advance their education and establish their own primary care practice.” According to the Association of American Medical Colleges, more than 6 million Floridians live in areas where there is a shortage of primary care physicians, making Florida last in the nation in access to primary care. The Availity Nurse Practitioner Scholars Fund

at Jacksonville University will help NPs earn the Continuing Education Credits required for obtaining a license for independent practice under House Bill 607, which Governor Ron DeSantis signed into law earlier this year. HB 607 allows NPs to offer primary care without an attending physician if NPs can demonstrate the following requirements have been met within the past five years: • 3,000 hours of practice experience under the supervision of a physician • either three credit hours of graduate-level coursework or 45 continuing education units (CEU) in advanced pharmacology and differential diagnosis Increasing the number of NPs practicing independently will help residents receive needed acute or chronic condition care sooner, potentially preventing a much more costly emergency department visit or hospitalization. Costs would be further reduced by enabling NPs to deliver care alone instead of with a physician supervisor. Under the leadership of Provost Dr. Chris Sapienza and Brooks Rehabilitation College of Healthcare Sciences Dean Dr. Mark Tillman, Jacksonville University will grant scholarships on a first come, first served basis and will offer the 45 continuing education units (CEU) needed to qualify for independent practice through selfpaced, 100% online modules. Qualified nurse practitioners can learn more about the CEUs and apply for the scholarship at www.ju.edu/availity. Users of Availity’s Provider Engagement Portal can find additional information on the homepage under News and Announcements.

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Elevate Medical Resources Announces New Hire, Craig Accardo Elevate Medical Resources is pleased to announce the hire of Craig Accardo as the newest Medical Practice Consultant. “I am truly looking forward to being a part of the nation’s largest network of Medical Revenue Management offices,” Accardo says. “I am excited to build a lasting relationship with practices so that they may become more profitable.” Accardo brings over 19 years of business consulting and relationship management experience along with a strong grasp of the Central Florida market. Originally from Louisiana, his business background began as he studied at Louisiana State University in Baton Rouge, with his interests including anything sports related. He is a member of the service organization, Rotary Club International, and is a supporter of the Dr Phillips Center For The Performing Arts. As a Medical Practice Consultant, Accardo will support practices in revenue cycle optimization and help with increasing cash flow while reducing expenses.

NORTH CENTRAL FLORIDA || GRAND ROUNDS

COVID Testing, LLC, Announces Second Location in “The Villages” COVID Testing, LLC has opened another Rapid Testing Center located at The Villages. “We are committed to providing Floridians with the fastest results without the long wait times. Our first site in Orlando has seen tremendous customer demand with people delighted to see their serology (finger prick antibody test) in only 15 minutes, and the PCR (nasal swab) results the next day. We recently announced SAME DAY results are available with a small rush charge, ” said COVID Testing LLC’s CEO, Sanjay Srinivasan The second location is on US 441 near Wawa and Lowes, next to 13535 US Hwy 441 in Lady Lake, and operates similar to the 33rd street Or-

lando model, where customers can simply drive through the testing center while remaining in the comfort of their car. “We have even designed this location to accommodate the golf carts that we know will be a significant part of the customer base,” said COVID Testing, LLC, COO Mike Collins. “We will also be offering the onsite service, where we can visit a group or company when needed” “For us, it’s about speed,” said COVID Testing, LLC, Medical Director Varesh Patel, MD. “It’s about getting kids back to school and employers getting their employees back to work. We also are taking care of the travelers who need to be tested prior to their flights. Ultimately it’s about doing the right

thing, and getting Florida back to normal as soon as possible.” Orlando-based COVID Testing, LLC, is partnering with a local lab to secure results within a day. The site can accommodate about 300 people every weekday. On the weekends, it can accommodate some 560-700 people. The Center will be open 7 days a week, 8:30am-5:30pm Monday through Saturday and 9:00am – 2:00pm on Sundays. Serology Tests are $59.95 and the PCR test is $35 with insurance for Next Day Service. Symptoms are not required to be tested.

