July.Aug ECMS Bulletin

www.escambiacms.org

jUly/AUGUSt 2012

BULLETIN

VolUmE 42, No. 4

Upcoming Events Tuesday August 14, 2012 General Membership Meeting “Veterans Mental Health: Identifying Patients & Local Resources” [1 AMA PRA Category 1 CreditsTM]

Heritage Hall 5:30p Sunday, September 30, 2012 Women in Medicine Brunch Fish House 11:30a - 1:30p Tuesday, October 9, 2012 General Membership Meeting [1.5 AMA PRA Category 1 CreditTM]

Speaker: Patricia Green, M.D./ Topic: “Breast MRI” Speaker: Bruce Horten, M.D./ Topic: “Breast Cancer Analysis”

RSVP: 478-0706

Founded in 1873

President’s Message

Landmark Decision Dr. George A.W. Smith On June 28 the U.S Supreme Court announced its decision on the challenge to the Patient Protection and Affordable Care Act (PPACA). Its decision to uphold the constitutionality of the health reform law came as a surprise. However, it has assured that millions of Americans who are presently uninsured will have the opportunity to gain insurance coverage in the future. To quote Glen Stream, M.D., M.B.I., president of the American Academy of Family Physicians, “there is plenty to like, and dislike about the PPACA. He feels that the Patient Protection and affordable Care Act has been a divisive issue not only in our country but also amongst physicians. I agree with his statement that the legislation is far from perfect, but now that the Supreme Court has issued its long-awaited ruling, we can move forward with needed health system reform.

The Court’s declaration that the mandate of Medicaid expansion was unconstitutional truly took everyone by surprise as all eyes were on the “Individual Mandate. It has limited the expansion of Medicaid by making it optional for states rather than a mandated expansion. This means that states that want to move forward with planned expansion (which would give coverage to all individuals under 133% Federal Poverty Level,(FPL) may do so, but states that do not want to will no longer be required to do so.

Already governors in several states including Florida and Louisiana have declared they will not participate in the expansion. Unfortunately this means that some of the poorest and neediest individuals who would have benefitted most from health care reform risk losing their only means to affordable health care coverage. The health reform law establishes subsidies on a sliding scale for individuals and families between 100% and 400% FPL. It did not establish subsidies for those under 100% FPL because it was assumed that they would be covered by the Medicaid expansion.

Dr. George A.W. Smith Even with its flaws it is felt that by extending healthcare coverage to over 30 million more people, the law will improve the health of the nation by ensuring access to basic primary care including preventive services and chronic disease management.

Physicians will need to advocate for changes in the flawed provisions of the law and will need to refocus on things that still need to be addressed. These include the Independent Payment Advisory Board (IPAB); meaningful liability reform; finding a permanent fix for the sustainable growth rate (SGR) formula and passing The Medicare Patient Empowerment Act (H.R. 1700/S.1042) that will give seniors the ability to see any physician they choose and privately contract to access their Medicare benefit without having to pay the full out-of-pocket cost for their care.

Several provisions of the health care law are beneficial for patients, physicians and the workforce.

It eliminates annual and lifetime coverage limits and covers preventive services. Insurers cannot deny coverage based on pre-existing conditions and young adults are allowed to remain on their parents’ insurance up to age 26.Medicaid payment for primary care services will be boosted to Medicare levels and primary care payment incentives will be created for Medicare. For our workforce there is provision for funding for teaching health centers and scholarship and loan repayment programs in the National Health Service Corps.

There are still many unknowns about the Affordable Care Act and additional legal challenges are likely. The FMA states that it will continue its advocacy efforts on issues not addressed by the ACA and will work to preserve its good provisions. It offers to provide guidance to members as the healthcare law is implemented and will be actively engaged in the regulatory and rule-making process.

E.C.M.S. Bulletin The Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.

Vision for the Bulletin: • Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond.

• Collaborate with the Alliance to bring together Escambia and Santa Rosa County medical families. To know the needs of the community and promote the healthcare needs.

• A powerful instrument to attract and induct members to organized medicine.

Views and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the directors, staff or advertisers.

