Doctor's Life Magazine Vol. 3 Issue 1, 2015

DOCTOR’SLife www.doctorslifetampabay.com

MAGAZINE

Business Lifestyles and Opportunities Vol. 3, Issue 1, 2015 Tampa Bay Edition

ROBOTS

MAKING AN

IMPACT IN

HEALTHCARE

PATIENT DATA AT RISK INNOVATION WITH YOUR WEALTH

Whatâ&#x20AC;&#x2122;s Inside From the Publisher A Dedicated Team

7 Prescriptions Doctors Use to Find Meaning in Medicine

Telemedicine

Page 6

Page 12

Robots Making an Impact in Healthcare

Wealth Management

Page 14

A Year-Round Guide to Beer and Wine Pairing

Page 16

Benefiting from Economic Cycles

Page 4

Changing Times Call for Innovation Page 8

The Legal Corner Extrapolating Overpayment Claims

Page 10

Advertisers

Page 18

Aris Medical Solutions

Burr & Forman

Dining Out For Life

Jarred Bunch

JW Marriott

The Meridian Club

PNC Bank

Point Grace

Publix 3

Protecting Patient Data 2

Rutherford Asset Planning

United Way

Page 20

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 1, 2015

{ } “My patients need help. I see them struggling with losing weight and trying

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Publix dietitian in St. Petersburg Megan Rose, RDN, LDN (727) 821-7568 Dietitian.0640@publix.com

Publix dietitian in Wesley Chapel Holly Long, RDN, LDN (813) 973-4295 Dietitian.0006@publix.com

Publix dietitian in Riverview Jamie Stolarz, MS, RDN, LDN (813) 684-3039 Dietitian.0890@publix.com

From the Publisher

www.doctorslifetampabay.com DOCTOR’SLife

www.doctorslifetampabay.com

very issue of Doctor’s Life is important to us as a team. Our goal from the beginning has always been to produce content that is relevant, regional and respected, while delivering it to be easily read and responsive. All of our contributing writers are the best of the best in their respected fields, with majority of them regionally located. This makes them available to schedule calls and face to face meetings. Please feel free to use them as a valuable resource. In this issue of DLM we welcome our new Legal Corner contributor Robert V. Williams from BURR & FORMAN. Mr. Williams discusses extrapolating overpayment claims with physician overpayment audits and the legal interpretation between Medicare and commercial payors. Scott Jarred, CEO of Jarred Bunch Consulting, provides you with a solid financial roadmap for changing times that involves brilliant innovation. 2014 was a devastating year for cybercrime and major data breaches. We brought back our Security Risk Analysis Expert Suze Schaffer to layout the risk, what to look for and how to keep your patient data safe. ARIS Medical Solutions has a proven system to protect your data. The cover tells it all with our Healthcare Tech feature in this issue. We display several Robots that are making a huge impact in healthcare across multiple sectors. Is this the future of healthcare? One area of tech that is reshaping healthcare is telemedicine. Nick Hernandez, CEO of ABISA, LLC explains why in his article Telemedicine: Reshaping Healthcare. Finally, I and the entire DLM team have always had huge hearts and a passion for philanthropy. We’ve had the pleasure over the years to work with great organizations like; the AHA, Moffitt, MDA, United Way, Playing Unplugged and Heart Beat International to name a few. I was extremely fortunate this year to be introduced to J. Eller from ASAP (AIDS Service Association of Pinnellas) a member program of Empath Health. Jon and his team will mark their 9th year of what I believe to be an extraordinary and visionary event. On April 28th, 2015 join us for Dining Out For Life. They make it so simple for everyone to be part of saving a life. All you have to do is dine out at a participating restaurant. Done, that is it and you helped save a life. Hope to see everyone dining out. As always, we thank our readership and partners, welcome your feedback and wish you all the best. Be Well,

-Edd

Business Lifestyles and Opportunities Vol. 3, Issue 1, 2015 Tampa Bay Edition

ROBOTS

MAKING AN

IMPACT IN

HEALTHCARE

PATIENT DATA AT RISK INNOVATION WITH YOUR WEALTH

TAMPA BAY

™

Tampa Headquarters 1208 East Kennedy Blvd. #1029 Tampa Fl, 33602 813-419-7788 Group Publisher Edd Suyak publisher@doctorslifetampabay.com Creative Director Bryan Clapper Editorial Director Danielle Topper Associate Publisher CJ Cooper Advertising Account Executive Ryan O’Neil Editorial Advisory Board Scott Jarred Robert V. Williams Contributing Writers Nick Fernandez Mathew Corrado Suze Shaffer Dr. Stanley Riggs Scott Jarred Robert V. Williams Dr. Starla Fitch Cover photo by Engineered Arts Ltd. Doctor’s Life Magazine, Tampa Bay is always seeking events, stories and remarkable physicians. Please email the publisher if you have an event, an editorial idea or you know of a doctor or dentist who may have done something extraordinary. We want your suggestions and feedback. publisher@doctorslifetampabay.com Doctor’s Life Magazine, Tampa Bay does not assume responsibility for the advertisements, nor any representation made therein, nor the quality or deliverability of the products themselves. Reproduction of articles and photographs, in whole or in part, contained herein is prohibited without expressed written consent of the publisher, with the exception of reprinting for news media use. Printed in the United States of America.

