Houston Medical Times News

Serving Harris, Galveston, Brazoria, Fort Bend and Montgomery Counties

HOUSTON

Volume 9 | Issue 7

Inside This Issue

July Edition 2019

Misaligned Technology Investments Leave Healthcare Very Exposed

By Mark Johnson President, Xtrii

Birthday Cupcake Campaign at Ben Taub Hospital Reaches 1,000th Milestone See pg. 11

INDEX Legal Matters........................ pg.3 Oncology Research......... pg.5 Mental Health...................... pg.6 Financial Forecast.............. pg.8 Healthy Heart..................... pg.10

W

e see the headlines too often… another healthcare organization has experienced a breach and millions of personal health records have been stolen. While we all are growing more concerned about the exposure of our 1. Misaligned Spending: 78% of healthcare cybersecurity spending personal information, healthcare data is on technology, and only 1% is is the most sensitive and vulnerable. spent on human capital solutions.

For several years healthcare data Yet, 68% of breaches are caused by has been the #1 target for hackers, and employee behavior, not technology it will continue to be the prime target hardware. Shockingly, only 1% until healthcare organizations change of cybersecurity investments their investments, actions and ongoing are being spent on the area that focus. You can easily get a new credit causes the majority of breaches. card number but fixing your Electronic One of the world’s most famous Medical Record when it is stolen/ Hackers, Kevin Mitnick, recently hacked is a different story. stated “Companies spend millions Why does this problem continue? of dollars on firewalls, encryption The top reasons and potential solutions and secure access devices, and are:

it’s money wasted; None of these measures address the weakest link in the security chain … People.”

What has caused this misaligned spending? One of the reasons is cybersecurity has typically been a responsibility of the Information Technology department, and traditional Information Technology leaders tend to focus on technology products, not human capital solutions and business processes. see Technology... page 14

Lower Rates of Opioid Prescriptions in States that Implemented Medical Cannabis Use Laws

U

Treating Hypertension with a Lifestyle Approach See pg. 13

sing data from privately-insured adults, new findings from The University of Texas Medical Branch at Galveston revealed that there is a lower level of opioids prescribed in states that have allowed the use of medical marijuana. The findings are currently available in Preventive Medicine.

“We found that the overall prescription opioid use increased by age, which we expected,” said senior author Mukaila Raji, UTMB professor and director, Division of Geriatrics Medicine. “But, when we looked at the results within different age groups, opioid prescription rates varied depending on the stringency of state cannabis laws. In particular, states that implemented medical cannabis laws

had lower rates of opioid prescription in people aged 18 to 54.”

Initially, opioids were seen as a way to ease pain and their use became

widespread over time, with little attention paid to possible side effects or the risk of addiction. Over the past 25 years, prescriptions for opioids have nearly tripled and in 2017 there

were 29,406 synthetic opioid overdose deaths in the U.S. alone. The desire to reduce the use of opioids has given rise to a search for non-opioid alternatives for pain treatment.

“As more states enact laws legalizing medical use of cannabis, there is growing interest in cannabis as a potential agent to mitigate harmful effects associated with synthetic opioid use,” said Raji.

“While this may suggest a public health benefit, it must be carefully examined across different groups of people to prevent unintended downsides of any new cannabis legislation,” Raji said. “Earlier studies that analyzed data from Medicaid see Cannabis... page 14

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Legal Matters Texas Passes Consumer Protection Law on Surprise Medical Bills

By Ebad Khan, JD Lauryn Sanders, JD JD Polsinelli, PC

G

overnor Abbot recently signed Senate Bill 1264 which, effective September 1, 2019, provides consumer protections against certain medical and health care billing by certain out-of-network (“OON”) providers.

Surprise medical bills have become a familiar life event for residents of the state of Texas. Either in instances of medical emergencies where Texans are left with no other option but to receive OON medical attention from providers or when Texans unknowingly receive OON ancillary services (e.g. lab or imaging services) despite their good faith attempts to receive in-patient or out-patient services from in-network

facilities, they are unnecessarily held financially responsible because of the everlasting reimbursement disputes between health insurers and health care providers. In recognition of the stress these surprise medical bills induce, the Texas Legislature passed a bipartisan bill that, when signed into law, will prohibit surprise medical bills from being sent to patients and force payers and providers to resolve these disputes, in good faith, on a claim-by-claim basis.

