Editors: Kacey Montgomery, M.D. | Erica Huffman, Executive Director
www.escambiacms.org
Bulletin MARCH/APRIL 2019 VOLUME 49, NO. 2
CONTENTS
I do not always live a healthy lifestyle and I am certainly not excessively wealthy but I try, at least intermittently to put efforts towards my health and my wealth. This month’s ECMS meeting “Health of Your Wealth” focuses on what we as physicians tend to let lapse – our financial wellbeing. I recently reviewed an article from James Dobbin’s Blog “The White Coat Investor” titled “Why Doctors Aren’t Rich?” He basically explained that: 1. We get a late start, due to years of medical school, residency and fellowship, thus missing many years of compounding our earnings. 2. Many physicians have high student loan debt. The average debt for those starting practice in 2016 was $190,000 and this amount is rising yearly. 3. Physicians have inadequate savings. Whether due to a lack of financial sophistication, a sense of entitlement or a lack of self-discipline; simply put we cannot invest money unless we save money. Choosing to skip retirement savings contributions can devastate a financial plan. 4. Bad investment plans. Being overly aggressive (day trading, tech stocks) or too conservative (leaving savings in poorly returning money market account) makes our goals unachievable. Compounding is not effective if it does not occur at a rate greater than inflation. 5. Failure to insure against financial catastrophe. There are only a few things that wipe us out financially: death, disability, natural disaster and liability. These are fairly easy to insure against. 6. Excessive investment costs -Investment advisors can be well worth their premium and I use one, but it is worthwhile to make sure we pay reasonable fees and we get what we pay for. Taxes, too, can wipe out returns. Part of a plan should include tax strategies to minimize this cost.
Page 4 - President’s Letter Ctd. Page 6 - Practice Mgmt. Page 8 - Medical/Legal Page 13 - Foundation Page 15 - Community
Save the Date March 26th “Health of Your Wealth” Pensacola Yacht Club April 25th “Top 5 Claims Against Doctors in Florida” V. Pauls May Social Networking June 6th Physician Wellness
A great book I recommend is “The Millionaire Next Door”. It is quite sobering to read that teachers are as a percentage far more successful at growing wealth than physicians. Did you know that the most common vehicle amongst millionaires was a Ford F150 pickup? Continued on Page 4 RETURN SERVICE REQUESTED PRSRT STD U.S. POSTAGE PAID PERMIT #258 PENSACOLA, FL
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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LEARN MORE AT HIP.AGENCY
New Members
4771 Bayou Blvd. # 157 Pensacola, FL 32503 Ph: 850-478-0706 Fx: 850-474-9783 Email: info@escambiacms.org www.escambiacms.org
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.
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Vision for the Bulletin:
Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond. A powerful instrument to attract and induct members to organized medicine.
Mission:
Advancing physicians’ practice of medicine in our community.
Ad placement Contact Erica Huffman at 478-0706 Ad rates 1/2 page: $350 · 1/4 page: $200 · 1/8 page: $150
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.