Edd Suyak Group Publisher publisher@doctorslifetampabay.com 4

MAGAZINE

Doctor’s Life Tampa Bay

Issue 1, 2015

7 Prescriptions Doctors Use to Find Meaning in Medicine By Dr. Starla Fitch, MD A doctor’s self-worth can be tied up with a lot of issues. How well can we make a diagnosis? How elegantly can we perform the surgery? How happy are our patients? Our staffs? Our families? How many articles have we had published or how many lectures have we given? The list goes on and on, doesn’t it? For me, it’s a daily, sometimes hourly, battle to separate my self-worth from how I think other people perceive me. We all want our patients (not to mention our staffs and our families) to be head over heels about us all the time. We want to feel we have made a difference, performed at our absolute best. We want to feel we’ve been the perfect doctor, the perfect parent, the perfect perfect spouse. Therein lies the rub. Perfection is the enemy of good. In the OR, have you ever decided to tweak something a little bit, only to go from an “A-” outcome to a “C+,” all in the name of trying to be a little more perfect? A study by the MacArthur Foundation showed good self- worth to be a strong predictor of good health and long life. (1) So it seems likely that those who have a strong sense of self-worth would provide better health to others as well. Those outside the medical profession are quick to say doctors have a skewed sense of increased self-worth and self-importance. For those of us who live it daily, we know that most of the time we feel a strong sense of self is necessary, every day: When we enter the emergency room to see a patient, not knowing what to expect When we boldly begin a complicated case in the OR When we deliver bad news to a patient about their pathology report Our patients expect us to be certain and secure in our approach, our knowledge, and our self-worth. These traits are what make us good doctors. I had the good fortune to interview Dr. David Olansky, a dermatologist specializing in Mohs surgery for cancer patients. He revealed his thoughts on self-worth. Dr. Olansky comes from a family of physicians. He said there was no 6

pressure for him to become a doctor; it was just understood. He did have a short-lived stint as a trombone player. Seriously. But medicine won out. “I can’t imagine doing anything else. Medicine fits me to a T. That’s one of the keys to happiness, when you and something where your karma and your dharma meet together: what you’re supposed to do and what you are doing,” he said. Dr. Olansky shared a defining moment in his youth during our interview. As a fourth-year medical student, he went with his father to see a patient in a nursing home. The patient’s husband met his dad at the door. When the man saw his dad, it was “like a ton of bricks had been lifted off of him.” Dr. Olansky said, “I realized no greater gift could have been given to that patient’s husband. He felt powerless before he saw my dad. It turned out to be an easy problem. But it made me realize the power we have, and we don’t even realize it,” he said. “I see that every day. It’s a tremendous gift to be able to help patients, physically and emotionally.” Dr. Olansky said his father taught him “to be authentic.” He continued, “Be exactly who you are. The most important thing is to follow the Golden Rule. Treat other people as you would expect to be treated. Not everyone will like you, but you’ll be authentic and genuine.” As I work with more and more doctors around the country, I am encouraged by what I am witnessing: Doctors who completely left medicine then returned later, refreshed and recharged Doctors who have slightly altered their original mode of practicing, discovered the parts of medicine they love most, then magnified them Doctors who have added and subtracted from their recipes until the unique flavor of their practice is perfect for them My mission is to help those of you who are sitting on the edge to fall in love with medicine again. I know you still have a tiny glimmer of hope in your hearts. You still believe there are subtle twists and changes that you can make to take the rough edges off. You believe there’s still hope. You believe you can make what you once considered an awesome job tolerable and—on a good day—a great way to earn a living again. How do I know? Because I have been where you are. I’ve stood right there, looked at my practice, and found a flicker of hope still burning. I examined my hope with a magnifying glass and it caught fire.

Doctor’s Life Tampa Bay

Issue 1, 2015

Wealth Management

Changing Times Call for Innovation

By Scott Jarred CEO Jarred Bunch Consulting

or some time now, models have been used in finance to determine what outcomes will arise from what inputs. With the ability to calculate formulas with specific values, in our field there may be no end to the continued tweaking of financial models in the hopes of finding that magic formula for financial success. However, what many people may overlook is that at the heart of every model are assumptions, and the ability to manipulate the data in order to support desired results.

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 1, 2015

Realizing the downside to financial models but also understanding the usefulness of them posed two questions for our firm: how do we lose the assumptions, and how do we help our clients make smarter financial decisions? Our answer came when we took a revolutionary health-based approach to finance, and combined it with technology and innovative thinking.

THE PROBLEM

One of the biggest problems in our industry today is that financial planning is flawed. It’s almost impossible to plan for an unknown future, and life isn’t set to adhere to a “plan.” Many advisors take a micro-specialist approach and only focus on one area of your financial life, causing your information to lie scattered among multiple advisors; what a big disadvantage for you. There are only a few things that we know when it comes to your financial life, two of them being that all we can control is your current financial position, and that your financial life is complex. Since a financial model can break down complexity and input data based on your current situation, many will say that this is the solution. But again, models tend to operate on assumptions, and when we first started using them the outcomes wouldn’t hold true for long, because the information surrounding the data was constantly changing; a trend which made us see that it’s not the data going into the model that’s important, but the information surrounding the data.

INFORMATION UNDER MANAGEMENT

Assumptions operate at the heart of many financial models because no one is managing the changing information that affects the data you are inputting, and while they may produce outcomes, assumptions typically don’t lead to smart decision making. A conclusion that shows information is key to smart decision making, and caused us to turn our focus to information under management. Now, if you’re thinking that we’re trying to tell you financial models are a waste of time, you would be wrong; financial models can actually be very helpful in clarifying your goals and putting things into perspective. But, it’s important to understand that the true value in our financial model is not found in its number crunching ability, but in the information behind the data. Harnessing all of your financial information into one, comprehensive picture of your current financial position allows you to capitalize on that collective knowledge, weighing and measuring financial decisions before they are made, ultimately giving you the tools to make smarter financial decisions. For example, almost every financial decision has a tax impact, but typically financial advisors and CPAs are kept separate. As one of the most radically changing landscapes in the industry, tax law is part of that information that is important to manage for our clients. By working with our in-house CPA firm, Prestige Business Enterprises, owner Marta Skik Harich and our team have been able to take our clients from tax preparation to actual tax planning, enhancing our holistic philosophy, and allowing our clients to take a more proactive approach than handing everything over to their CPA at tax time. Mapping out what financial decisions you want to make, the current Issue 1, 2015

A HEALTH-BASED TECHNOLOGY

Much like the human body, your finances are a complex, living organism, responding to changes in their environment, experiencing adverse effects from harmful agents, having interconnected components, and requiring nurturing for positive growth. By taking an uncommon view toward finance, we offer a wealth management platform rooted in a health-based approach to your financial life. First and foremost, our platform allows us to pull in all of your financial information, and break down its complexity into four domains: protection, assets, cash flow, and liabilities. Once we have all of the pieces connected into one big picture, then we can see how everything is working together, and diagnose problem areas. This comprehensive picture also produces real-time feedback, allowing us to see your current financial position, and how your four domains can be affected due to changing information. That information feed allows you to make smarter decisions today, and keeps you optimally balanced for a changing tomorrow.