The Texas Department of Insurance (“TDI”) describes a surprise medical bill (i.e a balance bill) as a bill from a doctor, hospital, or other health care provider who is not a part of the insured’s network, and provides the following example: A patient goes to an in-network hospital for emergency care and is treated by an out-of-network doctor.

The doctor and the hospital each bill $1,000 for their services, and the health plan [insurer] pays them each $400.

The in-network hospital can only bill the patient for copays, deductibles, and coinsurance amounts. The doctor,

however, may bill [the patient] for the $600 that the health plan [insurer] didn’t pay, as well as any copays, deductibles, and coinsurance.

Unsuspecting patients had previously been saddled with this OON bill because either the insurer underpaid the provider, the provider’s billed amounts were too high, or a combination of both.

With the passage of Senate Bill 1264 earlier this year, the Texas legislature took it upon itself to ensure that Texans are no longer left feeling exploited by this practice.

Once effective, Texans receiving health care services from OON providers in the above mentioned instances will no longer be responsible for any amounts greater than their cost-share obligations (i.e. copay, deductible, coinsurance).

Upon the processing of a claim, the patient’s insurer must include in the explanations of benefits a statement on the prohibition of balance billing the patient and the total amount the provider may bill the patient with an itemized breakdown of the patent’s

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cost-share obligations.

Furthermore, in the event an amount on a OON claim, less the patient’s cost-share obligations, remains outstanding, either the OON provider or the insurer has the option to request a mandatory mediation or a mandatory arbitration of the claim through the TDI’s website. If mediation is requested, a mediator will have the discretion to adjust an amount to be paid to the provider if the mediator believes more should be paid on the patient’s OON claim.

However, if arbitration is requested, then each party will submit the amount it believes to be paid (i.e. billed amount for provider and allowed amount for insurer) and the arbitrator, after reviewing the see Legal Matters...page 14

July 2019

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Houston Medical Times

Free-Standing Emergency Departments in Texas’ Big Cities Are Not Reducing Congestion at Nearby Hospitals, Says Rice Study

By Jeff Falk

F

nearby free-standing EDs did not affect the number of visits to hospital EDs, emergency room wait time, length of visit for discharged patients or the rate of patients who left without being seen in hospital EDs.” However, in areas outside of the four major metropolitan areas in Texas (Houston, Dallas, San Antonio and Austin), the authors found that if a hospital opened satellite free-standing EDs in the community, wait times in the hospital’s ED and length of stay in the ED both fell.

“Overall, the results suggest that free-standing EDs in general don’t function as a perfect substitute for hospital EDs,” Xu said. “Instead, our results imply that free-standing EDs

are increasing utilization of emergency care. They appear to locate in major metropolitan areas where there will be patients who are seeking emergency room care, but they don’t alleviate the burden of overcrowded hospital EDs. “Whether this additional care is beneficial to patients has not been shown,” Xu said. “But other studies have shown that visits to free-standing EDs are often associated with surprise medical bills for patients, and they have also contributed to higher emergency care spending in Texas.”

Ho said a recent move by the Centers for Medicare and Medicaid Services to lower reimbursement rates for free-standing EDs within six miles of a hospital ED is sensible.

RELAX

ree-standing emergency departments (EDs) in Texas’ largest cities have not alleviated emergency room congestion or improved patient wait times in nearby hospitals, according to a new paper by experts at Rice University.

That finding contradicts arguments made by proponents of free-standing EDs, who have claimed the proliferation of stand-alone emergency rooms would speed care in overcrowded hospitals, said the authors.

But unlike in Texas’ biggest cities, the research indicates that free-standing emergency rooms can indeed reduce wait times in smaller communities.

