Baptist physician communication packet may 2014 by Baptist Health

Physician Communication Packet May 2014

PHYSICIAN COMMUNICATION Packet

What’s Inside: 3

Baptist Physician Partners - Quality Connection

9 CDC Update 10 – 11

Physician Introduction

Baptist Heart Specialists; Scott Lee, MD

Baptist Infectious Diseases; James Allen, MD, PhD

YMCA/Baptist Health; Y Healthy Living Center

Travel and Tropical Medicine Center

14 – 19

Jacksonville Orthopaedic Institute

Anterior Hip Replacement

New Option for Knee Patients

Physician Directory

Baptist CareConnection

Link - May 2014

Baptist Briefs Link - May 2014

Physician Partners

Q UALITYCONNECTI O N

SPRING 2014

Dear Colleagues, In June of 2012, I was honored to become a part of the Vision Team for the Clinically Integrated Network (CIN) here at Baptist. Many lively discussions and salutary debates have taken place since that time as we have assiduously sought to develop an infrastructure that would allow the entity now known as Baptist Physician Partners (BPP) to contend in a healthcare world destined to no longer compete on the basis of volume but on value.

BAPTIST PHYSICIAN PARTNERS BOARD OF MANAGERS CHAIR

Timothy Groover, MD, MBA, CPE Anesthesiology VICE-CHAIR

Jennifer Fulton, MD Pulmonary Critical Care Charles Cousar, MD Cardiothoracic Surgery Michael Erhard, MD Pediatric Urology A. Hugh Greene, FACHE President & Chief Executive Officer, Baptist Health Jack Groover, MD Gastroenterology Ceree Harden Board Member, Baptist Health Board Chair, Baptist Medical Center Jacksonville Richard Picerno, MD Orthopedic Surgery David Rice, MD Chief Medical Officer, Baptist Physician Partners Edward Sim President, Physician Integration, Baptist Health Todd Snowden, MD Otolaryngology Keith Stein, MD Chief Medical Officer, Baptist Health and Senior Vice President, Medical Affairs/Clinical Effectiveness Mark Stich, DO Family Practice Randy Wainwright, MD Cardiology John Wilbanks, FACHE Executive Vice President and Chief Operating Officer, Baptist Health

Timothy Groover, MD, MBA, CPE Chair, Board of Managers

I am excited to share some recent updates and accomplishments that further advance our goal of improving quality and the continuity of care through a clinically integrated network.

During our January Steering Committee Meeting, Baptist Health CEO Hugh Greene and I had the opportunity to execute the Operating Agreement for Baptist Physician Partners, LLC. This signaled the transition in governance to the official Board of Managers of our physician-led CIN. We plan to hit the ground running and diligently work to reach our key milestones in the coming years. On January 1, 2014, BPP launched the Outpatient Quality & Efficiency Program, a phase I initiative which focuses on enhancing quality of care for Baptist employee health plan beneficiaries. To date, we have 129 Baptist Primary Care physicians enrolled in the network and participating in this program. To learn more, please refer to Dr. Fulton’s article inside. As we move ahead, our focus will be on developing an infrastructure to facilitate better coordinated care, improved outcomes and greater efficiency. This combined effort between Baptist Physician Partners and the health system will help prepare us for potential future changes in the marketplace. To learn more, please refer to Drs. Snowden & Fulton’s articles inside. I say thank you to the 40-plus physicians who were directly involved and offered support, feedback, and valuable time as we assessed the clinical integration strategy. It is because of you that we now have a roadmap to successfully position ourselves as the market shifts to total cost-of-care models. We will continue to deliver outstanding care with improved outcomes to the patients we serve, as we work collaboratively with independent as well as employed physicians and Baptist Health. At no other point in our history have our futures been more inextricably woven together than it will be as we shift from volume to value-based payment systems. No question, we will be challenged but we will have a shared success.