HOW OUR APPROACH IS DIFFERENT

While there is no shortage of technology available today to help you get financially organized, and the emergence of the “RoboAdvisor” gives you the ability to pull down data, these “advisors” are only reporting on what is in one area of your life. Our wealth management platform takes it one step further, and integrates the information surrounding your data in all of the components of your financial life in one, digital destination. Centering your current financial position on the information coming in allows us to build and implement effective risk management strategies, so that you can positively react to the changes happening around you. We believe that information and knowledge are power. By breaking down the barriers of the traditional financial industry, we give you the tools to make smarter financial decisions as we educate, guide, and counsel you toward reaching your full financial potential.

Doctor’s Life Tampa Bay

Legal Corner

Extrapolating Overpayment Claims

By Robert V. Williams Burr Forman

verpayment audits of physicians are commonplace and, indeed, should now be expected. When conducting such audits, Medicare auditors often include not only random sampling as an audit technique but have also extrapolated the results of that random sampling to arrive at overpayment claims that can be much larger. But is extrapolation a legitimate auditing technique? Even more important, is it legal? In a Medicare audit, the answer is yes. For example, the Medicare Managed Care Manual not only requires that Medicare Advantage plans develop auditing systems, it specifically recognizes that auditors may extrapolate the sampling results of that audit. But what about commercial payors? For those payors it is not that simple, nor is it necessarily a given that extrapolation is an authorized method that the payor may use to increase dramatically the dollar amount of an overpayment claim, sometimes by five to ten-fold. What is the deciding factor? At least one court, the Supreme Court of Rhode Island, used simple and straight forward contract law analysis to reach the conclusion that if the payorâ&#x20AC;&#x2122;s 10

provider contract does not authorize extrapolation, then the payor may not extrapolate. And, of course, the wording in the contract would be critical regardless of the jurisdiction. Other state courts, however, might reach different conclusions. So the lesson to be learned is that providers should read the auditing language of their provider agreements with private payors papers carefully. If the agreement does authorize extrapolation then attempt to negotiate that provision out of the contract altogether or at least limit its application. But even if your provider agreement does not expressly authorize extrapolation of auditing samples, it might be prudent to negotiate language that would expressly prohibit extrapolation without the providerâ&#x20AC;&#x2122;s consent. And, if neither of these options are realistically available, providers should at least recognize that extrapolated random audit samples today may well result in unreliable and excessive overpayment claims by the payor tomorrow and prepare accordingly.

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 1, 2015

5 Healthcare Legal Issues for 2015 1. PRIVACY & DATA SECURITY

2014 brought huge and expensive data breaches across all sectors to include many in health information data. The challenging task going forward will be implementing the correct balance of secured privacy and convenience. There’re estimates that upwards to over 5 million patients had their personal data compromised in 2014. Complying with HIPAA in 2015 will become more important than ever.

2. DIGITAL, MOBILE AND TELEHEALTH

The health tech boom and the widespread use of smartphones, patients are transforming into savvy health care consumers. In the next five years, the telehealth market is expected to reach over $1.5 trillion, driven by the use of 7 billion smartphones. This will open health care providers to deliver health care and wellness in a more ways than we have ever seen before. It will as well bring risk a new security breach issues.

3. FRAUD AND ABUSE ENFORCEMENT

The new HHS FY2015 budget reflects the larger focus on fraud prevention and improper payments this year. The Budget includes a $403 million mandatory investment in HCFAC and the Medicaid Integrity Program as part of a multi-year investment to

enable HHS and the Department of Justice to detect, prevent, and prosecute health care fraud. Additionally, the Budget proposes $25 million in new discretionary HCFAC funding to support program integrity activities in private insurance, including the Health Insurance Marketplaces. The budget also proposes a series of new authorities to strengthen program integrity oversight.

4. KING V. BURWELL (U.S. SUP. CT.)

The Supreme Court has agreed to decide how far the federal government can extend its program of subsidies to buyers of health insurance. Oral arguments are expected to be held in March 2015, and a decision is expected by late June or early July 2015.

5. NEW AND EXPANDING PAYMENT MODELS

The current administration wants 30 percent of payments for traditional Medicare benefits to be tied to alternative payment models such as accountable care organizations by the end of 2016. They want even larger portions of hospital payments to be tied to quality or value-based payment models. HHS indicated that it wants 85 percent of Medicare’s hospital payments made through programs such as the Hospital Value-Based Purchasing Program or the Hospital Readmissions Reduction Program by the end of 2016. Transitioning to value-based reimbursement has only just begun.

experience.

The health care industry is truly complex. At Burr, we connect the dots for our clients by guiding them step by step, from point A to point B, to seek the right solution.

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From physician practices, hospitals, long-term care, and home health, to medical devices, pharmaceuticals, and lenders, our capabilities cover practically every angle of the industry. If results matter to you, and you want them to matter to your law firm, give us a call. predictability.