The researchers reached their conclusion by studying data from the American Hospital Association annual survey, the American Community

Survey and free-standing ED licensing data from the Texas Department of State Health Services from 2010 to 2016.

The paper entitled “Freestanding emergency departments in Texas do not alleviate congestion in hospital-based emergency departments” was co-authored by Yingying Xu, a Ph.D. student in Rice’s Department of Economics, and Vivian Ho, the James A. Baker III Institute Chair in Health Economics and director of the Center for Health and Biosciences at Rice’s Baker Institute for Public Policy. It is published in the American Journal of Emergency Medicine.

“We looked at how entry of more free-standing EDs in local markets influenced the flow of patients in nearby hospital EDs,” said Ho, who is also a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. “Overall, entry of

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In the Heart of the Medical Center

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Oncology Research 10 Questions You Shouldn’t Be Afraid to Ask About Your Cancer Diagnosis

By Sanjay Sethi, M.D., Texas Oncology

N

o questions should be off limits when it comes to your health, yet some topics are simply hard to broach.

The truth is your doctors want you to ask the tough questions, even when the answers may be difficult to hear. Below are 10 questions your oncologist wants you to feel empowered to ask so you can receive the education and support you need.

What caused my cancer?

Fear of the unknown can be one of the most challenging aspects of a cancer diagnosis. Some patients experience feelings of guilt or anxiety about something they did, or did not do, that may have led to developing cancer. In reality, many cancers are unpreventable.

Does my diagnosis mean my family is at an increased risk for cancer?

According to the American Cancer Society, only about 5 to 10 percent of all cancers result directly from gene defects inherited from a parent. Family members do need to be vigilant about knowing their family history, including the type and age a family member was diagnosed, because they may need to start screenings earlier.

How will you choose the right treatment plan for me?

Every form of cancer is unique, and no single treatment is right for everyone. Your cancer treatment plan is created specifically for you and your disease – and you play an integral role in developing that plan.

Is my cancer curable?

Interestingly, this is one of the least asked questions. Your oncologist wants to have an open, honest conversation with you and your loved ones about your diagnosis, treatment, and your path forward.

Will this treatment increase my

chances of survival or improve my quality of life?

Just as every patient’s cancer treatment is unique, treatment impacts everyone differently. Discuss goals for your treatment, managing side effects, and expectations for short- and long-term treatment results.

How will my diagnosis and treatment impact my sex life?

It is perfectly natural to be concerned about how cancer and treatment will impact intimacy. The long-term effects of treatment can change libido and sexual function, and affect fertility, all of which can impact relationships. It’s important to have

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conversations about the effects and how to address them.

Should I seek a second opinion?

Despite misconceptions, getting a second opinion is not considered ‘bad etiquette’. It’s a normal part of a cancer diagnosis.

How can you help ease my greatest fear?

Whether it’s fear of being in pain, fear of what will happen to your family, or fear of dying, communicating your fears will help your oncologist alleviate them as best as possible.

Should I participate in clinical see Oncology Research...page 13

July 2019

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Mental Health New UH Pharmacy Center to Tackle Prescription Drug Misuse

By Laurie Fickman

F

or the first time in American history, a person is more likely to die from an accidental opioid overdose than from a car accident. That’s the alarming conclusion of a National Safety Council report earlier this year, which places the rising odds of dying accidentally from an opioid overdose at one in 96, eclipsing the odds of dying in a motor vehicle crash (one in 103).

Responding to such trends, the University of Houston College of Pharmacy has opened the Prescription Drug Misuse Education and Research (PREMIER) Center. The goal of PREMIER is to educate providers and patients on safe and effective controlled substance prescription use and to serve as a catalyst for collaborative research efforts to optimize pharmacotherapy used to manage pain and substance use disorders.

A recent study in JAMA also provided damning evidence against the pharmaceutical industry. It indicates

strong evidence of connection between opioid marketing to doctors and the opioid epidemic, concluding “The potential role of pharmaceutical industry marketing in contributing to opioid prescribing and mortality from overdoses merits ongoing examination.”