AdventHealth to Expand Women’s Health Care Services AdventHealth announced it has signed an agreement to acquire Tampa Bay’s leading provider of comprehensive women’s services, Exodus Women’s Center, and its affiliated entities. The agreement includes the purchase, or lease, of all 12 medical office locations in Hillsborough and Polk Counties, as well as an administrative office. Clinical operations under AdventHealth are expected to begin in early January 2021. “We are excited to expand our network of care and provide greater access to women’s health care services in our community,” said Mike Schultz, President and CEO, AdventHealth West Florida Division. “Exodus Women’s Center has a long his-

VOLUSIA/BREVARD || GRAND ROUNDS

VA Announces Award for Daytona Clinic The Orlando VA Healthcare System announces the award of a lease to Carnegie Management and Development Corporation, to build its Daytona Beach VA Multi-Specialty Clinic (MSC). The Daytona VA Multi-Specialty Clinic will be located off Williamson Blvd, just south of Technology Blvd (West of N. Williamson Blvd. and North of LPGA Blvd.), Daytona Beach, FL 32124. The new clinic will provide 106,826 net square feet of space which allow services to be located in one facility. Services provided at the clinic will include primary care, mental health, specialty services, and support services such as radiology and lab. Parking at the new clinic will include 750 spaces. The Daytona Beach VA Multi-Specialty Clinic design and construction is expected to take 26 months and be completed towards the end of calendar year 2022. Once construction is complete, the VA will install equipment and furniture prior to the clinic’s activation, and relocation of staff and services. Patients will be seen at the clinic in summer of 2023. For more information contact the Orlando VAMC Public Affairs office at (407) 631-4436, or via email at vhaorlpublicaffairs@va.gov.

tory in this community and is a valuable asset to the region. We look forward to building on their history and delivering our brand of faith-based, wholeperson care.” AdventHealth continues to grow its network of care in response to the needs of the communities it serves. The division recently announced its partnership with Moffitt Cancer Center to expand cancer services in Wesley Chapel, and opened an outpatient imaging center and expanded physician office locations in Brandon, FL, the fast-growing community in Eastern Hillsborough County. In addition, the network of care includes 10 hospitals, four freestanding emergency rooms, one long-term care

facility, urgent care centers, express care clinics, mobile mammography services, hundreds of physician practices and a clinically integrated network. Exodus Women’s Center has provided the community with women’s health care services since 1992 and specializes in low and high-risk obstetrics, gynecology, fertility, pediatric and adolescent gynecology, and menopause. Work to complete the transaction will take place over the next few months, as leaders work to ensure a smooth transition. Until the transaction is complete, current ownership will remain in place. Financial terms have not been disclosed.

Patrick Han, MD, Named Medical Director of the UF Health, Department of Neurosurgery at Halifax Health Medical Center Patrick Han, MD, a University of Florida Health board-certified surgeon, has been named the Medical Director of the University of Florida Health, Department of Neurosurgery at Halifax Health Medical Center. Board-certified in Neurosurgery by the American Board of Neurological Surgery, Dr. Han’s clinical interests include brain aneurysms, brain arteriovenous malformations, cavernous malformations, brain tumors, carotid stenosis, as well as cervical and lumbar spine surgeries, which includes but is not limited to artificial cervical and lumbar disc surgery for motion preservation disc replacement. He has training in

clipping and coil embolization of aneurysms, as well as carotid endarterectomy and stenting. Han graduated from the University of Kansas Medical School in 1997. He then completed his neurosurgical residency at the Barrow Neurological Institute in Phoenix, AZ, and went on to perform fellowships in Cerebrovascular Neurosurgery, Endovascular Neurosurgery and Complex Spine Surgery at the Barrow Neurological Institute. Before coming to UF Health Neurosurgery at Halifax Health, Dr. Han was the Medical Director at St. John Neuroscience Institute in Tulsa, Oklahoma. Han will be joining UF Health surgeons, Dr. Jacques Farkas and Dr. Rohit Khanna, bringing advanced Neurosurgery to Volusia, Flagler and Brevard Counties.

Halifax Health, UF Health Announce Urology Collaboration Halifax Health and University of Florida Health have collaborated to enhance and strengthen the Urology services that are offered. The program’s team of doctors will include Bennett P. Scaglia, MD and Shawn W. Thomas, MD. Program highlights include full range of urological surgeries, including minimal invasive procedures and state-of-the-art technologies, like

the da Vinci S® Surgical System. Another highlight is a specialized program for kidney stones and seamless integration with medical and radiation oncology in the event that urological malignancies are part of a diagnosis. To learn more about the program, please visit https://halifaxhealth.org/services-treatments/ our-services/urology/

Orlando Medical News October 2020

Articles inside

Medical Practices and Cloud Computing

Use of Cannabis Prior to Bodily Trauma Limits Damage and Increases Recovery

EOCC MEDICAL CITY The Great Debate over

Sex and Aging: Talking with Patients

Is it Now Time for Patients to Return to Their In-person Out-Patient Appointments?

Knowledge is Power

PHYSICIAN SPOTLIGHT Drawing Inspiration at an Early Age