Editors: Christopher Burton, MD Erica Laxson, Executive Director

Ad placement Contact Erica Laxson at 478-0706 Ad rates 1/8 page: $100 • 1/4 page: $150 • 1/2 page: $300

Contents Page 3 -New Members Page 4 - Internal Threats Can Harm Your IT Network Page 5, 6 & 7 - Electronic Health Record Risks Page 8- Pain Management Remains a Pain for Some Practitioners Page 9 - Failed Communications in the Medical Office Lead to an “Alleged Delay in Treatment” Page 10 & 11 - Hospital News

Membership

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New Members Move/relocated Ismeth Abbas, M.D. 1000 W. Moreno St. Pensacola, Fl 32501 Phone: 850-469-7406 Fax: 850-437-8283 Elias Banuelos, M.D. 5992 Berryhill Rd., Ste. 300 Milton, Fl 32570 Phone: 850-623-9787 Fax: 850-626-7512 Vishnu Behari, M.D. 1921 East Nine Mile Road Pensacola, FL 32514 Phone: 850-479-4791 Fax: 850-494-2260 Amy Doyle, M.D. 1000 W. Moreno St. Pensacola, Fl 32501 Phone: 850-469-7406 Richard Sims FSU College of Medicine, 3rd Year Student

Alecia Chen, M.D. 4900 Bayou Blvd. Ste. 107 Pensacola, Fl 32503 P: 607-6269 F: 607-6279 John Gary, M.D. | Dr. Mark Scott, M.D. Pulmonary, Critical Care & Sleep Disorders Medicine, PA 435 Airport Blvd.

Pensacola, Fl 32503 P: 435-7448 F: 471-3410

Correction to the 2012 Directory: Edward Friedland, M.D. | Humam Humeda, M.D. | Ronnie Wiles, M.D. | Maged Nashed, M.D. Pensacola Nephrology 1619 Creighton Road Pensacola, Fl 32504 P: 444-4700 F: 444-7497

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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Practice Management

Internal Threats Can Harm Your IT Network Security of data and networks, an issue that companies are taking seriously. They’re going to great lengths to protect themselves from external threats and are, for the most part, safe from them. And yet, there are still stories about how businesses are being infected by malware. If they’re safe to the external environment, where’s the threat coming from?

In recent years the majority of security threats and compromises have come from within the company. A common threat to companies is the logic bomb - malware that targets IT systems and disabled data. As a logic bomb is introduced from within the network, the blame often lies with a disgruntled employee with full access to internal systems.

Insider threats giving employees full access to the network when they don’t need it is a common mistake often made by companies. There’s little need for an employee who does nursing to have access to accounting records. This practice could set your company up for a considerable security problem in the future.

Article submitted by LANformation

Take Precautions, Security threats can be a particularly harsh nightmare for small practices, as many don’t have an IT department or staff with the technical expertise needed to maintain a secure network. If you’re one of these organizations, it’s a good idea to hire an outside consultant to help you with your network security. With consultants, it’s important that you maintain close contact with them to ensure any issues that crop up are dealt with expeditiously.

If you don’t work with an external company there are a few things you should do when you have an employee leave the company. First, their accounts should be deleted immediately and their access privileges should also be revoked. Second, if you have accounts with shared passwords, you should change them to ensure an exemployee can’t gain access to the system.

If you’d like to learn more about internal security, and measures you can take to ensure you are safe, we are ready to help you. Please contact us.

Practice Management

ESCAMBIA ESCAMBIACOUNTY COUNTYMEDICAL MEDICALSOCIETY SOCIETYININCONJUNCTION CONJUNCTIONWITH WITHSANTA SANTAROSA ROSACOUNTY COUNTY

Electronic Health Record Risks A survey of 50,000 members of The Doctors Company in the third quarter of 2011 (with 5,100 responses) revealed that 30 percent of responding members have an electronic health record (EHR) in their practice that fulfills Meaningful Use criteria. Another 14 percent of responders plan to have an office EHR within the next three years. Only 17 percent have no plans to use a practice EHR (56 percent of members in this group are likely to retire within five years).

In the fall of 2011, the Institute of Medicine issued a report titled Health IT and Patient Safety: Building Better Systems for Better Care. It concluded that the information needed for analysis and assessment of the safety of health IT (HIT) and its use isn’t available, adding that our understanding of EHR benefits and risks is largely anecdotal. The report recommends creating a federal agency for systematic and uniform data collection to investigate harm and safety events related to HIT. Currently, PDR Network’s EHRevent is the only national reporting system for EHR users to document adverse events. This Web-based, confidential EHR Safety Event Reporting System is available at www.EHRevent.org.