“We want to keep patients healthy, especially those who use controlled substance medications and that starts with doctors and pharmacists, making sure they have the best training possible and the most appropriate treatment options available,” said Douglas Thornton, co-director of PREMIER and assistant professor of pharmaceutical health outcomes and policy. Those treatment options, especially for pain management, include both non-controlled substance prescriptions and non-pharmaceutical choices.

Thornton says PREMIER will address currently unmet needs by examining the role of health

providers in prescribing and dispensing controlled substances and developing educational opportunities for both health care professionals and patients alike.

“The education component will be aimed at training and educating health professional students on issues of prescription drug misuse, addiction, dependence and options for pain management,” said Thornton. “Additionally, in 2019, Texas pharmacists are required to participate in continuing education related to opioid misuse. The new requirement provides the service an open avenue for professional engagement and the opportunity to create new educational programs for pharmacists as well as other health care professionals including physicians.”

PREMIER will be a key driver of collaborative research with other institutions in the Texas Medical Center, Greater Houston Area and the State of Texas through the collaborations with the Texas Health and Human Services Commission.

Safe disposal grant One piece of the education puzzle includes safe disposal of controlled substances. That’s covered in a $3.34 million Texas Health and Human

Services State Opioid Response grant to Thornton, part of $92.5 million in federal funding the state received as part of the States Opioid Response.

The grant will support the purchase, distribution and evaluation of “safe disposal kits” for dissolving/destroying unused and unwanted prescription controlled substance medications.

In Texas, the Drug Enforcement Administration collects and incinerates unused prescription medicine discarded in drug drop boxes housed in police stations.

“For a wide variety of reasons, see Mental Health...page 13

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Financial Forecast Costs of Caregiving When a Loved One Suffers from Dementia

By Grace S. Yung, Managing Director Wealth Advisor Midtown Financial Group, LLC

W

hile it’s a well-known fact that people are living longer today, an extended life span could equate to costly care needs – particularly in the case of dementia. Because those with dementia are often healthy from a physical standpoint, the average life span after being diagnosed can range from four to eight years…and in some cases, much longer.1

This can take a heavy physical, emotional, and financial toll on both the affected individual, and on his or her loved one(s) who provide their care. In fact, according to AARP’s Family Caregiving and Out-of-Pocket Costs report, care givers spend an average of nearly $7,000 while caring for a cognitively or physically disabled loved one.

Planning Ahead for Providing Care to a Loved One with Dementia

Although there is no way to prevent conditions like dementia from occurring, there are ways to plan ahead for care and for the costs that are incurred by the patient and their care provider(s). For instance, advanced technology like the Apple Watch can help care givers track a loved one’s whereabouts, and can even send a signal if the individual faces an emergency.

Likewise, services like InstaCart, Uber Eats, and Favor can be utilized to ensure that meals are delivered to a loved one, without the caregiver having to spend time in a grocery store or take additional time off from work to run errands.

Certainly, one of the better ways to help with planning ahead for the cost of a long-term care need is to purchase a long-term care insurance policy. These plans will usually cover some or all of the cost of care that is provided in a facility and / or in the

insured’s home.

Many long-term care insurance policies will also provide at least some reimbursement for a non-licensed care provider such as a spouse, partner, adult child, or other loved one. Plus, because not all care needs are the same, long-term care insurance coverage can typically be “customized” to fit with specific objectives.

For instance, reimbursement plans will reimburse an insured for care that is received, up to a maximum daily or monthly dollar amount.

Alternatively, indemnity plans will pay a set dollar amount, regardless of how much the insured’s care actually costs.

In addition to benefitting the insured, though, long-term care insurance can also provide a way for loved ones to spend time with a cognitively or physically impaired family member, while at the same time knowing that the physical and financial aspects of care are being performed by the right professionals.

It is important to note, though, that in order to qualify for long-term

care insurance coverage, the insured must be in relatively good health at the time he or she applies for the policy. So, if a loved one is already showing signs of dementia, long-term care coverage may not be a viable option.