INSIDE THIS ISSUE

This truly is a physician-led endeavor and I must insist upon your feedback and input. These are exciting times in our history and I look forward to working with you as the Chair of the BPP Board of Managers in the coming year!

n Introducing

the clinical integration governance structure

n Strong

IT foundation critical to CIN’s success

n Making

strides in performance improvements n Identifying

market readiness

Introducing the clinical integration governance structure By David Rice, MD Chief Medical Officer, Baptist Physician Partners

Clinical integration (CI) can be defined as a network of entities that collaborate to improve patient care, decrease costs and demonstrate value to the market. Baptist Physician Partners (BPP), a notfor-profit subsidiary of Baptist Health, is a Clinically Integrated Network between the employed and independent physicians and Baptist Health. One of the overarching vision elements of this network, as determined by the physician-led visioning team, was to develop a physician-driven network with strong citizenship

and leadership representation from multiple specialties. Six physician-led committees have been established to drive strategy and effect change. I would like to take this opportunity to thank those physicians who have been involved, collaboratively working for more than 18 months to advance the mission and vision of BPP. Our greatest asset is our physicians and we appreciate your commitment and support. Below please find an overview of the governance structure and responsibilities. Please don’t hesitate to contact me at 904-202-3354 or David.Rice@bmcjax.com if you have any questions, or are interested in learning more.

Governance Structure Board of Managers Timothy Groover, MD – Chair Jennifer Fulton, MD – Vice Chair Charles Cousar, MD Michael Erhard, MD A. Hugh Greene, FACHE

Information Technology Todd Snowden, MD - Chair Deborah Abram, MD Dale Boyd, MD Charles Cobb, MD Adam Dimitrov, MD Kyle Etzkorn, MD Roland Garcia Philip Hardy, MD Bonnie Hudak, MD

Finance & Contracting Michael Erhard, MD - Chair Philip Boyce Charles Cousar, MD Cheryl Dixon, MD Jose Ettedgui, MD Richard Glock, MD Jack Groover, MD Ceree Harden Pamela Rama, MD Edward Sim Richard Stromberg, MD Jeffrey West, MD

Jack Groover, MD Ceree Harden Richard Picerno, MD David Rice, MD Edward Sim

Performance Improvement Jennifer Fulton, MD - Chair Jerry Bridgham, MD Nicholas Dodaro, MD Theodore Glasser, MD Steven Hodgett, MD Michael Howington, MD Kerry Maher, MD Kenneth Meyer, MD Carlos Sotolongo, MD Keith Stein, MD Mark Stich, DO Unni Thomas, MD Kristin Vondrak, DNP-ARNP Maryellen Wechter, MD

Membership & Quality* Timothy Groover, MD - Chair Patricia Calhoun, MD Perry Carlos, DO Steve Felger, MD Vikram Gopal, MD Catherine Graham Peter Harding, DO Ilene Levenson, MD Kurt Mori, MD Richard Myers, MD Richard Picerno, MD Randy Wainwright, MD John Wilbanks, FACHE *Formerly named Communication & Education Committee

Information Technology Committee

Performance Improvement Committee

Finance & Contracting Committee

Membership & Quality Committee

Identifies the IT infrastructure needed to ensure that accurate and reliable clinical data is easily accessible throughout the network to meet network objectives. In the process of finalizing the IT software system that will be used to manage BPP’s patient registry and population health management system. Evaluates the market readiness to adopt CI payment models, identifies available contracting options to fund network development, and develops a preliminary distribution methodology that supports network objectives.

Baptist Physician Partners

Todd Snowden, MD Keith Stein, MD Mark Stich, DO Randy Wainwright, MD John Wilbanks, FACHE

Evaluates and identifies participation and performance criteria to create a high-performing CIN. Involved in defining the metrics that are currently being tracked in the Outpatient Quality & Efficiency Program. Monitors the ongoing performance of the CIN, as it relates to meeting the defined quality metrics. Develops the education and communication plan to support initiatives and engage Baptist Health and the broader medical staff. Identifies and validates membership needs, reviews applications and makes recommendations to the Board of Managers. Assists with the onboarding process. This was formerly named the Communication & Education Committee.

Strong IT foundation critical to Baptist Physician Partners’ success

‘‘

For the foreseeable future, the new CIN-IT will perform alongside existing inpatient and office EMR platforms. Given that arrangement, it is unlikely that this will require significant hardware changes for most offices currently employing an EMR who join the CIN.

By Todd Snowden, MD Chair, Information Technology Committee

In order to improve the quality of health care delivery in our Clinically Integrated Network (CIN), we will need a reliable, comprehensive IT platform capable of coordinating care delivery across multiple care settings and various groups of patients. This capability will revolve upon monitoring multiple patient registries. For those unfamiliar with the term, a registry is a data set containing patients sharing one or more designated characteristics, such as diabetes or colon cancer. From these registries, data will be automatically extracted, allowing the IT system to track patients and their compliance with specific guidelines. It will also allow the system to track larger populations of patients and therefore measure outcomes for specific interventions.