Report confidentiality is protected through its designation as a certified Patient Safety Organization.

The discussion of EHR benefits and risks that follows is based on articles and reports appearing in peer-reviewed and non–peer-reviewed medical literature and in the EHRevent Newsletter, a publication that features an “Event of the Month” reported to EHRevent.org.

EHR Benefits and Associated Risks Improved medical Record Documentation and legibility. Computer physician order entry (CPOE) reduces errors by eliminating illegible orders and transcription errors.

Enhanced medication management. EHRs generate alerts for improper drug dosages, adverse drug-drug interactions, and drug allergies.

However, drug-drug interaction lists may generate frequent, annoying, or disruptive alerts. Doctors may develop “alert fatigue” and override or disable them. If the alert would have prevented an adverse drug event, the physician may be liable. Optimized or expert consensus lists focused on fewer clinically meaningful interactions may be a solution.

Facilitates medication Reconciliation. EHRs ensure that the active medication list corresponds to what the patient is actually taking.

Better Presentation of Data for Clinical Decisionmaking. Examples include procedure findings, consultations, and lab and imaging results—and abnormal results can be flagged. However, be aware of the following:

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By David B. Troxel, MD, Medical Director, Board of Governors, The Doctors Company

Doctors may copy information from prior notes (theirs or others) and paste it into a new note—then make edits as appropriate. This may cause irrelevant over-documentation, often aggravated by the use of templates, that results in the loss of narrative documentation.

EHRs may autopopulate fields in the history and physical (H&P) (from data fields in a prior H&P) and in procedure notes (from personalized or packaged templates). Entering erroneous or outdated information may increase liability.

Example: An internist’s EHR was the medical record. Some of the autopopulated fields contained obviously wrong information. At deposition the plaintiff’s attorney asked these questions: “So is the information in this record accurate or not?”

“Do you bother looking at your records?”

“If these ‘autopopulated’ fields are incorrect, can we trust anything in this record?”

“Do you deliver the same level of patient care as the care you take in record keeping?”

Templates with drop-down menus facilitate data entry but are often integrated with other automated features. If you select an item above or below the one desired, amoxapine becomes amoxicillin or “qd” becomes “qid.” Entry errors may be perpetuated elsewhere in the EHR—and be overlooked.

Erroneous information is easily disseminated.

Meaningful Use requires online patient connectivity through patient portals. Some EHRs have questionnaires using algorithms to interview the patient. These may address issues physicians are not prepared to pursue (depression, substance abuse, STDs, etc.). Failure to follow up can create liability.

Clinical Decision Support (CDS) Systems. As required by Meaningful Use, CDS systems provide algorithm-based alerts, warnings, and reminders for medication management, chronic disease management, and preventive care. It’s important to know the source of this information because it may conflict with your specialty’s clinical standards of care or practice guidelines—and with the information in FDAapproved drug labels and alerts.

EHRs provide extensive documentation of clinical decision-making and activity, including departures from CDS guidelines, that physicians may have to justify. Will CDS systems establish new standards of care?

Facilitates E-Prescribing. It is estimated that 35 percent of office practices use e-prescribing. SureScripts has medication data on 66 percent of patients and transmits to all chain pharmacies, 60 percent of independent pharmacies, and most insurance formularies. E-prescribing reduces costs by flagging generic and “on-formulary” drugs and encourages Continued on page 6

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Practice Management

Electronic Health Record Risks continued from page 5 patients to fill prescriptions (25 percent do not). The software checks for drug-drug interactions, dosage errors, medication allergies, and patient-specific medication factors (renal failure, liver failure, etc.). However, be aware that EHR e-prescribing creates exposure to community medication histories (drugs prescribed by others). Drug-drug interactions can be timeconsuming to trace, as in the following example: Dr. A renews a medication. His e-prescribing program sends an alert advising him that it could interact with another drug the patient is taking. He did not prescribe that drug, so his office will have to contact the patient to identify who did.

Dr. A will then have to contact Dr. X to discuss which drug will be discontinued or changed. If failure to do so results in patient injury from a drug interaction, Dr. A may be liable.