New Members Anwar, David, M.D IC NPI: 1609196377 West Florida Cardiology/Northwest Florida 8333 North Davis Highway 4th Floor Pensacola, FL 32514 (850) 969-7979 Fax: (850) 474-9352 www.nwfheartgroup.com Bautsch, Bill, M.D. IM NPI: 1629176813 West Florida Medical Group-Avalon 4244 Avalon Blvd. Milton, FL 32583 (850) 494-4600 Fax: (850) 983-4025 www.westfloridamedicalgroup.com Cahill, Joseph, M.D. N NPI: 1427346766 West Florida Specialty GroupsNeurology 8383 North Davis Highway Pensacola, FL 32514 (850) 494-3954 Fax: (850) 494-3960 www.westfloridamedicalgroup.com DeNapoles, Christpher, M.D. FM NPI: 1578973715 West Florida Medical Group/ Immediate Care 2360 U.S. Highway 29 S Cantonment, FL 32533 (850) 968-2083 Fax: (850) 968-6024 www.westfloridamedicalgroup.com
Martucci, Jean Pierre, M.D. GS NPI: 1669627055 Baptist Medical Group - Surgery 1717 North E Street, Ste. 205 Pensacola, FL 32501 (850) 437-8810 Fax: ( 850) 437-8809 www.baptistmedicalgroup.org Morris, Carol, M.D. Gastro NPI: 1295972206 Baptist Medical Group 1118 Gulf Breeze, Parkway, Ste. 101 Gulf Breeze, FL 32561 (850) 626-9626 Fax: (850) 626-9606 www.baptistmedicalgroup.org Phillips, P. Kim, M.D. Derm NPI: 1962481044 Tarantola Dermatology, Inc. 9400 University Parkway Ste. 306 Pensacola, FL 32514 (850) 439-5394 Fax: (850) 696-2613 Schuka, Edward, M.D. FM NPI: 1194712554 West Florida Medical Group 1190 East 9 Mile Road Pensacola, FL 32514 (850) 494-4600 Fax: (855) 516- 4368 www.westfloridamedicalgroup.com Sonthheimer, Dan, M.D. FM NPI: 1528158458 Lighthouse Health Plan 700 East Gregory Street Pensacola, FL 32502 (850) 908-3001 www.lighthousehealthplan.com
Kalis, Michael, M.D. IM NPI: 1134539307 Baptist Medical Group 1000 West Moreno Street Pensacola, FL 32501 (850) 437- 8600 www.baptistmedicalgroup.org
Webb Ann, Laura, D.O. OBGYN NPI 1578871471 West Florida OBGYN 8333 North Davis Highway Pensacola, Fl 32514 (850) 969-2038 Fax: (850) 969-2037 www.westfloridamedicalgroup.com
Keith, Douglas, M.D. Nephrology/IM NPI: 1023290475 Renalus Center for Kidney Care 1619 Creighton Road Ste. 1 Pensacola, FL 32504 (850) 444-4700 Fax: (850) 444-7494 www.renalus.com
Yonnett, Gael, M.D. PM & R NPI: 15144475146 West Florida Internal MedicineRehabilitation 8391 North Davis Highway Pensacola, FL 32514 (850) 494-6100 Fax: (850) 494-3960 www.westfloridamedicalgroup.com
Konnell, Benjamine, M.D. FM NPI: 1164512224 West Florida Primary Care- West Pensacola 321 S. Fairfield Drive Pensacola, FL 32506 (850) 494-4600 Fax: (850) 456-7222 www.westfloridamedicalgroup.com Krier, Christine, M.D., Ped Hospitalist NPI: 1285064543 West Florida Hospital 8383 North Davis Highway Pensacola, FL 32514 (850) 494-4030 Fax: (850) 494-4535 www.westfloridamedicalgroup.com
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Vannorsdall, Mark, M.D. Nephrology/IM NPI: 1336141555 Renalus Center for Kidney Care 1619 Creighton Road Ste. 1 Pensacola, FL 32504 (850) 444-4700 Fax: (850) 444-7494 http://renalus.com/
Rejoining Goto, Mark, M.D. OTO NPI: 1033189758 Riesberg Institute 4900 N Davis Highway Pensacola, FL 32503 (850) 476-0700 Fax: (850) 476-4300
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Letter Ctd. Hanline Jr., Manning H., M.D. IM NPI: 1396717906 Manning Hanline JR, M.D. 1717 North “E” Street, Ste. 526 Pensacola, FL 32501 (850) 438-1878 Fax: (850) 433-1778 Riehl, John, M.D. OS NPI: 1558525733 Comprehensive Orthopaedics of the Gulf Coast 3298 Summit Blvd Ste. 4 Pensacola, FL 32503 (850) 492-7775 Fax: (888) 974-1051 www.johnriehl.com Somesan, Andy, M.D. Hospitalist NPI: Baptist Medical Group Hospitalists 1000 W. Moreno Street Pensacola, FL 32501 (850) 469-7406 Fax: (850) 437-8283 www.baptistmedicalgroup.org
OFFICE SPACE FOR LEASE Class “A” professional/medical office space for lease in the heart of the Davis Highway Medical corridor. This secondfloor space has private elevator and contains approximately 4,298 SF. The office area is divided into registration & waiting room; 10 exam rooms; Two (2) provider and medical assistant work areas; four (4) restrooms; and kitchen/break area. The interior finish is Class “A”, consisting s of 10’ ceilings with 2x2 dropped ceiling tiles; fluorescent lighting, custom cabinetry throughout; decorative paint, solid wood doors, commercial grade tile and carpeting. This market area has experienced accelerated growth in recent years, primarily due to its central location between 3 major hospitals/medical facilities. This building has great access to Davis Highway and interstate 110. Please contact 850-494-0000 ext. 2012