Designing a Long-Term Care Plan Because unanticipated illnesses can and do occur, it is always best to put financial protection in place sooner rather than later. Doing so can help preserve savings and other assets for their originally intended purposes.

There are many available options today that can help to pay for the cost of long-term care. Because of that, it can help to work with an experienced advisor who will walk you through the possible solutions for your specific anticipated needs.

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Healthy Heart How to Stay Active in Warm Weather

By American Heart Association

A

mple sunshine and longer days provide more opportunities for the whole family to get outside and get active! But when the temperature goes up in Houston, being active outdoors can be more challenging. It’s easier to become overheated when the sun is beaming down all day. The warm months also bring humidity. With humidity, your sweat doesn’t evaporate as quickly, so your body has a harder time releasing heat.

Tips to keep in mind 1. Timing is key: Try to avoid exercising outside in the early afternoon. It’s usually hottest between noon and 3 p.m.

2. Hydrate: Drink water before, during and after physical activity, even if you don’t feel thirsty. Bring a bottle of water with you, or plan water stops along your route.

3. Dress for success: Wear lightweight, light-colored, loosefitting clothes. Moisture-wicking fabric can also be a big help.

Protect yourself from the sun with sunglasses, a hat or visor and plenty of sweat-resistant sunscreen.

4. Listen to your body: Take frequent breaks in the shade, and drink water before you’re thirsty.

Allow yourself time to adapt to the heat -- some experts say that this can take about 4-14 days. You may not be able to work out as long or as hard as usual when it’s very hot.

5. Doctor’s orders: Check with your healthcare professional before starting an exercise routine or moving your workout outdoors if you have cardiovascular disease, diabetes, other chronic disease or any medical concerns. Certain medications like beta blockers, ace receptor blockers, ace inhibitors, calcium channel blockers and diuretics can exaggerate the body’s response to heat.

6. Buddy up: If you can, work out with a partner for safety ... and fun!

If you find you just can’t tolerate the heat, don’t skip out

on your workout or physical activity time!

• Find indoor locations where you can be active, such as a shopping mall, gym or community recreation center.

• Discover activities you can do in your home or at work.

• Adjust your workout schedule to early morning or late evening when it’s cooler outside.

Know the signs of heat-related conditions.

According to the National Institutes of Health, heat illnesses or emergencies can occur with exposure to high temperatures and humidity.

Dehydration can occur when you don’t replace body fluids lost by sweating. Being even slightly dehydrated can make you feel bad and put you at greater risk for heat-related illnesses like heat exhaustion and heat stroke.

Watch for these signs of mild to moderate dehydration: • Thirst

• • • • •

Dry or sticky mouth Dry, cool skin Headache Muscle cramps Not urinating much or darkercolored urine

Signs of severe dehydration: • Not urinating or very dark-colored urine • Dry, shriveled skin • Irritability or confusion • Dizziness or lightheadedness • Rapid heartbeat • Breathing rapidly • Fatigue or listlessness • Unconsciousness

Always talk with your doctor before starting any exercise to be sure you’re following a safe, effective physical activity program.

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Birthday Cupcake Campaign at Ben Taub Hospital Reaches 1,000th Milestone

A

simple project to stimulate conversation and foster good-will with patients at Harris Health System’s Ben Taub Hospital recently blew out the candles on its 1,000th birthday cupcake celebration. The project is part of Harris Health’s greater effort to create a more empathetic workforce and engage with patients.

The birthday cupcake celebrations are a physician and staff driven program by Dr. Niraj Mehta, physician, Internal Medicine, Ben Taub Hospital, and associate professor, Department of Internal Medicine, Baylor College of Medicine, and Michael Segal, LMSW, senior patient liaison, Patient and Customer Relations, Harris Health, to spark a personal connection among caregivers and their patients.

“My motto is healing begins with feelings. I teach (young doctors and residents) that we always aim to cure, but more importantly we should aspire to heal. Trust and communication are

pillars of all human relationships and what better way to foster both than to find a common bond that all of us share — a birthday,” Mehta adds.

Many healthcare providers fail to understand that to achieve longterm success for a patient, staff needs to take care of a patient’s emotional well-being while taking care of their medical needs.