EHR Risks Doctors are responsible for e-health information they can access from outside the practice, from their practice EHR or Web site, or through a health information exchange (hospital charts, consultant reports, lab and imaging reports, etc.). It will be a challenge to examine the patient and his or her electronic dossier in a 15-minute visit.

The computer may become a barrier between doctor and patient. Filling in a computer template may divert attention from the patient, limiting interactive conversation and restricting creative thinking—further weakening the doctorpatient relationship.

Vendor contracts may attempt to shift liability resulting from faulty software design or clinical decision support onto the user. Malpractice policies may exclude coverage for product liability and for indemnification of third parties. Read all EHR contracts carefully.

As part of the discovery process, lawyers may request not only printed copies of the EHR but also the raw e-data for metadata analysis. This includes logon and logoff times, what was reviewed and for how long, what changes or additions were made, and when the changes were made. Smartphone and e-mail records are also discoverable. Remember: all physician interactions with the EHR are time-tracked and discoverable.

Computer-assisted documentation, including point-andclick lists, drop-down menus, autofill, templates, and canned text, bypasses natural language and produces structured progress notes. These often contain redundant, formulaic information. It is easy to overlook significant clinical information lost in a sea of normal or irrelevant findings (primarily documented for coding and billing purposes). As a result, communication with on-call and consulting physicians (and with patients) may be compromised.

In a misguided attempt to protect records from alteration, some EHRs won’t allow editing or correction of entry errors made in progress notes. You can make another note calling attention to the error, but the error may persist elsewhere in the EHR.

Practice Management

ESCAMBIA ESCAMBIACOUNTY COUNTYMEDICAL MEDICALSOCIETY SOCIETYININCONJUNCTION CONJUNCTIONWITH WITHSANTA SANTAROSA ROSACOUNTY COUNTY

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Electronic Health Record Risks continued from page 6 The transition from paper to EHRs can be risky. When scanning or entering paper records into an EHR, you must comply with federal and state record retention laws before destroying old records. Failure to do so can result in an allegation of spoliation of evidence.

The Medical eRisk Considerations for Online Communication were originally created by the eRisk Working Group; development has been transferred to the iHealth Alliance. The eRisk Considerations are available in the EHR and Telemedicine Resource Center at www.thedoctors.com/erisk. These are a few highlights: Clinician-patient relationships should be preexisting and not be initiated online.

Online diagnosis and treatment of new conditions may increase liability; consultation should be limited to known preexisting conditions.

Licensing jurisdiction: Online interactions are subject to state licensure requirements. Physicians should be licensed in the state in which the patient resides.

Avoid emergency subject matter. Send patients to the ER for chest pain, shortness of breath, high fever, trauma, bleeding in pregnancy, etc.

Web site advertising and promotional material may raise patient expectations, imply a warranty or an implicit guarantee, or violate consumer protection laws (and damage caps don’t apply). Cosmetic medicine and surgery, off-label drug use, and non–FDA-approved drugs and medical devices

are at high risk.

Avoid discussing sensitive subject matter, including substance abuse, mental health, HIV status, and sexually transmitted diseases. tips to reduce social media risks: • Social networking is too informal for physician-patient communication.

• Don’t discuss individual patients or give medical advice.

• Social media sites are not HIPAA-compliant, secure networks.

• Assume that anything you say or post is in the public domain.

• Don’t text message hospital orders (Joint Commission requirement).

This article originally appeared in The Doctor’s Advocate, second quarter 2012 (www.thedoctors.com/advocate).

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

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Medical/Legal

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Pain Management Remains a Pain for Some Practitioners Factoid: the number of pain management clinics in Florida has dropped from over 900 to 444.

And changes are afoot again for physicians treating patients with chronic nonmalignant pain! House Bill 787, which became law on July 1, 2012, affects many aspects of the health care industry, including controlled substance prescribing and pain management clinics. The bill is 69 pages. A summary of those changes is as follows: Prescribing Only physicians prescribing controlled substances listed on schedule II through IV for the treatment of chronic nonmalignant pain must designate themselves as a controlled substance prescribing practitioner on the Board of Medicine practitioner profile Patients with chronic nonmalignant pain who also have a history of substance abuse or have a co-morbid psychiatric disorder now require a consultation with an addiction medicine specialist or psychiatrist, rather than an addictionologist or physiatrist.