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Telemedicine:

RESHAPING HEALTHCARE O

By Nick Hernandez CEO, ABISA, LLC

ne of the tenets of the Affordable Care Act was to provide access to care for all Americans. To that end, telemedicine is a piece of the healthcare transformation and the government is slowing helping with telehealth initiatives. Currently, states fall into one of twelve regional resource centers. Each resource center is funded by a federal grant to promote the use and expansion of telemedicine. Florida falls under the Southeastern Telehealth Resource Center, along with Georgia, Alabama, and South Carolina. It is important to note that telemedicine is not a separate medical specialty but rather a different means of healthcare delivery. Telemedicine is defined as the use of medical information exchanged from one site to another via electronic communications to improve a patientâ&#x20AC;&#x2122;s clinical health status. It is an effective delivery system for providing quality care and produces better utilization of limited healthcare resources. Under healthcare reform, we are expecting patients to be consumers and as telemedicine promotes competition, we should see prices drop. Additionally, the use of telemedicine has already revealed high patient satisfaction and demonstrated that patients prefer telemedicine over travel or wait times. Moreover, by implementing telemonitoring (the use of devices to remotely monitor patients vital signs), patients are empowered to be active participants in their own health care. There is a growing shortage of healthcare providers and telemedicine seeks to solve that issue as a disruptive innovation for the healthcare industry. We will begin to see part time and retired physicians engaged in telemedicine. It has been stated that there are two types of physicians: those that are doing telemedicine and those that will be doing telemedicine. That being said, there are many considerations physicians must consider before jumping into telemedicine with both feet. While telemedicine is already available to patients nationwide, programs vary significantly in their objectives, scope, and complexity. Not all telemedicine programs are designed the same or offer the same level of service. Additionally, telemedicine needs are different 12

for solo and small group practices than for hospitals and healthcare systems. Assessing service needs and the organization of the practice, defining a program model, and developing a business case are some of the initial steps that a practice must undergo. These are critically important detailed steps to take prior to developing a plan and selecting technology. There are diligent legal concerns that must be considered throughout the process as well. Patient confidentiality needs to be a paramount consideration. Deciding to implement a telemedicine solution with ad hoc processes, procedures, and technology is ill-advised indeed. Indeed there are a multitude of tasks to cover before adding a telemedicine service to your practice. Some other considerations include licensure, malpractice insurance, patient consent forms, job duties, EMR integration, charge capture, metrics capture, and marketing. You may also be in need of financing for this new service as a startup business. Furthermore, when working on the technology phase, selection of cool toys and software applications is not enough. Practices must also deliberate over connectivity development and contingency plans. For all these reasons, it is highly advisable to seek out a practice consultant with experience in telemedicine solutions. An experienced consultant can help you consider critical aspects of development as well as support decision making. A structured development process allows you to consider decisions and impact before making buying and other costly decisions.

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 1, 2015

Does your financial advisor work as hard as you do?

Does your financial advisor... ...ask you the right questions? ....have the right credentials and experience? ...listen thoughtfully to your concerns? ...provide regular, comprehensive check-ups?

Is it time for a second opinion? R U T H E R F O R D A S S E T P L A N N I N G KEITH A. AMBURGEY MBA, CFP ÂŠ , CFA

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Robots Making an Impact in Healthcare R

oboThespian is a life-sized humanoid robot that is made in the U.K. by Engineered Arts, designed to communicate and interact with humans. Greg Welch, Ph.D Professor from The University of Central Florida and the Florida Hospital Endowed Chair in Healthcare Simulation is working on research to make RoboThespian the future of Simulation Healthcare Training. Currently, RoboThespian is designed and programmed to mimic facial expressions and body behavior of humans. However, there’re several universities working ways to implement RoboThespian into Healthcare. Oxford Brookes University is looking to improve the natural interaction with robots. Nigel Crook,Ph.D Department Head of Computing and Communication Technologies from the University has a project that is using robots as surrogates, especially for paralyzed people, and using EEG to read brain activity to control a robot remotely and be a presence for people that are paralyzed. The Vasteras Giraff by Giraff Technologies (www.giraff.org) is a mobile communication tool that enables the elderly to communicate with the outside world. It is remote controlled, has wheels, a camera and a monitor. Essentially, the Giraff is a robot that provides two-way video calling similar to Skype. A caregiver can control the robot using a typical PC. To date, 42 Giraff robots have been delivered to seven European countries, and 20 more were recently built. According to the company, each production run includes improvements based on “rigorous testing and feedback from end users.” The Aethon TUG (www.aethon.com) is an automated system that allows a facility to move supplies such as medication, linens and food from one space to another. The robot moves through hospital corridors, elevators and departments at any time during the day to make either scheduled or on-demand deliveries. End users can attach the system to a variety of hospital carts to transport supplies and it can be employed for a variety of applications. According to the company, the system allows for increased productivity since it “doesn’t get distracted while making a delivery, allowing it to accomplish more in less time.” Photo courtesy of Engineered Arts Ltd. 14

Doctor’s Life Tampa Bay

Issue 1, 2015

iRobot built an emerging technologies group and announced a partnership with InTouch Health (www.intouchhealth.com) to put its AVA telepresence technology to better use. As a result, the two companies developed the Remote Presence Virtual + Independent Telemedicine Assistant, or RP-VITA, which combines iRobot’s AVA telepresence units with InTouch health’s distance education tools, creating a system that, allows physicians to care for patients remotely. The system features mapping and obstacle detection, as well as avoidance technology and an iPad user interface for control and interaction. The robot can also interface with diagnostic devices and electronic medical records (EMR) systems. The remote rig will eventually be able to navigate to specified target destinations autonomously. Bestic is a small robotic arm with a spoon on the end (www.besticinc.com). The arm can be easily maneuvered, and a user can independently control the spoon’s movement on a plate to choose what and when to eat. According to the company, the robot has a “unique design” that fits on tables and can also be adjusted for each user by choosing buttons, a joystick, a foot control or another control device they prefer. Sten Hemmingsson, founder and initiator of Bestic has experienced his own personal difficulties of eating by himself and developed the product from his and others’ personal needs. Healthcare Robotics Lab at Georgia Tech Nursing Assistant uses a direct physical interface (DPI) that lets a nurse have direct control over the movement of the robot, a “human-scale” mobile manipulator called Cody. Using the DPI, the nurse is able to lead and position Cody by making direct contact with its body. When the user grabs and moves Greg Welch, Ph.D. professor from the University of Central Florida and the Floreither of the robot’s end effectors or the ida Hospital Endowed Chair in Healthcare Simulation, is working on research to black rubber balls attached to the robot, make RoboThespian the future of simulation healthcare training. Cody responds. For example, pulling forward or pushing backward make the The company designed CosmoBot to collect data on a child’s robot do the same and moving the end effector to the right or performance. This allows therapists to evaluate how successful the left causes the robot to rotate. Users can also grab Cody’s the therapy is. arm and abduct or adduct it at the shoulder, causing Cody to Anybots performs robot research and development. move sideways. Within healthcare, AnyBots provides a type of immersive AnthroTronix developed a robot called CosmoBot that telepresence, meaning instead of focusing merely on audio interacts with children with and without disabilities to promote and video communications, the AnyBots robot allows for educational and therapeutic activities. The current version, movement controlled by a remote. Short of being face-to-face, CosmoBot V3, is at the Mayo Clinic in Rochester, MN and Anybots offers the most interactive form of communication being used in physical therapy with children with disabilities available today by providing the user a personal remote avatar. through a NIH funded project. CosmoBot has been tested With Anybots, you can instantly be immersed in a distant with children with a range of abilities including children environment experiencing the forefront of a new class of with autism, Downs Syndrome, cerebral palsy, muscular communication called mobile telepresence, allowing you to dystrophy, apraxia, neurodevelopmental disorders, language always meet face to face with your patients and never miss an developmental disorders and who are typically developing. important event, meeting, or experience again. Issue 1, 2015