“I tell people; I learned about diseases in the hospitals and, unfortunately, I learned about my patients at their funerals,” Mehta laments.

For the past few years, Harris Health has been training its staff about empathetic communication and how to connect with patients and colleagues through, Language of Caring, a program that teaches relatable skills and techniques. The hope is that these improved connections will help relieve anxiety in patients and families and develop more trusting and engaged relationships with their caregivers.

Call 713-600-9500 for a free assessment, 24/7.

“We want our patients to feel that they’re not only wellcared for, but also cared about Dr. Niraj Mehta and team visiting cancer patient Dagoberto Rodriguez by our staff. all inclusive with participation from Patients judge the quality of care they receive based nurses, technicians, nutritionists and on how we make them feel. Language other support staff.

“The celebrations are so well of Caring teaches our highly-skilled received by staff that many request to healthcare team how to show caring and empathy while practicing stellar be on our group email and text alerts patient care,” says Lesa McLeod, to let them know when they happen,” director, Service Excellence, Mission Segal adds.

For patient, Dagoberto Advancement, Harris Health.

Segal and his patient and Rodriguez, seeing a large gathering customer relations team are the driving of caregivers (about 20) descend on force monitoring the hospital’s patient his room for his birthday celebration census to identify upcoming birthdays. was an unexpected treat. The cancer Once identified, the team schedules patient had been in the hospital for the celebration complete with more than a week and was content cupcakes, balloons and birthday cards, see Birthday...page 13 and notifies staff. The celebrations are

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An 84-Year-Old Man Becomes Oldest Living Kidney Donor in The United States at Houston Methodist Hospital

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n 84-year-old Texas man recently became the oldest living kidney donor in the country after donating one of his kidneys to his 72-year old neighbor at Houston Methodist Hospital.

Frank Dewhurst, who lives six houses down from Linda Nall, had known for years that his neighbor’s kidneys were failing, but it wasn’t until he saw a sign in her front yard that he decided to take action.

“The sign read ‘I am type O and I need a kidney transplant. Please help me.’

So after talking it over with my wife, I told her she could have mine,” Dewhurst said. 84-year old, Frank Dewhurst, meets with 72-year old, Linda Nall, “After undergoing a number after giving her his kidney. Dewhurst became the oldest living kidney donor in the United States. of tests I was cleared to donate and very happy to do so.”

Nall said because Frank was “On average, over 60 percent the past president of Homeowner’s of kidneys from living donors Association and is still very last greater than 10 years in actively involved, she thought he comparison to 46 percent from knocked on the door to tell her deceased donors,” said Hassan to take down the sign. Dewhurst, Ibrahim, M.D., chief of kidney who retired from IBM after 30 diseases at Houston Methodist years, said he watched his neighbor Hospital. “This is why we struggle to even get out of her car. encourage patients to find a living

“When he told me he wanted donor whose odds of never having to give me his kidney, I was kidney problems after transplant shocked. It’s an incredible thing exceed 99 percent.” he has done for me and I am so There is a common grateful,” Nall said. Dewhurst left misconception that older people the hospital within 48 hours after cannot be donors because of their surgery and is already back to age. Ibrahim said that is not true, exercising and resuming normal and, in fact, more than 200 people activities. over age 70 have become living

More than 100,000 people are donors in the United States since waiting for kidneys and only one 1995. out of three of these patients are “Besides Mr. Dewhurst, transplanted within three years. we have taken kidneys from an Nearly 5 percent of these people 80-year old, a 79-year old and other die every year waiting. Transplant donors in their late 60s and early through living donation can be 70s,” Ibrahim said. “They receive a done in three to four months and full workup to make sure they are can either prevent the need for dialysis or shorten the time spent see Kidney Donor...page 13 on such a cumbersome therapy.

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Houston Medical Times

Page 13

Treating Hypertension with a Lifestyle Approach

By Denise Hernandez MS, RD, LD Houston Medical Times

T

he American College of Cardiology and the American Heart Association released updated blood pressure guidelines, where the definition of an elevated blood pressure has changed from 140/90 to 120/80.