President’s Letter Continued Continued from Page 1 Furthermore, one of the worst things as a parent I can do to raise financially independent, successful kids, is to give them cash. Food for thought! Physicians as a generalization are considered by those outside of healthcare as bad businessmen and women and poor financial stewards. In the early years of my wife Rocky’s practice as a CPA much of her client base were physicians. One client was a PM&R doctor who hired her to do forensic accounting when he and his wife did not have the cash to pay their tax bill. Despite earning a seven-figure income, this physician was cash poor. Rocky asked them to review their accounts and identify discretionary and non-discretionary spending and they asked her to do the same. She flagged the horse farm, private plane and pilot (on retainer) as discretionary, yet the physician and his wife emphatically defended them as necessary “entertainment” expenditures. Ultimately, she couldn’t change their spending habits, however the experience shaped our financial philosophy to this day. We made a conscious decision to live within our means and plan for the future while I was a military urologist. The plan was simple, “save an amount equal to what we pay in taxes.” From 2002 until 2015, we strictly followed this plan. As our children’s educational expenses increased, we modified the plan a bit and are still saving, just not quite as much (one child in private middle school and three more in college will do that). This savings philosophy is just one piece of the plan, we also rely on professionals to assist in wealth protection and preservation. Wealth preservation and protection includes proper portfolio diversity for our age and stage of life, income tax planning, maintaining appropriate insurance coverages (medical, life, disability, long-term care), setting up trusts and updating wills. Our priority also included asset protectionthus diminishing the risk of losing our savings to an excessive malpractice judgment or someone’s slip on our pool deck. We also uniquely have set up a special needs trust for our youngest son. My goal was to educate and care for my four children until they can support themselves and to achieve financial independence. In essence to practice medicine only because I want to, not because I need to for the paycheck. Not having a plan was not an option for us. Regarding our health one can debate the best method: a personal trainer, jogging, a gym membership, yoga, swimming, pilates or cycling. So too there are many options to achieve financial independence. Whether you use a financial planner, CPA, attorney or banker and whether you invest in real estate, stocks, bonds, gold or passive income investments – it does not matter as much how you do it as it matters that you do it. Use the power of years of income and compounding to your advantage. Passively sitting on the sideline doing nothing is both bad for your health and your wealth.
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Benefits ECMS Member Benefits Hilton Garden Inn Pensacola (Airport Blvd.) Book your room today and mention “ECMS” for a discounted room rate. $129/night. The Florida Healthcare Law Firm: ECMS members receive FREE downloads of practical educational presentations and free registration on future events in the online store. Visit https://www.floridahealthcarelawfirm.com/ CE Broker: $5 off Professional Account call for code Gulf Coast Premier Promotions: 4 page website built for your office. $1200 ($2000 value) Use Coupon Code: ECMSWEB13 8 Meetings in 2019: Opportunities to receive Free Florida Mandated Courses. Physician Wellness Program: Free, anonymous counseling available through the ECMS Foundation partnership program. Visit www.escambiacms.org/foundation for more information. Representation in Legislature: ECMS has members actively participating in the FMA and AMA. Such topics include: Managed care legislation, PRN sovereign Immunity, Mandatory malpractice, tort reform, and grass roots efforts. ECMS gives our physicians’ updates through our newsletters, email, and faxes. Workers’ Compensation Insurance: Members can receive up to 24.8% return on insurance premiums with Associated Industries through our local agent, Daniel Rentz at McMahon Hadder. Call #430-1637 for more information CME: ECMS offers free CMEs to our members at many of our meetings. Directory and Website: ECMS website and Member directory, which includes you office information and picture, as well as allows you to control the information and register for ECMS events. We also work with physicians to create and manage their own internet site. Physician Information Service: ECMS has connections in Pensacola. The society is pleased to research, ask, and retrieve information for you or your office personnel. Vested Vendor Resource Guide: These vendors are financially and personally invested in the success of the practice of medicine. They support our CME events, dinners, special events and our Bulletin newsletter. Please make sure to call a supporter of ECMS. The Florida Healthcare Law Firm: At no charge for the first 15 minutes, members of the Escambia County Medical Society may call the hotline 561-306-5699 with questions regarding specific legal issues. Orange Theory Fitness: Elite membership $89, Unlimited membership $149. Use code: ECMS member
Save The Date • Who: ECMS General Membership Meeting • What: The Five Most Frequent Claims
• •
Against Physicians in Florida When: April 25, 5:30 p.m. Where: V. Paul’s Italian Restaurant
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Practice Mgmt. Are Your Employees or Processes a Threat to HIPAA Compliance? By Jim Beran, Gilmore Services HIPAA compliance requires adherence to HIPAA laws regarding the storage and destruction of health records is a must for every provider. HIPAA outlines administrative, physical, and technical safeguards to protect patient information. At Gilmore Services, we provide HIPAA-compliant data storage and moving services. One of the biggest mistakes we see providers make is focusing on outside threats to their data while ignoring threats closer to home. Are your employees or internal processes a threat to your HIPAA compliance? Here’s how to tell. Evaluating the Employee Threat Your employees are your first line of defense against data breaches, but it’s common for organizations to overlook obvious issues with employee access to data. It’s important to remember that even your best employees may make mistakes that can leave your sensitive patient data vulnerable to theft. One of the most common reasons for such mistakes is a lack of employee education and written security protocols for employees to follow. Here are some things to do to evaluate potential weaknesses and make your employees part of your security team. • Limit access to patient information to the people who need it. Your patient data should not be stored where unauthorized personnel can get to it. You can start by determining who has access, and then eliminate access to anyone who can do their job without medical data. • Use two-factor or multi-factor authentication for data access. It’s not enough simply to protect your data with passwords. Adding a second authentication factor (usually a fingerprint) minimizes the chances that someone unauthorized will be able to access your data. • Get control of mobile access and outside apps. Many organizations allow employees to bring their own devices to work (BYOD) or use outside apps (BYOA) to do their jobs. You must put a system in place that ensures your data won’t be accessed on unsecured networks or put at risk by unapproved applications. Putting a written policy in place can help with these issues. • Create an ongoing employee education program. Training your employees to access data safely, recognize threats, and understand your obligations under HIPAA will ensure that you’re all on the same page regarding data security. • Remove old IDs and logins. Finally, you should make sure that when an employee leaves, their ID is deleted. Former employees should no longer have access to your system. These steps will protect your data and minimize the likelihood that one of your employees will either steal data or leave your data at risk from an outside attack. Evaluating Your Processes for Problems The second thing you must do is ensure that your processes for handling, storing, transporting, and destroying data are correct and comply with HIPAA regulations. Here are some pointers to help you: • All paper records must be managed in accordance with a written policy and physical security protocols. Nobody who is unauthorized should ever have access to them. Your policy must include a labeling system. • Your organization must appoint a security officer to oversee all aspects of HIPAA compliance. ECMS | 6
Practice Mgmt. • All paper and electronic PHI must be stored in a secure location where authorized personnel can access it. • Access must be protected with passwords, two-factor authentication, and physical and digital barriers, including locks and firewalls. • A system of regular audits to track access to protected data. • Integrity controls to ensure that protected data is not altered or destroyed until its scheduled destruction date. • Transmission security to govern the moving of any protected data. Securing your internal processes will minimize the likelihood of PHI being left unattended or at risk for theft. Conclusion Both your employees and your internal processes should be part of your overall HIPAA compliance plan. The right written policies and processes, combined with a vigorous employee training program, will ensure that they are.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Medical/Legal MACRA 2019 Changes Address Physician Concerns By Kim Hathaway, MSN, CPHRM, Healthcare Quality Patient Safety and Risk Consultant, The Doctors Company Centers for Medicare & Medicaid Services (CMS) is taking steps to ease regulatory burdens by removing process measures, developing more outcome measures, changing the fee schedule to support telemedicine technology, and focusing on EHR interoperability. That’s because CMS listened to stakeholder input before releasing the final changes to the Quality Payment Program (QPP). The changes were effective on January 1, 2019.
This marks the third year of the QPP, which was established in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA repealed the sustainable growth rate (SGR) formula for reimbursing physicians and other clinicians participating in Medicare. The QPP encourages value-based care through two tracks, the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). With these new changes, CMS vows to continue using the Patients over Paperwork framework so that physicians may focus more on taking care of patients and less on redundant documentation. Other changes are that CMS has renamed the EHR Incentive / Meaningful Use / Advancing Care Information category to “Promoting Interoperability,” placing a strong emphasis on sharing healthcare data between providers and providing full access to patients of their healthcare records. Highlights of the changes made to MIPS for 2019 that will affect clinicians include: 1. Category weights have changed for two categories. The categories are fundamentally the same. The category changes include: • Quality: 45 percent (down from 50 percent in 2018). • Promoting Interoperability: 25 percent. • Improvement Activities: 15 percent. • Cost: 15 percent (a 5 percent increase from 2018). • Hospital-based or facility-based clinicians have some flexibility in 2019. Eligible clinicians may use facility-based reporting for MIPS Quality and Cost categories based on the hospital value-based program. Eligibility will be published on the QPP website in quarter 1 2019. 2. Important general MIPS changes for performance year 2019 include: • The performance period for the third year of the QPP/MACRA is the calendar year 2019. Performance for 2019 will affect payment in 2021. • The performance threshold increases in 2019 from 15 MIPS points to 30 MIPS points to ensure a neutral payment adjustment, and greater than 30 points for an increase. • The exceptional performance bonus increased to 75 points (up from 70 points in 2018). • The total amount of Medicare reimbursement at play for 2019/2021 has increased. Practices scoring between zero and 30 total MIPS points will see up to a -7 percent adjustment. Practices scoring over 30 points could see up to a 7 percent increase. (Note: Any positive payment adjustments will be multiplied by a scaling factor to ensure budget neutrality, so the maximum positive adjustment will likely be below 7 percent.) • The five bonus points added to the final score of clinicians in small practices (TINs with fewer than 15 associated NPIs) increases to six points. The points will be added to the numerator of the Quality score rather than the overall MIPS score. • Eligibility has been adjusted to allow more clinician participation in MIPS, even by providers excluded based on the low-volume threshold criteria. • Options include: (a) voluntary participation without a payment adjustment, or (b) choosing to opt in and be subject to the performance requirement and payment adjustment. • Eligible clinician types have expanded. These will include the five categories that were included in the two previous years, plus clinical psychologists, physical therapists, occupational therapists, speech-language pathologists, audiologists, and registered dieticians or nutrition professionals. 3. The MIPS Quality category has: • Separated collection types from submission types, clarifying some of the confusing language. • Added eight measures, with four being patient-reported outcomes, and removed 26 measures that didn’t add value, were process measures, or were topped out. ECMS | 8
Practice Management
Medical/Legal
• Made claims-based measures available only to small groups with fewer than 15 physicians. 4. MIPS Advancing Care Information category changed in 2018 to Promoting Interoperability. In this category, it is much more difficult than it has been in the past to achieve maximum points. The Promoting Interoperability changes for 2019 include: • Four aims clinicians must meet: e-Prescribing, Health Information Exchange, Provider to Patient Exchange, and Public Health and Clinical Data Exchange. Clinicians would be required to report certain measures from each of the four objectives, unless an exclusion is claimed. • Any unreported measure or no answers to a yes/no measure will result in a zero Promoting Interoperability score. • MIPS-eligible clinicians are required to use the 2015 Edition of Certified Electronic Health Record Technology (CEHRT) if they report in this category, and must submit evidence to CMS. • The Promoting Interoperability reporting period will remain a minimum of a continuous 90-day period. • Scoring is now solely based on performance and the base. Bonus and performance scores are eliminated. • Security risk analysis is still required, but no points will be assigned. • Two new measures are added for the e-Prescribing objective: Query of Prescription Drug Monitoring Program (PDMP) and Verify Opioid Treatment Agreement as an option to earn bonus points. 5. MIPS Improvement Activities category changes include: • Removal of the 10 percent Promoting Interoperability bonus for using a CEHRT to complete the Improvement Activity. • Clarification of the criteria for “high-weighted” classification. 6. MIPS Cost category changes include: • Eight episode-based Cost measures have been added. The same two core measures for Medicare Spending per Beneficiary and Total Per Capita Cost remain. • All cost measures have the same weight. 7. Alternative Payment Models: More specialty-related models will be developed. Practices that are looking to achieve top scores should review past performance, especially the Cost and Promoting Interoperability categories, as the Cost weight increases, and the Promoting Interoperability measures will be more difficult to achieve. For more information: 1. Calendar Year 2019 Updates to the Quality Payment Program 2. Quality Payment Program Year 3 (2019) Final Rule Overview webinar 3. 2019 MIPS Quick Start Guide Practices that find these changes overwhelming may want to reach out for expert help with industry-leading best practices to maximize Medicare payments. Visit Medical Advantage Group (medicaladvantagegroup.com) for more information. For resources on MACRA and success in optimizing reimbursement, go to MACRA Resources for Medical Practices (thedoctors.com/MACRA).
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Medical/Legal Wearable Medical Devices Give Abundant Data—and Risks Miranda Felde, MHA, CPHRM, Vice President, Patient Safety and Risk Management
Since 2013, the number of US consumers tracking their health data with wearables has doubled. And that number continues to rise: During the third quarter of 2018, the wearables market saw a nearly 60 percent increase in earnings over the prior year. Wearables are electronic devices worn on the body, often like a watch. Wearables can track patient data like heart rate, blood pressure, or blood glucose. They can also track activity level, e.g., counting steps. Promoters of wearables say that they could provide physicians with abundant data when caring for patients with chronic health issues. They also predict that combining wearables and gamification—e.g., competing with family members to see who can “score” the most steps in a day—may lead to improved health and better health outcomes. However, skeptics question whether gamification will really lead to healthier behaviors long-term. And questions abound about what to do with wearables’ data and how to protect it. Wearables bring promise, but also real risks for patient safety and physician liability. Benefits of Wearables Promoters of wearables believe wearables will drive the transition to intelligent care, whereby physicians have access to more data—in which they can identify actionable components. Florence Comite, MD, a New York endocrinologist who describes wearables as “almost like magic,” uses data from wearables to tailor her interventions for patients with chronic conditions. Wearables can help patients take action, too. In one recent study, diabetes patients using a wearable app showed randomized controlled trial results comparable or superior to patients taking diabetes medications. Promoters of such digital strategies hope that they will encourage healthy behaviors while requiring fewer office visits purely for monitoring purposes, thereby reducing healthcare costs while improving patient experience and engagement. For instance, David Rhew, MD, chief medical officer for Samsung, hopes that wearables can help patients move to the highest level of patient activation, Level 4: The Four Levels of Patient Activation • • • •
Level 1: Predisposed to be passive. “My doctor is in charge of my health.” Level 2: Building knowledge and confidence. “I could be doing more.” Level 3: Taking action. “I’m part of my healthcare team.” Level 4: Maintaining behaviors, pushing further. “I’m my own advocate.”
Some apps promote healthy behaviors with gamification. For instance, a user might compete with family or friends to take the most steps each day, either informally or through an organized group. Harvard professor Ichiro Kawachi, PhD, wrote in JAMA Internal Medicine that this is “an opportunity for clinicians to turn health promotion into an engaging, fulfilling and fun activity.” Sponsors hope that such groups can promote accountability, responsibility, and mindfulness about activity and health conditions. Skepticism about Wearables It is too soon to say whether wearables will increase healthy behaviors and/or reduce office visits, thus lowering healthcare costs. Some studies have found that wearable devices have no advantage over other forms of goal tracking or social support in helping people meet their health and fitness goals. A 2016 study from the University of Pittsburgh, for instance, found that “young adults who used fitness trackers in the study lost less weight than those in a control group who self-reported their exercise and diet.”
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Medical/Legal Risks of Wearables Though each device has its pros and cons, all wearables generate concerns for physicians, including: • Poor data quality: Data from wearables may or may not be reliable enough for medical use. • Data fixation: Patients may fixate on one number—steps per day, for instance—at the expense of other health variables, such as their diet, sleep habits, etc. • Lack of interoperability with electronic health records (EHRs): If a patient’s wearable cannot stream data to the patient’s EHR, then how can the physician’s practice securely acquire the data? • Data saturation: Physicians receiving patient data from wearables risk being soaked by a data fire hose. Physicians need a plan and a process to determine what measurements are relevant to a given patient. • Unclear physician responsibilities for collecting, monitoring, and protecting data: HIPAA applies to patient data collected by physicians, but differing state laws mean that a physician’s specific responsibilities for monitoring and protecting patient data vary by location. • Lack of data security—and liability for physicians: Wearables are subject to cyberattack. In addition to presenting obvious risks to patient safety, this may also present liability risks to physicians—who may be expected to notify patients of recalls issued for their wearables. Next Steps As more and more physicians are accepting—or requesting—their patients’ data from wearables, questions include: How can we tell when data from wearables is accurate? When it’s actionable? When it’s secure? Certainly, physicians interacting with data from wearables should independently confirm that data before changing a patient’s care, and should store data from wearables securely. For help implementing remote patient monitoring in your practice, see the American Medical Association’s (AMA’s) Digital Health Implementation Playbook.
Mark Your Calendar Join us March 26 at the Pensacola Yacht Club for the “Health of Your Wealth” seminar and pick up your copy of the 2019 ECMS Pictorial Directory.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Foundation
THE 1873 SOCIETY Since 1873, Escambia and Santa Rosa County Medical Society physicians have dedicated themselves to their patients and the people of Escambia/Santa Rosa County. To further our mission and build on the loyal support of our members, the Board of Directors approved the formation of The 1873 Society, a special recognition opportunity to formally honor physicians who contribute to our organization and have demonstrated a long-term commitment to the quality of health care and well-being of our community. As a member of The 1873 Society your good name as a physician will be honored in our community forever--entwined with the good works of the medical society in a cherished legacy. Membership in The 1873 Society is for physicians who have chosen to pledge $3,000 to Escambia County Medical Society Foundation, Inc. This can be accomplished through a single gift or a recurring gift of $1,000 over three years, THREE IN THREE! The 1873 Society members are recognized and awarded with their names permanently engraved on a traveling Wall of Honor to be displayed in the ECMS office and at ECMS and ECMSF events.
THE 1873 SOCIETY MEMBERS The individuals listed below are both founding members as well as others who have joined The 1873 Society since its founding. We thank you for joining their distinguished ranks. Joanne Bujnoski, D.O. Hillary Hultstrand, M.D. Kurt Krueger, M.D. Brett Parra, M.D. Ken Long, M.D. Robert Sackheim, M.D. Ellen W. McKnight, M.D. Michelle Brandhorst, M.D. Jennifer Miley, M.D. Steve Ziller, M.D. Jack Kotlarz, M.D.
Who is the Escambia County Medical Society Foundation? The Escambia County Medical Society Foundation is a non-profit organization dedicated to providing healthcare services on a volunteer and funding basis through its members. The Foundation was created in 1994. The primary goal is to assure access to adequate healthcare for the medically indigent citizens of the area, to study and promote improved methods and facilities for healthcare, to pursue the protection of public health, implement the means of financing healthcare at reasonable costs to cooperate with other organizations and institutions interested in pursuing these goals, and disseminate information concerning healthcare in general. Current Foundation programs include “We Care” and “Go Seniors!” Contact the ECMS Foundation for more information | 850.478.0706 or info@escambiaCMS.org
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Foundation ECMS Foundation Newsletter County Medical Society Members, Greetings as we near the end of the first Quarter already! Spring Breaks are upon us and the weather is getting better every day. Pensacola and surrounding areas look great. Gulf Breeze and surrounding areas look great. And the new 3-Mile Bridge is almost done! Oh. Well. Wrong on that one. I hope that you were able to attend the Valentine’s Day “Bubbles and Bling” at Bere’ Jewelry. It was superbly presented and a good time was had by all. Best part - it supported our many programs and enabled all of them to grow. Please consider how you can help support them further! The Blood Pressure Program continues to supply blood pressure cuffs to patients who can’t afford them. We have distributed almost 400 cuffs through our four local Free Clinics. The Physician Wellness Program; guys - and gals - the problem of Physician Burnout is real. It affects a lot of us. But the good news is that it’s treatable and your Foundation has continued to expand our PWP with the addition of another Psychologist. She is presently helping us and has good experience with Burnout issues. This program is completely confidential and the first three sessions are free for Active Members. The We Care Program continues to provide needed medical care to indigent patients. Please consider volunteering your services.
A local Medicaid Health Plan created by doctors you know and trust. Serving adults and children in Escambia, Okaloosa, Santa Rosa, Walton, Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington Counties.
The Go Seniors Voucher Programprovides transportation vouchers for patients’ doctor visits. The Pensacola State College Endowmentcontinues to be strengthened through the Foundation and enables health related scholarships for selected students. The FSU Medical Student Scholarship Program is expanding with the Foundation’s collaboration. This program continues to provide scholarships to qualified medical students, and the endowment has almost been achieved! The Panhandle Regional Engineering and Science Fair was recently held and three of our Board members attended as judges. Two special awards were made to outstanding presentations and we look forward to yearly participation in the future. The 1873 Society continues to expand and further enables our programs to grow. Consider joining to make a lasting impression on the health and welfare of our patients and providers. Your attendance and donations help support your Foundation and its programs. Consider a donation and membership in The 1873 Society! Personally, Kurt A. Krueger MD Pres., ECMS Foundation ECMS | 14
844-243-5176 (TTY: 711) www.lighthousehealthplan.com LHP1902WMA911675N
In the Community In The Community Baptist Health Care Dr. Michael Kails joins Baptist P. Michael Kalis II, J.D., M.D., M.A., joined the Baptist Medical Group palliative care team and expansive physician network. Dr. Kalis is board certified in internal medicine and is dedicated to improving quality of life for patients who are coping with a serious illness. He earned his medical degree at the University of Cincinnati College of Medicine in Cincinnati, Ohio, completed his residency in internal medicine at Kettering Health Network in Kettering, Ohio and completed a fellowship in hospice and palliative medicine at Wright State University in Kettering. Dr. Kalis cares for patients admitted to Baptist Hospital and Gulf Breeze Hospital. Neilia-Kay McGill joins Baptist Baptist Health Care is pleased to welcome back fellowship-trained rheumatologist Neilia-Kay McGill, D.O., to Baptist Medical Group – Rheumatology. Dr. McGill earned her medical degree at the University of the West Indies in Mona, Jamaica, and her Master of Science in clinical dermatology from Cardiff University in Wales, United Kingdom. She completed a residency at Howard University Hospital in Washington, D.C., and a fellowship at the University of Pennsylvania in Philadelphia. She specializes in diagnosing and treating conditions and diseases that affect the joints, muscles and bones. Martha Green join Baptist Family medicine physician Martha M. Green, M.D., has joined Baptist Medical Group Primary Care – North Hill. She provides care for individuals 18 years and older. Dr. Green earned her medical degree at the University of Medicine and Dentistry of New Jersey Medical School in Newark, and completed her family medicine residency at the University of Louisville – Glasgow Family Medicine Residency in Kentucky.
Sacred Heart Health Care Emergency Center Recognized for Excellence The Pediatric Emergency Department at the Studer Family Children’s Hospital at Sacred Heart has been named a recipient of an Excellence in Healthcare Award by Professional Research Consultants (PRC) – the Award of Distinction, which is PRC’s highest honor. The department earned the highest score on key measures of patient satisfaction in 2018. The award recognizes the department for achieving the highest Overall Quality of Care score among 16 pediatric emergency departments in the PRC database. The score is determined from the percentage of respondents who rated the overall quality of care as “Excellent.” The unit sees approximately 35,000 patients a year. Sacred Heart to Celebrate opening of new Children’s Hospital Sacred Heart will celebrate the opening of the new four-story Studer Family Children’s Hospital at Sacred Heart in March and April, including two special events open to the public. A Community Open House will be held on Saturday, March 30, from noon to 4 p.m. Tours will be available, as well as free car seat safety checks, fun activities for children and more. On April 1, a ribbon-cutting ceremony will be held at 10 a.m. to celebrate both the opening of the new hospital as well as its 50th anniversary of service to Northwest Florida. Refreshments and tours will follow.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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