Doctor’s Life Tampa Bay

A Year-Round Guide to Beer and Wine Pairing W

hen you hear the phrase “pairing tips,” do you instinctively grab your wine opener and pull out stemmed glasses? Wine is divine, but over the past few years there’s no denying that craft beers are trending and getting foodies everywhere excited to re-think pairing possibilities. Artisan and handcrafted beers are no longer just an afterthought on the drink menu - they’re standing tall next to your favorite red and white wine varietals, proving to be just as food-friendly. Whether you’re an aspiring sommelier or a beer enthusiast, it’s time to pour a glass of something new and see how the other side pairs. Get started with these tips from renowned foodie expert and blogger Brian Samuels of “A Thought for Food.” Samuels recommends the acclaimed, handcrafted wine varietals of Bridlewood Estate Winery along with your beer of choice. For more information visit www.BridlewoodWinery.com. Food: Burger with caramelized onions Beverage: Pinot noir or English IPA Why: Burgers and beer always seem like a natural pairing, but have you ever tried pairing it with a glass of wine? Next time you’re lighting up the grill, pull out a bottle of Bridlewood Pinot Noir. A slight char on the burger pairs beautifully with the hint of black pepper in the wine. For the brew lovers in the group, serve an English IPA. The caramel notes that come through in the beer pair perfectly with burger toppings such as grilled red onions. Food: Lobster roll Beverage: Chardonnay or Pilsner Why: There are few things more enjoyable than sitting outside on a blazing hot summer day with a tall beer or a glass of wine. Pilsners and chardonnay are lighter options that

pair with a variety of foods. For heavier dishes, like a lobster roll, the vanilla notes of a chardonnay go perfectly with the natural sweetness of the lobster meat. If craft beer is more your thing, try a Pilsner. The slight bitterness (from the hops) and sweetness (from the malt) flavors, as well as the fizziness of the beer, help cut through the richness in the creamy lobster roll. Food: Roasted vegetables with Gorgonzola and fresh herbs Beverage: Brown ale or cabernet sauvignon Why: Traditionally cabernet pairs best with meat, but what about a dish for vegetarians? Roast up cold weather favorites such as carrots, parsnips and turnips to bring out their natural sweetness. These satisfying flavors will shine when sipping on cabernet sauvignon with its subtle notes of chocolate and molasses - or try a glass of brown ale, which embodies caramel and nutty flavors. Food: Chocolate truffles Beverage: Red blend or stout Why: End the feast with a plate of decadent chocolate truffles and serve with the Bridlewood Blend 175, loaded with jammy notes. For the beer lovers at the table, a stout, which is rich in chocolate and coffee notes, is another natural accompaniment.

Doctor’s Life Tampa Bay

Issue 1, 2015

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Benefiting From Economic Cycles: The Four Economic Indicators of 2015 By Dr. Stanley Riggs

conomic cycles were first recorded in 1349 in Florence, Italy. Sir Isaac Newton (as in “gravity”) lost his fortune when he failed to recognize the 1720 South Sea Company financial bubble. There have been over 300 asset bubbles since 1720. But you don’t need to be a genius to avoid getting caught up in an economic cycle. By always being aware of where you are in the economic cycle, you can both protect and grow your savings in the New Year. Economic cycles, often referred to as “booms and busts,” are recurring macroeconomic events with high and low inflection points triggered by a change in macroeconomic, demographic or geopolitical events. The ever-changing cycles present both crisis and opportunity. It is a predictable model based on the theory of “reversion to the mean.” Reversion to the mean is a concept that when correctly applied to a cyclical situation, assumes that both the highs and the lows are only temporary, and values will always move back to the mean or average. A common mistake is to consider the values as reverting only back to the mean. In reality, the values revert back to the mean and continue to overshoot the mean before reaching their next high or low inflection point. It is the constant, symmetrical, bi-directional overshooting of the mean value that keeps the mean or average value relatively stable. Another common mistake, even the best economists make, is to apply linear thought to nonlinear, cyclical events. When the stock market was booming in 1999, the linear thinkers were talking about the “new metrics” and when the waitresses at the local IHOP were making money flipping houses in 2007, the mortgage brokers were talking about the “new paradigm” as they extrapolated the cyclical upward curve to an endless, linear, climbing forecast. Even at the bottom of the Great Recession in March 2009, Wall Street bond fund sages coined the phrase “the new normal,” implying the economic recovery was forever going to be linear and almost horizontal. Linear thought only leads people to believe that the good times will never stop and the bad times will never end. Hockey star Wayne Gretzky often said: “I skated to where

the puck was going, not to where it was.” There are four reliable and readily accessible economic indicators that will help you to know where the economy is going. It is almost impossible to determine the actual inflection points (the top or bottom of the curves), but it is critical to have a clear understanding of which side of the curve you are on, which inflection point you are approaching and how much time you have left. 1. The Yield Curve is the most accurate indicator. It is the plotted range of yields of U.S. treasuries from short-term to long-term maturities. There is a strong correlation between this interest rate spread and the future U.S. GDP six to twelve months ahead. A steeply climbing curve illustrates long-term U.S. treasury rates significantly higher than short-term rates and is a forecast for economic growth. An inverted or downward curve illustrates long-term rates lower than short-term rates and indicates the probability of an economic downturn. Since 1960, all seven U.S. recessions have been preceded by inverted yield curves months in advance. 2. The Institute of Supply Management (ISM) is a private institute founded in 1915. They release to the public monthly reports on the recent trends of purchasing and supply management professionals. 3. The Composite Index of Leading Economic Indicators is data released by the U.S. Commerce Department. From 1959-2001 it correctly forecasted all seven recessions that did occur and five recessions that did not occur. 4. The Chicago Board Options Exchange Market Volatility Index (VIX) has been used since 1986 as a measure of the implied volatility of the Standard and Poor 500 Index based on options and future trades. If your financial advisor thinks the “VIX” is a brand of cough drops, you might have a problem. Changing economic events should never be a surprise to the student of economic cycles. Whether you are investing in stocks, bonds or real estate, you can benefit from these cyclical changes by using your understanding of the economic cycle as a cornerstone in your investment decision-making process in 2015. By always knowing where you are in the cycle, you can anticipate and benefit from future economic, cyclical changes and build your wealth by skating to where the puck is going. Dr. Stanley Riggs is the author of Build Wealth & Spend It All, Live the Life You Earned www.buildwealthandspenditall.com.

Doctor’s Life Tampa Bay

Issue 1, 2015

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How Well Do You Trust Your Efforts to Protect Patient Data? By Suze Shaffer Aris Medical Solutions

atient Data is valuable and criminals want it! We have all heard about the recent data. They make the news because they are HUGE breaches. What you haven’t heard much about is the medical breaches. It happens every day, somewhere, could you be next? To understand how medical data breaches happen, you must first know where your data is located. By conducting a thorough Risk Analysis you will discover that patient data resides in more places that just your EHR or PM software. It can be located on copiers, fax machines, and workstations. Once you know WHERE your data is located, then you must create a Risk Management Plan to mitigate any vulnerabilities. Federal law requires Covered Entities to protect patient data, and Florida State law requires ALL businesses to protect personal identifiable information. Although there is no one magic way to protect your data, layers of security is your best bet. Keep in mind the size of your organization has a lot to do with what type of security measures are needed. Here are some helpful hints to help you to protect patient data:

You can build a fortress around your network and ONE mistake can cause a breach. Employees typically are your weakest link. Continuous training and security awareness is vital in the fight against a data breach. Most employees do not intentionally cause a breach. Sign up for security alerts from your HIPAA Compliance vendor or use the internet to research the latest threats and share them with your staff.

»» Audit logs are essential in protecting your data. By

understanding what they are, where they are, and how to monitor them is critical. Once you know what the normal activity of your users are, then you can monitor for abnormal behavior. It takes an enormous amount of time to monitor and review every employee. An automated service is highly recommended.

»» Everyone must be educated on how their personal habits can compromise data.

Doctor’s Life Tampa Bay

Issue 1, 2015

»» Unpatched software or anti-virus/anti-malware that is not up

to date can allow your network to become infected and result in a data breach. More than likely you may not even realize it happened. Breaches like this typically go undetected for approximately 265 days. A practice was fined $150,000 for unpatched software resulting in a data breach. Unless you have an employee that is well versed in technology and has the time to ensure that all computers are up to date on a DAILY basis, end point security monitoring is recommended.

»» Although a server configured as a domain controller is highly

recommended, it may not necessarily be required. For instance if you have less than 10 workstations and can monitor and keep security permissions for your employees up to date, then a business class firewall may be a more affordable option for you. You can use your firewall to block certain websites and allow only certain IP address to access your network. If you have a large number of employees and can’t monitor the settings on each and every computer on a constant basis, then a domain controller should be implemented.

»» As we mentioned earlier, personal habits can directly affect

your data. Computers and other devices that are used to access ePHI should NOT be used for personal use. If you download a program or app on your tablet it could corrupt or steal medical records if malware was embedded. Yes, this can happen! This can also happen if employees and patients use their personal devices on your Wi-Fi unless it is separate from where your patient data resides.

»» You should have an inventory list of every piece of equipment,

computer, and portable media device that contains ePHI. Policies and Procedures need to address how to destroy and remove ePHI when a device is no longer needed. A not-for-profit managed care plan was fined $1,215,780.00 for returning their copiers to their leasing company and they were not sanitized before being resold. Although the leasing company should have performed this, the client was fined. It is YOUR data and YOU are responsible for it!

»» Passwords are commonly used to authenticate a user. It is also the

most hacked. Using strong passwords (minimum of 8 characters, upper and lower case, numerical digits, and at least one special character) and changing them at least every 90 days is another layer of security. If your organization allows users to access your ePHI remotely, it is recommended to use two forms of authentication.

»» When accessing ePHI wirelessly, of course you need to have a

secure connection. Make sure the transmission encryption is at least a WPA or a WPA2. This could change, as technology changes so must we! If you access your desktop or server remotely, you should use VPN or RDP software. Keep in mind, this is a “tunnel” and if the computer or device you are using is infected you can infect your network. Any device that is used to access ePHI, whether company owned or personally owned, should be included in your end point security monitoring to ensure it is virus free.

»» Of course you have business

associate agreements in place, but how do you know if they are HIPAA compliant? As a Covered Entity it is your responsibility to ensure they are. If you do not, you could be fined the same penalties. Either way you are still responsible for the “cost” of a breach. This is why we recommend breach insurance for yourself and your business associates. The average cost of a breach in the U.S. is approximately $201.00 per patient record. Do the math, and make sure you have enough coverage. If you have 5,000 patient records the cost would be over $1millon for the breach, and then add the fines and penalties. Issue 1, 2015

Although thre is no one magic way to protect your data, layers of security is your best bet. Keep in mind the size of your organization has a lot to do with what type of security measures are needed. »» Everyone who accesses ePHI must have unique user identification.

Most commonly used is first initial and last name. When a hacker discovers this, they only have to figure out passwords to get into your network. By adding four numerical digits, this adds more difficulty. The username is used to track what a person does and to ensure they are only performing their job function.

»» Although encryption is not a required standard under the Security

Rule, it is your ONLY safe harbor against a data breach. If your practice is burglarized and workstations or servers that contain ePHI are stolen and not encrypted, you will be fined and penalized. There are many encryption solutions available. Depending on the size of your organization and what needs to be encrypted, some solutions are free.

This sounds like a lot of work and if Sony can be hacked why bother trying to protect your practice. Those types of hackers are not typically interested in your data; you simply do not have enough of it. The others that you have to worry about are much closer. They can be a disgruntled employee or what we call a low-level hacker. Just remember we are talking about protecting patient data, which includes everyone; yours, mine, friends, and family. Our data is located in a medical practice somewhere. Again, layers of security are your best defense in protecting this valuable information. For more information on protecting Patient Data contact Aris Medical Solutions at 877-659-2467, “Aris takes the fear out of HIPAA through Partnership, Education, and Support.”

Doctor’s Life Tampa Bay

Imagine a private island with a spectacular two-mile, white sand beach and the only footprints are yours. Such a place really exists. Just 13 beachfront units and several private rental homes. No cars, no crowds, no hassles. It will win your heart.

Elegant cuisine and as much or as little as you want to do. Daily Snorkeling Trips Bone, Reef, Deep Sea Fishing Off-Island Excursions New Spa Services

The Meridian Club on Pine Cay Turks and CaiCos islands For inFormation 649.941.7011 reservations@meridianclub.com meridianclub.com

s o c i a C & A PRIVATE ISLAND s k r u T HIDEAWAY

ome call it “Cast Away meets Wolfgang Puck” where “shoes are optional” (Hideaways Collection), while others call it “an authentic tropical getaway” (Andrew Harper) and bestow awards (Trip Advisor Readers Choice), but regardless of how it’s defined, it’s clear The Meridian Club staff enjoy hosting guests on this private hidden gem. Beautifully positioned on a two-mile stretch of talcum-powder beach - considered by many as the finest in the Caribbean - The Meridian Club is an environmentally-sensitive private island resort ideally suited for those seeking an unspoiled, upscale but unpretentious retreat. With no automobiles, televisions, radios or telephones, guests unwind and enjoy the island’s natural beauty. Soothing trade winds ensure comfortable temperatures and low humidity while surrounding waters teem with marine life. Underwater visibility often exceeds 100 feet and there are miles of coral gardens within a five minute boat ride. Ashore, Pine Cay remains a pristine natural haven with vast open space and seven freshwater ponds, a perfect habitat for the abundant local fauna and flora. Aside from the obvious – bask in the sun on a deserted beach – guests can enjoy a variety of activities such as snorkeling, kayaking, paddle boarding, biking, playing basketball or tennis, and the most popular … taking golf carts out to explore the island. Culinary Adventures Mornings begin with freshly brewed coffee, fresh-baked pastries and breakfast on a private screened porch, with the option to join other guests at outdoor tables on the pool terrace. In the afternoon visitors have the option of a tasty buffet lunch, often off the grill, or a more adventurous picnic lunch (prepared upon request.) The club offers only the freshest seafood - locally caught ocean fish, lobster and conch prepared in various styles. There are other options, such as steak, chops, rack of lamb, duck and Cornish hen, and the award-winning chef prepares vegetarian meals upon request. With an new pastry chef this season, the club is excited to continue the tradition of fine desserts, beautifully presented with coffee or cordials.

Spa Offerings The Sand Dollar Spa, staffed by a Balinese masseuse, offers specialty spa techniques, including massage, hot stone treatment, manicures, pedicures, and facials. Balinese massage is a highly evolved, distinctive form employing a combination of gentle stretches, deep tissue kneading, acupressure and aromatherapy oils to stimulate the flow of blood, oxygen and “qi” (energy) around your body, bringing relaxation and a sense of wellness. An ancient technique, related to the Ayurveda, the Indian holistic medical system, this type of massage is known to help with a wide range of ailments, including migraine, muscle and joint pain, sleep disorder, anxiety and depression, as well as allergies and breathing problems such as asthma which often are worsened by stress. The use of oils is calming and sensual and leaves guests feeling tranquil and serene. Fishing With great fishing only 20 minutes off shore and a boat ride that in itself is an memorable excursion, many who visit Pine Cay come for the fishing or include fishing in their visit to the island. From deep sea fishing to fishing in the flats, there is always something interesting for any level fisherman. Some take their catch back to our chef and have it prepared for the next meal, while others enjoy “catch and release” for the sport of it. Whatever your pleasure, if you plan to fish during your Caribbean vacation, many say Pine Cay is the best option. For more information, call The Meridian Club at 866.746.3229 or visit www.meridianclub.com.

Luxury getaway on the world’s best beach What do you need in a vacation? Comfort without fuss? Warmth mixed with refreshing trade winds? Natural beauty? Excellence in service performed at a relaxed pace with a certain charm? Then make some time for the Turks & Caicos Islands, where your pulse rate is sure to slow down. Turks and Caicos is actually made up of over 40 islands and cays east south east of the Bahamas, spanning a distance of less than 100 miles from east to west and even fewer north to south. Just eight are inhabited, each reflecting distinct natural beauty, history and culture. Most visitors spend their time on Providenciales, the perfect place to unwind, but trips to the outer islands are highly recommended if you are looking to get a better impression of this small lively nation. Scheduled air flights and well organized excursions are readily available. Providenciales’ Grace Bay Beach consistently receives accolades as the world’s best beach. It was named after Grace Hutchings, an early visitor in 1892, in honor of her beauty, style and of course grace. This pristine 12 mile beach seems to have that perfect combination of fine white powder sand, expansive vistas, constant breezes and yet no crowds. The sea colors will stay with you forever; shades of Tiffany blue, turquoise, cobalt and more; and the sunsets are not to be missed. Many of the country’s most luxurious resorts are here, making for easy movement between one world class refreshment experience to another. Of course there’s nothing like becoming a ‘local’ in your own luxury resort, and one that has received the World Travel Award for the Caribbean’s Leading Boutique Hotel from 2005 to 2010 is Point Grace, Luxury Resort & Spa. The resort is appropriately named as it sits on the ‘point’ half way along Grace Bay Beach where with it’s expanse of white sand and untamed beauty you feel like you are on your own desert island. The resort’s magnificent suites, restaurants and spa are all inspired by classic turn-of-the-century British Colonial architecture creating a West Indian setting untouched by time. The islands are a divers feast with close to shore wall drops of up to 8,000 feet. Humpback whales pass by during Spring whaling season. Nature can be found in many forms from turtles to osprey eagles. Fitness lovers will find quality gyms, classes and watersports with expert tuition. Kite-boarding, triathlons, 5/10K runs, sea-swims are all pursuits to join in. Tennis, golf and horse-back riding are all catered for, again with experts on hand. Fishing from bone fishing to deep sea fishing is world class. There is plenty to do if you are looking to be active.

World class chefs seek to impress you with their signature dishes creating a cosmopolitan fare, but Caribbean and nativestyle dishes abound with the fresh catch of the day and the country’s own Conch. Dining is everything from a simple to luxurious experience. You’ll find a huge selection of wines and drinks on offer too. Point Grace’s elegant gourmet restaurant, Grace’s Cottage, has specialized in pairing fine wines with inspired cuisine for many years now. Come, take time to enjoy cuisine at it’s best, in the best possible settings. Your body and soul have already entered a new dimension, where you feel energized but utterly peaceful. The Point Grace Thalasso Spa is all you need to further the restoration process. Treatments are European in style; Thalassotherapy using the islands natural resources and Thalgo products. The setting is truly West Indian; white washed exquisite cottages just set back from the natural beach dunes with inspiring sea views and breezes. Turks and Caicos is very accessible with many international flights. It’s just over an hour from Miami and two and a half hours from New York amongst many routes. Your first vision of the islands from the plane will be awe inspiring. You’ll finally know you are on vacation. Getting through the soon to be expanded small airport terminal is fine but a discrete courteous fast track VIP Flyers service is available; Turks and Caicos will give you the luxury you desire at every step. Those that live in the islands keep their history and culture close to their hearts, but they also move with the times and going-green, ecotourism and government-reform are all hot topics. There is certainly a pride in the islands that we do things our way, we don’t just follow others, and that gives the islands a spirit all to their own. If you chose to visit Turks and Caicos you’d very likely become one of our many return visitors, so we hope to see you very soon.

Dine Out, Save Lives D

By Edd Suyak and Mathew Corrado

ining Out For Life is an annual fundraising event that relies on participation from passionate volunteers, corporate sponsors and restaurants. The event was created in 1991 in Philadelphia and today spreads across 60 cities throughout United States and Canada. The event today has more than 3000 restaurants that participate on one special day and donate a portion of their revenue to a licensed AIDS agency in their city. Each year the event has collectively raised over $4 million dollars to support HIV/AIDS service organizations throughout North America. The history of the domestic AIDS epidemic dates back over 30 years. Today more than 1.2 million people in the United States are living with the HIV infection and 1 in 7 are unaware that they have the infection. HIV is the world’s leading infectious killer. According to the World Health Organization (WHO) an estimated 78 million people have contracted HIV and close to 39 million people have died since the first cases were reported in 1981. Just in 2013 alone, 1.5 million people lost their lives to AIDS-related causes in the United States. Not everyone who has HIV progresses to AIDS. This is due to the world wide scientific medical research that resulted in the development of treatments that can control the virus. Allowing people with HIV to not only live longer, healthier lives but reduce the risk of transmitting to others. Today, people diagnosed with HIV and are treated before the disease is far advanced can live a nearly normal life expectancy. To this date, there’re still no safe and effective cures for HIV but what started out as illness, fear and catastrophic death, now after 30 years we see hope. 26

On Tuesday, April 28th restaurants across the Bay will be joining forces with ASAP (AIDS Service Association of Pinellas) a member program of Empath Health. ASAP is an organization that provides medical case management, substance use counselors, food pantry, HIV centric Affordable Care Act counseling, Co-Pay assistance programs, pediatric programs, mobile testing units, confidential rapid 20 minute HIV testing and nutritionists. The ASAP are the boots on the ground making a difference. Education and programs that ASAP provides help reduce the number of unknown infected people and help stop the spread of new cases. This one day benefits over a thousand men, women, and children living with HIV/AIDS in Tampa Bay. This year will mark the 9th year in the Bay Area. Last year alone the Tampa Bay region raised over $45,000 for ASAP (AIDS Service Association of Pinellas) and the event itself raised $4.13 million dollars for HIV/AIDS. They make it so easy to make a difference. In times where there are so many important needing causes and organizations, it can become financially difficult to support them all. All you have to do is do no more than you would any other night of dining out. Join us and our generous restaurants, ambassadors, volunteers and give the gift of life. Each of the participating restaurants will donate a percentage of 25%-50% of the cost of your meal to the fight against HIV/ AIDS. Remember, making a difference is as easy as going out to eat. Your meal may save a life! Go to www.diningoutforlife.com/tampabay to locate a participating restaurant.

Doctor’s Life Tampa Bay

Issue 1, 2015

Benefits The Alfred T. May Food Pantry and AIDS Service Association of Pinellas

Tuesday APRIL 28, 2015 NEW DAY OF THE WEEK

35 401 Store #154

er Beach

e., Clearwat

Poinsettia Av

On Tuesday, April 28th, restaurants across the Tampa Bay region will come together to fight AIDS by donating 25% or more of your bill. For the current list of participating restaurants please visit

DiningOutForLife.org

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