Anything above will now group several Americans as hypertensive. If an individual finds themselves in the elevated blood pressure category, an evidence-based, non-drug intervention is first recommended (the physician will use some guidelines to determine whether medication is necessary).

Dietary Intervention

One of the highest regarded approaches to managing blood pressure is a diet called the DASH diet, which is high in plant-based foods, such as fruits and vegetables. A positive consequence of eating more fruits and vegetables is that an individual’s potassium intake increases. Potassium will decrease the effects of sodium, by increasing the amount of sodium that is lost in urine and also helps to ease the tension in your blood vessel walls.

Potassium and Your Diet

It is recommended that we consume 4,700 milligrams of potassium per day. Most Americans consume an average 2,150 milligrams on a good day 1. The best natural sources of potassium come from fruits, vegetables, legumes, dairy and fish. For example, half a cup of plain mashed sweet potatoes contains about 475 mg of potassium.

Other potassium-rich foods include: Apricots Avocados Beans Cantaloupe

Greens – all Grapefruit Halibut Honeydew

Lentils Milk Mushrooms Oranges

Peas Potatoes Prunes Raisins

Spinach Tomatoes Tuna Yogurt

Can you have too much potassium?

Most often potassium toxicities are seen through supplementation.

Therefore, always consult with your healthcare professional (physician, pharmacist, dietitian) before considering any over-the-counter

potassium supplement. Anyone with a kidney disorder should also be weary due to the inability to remove potassium from the blood, causing a build-up.

including your age, cancer type and stage, previous treatments, and overall medical history. Curious?

Just ask.

What happens if I can no longer speak for myself?

Advance care planning is the

process of outlining your choices about your future medical care. This process offers peace of mind for patients and loved ones, and it also helps your oncologist ensure your values and wishes are at the forefront of your care.

At Texas Oncology, we believe

asking questions is the best way for patients to stay informed about their cancer care. Bring a family member or friend for extra support, take notes, and prepare for honest discussion. You’ll be glad you did.

time when single use disposal pouches are given out at the pharmacy along with the prescription which prompts a discussion between the patient and pharmacist covering the need to safely dispose of all unused medications.”

One study by Thornton concluded

that patients who had such a discussion with either a pharmacist or doctor were more willing to dispose of their medications. But even then, Thornton admits that controlling the abuse of controlled substances is a Herculean task.

“Increasing prevention and understanding between providers and patients is a Band-Aid, while we work together to figure out the best way to go about this on a larger scale,” he said.

with me. I was very surprised by it.

Today has uplifted my mood and reminded me that I’m well taken care of. I’m very grateful and I’ll never forget this moment,” he says.

Mehta says these are fun breaks for staff and a chance for them to refuel and connect with patients on

a different level. From the celebration, they can strike conversations to bond on a more personal basis.

“Empathy is key. I try to model joy. My goal is to put a smile on the faces of patients and staff. The idea of the birthday celebration is one of the ways we definitely create joy and smiles

to make a huge difference in the way patients view their hospital stay,” Segal adds.

Mehta and Segal hope to expand the program into other parts of Harris Health and eventually provide a template that others across the country can emulate.

nationally were older than 65. If more older adults donated, fewer Continued from people would remain on the list.”

The best use of these older page 12 kidneys is to transplant them into physically strong enough to older patients. Ibrahim says if donate. If everything checks out, you transplanted an 80-year old there is no reason to keep them kidney into a 20-year old and that from saving someone’s life. In person lived to age 60, the kidney 2018, 5 percent of kidney donors would be 140-years old. However,

he said, for someone like Linda Nall, who could have spent years on the waiting list, it is perfect.

In 1986, Nall was diagnosed with lupus, an autoimmune disease that can attack healthy organs.

In 2001 the disease attacked her kidneys and she was put on a strict diet for years and eventually went on dialysis for a brief period before

Dewhurst stepped in.