Additional exemptions from pain management registration and standards of practice have been extended to board certified rheumatologist and certain board eligible practitioners.

Certification by the American Board of Pain Medicine has been added to the list of valid certifications.

“Board eligible” is defined as successful completion of an anesthesiology, physical medicine and rehabilitation, rheumatology, or neurology program approved by ACGME or the American Osteopathic Association for 6 years from successful completion of the program.

Physicians who prescribe medically necessary controlled substances for a patient during a hospital inpatient stay no longer must register as a controlled substance prescriber.

The definition of “addiction medical specialist” now includes now includes a board certified psychiatrist, but it excludes physiatrists.

Rheumatoid arthritis no longer is considered chronic nonmalignant pain for the purposes of registration and standards of practice for physicians.

By Linda Keen, P.A., The Law Office Of Linda A. Keen Tallahassee, Fl

“Board certified pain management physicians” now include physicians certified by the ABMS. Pain Management Clinics The following now are exempt from registration as pain management clinics: • Clinics wholly owned and operated by one or more board certified rheumatologists.

• Clinics wholly oned and operated by one or more boardeligible anesthesiologists, physiatrists, rheumatologists, or neurologists.

• Clinics wholly owned and operated by board eligible or boardcertified medical specialists in a multi-specialty practice in which one or more of the specialists has completed a fellowship in pain medicine, recognized by certain accrediting organizations and performs interventional pain procedures.

• Clinics appproved or certified by the American Association of Physician Specialists, the American Boasrd of Pain Medicine or the American Osteopathic Association are now exempt from registration.

Changes in pain management regulation start at page 44 of HB 787. To see the full text visit www.flsenate.gov/Sessions/Bill/2012/0787

Medical/Legal

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Failed Communications in the Medical Office Lead to an “Alleged Delay in Treatment” Case: A young woman with a long history of migraine headaches, sickle-cell trait, and several first trimester miscarriages, finally had a normal delivery of a full term healthy infant. Her pregnancy was complicated by pregnancy induced hypertension (PIH), and possibly pre-eclampsia. She remained under the care of her obstetrician, and continued to have high blood pressure readings. No blood pressure medications were prescribed. At five weeks post-partum she went to her primary care physician (PCP) with complaints of chest pain, cough, shortness of breath and dizziness. She was diagnosed with bronchitis and prescribed antibiotics, prednisone and inhalers. A month later, she returned to her PCP with complaints of bilateral feet swelling; she had 2+ peripheral edema. Two months later, she returned with similar complaints and also complained of congestion, wheezing and flulike symptoms. She had no fever or chills. On physical exam, she had no heart murmur or gallop; her chest x-ray showed left ventricular cardiac enlargement, but was otherwise unremarkable.

Ten days later her PCP noted new findings: she had gained ten pounds, had swelling in her lower extremities (3+ edema) and abdomen and a S3 heart gallop. The PCP diagnosed congestive heart failure (CHF), and contacted a cardiologist.

In his deposition, the PCP testified that he spoke to the on-call cardiologist, and discussed the patient’s history and findings in detail. Also he said that he had instructed the patient to see the

cardiologist in the morning (Friday) for an echocardiogram (ECHO). The primary aspect of his testimony that implicated the cardiologist was that the PCP asked her to call the patient the following day to arrange for the ECHO. In fact, he documented in the medical record that the cardiologist was given the patient’s name and number, agreed the patient needed the ECHO, and that she (cardiologist) would have her staff call the patient the following day. This information was also written on a referral sheet, but the referral sheet never reached the cardiologist’s office.

As instructed, the patient called the cardiology office, and was told that there were no appointment openings, and that the office did not perform ECHOs on Fridays. The cardiology scheduling secretary further advised the patient that there was no urgency and that she could be seen on Tuesday the following week. The patient called her PCP’s office for assistance. An employee in that office told her to come back and see the PCP in two days if she did not feel better.

On Sunday, the patient presented to the hospital emergency department (ED) with an inability to speak and a right-sided hemiplegia. A CT showed a large evolving left-sided cardio-embolic stroke. She was also diagnosed with post partum cardiomyopathy.