‘‘

Analytic features will be a critical component of the CIN-IT platform. We will be able to monitor costs and utilization, looking at categories including readmissions, prescriptions, imaging studies, and lab testing. Predictive modeling strategies will be used to identify higher-risk and higher-cost groups. In this way, we can identify opportunities for greater health care quality and efficiency, and eventually demonstrate value for purposes of managed care contracting.

Nominating

Executive

As of February 2014

Nominating Committee

Identifies and nominates physician candidates for election to the Board of Managers, and develops and oversees election activities for committees and other leadership positions.

Executive Committee

Oversees day-to-day business, providing efficiency, flexibility and decidedness in management and oversight of the implementation of the Board of Managers’ decisions.

One of the challenges facing the IT Committee is to reconcile the needs of the CIN with the realities of the existing technology. From the outset, we acknowledged certain realities: first, contrary to the true data synchronization suggested by the name “Clinical Integration,” existing technology does not yet support the type of idealized super-EMR most of us would like to see. It may be years before the industry supports a truly unified, seamless data repository encompassing all points of inpatient, outpatient, and ancillary care. Selecting our IT solution: Baptist Physician Partners is among the vanguard of health systems currently evaluating CIN-IT solutions for improving health care delivery. After a lengthy evaluation process, BPP’s IT Committee has winnowed the list to the two most promising CIN-IT vendors. We have completed two site visits to observe how each of these IT platforms has been implemented by other CINs. A final note: It is understandable, particularly among current EMR users, that the arrival of additional IT is greeted with skepticism if not outright suspicion. Medicine is challenging enough without the clerical responsibilities of electronic record keeping. As a physician-led group, the IT Committee intends for this technology, as much as possible, to respect the existing workflow of our clinicians. No CIN can be successful without the full participation of its members. Our primary focus should and always will be taking care of patients.

Making strides in performance improvements By Jennifer Fulton, MD Vice-Chair, Baptist Physician Partners & Chair, Performance Improvement Committee It is with great enthusiasm that I share an update of the Performance Improvement Committee’s efforts as well as some highlights regarding our first program and future plans. The Outpatient Quality and Efficiency Program (OQEP) is designed to “prime the pump” for more sophisticated quality programs in subsequent years. This pilot program for primary care physicians focuses on the quality monitoring of outpatient metrics related to chronic disease management and preventative care. Listed below are the current metrics employed in the OQEP. The year 1 patient population only focuses on those enrolled in the employee health plan for Baptist Health. • Control of high blood pressure • Comprehensive adult diabetes care

important to evaluate the tracking feasibility of the proposed metrics and ability of physicians to impact results. A special thank you to Mark Stich, DO, a fellow BPP Board Member and family practice physician, for leading his primary care colleagues in the selection of these year 1 metrics. Our next area of focus is on the development of an ambulatory care coordination program. We will be forming a physicianled workgroup, as a subset of the Performance Improvement Committee, to champion these efforts. This is fundamental to developing a successful CIN and will better position us for the future. The workgroup will be tasked with developing our definition of “care management/coordination” and establishing specific, actionable and measurable objectives for the program. We look forward to hiring an experienced care coordination clinical leader to oversee the implementation. We anticipate piloting this program in a few primary care offices no later than January 2015. We look forward to updating you on the implementation and success of this program in future newsletters. It is our goal to develop a model that allows for less fragmented care and improved quality and efficiency for the patient population we serve.

• Use of appropriate medications for people with asthma • Hospital follow-up visits • Generic medication usage • Pediatric immunization schedule When we set out to define the proposed metrics for this program, it was important to identify items that would be meaningful for all participants. We reviewed current performance indicators, evidence-based guidelines and worked with key stakeholders and physician leaders to select metrics that put the patient first, focused on quality, and aligned the goals of the patients, medical staff and health system. It was

As we embark on our future initiatives, focused on improving quality and impacting total cost of care, we need your input to successfully define the specialty-specific metrics. In addition to utilizing evidence-based guidelines, these metrics should be created by the physicians within those specialties. I look forward to further dialogue and working closely with you and your colleagues to select the metrics appropriate for your respective specialty.

‘‘

As we embark on our future initiatives, focused on improving quality and impacting total cost of care, we need your input to successfully define the specialty-specific metrics. In addition to utilizing evidencebased guidelines, these metrics should be created by the physicians within those specialties. I look forward to further dialogue and working closely with you and your colleagues to select the metrics appropriate for your respective specialty.