“I can’t wait to spend more time with family and friends and just socialize more,” Nall said. “I have lived a long time not being able to eat what I want to eat and do what I want to do. I am going to make the most of Frank’s generous gift and live life to the fullest. I cannot wait.”

Oncology Research Continued from page 5 trials?

Many factors will determine if you’re a candidate for a clinical trial,

Mental Health

Continued from page 6 people may not want to go to the police station with prescription drugs,” said Thornton. “We’d like to see a

Birthday

Continued from page 11 with celebrating his birthday in silence.

“The care has always been great, but today was way better thanks to the people who came to celebrate

Kidney Donor

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Houston Medical Times

Page 14

Technology

Continued from page 1 Information Technology leaders are more comfortable buying more equipment/tech products from traditional I.T. vendors. They have not evolved their focus to assess and address gaps in ongoing employee cybersecurity education, social engineering tactics, and business processes.

Just buying more technology is easy, but properly fixing the gaps and business processes is far more challenging and requires a different expertise.

2. Engage the right expertise: Healthcare organizations must also engage the right experts to advice, educate and drive these improvements.

Leaders must reevaluate their subject matter experts to engage new vendors/ advisors that are true experts on these modern-day threats and are the more appropriate resources for

Cannabis

Continued from page 1 and Medicare enrollees suggest a relationship between cannabis laws

these new challenges. It’s a different expertise than what traditional healthcare technology vendors provide, and it’s typically not found internally within most healthcare organizations.

To be done successfully, it requires a special expertise with in-depth knowledge of healthcare workflows, business processes, technology, cybersecurity, and the optimal solutions.

3. Leadership: To address this misalignment, cybersecurity must be the responsibility of the entire organization. This critical area must receive ongoing oversight from the Board and top executives and be led with a “Business Leaders” mindset that focuses on the big picture, including end-to-end business processes and the ongoing cybersecurity education of their workforce. The company’s leadership must engage, stay engaged, and be held accountable.

Act like the organization’s future

is on the line… because it is.

“It can take 20+ years for a company to build a great reputation, but it can be destroyed in less than 20 minutes by a cybersecurity breach.”

With such an extremely competitive healthcare market, a healthcare organization can’t afford to have a breach that impacts their credibility/trustworthiness.

Organizations must change their cybersecurity focus and investments to human capital solutions, which assess and protect against social engineering, the exploit of human tendencies, and gaps in business processes. Board members and business leaders must be more actively engaged in this ongoing exposure and insist on the right cybersecurity investments to address these new tactics and threats. Let’s challenge healthcare leaders to take the right actions, set the right example and provide a secure, trustworthy healthcare environment. 

and lower opioid use, but we’re the first to explore whether this link is mirrored among commercially insured adults – which encompasses a wide range of ages and other demographics.”

The researchers used de-identified data from Clinformatics Data Mart, a database of one of the nation’s largest commercial health insurance providers that contains 87 percent of commercial enrollees. They calculated the number of people who had opioid prescriptions for one month and three months within a year and then separated the data into groups by level of legalization of cannabis laws and different age groups.

Legal Matters

Continued from page 3

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713.807.8100 ELTIEMPOCATERING.COM July 2019

supporting documents provided from each party, will determine one of the submitted amounts as the final award. The arbitrator will not have the discretion to make any adjustments on the amount to be paid. This style of arbitration is commonly referred to as “baseball” style arbitration.

By the passage of this law, Texas has positioned itself to become one of the more patient friendly states by shielding its residents from the practice of surprise billing, and has created a pathway for all other states to follow.

Of important note, this law only applies to insurance plans that are regulated by the State and TDI -which represent less than a quarter of the health insurance sold in Texas.

The law does not apply to other types of health insurance plans that are not regulated by the TDI including self-funded employee benefit plans. 

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Page 15

GOOD. CLEAN. FUN. IN KATY Typhoon Texas is more than a waterpark.

It’s slides for all ages, award-winning food, a full bar, shaded cabanas and the cleanest water in Texas. In other words, it’s a summer of GOOD. CLEAN. FUN. Learn more at TyphoonTexas.com.

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