The patient was eventually discharged to a rehabilitation center. At discharge from the rehabilitation center, she continued to have limitations, and was unable to care for her baby.

Disposition: The claim settled for a moderate dollar amount.

Allegation/s: The patient should have been sent to the ED and admitted to the hospital for urgent treatment of her congestive heart failure, which would have averted her postpartum stroke.

Clinical/Risk Management Commentary: The experts gave good causation arguments that, even if the patient had seen our insured cardiologist and/or had been admitted to the hospital, it is unlikely that her outcome would have been different. After the patient suffered the stroke, an ECHO was performed in the hospital setting and indicated no thrombus was present in the left ventricle. The cardiologist also performed a transesophageal echocardiogram (TEE). It revealed a left ventricle thrombus. It was unlikely that anti-coagulation would have helped her, given the timing of the event.

However, the standard of care argument remained a challenge.

Experts opined that once the referral was made to the cardiologist, it was the cardiologist’s responsibility to assess the patient and make the determination on what course of treatment should be pursued, and the timing of it. Given this position, the experts opined that although the guidelines don’t necessarily require immediate hospitalization for CHF, once the cardiologist was informed that the patient was postpartum with suspected CHF, she should have immediately admitted her to the hospital as for an “urgent” ECHO and further evaluation. To do otherwise was a breach of the standard of care by the cardiologist.

From a risk management perspective, had there been better communication systems in place in both the PCP and Cardiology offices, the office staffs would have been better able to ensure that if the original plan of care agreed upon by both physicians was not practical according to scheduling constraints, an immediate, but appropriate alternate plan could have been devised.

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In The Community

Hospital News West Florida Hospital

Sacred Heart

Receives Important Distinctions

Prepares for Launch of EMR Systems

ACR Accreditation in Breast Magnetic Resonance Imaging West Florida Hospital has been awarded a three-year term of accreditation in breast magnetic resonance imaging (MRI) as the result of a recent review by the American College of Radiology (ACR). MRI of the breast offers valuable information about many breast conditions that may not be obtained by other imaging modalities, such as mammography or ultrasound.

The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Guidelines and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. Image quality, personnel qualifications, adequacy of facility equipment, quality control procedures, and quality assurance programs are assessed. The findings are reported to the ACR Committee on Accreditation, which subsequently provides the practice with a comprehensive report they can use for continuous practice improvement.

The ACR is a national professional organization serving more than 34,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

UnitedHealth Premium® Specialty Center Designations for Cardiac and Surgical Spine Services West Florida Hospital is proud to receive UnitedHealth Premium specialty center designations in recognition of quality care in two areas: Cardiac Services and Surgical Spine Services.

UnitedHealthcare® developed the UnitedHealth Premium specialty center program to give its members information and access to hospitals meeting rigorous quality criteria.

The designation is based on detailed information about specialized training, practice capabilities and outcomes and is designed to help members make informed decisions should they need cardiac and/or surgical spine care.

To receive these designations, West Florida Hospital met extensive quality and outcomes criteria based on nationally recognized medical standards and expert advice. The criteria incorporate measurements of breadth and depth of care, staff experience, emergency care, quality and outcomes reporting.

This fall, Sacred Heart Hospital in Pensacola will go live with eOrders, our Computerized Practitioner Order Entry (CPOE) system.

Multi-disciplinary teams are preparing for the October implementation, including creating, evaluating and prioritizing the order sets that will be available at Go Live. Our goal is to have four to eight order sets finalized per service or section, prioritized by the frequency or complexity of their use. Order sets are generally used for admission or immediate postoperative management, rather than daily rounds.

For a brief introduction to the new CPOE system, which will be used at both Sacred Heart and Baptist Hospitals, Dr. Michael Brown, Sacred Heart CMIO, recommends the six-minute demo video by Dr. Mark Pratt, accessible via YouTube at www.bit.ly/CPOEdemo.

Hospital work teams also are gearing up for our much-anticipated eBarCode MedAdmin implementation this summer, which will use the barcodes on patients’ hospital wristbands to enhance patient safety at one of the most critical points of care. When administering patient medications using eBarCode MedAdmin, clinical staff members will digitally identify the patient by scanning the barcode on the patient’s wristband, and then scan the barcode on the ordered medication before it is given. The system will alert the caregiver of any potential error in medication administration.