‘‘ Baptist Physician Partners

Identifying market readiness By Michael Erhard, MD Chair, Finance and Contracting Committee

Baptist Physician Partners has developed a vision and long-term strategy to successfully allow the independent and employed physicians and Baptist Health to improve the quality and connectivity of care through a clinically integrated network. As the chair of the Finance & Contracting Committee, it is our committee’s responsibility to evaluate our market’s development of CI payment models, identify available contracting options to fund network development and develop a distribution methodology to support network objectives. As we developed our framework and contracting strategy, our committee learned from other CI programs throughout the country. In an effort to strategically and systematically advance on a successful CI journey, it was determined that the earlier initiatives would serve as “pilot” projects to measure the impact BPP’s efforts would have on enhanced quality, improved efficiency and cost reduction.

Additionally, a shift in thinking is necessary — from episodic care to population health management, through care coordination, enhanced communication and more robust data systems infrastructure. Baptist Physician Partners is preparing for evolving payment methodologies that increase provider accountability. Markets across the country are already demanding higher accountability from its physicians, hospitals and other providers. Our Committee will continue to monitor our market to be ready to respond to similar changes when needed. In the meantime, fee-for-service payments will continue to be paid directly to physicians and hospitals the same way they are today. We need to be ready for opportunities in this market for shared saving. Of course, effective coordination of care and the resulting improvement in quality are essential to our readiness. In closing, as we move forward, our focus remains clear. Please find our strategy outlined below.

BPP Strategy

Build infrastructure & alignment: INFRASTRUCTURE: 1) Develop ambulatory care coordination model with employed & independent physicians

PREPARATION

2) Deploy IT solution for population health management ALIGNMENT: 1) Involve specialists in design & development of metrics, model, etc. 2) Involve post-acute providers

Baptist Health contracts with BPP to provide care coordination for employee health plan

DEMONSTRATION

beneficiaries • To achieve competency with model

Dependent on:

TRANSFORMATION

• Success of previous phases • Determined by market changes/shifting payment models

Baptist Physician Partners

New Baptist Physician Partners website launched By Sharon Kaplan Director, Baptist Physician Partners

We are excited to announce our Baptist Physician Partners website, baptistphysicianpartners.com. This site is designed for interested physicians to learn more about BPP and download the necessary paperwork to submit for membership consideration. As the network further develops, the website will evolve in scope to include information for patients and payors. In the future, we envision adding the following components: • More in depth look at our Clinical Integration Programs • BPP Member Login for participating physicians • Patient Portal • Interactive communications We encourage you to explore the site to familiarize yourself with BPP. We welcome your comments and suggestions as we continue enhancing the online experience for participating physicians. Please send your comments to sharon.kaplan@bmcjax.com.

www.baptistphysicianpartners.com 6

To:

Medical Staff

From: Keith L. Stein MD, FCCM, FCCP Chief Medical Officer and SVPMA

Re:

Robyn S. Kay MPH Clinical Epidemiologist

CDC Update on Middle East Respiratory Syndrome Coronavirus

Date: May 8, 2014 As you are aware, last week the first case of imported Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was reported by a hospital in the state of Indiana. The patient recently traveled from Saudi Arabia, where MERS outbreaks are occurring. He is now isolated and is in stable condition. The MERS-CoV virus is known to cause severe respiratory illness and death; it spreads during close contact. In order for our Medical Staff to recognize and manage any suspected cases of MERS-CoV should they present at a Baptist Health facility, we are providing the following CDC guidelines. MERS-CoV: What to Look for If a patient exhibits the following traits, it is important to get a good travel history up front. • Fever (≥38°C, 100.4°F) and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence) AND EITHER • History of travel from countries in or near the Arabian Peninsula1 within 14 days before symptom onset OR • Close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula OR • Is a member of a cluster of patients with severe acute respiratory illness (e.g. fever and pneumonia requiring hospitalization) of unknown etiology in which MERSCoV is being evaluated, in consultation with state and local health departments. As soon as you suspect MERS-CoV—even before you do the testing—make sure you have that patient on isolation precautions. For full details of these precautions, see 2007 Guideline for Isolation Precautions: http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html Should Baptist have a Patient Under Investigation for MERS-CoV, we would contact the health department and collect appropriate specimens. For more details, go to: http://www.cdc.gov/coronavirus/mers/interim-guidance.html We will continue to participate in Health Department calls and keep you apprised of significant updates. In the meantime, please let us know if you have any questions.

PHYSICIAN INTRODUCTION

Welcome Dr. Lee

Cardiac Electrophysiologist, Baptist Heart Specialists

The physicians of Baptist Heart Specialists are pleased to welcome Scott Lee, MD, who has joined the practice at the Baptist Medical Center Jacksonville location. Dr. Lee believes in educating his patients on their medical condition so that they may share in decision making regarding their care. He is excited to join the electrophysiology team and wants to continue to build upon the existing program and expand services to include cutting-edge procedures and technology to better serve his patients and community. His education and qualifications include: • Doctor of Medicine from Saint Louis University, St. Louis, MO • R esidency in Internal Medicine, UCLA-WLV VA Medical Center, Los Angeles, CA • Fellowship in Cardiology, UC Davis Medical Center, Sacramento, CA • Fellowship in Cardiac Electrophysiology, Stanford University Medical Center, Stanford, CA • Board-certified in Cardiovascular Disease and Clinical Cardiac Electrophysiology

To make an appointment with Dr. Lee, please call 904.398.0125. Baptist Heart Specialists Pavilion Office 836 Prudential Drive Suite 1700 Jacksonville, FL 32207

PHYSICIAN INTRODUCTION

Welcome Dr. Allen Physician, Baptist Infectious Diseases

The physicians of Baptist Infectious Diseases are pleased to welcome James Allen, MD, PhD, to their Baptist Medical Center Jacksonville practice. Dr. Allen has extensive experience in all areas of infectious diseases. He has a special expertise in travel and tropical medicine and has served as a medical missionary in Peru, Ecuador, Honduras, Costa Rica, Kenya and Nepal. He is excited to bring his expertise to the Northeast Florida community. His education and qualifications include: • D octor of Medicine from the University of Miami, Miami,FL • R esidency in Internal Medicine, Loyola University Medical Center, Maywood, IL • F ellowship in Infectious Diseases, University of Colorado, Denver, CO • B oard-certified Internal Medicine • B oard-certified Internal Medicine sub-specialty Infectious Diseases • C ertificate in Knowledge in Tropical Medicine and Travelers Health • Certificate in Travel Medicine

To make an appointment with Dr. Allen, please call 904.396.4886. Baptist Infectious Diseases 820 Prudential Drive Suite 515 Jacksonville, FL 32207

to t

Introducing a whole new concept in wellness:

The Y Healthy Living Center in Mandarin

The new Y Healthy Living Center in Mandarin brings expertise from Baptist Health to your neighborhood. A variety of classes, screenings and support groups are offered — and you don’t have to be a Y member to attend, making everyday health easier. That’s changing health care for good. May 28

Senior Health and Fitness Day, 11 am – 2:30 pm (free)

May 29

Advance care planning, noon (free)

June 2

Safe Kids car seat checks, 10 am - noon (call 202.4302 for free appt.)

June 9

HeartWise 1-hour consult – 7 am – 3 pm (call 202.5669 for appt.)

June 10

Talk-With-A-Doc about tips for healthy living, noon and 6 pm (free)

June 24

Talk-With-A-Doc about summer travel abroad, noon (free)

June 24

HeartWise Nutrition 6-8 pm (baptistjax.com/heartwise)

To register, please visit baptistjax.com/ymca.

Y HEALTHY LIVING CENTER Williams Family YMCA 10415 San Jose Blvd. 904.202.6452

blic

Introducing Baptist Travel and Tropical Medicine Center A travel medicine and infectious diseases expert, James Allen, MD, PhD, consults with his patients to provide valuable information that is customized to their health needs and travel itinerary. James Allen, MD, PhD, is board-certified in Infectious Diseases and Internal Medicine, with a PhD in microbiology. He has earned a Certificate of Knowledge in Clinical Tropical Medicine and Travelers’ Health through the American Society of Tropical Medicine and Hygiene and a Certificate in Travel Health from the International Society of Travel Medicine. As an Infectious Diseases and Travel Medicine specialist, he is an active member in the following medical organizations: International Society of Travel Medicine International Society for Mountain Medicine Wilderness Medical Society

International Society for Infectious Diseases Infectious Diseases Society of America The American Nepal Medical Association

American Society of Tropical Medicine and Hygiene

As a highly sought-after speaker, Dr. Allen has given presentations internationally and domestically to corporations, physicians, nurses, students and travelers on the topics of travel medicine, hepatitis, malaria and other travel health issues. In addition to providing the appropriate immunizations to each Travel & Tropical Medicine patient, Dr. Allen provides them with valuable information, including: Country specific health information Country specific immunization requirements Malaria prevention - medicines and repellents CDC Travel Notices Country specific diseases Food and water precautions Traveler’s diarrhea - prevention and treatment High altitude illness

Jet lag World Disease Maps Vaccine Information Statements (VIS) U.S. Dept. of State Travel Warnings and Alerts U.S. Consular information Immunocompromised traveler Deep vein thrombosis Health advice for women/child travelers

To schedule a Travel Consultation or to learn more, please contact Dr. Allen’s office at (904) 396.4886

“ I have served as a medical missionary in Peru, Ecuador, Honduras, Costa Rica, Kenya and Nepal. As a result of my experiences, I gained extensive knowledge and a passion for tropical and travel medicine which I enjoy sharing with others.” - James E. Allen, MD, PhD

Anterior Hip Replacement Technique Has Patients Walking — and Talking Causes of Hip Pain Hip pain is a common problem, and can cause discomfort and difficulty in walking, sitting, activities of daily living, working and playing sports. Sometimes diseases that affect other joints in the body, such as arthritis, can be the cause of pain in the hip. Because there are so many causes that may result in hip pain, it can be confusing. It is important for you to see a physician who will make an accurate diagnosis.

Anterior Hip Surgery One innovative option available is Anterior Hip Surgery. Some of the benefits include: • Smaller incisions • Greater precision and safety • Quicker recovery and shorter hospital stays • Less pain • Return to normal activities sooner

Jacksonville Orthopaedic Institute surgeons Dale Whitaker, MD (left), and John Von Thron, MD.

Some signs that you should see a doctor include: • Inability to walk comfortably on the affected side • Injury that causes deformity around the joint • Hip pain that occurs at night or while resting • Hip pain that persists beyond a few days • Inability to bend the hip • Swelling of the hip or the thigh area • Signs of an infection, including fever, redness, warmth The physicians at Jacksonville Orthopaedic Institute are well experienced in diagnosing and treating your hip pain, whether you need a course of physical therapy or surgery.

If you’re struggling with hip pain, consider these questions before you meet with a doctor: • Are you forced to limit your activities because of your hip? • Do you have more bad days than good days? • Can your symptoms be controlled with medications?

To find out if you qualify for anterior hip replacement procedure, contact us today (904) 627-1 HIP

Eleven JOI orthopaedic board-certified surgeons can talk with you to determine if surgery is necessary. • Steven M. Crenshaw, MD • Gregory C. Keller, MD • Timothy R. Hastings, MD • Steven J. Lancaster, MD • Stanton L. Longenecker, MD • R. Stephen Lucie, MD • Richard A. Picerno II, MD • William G. Pujadas, MD • M. John Von Thron, MD • Dale A. Whitaker, MD • Edward D. Young, MD

To see an instructional video and set an appointment online, go to JOI.net and click on the photo at the top of the page.

Office Locations 1 Baptist Beaches

Riverside

1577 Roberts Dr., Suite 225 - Jacksonville Beach, FL 32250 P: 904.241.1204 • F: 241.7331

2 Shircliff Way, DePaul Bldg, Suite 300 - Jacksonville, FL 32204 P: 904.388.1400 • F: 388.9644

Hours of Operation 8:00 am to 5:00 pm – Monday, Tuesday, Wednesday 8:00 am to 4:30 pm – Thursday 8:00 am to 3:00 pm – Friday

Hours of Operation 8:00 am to 5:00 pm – Monday thru Friday

1325 San Marco Blvd, Suite 200 - Jacksonville, FL 32207 P: 904.346.3465 • F: 396.0388

2 Baptist South 14540 Old St. Augustine Rd., Suite 2201 - Jacksonville, FL 32258 P: 904.880.1260 • F: 880.1210 Hours of Operation 8:30 am to 5:00 pm – Monday, Tuesday, Thursday, Friday 8:00 am to 5:00 pm – Wednesday

3 Fleming Island/Orange Park/Clay County: 1845 Town Center Blvd., Suite 405 - Fleming Island, FL 32003 P: 904.276.5776 • F: 276.5958

San Marco

Hours of Operation 8:30 am to 5:00 pm – Monday thru Friday

University 5737 Barnhill Dr., Suite 102 - Jacksonville, FL 32207 P: 904.739.3319 • F: 448.1416 Hours of Operation 8:30 am to 4:30 pm – Monday thru Friday

Hours of Operation 8:30 am to 4:00 pm – Monday 8:00 am to 6:00 pm – Tuesday 8:00 am to 6:00 pm – Wednesday 8:30 am to 4:00 pm – Thursday 8:30 am to 4:00 pm – Friday Exclusive Sports Medicine Provider

New Option for Knee Patients Baptist Health and Jacksonville Orthopaedic Institute present the new minimally-invasive surgical procedure, Robot-Assisted Partial Knee Resurfacing, called MAKOplasty. Using a highly-advanced robotic arm system, we are now able to more precisely replace only the diseased part of the knee with a small implant, leaving healthy bone, tissue and cartilage intact. JOI surgeons have performed more of these surgical procedures than any other provider in the region.

Positive post-surgery results On all key measures of post-surgery success, results for the partial knee resurfacing procedure exceeded outcomes for total knee replacements and beat target goals.

2012/2013 Post-Surgery Results for JOI/Baptist Health Robot-Assisted Partial Knee Resurfacing

Versus Total Knee Replacement

2.3 days

2.6 days

Flexion

96.7°

91.3°

Extension

1.21°

1.81°

916 feet

810 feet

Average Length of Hospital Stay

Ambulation

Results based on 112 surgeries performed by six JOI surgeons at Baptist Medical Center Jacksonville in 2012 and 2013 (as compared to 608 total knee replacements for the same period).

Superior implant survivorship and high patient satisfaction 89% of patients who received robotic-arm assisted procedures were “very satisfied” or “satisfied,” compared with 75% of patients who received total knee replacements.

Patient Satisfaction with Robot-Assisted Partial Knee Resurfacing

80% 64% 60%

89% of patients were very satisfied or satisfied

40% 25% References

20%

1. Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006; 452: 35-43. 2. Roche MW, Coon T, Pearle AD, Counchis J. Two year survivorship of robotically guided medial MCK onlay. 25th Annual Congress of ISTA. October 3-6, 2012, Sydney, Australia.

5% 0%

Very Satisfied Neutral Dissatisfied Very Satisfied Dissatisfied

Refer your patients with knee pain that remains unresolved after conservative treatment. Who is a candidate? • Adults living with early- to mid-stage, non-inflammatory arthritis in the medial, patellofemoral or lateral compartments of the knee • Younger patients who were previously not considered good candidates for total knee replacement

What distinguishes this approach? • Pre-operative 3-D planning technology allows the surgeon to size the implant to match a patient’s knee

We are ready to take your referrals. Please fax your referrals to our San Marco location. We will contact your patients within 24 hours and schedule appointments that meet their requested needs.

• The ability to perfectly align components controls the loads on the implant’s articulating surfaces for maximum implant function and longevity

If you would like to consult about a patient, please call and ask to speak with one of our Board-Certified Orthopaedic Surgeons credentialed in MAKOplasty. We would be happy to answer any questions you may have.

What are the benefits?

Jacksonville Orthopaedic Institute – San Marco

• Greater accuracy of implant positioning vs. conventional instrumentation

1325 San Marco Blvd., Suite 200

• A smaller incision (therefore, less scarring) with better range of motion and a more natural-feeling knee following surgery

Fax: 904.396.0388

• Less soft tissue trauma during surgery, resulting in reduced post-surgical pain, accelerated recovery and improved outcomes • Does not disqualify a patient from total knee replacement later in life

Jacksonville, FL 32207 Phone: 904.858.6400

For your patients’ convenience, we also offer a dedicated phone line for scheduling a consultation for this procedure at 904.202.KNEE (5633). We are committed to ensuring your patients’ safety, comfort and excellent outcomes and appreciate that you entrust us with their care. joi.net partialkneejacksonville.com

Northeast Florida’s Most Respected Name in Orthopaedics

Wherever your path takes you, we’ll keep you on it!

Hiram A. Carrasquillo, MD Foot & Ankle Sports Medicine San Marco

Steven M. Crenshaw, MD Sports Medicine Joint Replacement San Marco

David A. Doward, MD Physical Medicine & Rehabilitation - Spine Team Sports Medicine San Marco

Sunday U. Ero, MD Spine Surgery Orthopaedic Traumatology Riverside

Richard R. Grimsley, MD Joint Replacement Fleming Island/Clay County & Riverside

Philip R. Hardy, MD Sports Medicine Joint Replacement San Marco

Timothy R. Hastings, MD Sports Medicine Joint Replacement Foot & Ankle, Spine, Hand Baptist Beaches

Brandon J. Kambach, MD Spine Baptist South

Kevin Michael Kaplan, MD Sports Medicine Joint Replacement San Marco

Gregory C. Keller, MD Spine, Joint Replacement Sports Medicine Baptist South & San Marco

Garry S. Kitay, MD Hand & Upper Extremity Joint Replacement Sports Medicine San Marco

Robert J. Kleinhans, MD Hand, Joint Replacement Sports Medicine University

R. Stephen Lucie, MD Sports Medicine Joint Replacement San Marco

Jennifer L.M. Manuel, MD Hand & Upper Extremity Baptist South

H. Lynn Norman, MD Sports Medicine Joint Replacement Riverside

Richard A. Picerno II, MD Sports Medicine Joint Replacement Baptist South

Michael S. Scharf, MD Joints, Spine, Upper & Lower Extremities San Marco

Gregory Solis, MD Foot & Ankle Sports Medicine Baptist South

Maxwell W. Steel III, MD Sports Medicine, Foot & Ankle Joint Replacement University

Dale A. Whitaker, MD Sports Medicine Joint Replacement Foot & Ankle, Hand Baptist Beaches

Edward D. Young, MD Sports Medicine Joint Replacement Foot & Ankle, Hand Baptist Beaches

Steven J. Lancaster, MD Sports Medicine, Joint Replacement Foot & Ankle, Hand Baptist Beaches

Stanton L. Longenecker, MD Joint Replacement Sports Medicine Riverside

William G. Pujadas, MD Joint Replacement Sports Medicine San Marco

Robert G. Savarese, DO Physical Medicine & Rehabilitation - Spine Team Baptist South & San Marco

Carlos R. Tandron, MD Sports Medicine Joint Replacement San Marco

M. John Von Thron, MD Sports Medicine Joint Replacement Foot & Ankle, Hand Baptist Beaches

Bruce Steinberg, MD Hand & Upper Extremity Joint Replacement Sports Medicine Baptist South & San Marco

Baptist Beaches 1577 Roberts Dr., Suite 225 - Jacksonville Beach, FL 32250 P: 904.241.1204 • F: 241.7331

Baptist South 14540 Old St. Augustine Rd., Suite 2201 - Jacksonville, FL 32258 P: 904.880.1260 • F: 880.1210

San Marco 1325 San Marco Blvd, Suite 200 - Jacksonville, FL 32207 P: 904.858.6400 • Main 904.346.3465 • F: 396.0388

Fleming Island/Clay County 1845 Town Center Blvd., Suite 405 - Fleming Island, FL 32003 P: 904.276.5776 • F: 276.5958

University 5737 Barnhill Dr., Suite 102 - Jacksonville, FL 32207 P: 904.739.3319 • F: 448.1416

Riverside P: 904.388.1400 • F: 388.9644

Rehabilitation Centers A

Baptist Beaches 1577 Roberts Dr., Suite 320 - Jacksonville Beach, FL 32250 P: 904.247.3324 • F: 247.3926

Westside 5393 Roosevelt Blvd, Suite 17 - Jacksonville, FL 32210 P: 904.389.8570 • F: 389.8599

Mandarin 12276 San Jose Blvd., Suite 716 & 717 - Jacksonville, FL 32223 P : 904.288.9604 • F: 288.9643

San Marco 1325 San Marco Blvd., Suite 102 - Jacksonville, FL 32207 P: 904.858.7045 • F: 858.7047

North 12961 North Main St., Suite 201 & 202 - Jacksonville, FL 32218 P: 904.757.2474 • F: 757.5541

South (Spine Center) 14985 Old St. Augustine Rd., Suite 106 - Jacksonville, FL 32258 P: 904.288.9491 • F: 288.9698

Fleming Island 1845 Town Center Blvd. Suite 410 - Fleming Island, FL 32003 P: 904-621-0396 • F: 621.0397

University 5737 Barnhill Dr., Suite 204 - Jacksonville, FL 32207 P: 904.733.9948 • F: 733.9984

Point Meadows 7740 Point Meadows Dr., Suite 1 & 2 - Jacksonville, FL 32256 P: 904.564.9594 • F: 564.9687

Sports Medicine Provider

03/19/2014