FSU COM OB/GYN Residency Program Accredited for 5 Years Congratulations to the Florida State University Obstetrics and Gynecology Residency Program at Sacred Heart Hospital for achieving the prestigious five-year accreditation cycle from the Residency Review Committee. The committee also approved an additional residency position at each year level, which will increase our quota of OB/GYN residents from 12 to 16.

In The Community

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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Hospital News Continued

Baptist Health Care Baptist Wins National Award for Clinical Excellence & Patient Satisfaction VHA Inc., a national health care network, recently awarded Baptist Hospital the Leadership Award for Clinical Excellence for top performance on core measures and patient satisfaction (HCAPHS) scores. Only 27 other hospitals in the nation received the award. Learn more at eBaptistHealthCare.org.

Baptist Medical Group Grows in Leaps and Bounds Since launching in 2009, Baptist Medical Group, Baptist’s network of employed physicians, has strategically grown to more than 110 physicians.

Over the next three months, the growth will continue, as Baptist welcomes 20 additional providers to the network. The bulk of the growth will occur in primary care with additional specialty support in key services lines including orthopaedics, cardiology, oncology and neurosurgery. Learn more at BaptistMedicalGroup.org.

Baptist Hospital Invests $2 million in Emergency Department Enhancements Baptist Hospital recently completed a $2 million ED renovation project to ensure seamless care for patients. The enhancements will help ensure personal attention while ensuring high quality care. Features of the project include: centrally located physician work stations, six new behavioral medicine patient beds, and improvements in safety and security. Learn more at eBaptistHealthCare.org.

Cardiac Cath Lab Now Open at Gulf Breeze Hospital A new, state-of-the-art cardiac catheterization lab now open at Gulf Breeze Hospital offers patients and physicians convenient access to diagnostic imaging and treatments for heart disease, heart valve disease, blockages of the arteries in the legs and some interventional radiology procedures. Learn more at GulfBreezeHospital.org.

3D Mammography Now Available at Three Baptist Locations In 2011, Baptist Hospital was the first hospital in Florida to gain FDA approval to perform digital breast tomosynthesis, 3-D digital mammography. Beginning in August, 3D mammography will also be offered at Gulf Breeze Hospital and Baptist Medical Park – Nine Mile. Learn more at ebaptisthealthcare.org/DigitalMammography.

Baptist Welcomes New Oncologists, Builds Robust Cancer Program Baptist is pleased to welcome two new fellowship-trained medical oncologists –Sherif Ibrahim, M.D., and Nutan DeJoubner, M.D. – to its growing cancer program. Beginning in August, Drs. Ibrahim and DeJoubner will work alongside medical oncologists Dr. Carletta Collins, Dr. German Herrera, Dr. David Mann, radiation oncologist Dr. James Adams, gynecologic oncologist Dr. Tom Patton, and physician assistant Gary Belanger. With a robust, multidisciplinary cancer team, The Baptist Cancer Institute offers a comprehensive array of cancer services. Learn more at BaptistMedicalGroup.org.

Rehab Services Expand at Baptist Medical Park - Navarre Baptist Medical Park - Navarre recently completed an expansion that nearly doubled the space of its Andrews Institute Rehabilitation department. The program serves patients recovering from a wide variety of conditions – including orthopaedic post-operative recovery, neurological disorders, general deconditioning and weakness, and gait/walking disorders. One of the new services offered is vestibular rehab, a form of physical therapy to help people with inner ear disorders improve overall balance, mobility and coordination.

Learn more at TheAndrewsInstitute.com/Rehabilitation.

www.escambiacms.org

8880 University Pkwy., Suite B Pensacola, FL 32514 Ph: 850-478-0706 Fx: 850-474-9783 Email: info@escambiacms.org Executive Director: Erica Laxson

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mECoP Reminder Infectious Diseases and Travel Medicine Conference Friday, September 28, 2012 Sacred Heart Hospital’s Greenhut Auditorium - 7 am until 4 pm visit www.mecop.org for full list of topics and agenda Contact mECoP at 850.477.4956 (option 1) to register

Member Benefit: The Health Care Attorney On Call Hotline (561) 306-5699 View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission.