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Proudly Serving Central Florida, North Central Florida, Volusia & Brevard
UCF Med Students’ Podcast Helps Build Soft Skills
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Learning in the “non-existent 5th year”
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CONTENTS || FEATURES
PHYSICIAN SPOTLIGHT
Visionary Leadership: Colleen G. Koch, MD
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FEATURES 4
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COVER
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UCF Med Students’ Podcast Helps Build Soft Skills A Growing Population of Wheelchair Users Will Need Exercise to Fight Off Future Diseases PHYSICIAN SPOTLIGHT
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EOCC Welcome
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Visionary Leadership: Colleen G. Koch, MD 7
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to June: Professional Wellness Month
HEALTHCARE LEADER
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Addressing Burnout in Radiology Post Pandemic, the Pivot for Medical Practice will be Tracking Complications of COVID-19 Syndrome
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Boosting Healthcare Revenues More Cannabis Dispensaries Equaling Fewer Opioid Deaths
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ORLANDO GRAND ROUNDS
Choosing the Right Floor for Your Application
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NORTH CENTRAL FLORIDA GRAND ROUNDS
New IRS Guidance on 2021 Employee Retention Credit
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VOLUSIA-BREVARD GRAND ROUNDS
PUBLISHER John Kelly | jkelly@orlandomedicalnews.com ————————————————————————————— AD SALES John Kelly, 407-701-7424 ————————————————————————————— EDITOR PL Jeter | editor@orlandomedicalnews.com ————————————————————————————— CREATIVE DIRECTOR Katy Barrett-Alley | kbarrettalley@gmail.com ————————————————————————————— CONTRIBUTING WRITERS Tony Cowan, Dorothy Hardee, Michael Kelleher, MD, Daniel Mayo, Lauren Oddo, Joanna Palmer, Michael Patterson, Martin Trautschold ————————————————————————————— UCF INTERN Brianna Kirby ————————————————————————————— CIRCULATION jkelly@orlandomedicalnews.com ————————————————————————————— All editorial submissions and press releases should be emailed to editor@orlandomedicalnews.com ————————————————————————————— Subscription requests or address changes should be emailed to jkelly@orlandomedicalnews.com
Orlando Medical News January 2021 is published monthly by K&J Kelly, LLC. ©2021 Orlando Medical News.all Rights Reserved. Reproduction in whole, or in part without written permission is prohibited. Orlando Medical News will assume no responsibility unsolicited materials.
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UCF Med Students’ Podcast Helps Build Soft Skills Learning in the “non-existent 5th year” Second-year UCF medical student Aaishwariya Gulani and her former college roommate, Swathi Raman who attends medical school at Temple University both admired physicians who were skilled at communication and team-building, but weren’t sure how to learn those “soft skills.”
Swathi Raman
Aaishwariya Gulani
years of medical training, but rather to start discussions and gets us thinking about personal and professional development as we delve into medical training. It is so easy to get wrapped up in the mindset that success in medical school comes solely from testing and scores, however, we want to talk about how this isn’t the only track to succeed in medicine. We want to focus this podcast on developing the intangibles, the soft skills that are often left out of the medical school curriculum.” The experience has been eye-opening for both. “We were blown away by how similar our experiences were with other medical students,” said Gulani. “I could really relate to the many issues students brought up about the need to fine tune their speaking and personal skills to be well-rounded doctors.” They are particularly proud of a series they did on Women in Medical School, which covered topics such as juggling parenting and studies, and the transition from undergraduate studies to the challenges of medical school. Student reviews of the podcast has been positive with reviewers giving the series a fivestar rating for its helpful content. With the availability of free podcasting apps, Gulani said most of their com-
So faced with isolation from COVID-19, they developed a series of podcasts that are getting the attention of medical students nationwide. They call their podcasts MS5 (anchor.fm/ms5-podcast) to stand for a fifth year of medical school. Since August, they have produced 12 podcasts. “So far it’s been so fun to interview guests on leadership, teamwork, networking and building relationships,” said Raman. Topics include navigating the hierarchy of the medical profession and self-branding as well as academic issues such as medical education curriculum and the challenges of virtual learning. They have interviewed expert guests from across the country, including New York University, University of Michigan and University of Pennsylvania. They women emphasize “the goal of the podcast is not to overwhelm anyone on top of an already vigorous four
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mitment is time and trying to balance podcast production with their studies. They spend up to four hours writing and editing the interviews. Gulani’s undergraduate degree was in business, a perfect fit for developing and marketing the podcast. They both decide on the guests to interview, and Raman edits the podcast. The students say the project has reinforced their belief that soft skills – attitude, personality, motivation and manners – are part of being a skilled physician. “We hear about successful doctors within medicine, and we all know some role models who are so good at engaging with their teams - but no one ever tells you how,” said Raman. “What we have to remember is that medicine is like any other profession, which means being able to work with peers and staff members in a team.” The MS5 Podcast can be found on Apple Podcasts, Spotify, Google Podcasts and all other major podcast platforms. It can also be found on Instagram and Twitter @MS5_Podcast and anchor.fm/ms5-podcast.
Welcome to MS5! by The MS5 Podcast A podcast on Anchor
A Growing Population of Wheelchair Users Will Need Exercise to Fight Off Future Diseases Physical disability in adults is rapidly rising worldwide BY JOANNA PALMER
Sitting is the new smoking is a popular phrase these days to address the effects of inactivity. In fact, recent scientific studies have demonstrated the dangers of too much sitting can be a risk factor for other comorbidities such as obesity, heart disease, Type 2 diabetes, back pain, and more. But what of those who cannot stand up to move around and are wheelchair bound? Physical disability in adults is rapidly rising worldwide. A growing aging population means older generations will be more likely to suffer from chronic diseases that can increase disability, mobility disorders, and injuries. The National Spinal Cord Injury Statistical Center (NSCISC) reports that there are approximately 17,730 new spinal cord injuries in the U.S. each year. As such, we are seeing a quickly growing population of wheelchair users. In fact, the global wheelchair market is expected to see an annual growth rate of 8 percent from 2021 to 2028, to reach 4.9B wheelchair users in the U.S.* With this many current and anticipated wheelchair users, it is important to for this population to find safe and effective exercises to increase physical activity and avoid the health complications that come from constant sitting. Through proper and safe seated exercises, physical activity interventions can help wheelchair users reduce falls during transfers while improving balance, independence, cardiovascular health, and overall quality of life. Those with limited mobility have found great success in maintaining physical fitness through the application of upper body and chair-based exercises. The ability to
strengthen your core muscles, upper body, arms, and torso, is possible even for those who do not have use of their legs. Embarking on a fitness journey as a wheelchair user should not feel like a daunting task. Many wheelchair-based exercises can be done without any equipment, such as side twists, shoulder retractions, and side bends. Others can be done with items around the house or simple equipment such as elastic bands, small hand weights, and a medicine ball that can help with strengthening exercises. New technology in the market called VitaGlide is also making it easier for wheelchair users to achieve a cardio and aerobic workout. VitaGlide, provides resistance technology that simulates the motions of cross-country skiing (push-pull) or rowing (push together -pull together) while reducing the risk of shoulder impingement. Through these motions, this technology works to increase heart rate and develop upper body and core strength with cardio conditioning. This technology can be beneficial to those in wheelchairs due to paralysis, multiple sclerosis, muscular dystrophy, and even those recovering from a stroke or shoulder surgery. Users of the VitaGlide have been able to increase
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strength that allows transfer in and out of their wheelchair with greater ease and even moving from a mechanical chair to a self-propelled one. Design-wise, the unit is built with a wide "V" opening to allow a wheelchair to enter the front of the machine comfortably while allowing the user to reach the control panel and gliders. The user positions themselves in the arms of the "V" shape which is 33" wide, which accommodate both regular and power wheelchairs. Next Step Orlando, a paralysis recovery and fitness center, is one of various rehab facilities throughout the country that now offers VitaGlide as part of its rehabilitation technology. Exercise and its benefits are not out of reach for wheelchair-bound individuals and can provide social and emotional benefits, as well as stave off future diseases. Whether you are embarking on a fitness journey or as part of your rehabilitation program, it is important to consult with a rehab specialist to ensure that your exercise regimen is tailored to your capabilities. *Source: Wheelchair Market Size, Industry Analysis Report, 2021-2028
PHYSICIAN || SPOTLIGHT PRESENTED BY
New UF College of Medicine dean takes helm at pivotal moment for UF Health FROM THE POST, UF HEALTH
Annually, the college trains more than 800 residents and fellows and nearly 1,000 medical, PA and graduate students. Faculty members practice in six UF Health hospitals in the Gainesville area and dozens of UF Health physician practices throughout North Central Florida and are associated with a number of affiliate clinical and residency programs around the state. Koch moves into the role that had been held on an interim basis for the past two and half years by Joseph A. Tyndall, MD, MPH, who has transitioned to associate vice president for strategic and academic affairs for UF Health as well as continuing as chair of emergency medicine. “It is an honor and a privilege to have been selected as the first woman dean of the University of Florida’s College of Medicine, the result of much hard work by the search committee, Dr. Nelson, and members of the College of Medicine and university community,” Koch said. “The college’s emphasis on quality, safety and value align with my experience and career goals. I intend to work closely with Dr. Tyndall on diversity, equity, inclusion and academic affairs, and humbly accept this leadership opportunity.” Prior to joining Johns Hopkins in 2014 to lead its anesthesiology department, Koch practiced at the Cleveland Clinic for 22 years while also serving in numerous roles in research, education, administration and medical operations throughout the organization. She is a cardiothoracic anesthesiologist who has authored more than 100 publications and is nationally known for her clinical outcomes research in cardiac surgery, transfusions and quality of life. Under her leadership, the department of anesthesiology at Johns Hopkins has implemented a number of innovative initiatives and strategies in areas like research, professional development and quality and safety. For the second year in a row, the department was ranked the No. 1 anesthesiology program in 2020 by U.S. News & World Report’s medical
Colleen G. Koch, MD, MS, MBA, has been named dean of the University of Florida College of Medicine, becoming the 10th dean and the first woman to hold the appointment in the college’s 64-year history. Koch began her new role earlier this year after serving as a professor and chair of the department of anesthesiology and critical care medicine at Johns Hopkins Medicine and anesthesiologist-in-chief of The Johns Hopkins Hospital. “Dr. Koch brings with her a distinguished record of visionary leadership, scholarly accomplishments and demonstrated excellence in academic health and clinical administration,” said David R. Nelson, MD, senior vice president for health affairs at UF and president of UF Health. “We are at a pivotal moment in the history of UF Health, and the College of Medicine and its faculty, staff and students are an integral part of shaping our path forward as they continue to translate scientific discoveries into the clinical advances that will help our patients achieve the best possible outcomes. I look forward to what we will accomplish together on behalf of the university, the state of Florida, and beyond.” As dean, Koch serves as chief academic and executive officer for the College of Medicine, the largest college within the UF Health academic health center. Ranked No. 18 among all public medical schools in the country and the highest-ranked in Florida, it comprises 28 research-oriented and clinical science departments and the School of Physician Assistant Studies, staffed by more than 1,400 faculty members.
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school specialty rankings and is among the top five funded academic anesthesiology departments in the U.S. “After a thorough national search that attracted a great number of superb candidates, Dr. Koch was recognized as the ideal choice to lead the College of Medicine through continued growth in national recognition and impact in all three of its mission areas of research, education and patient care,” said UF President Kent Fuchs. “As UF Health expands its footprint across North Central, Northeast and Central Florida, Dr. Koch’s proven ability to collaborate and build successful and strategic relationships, both internal and external, will be invaluable.’’ Nelson said Koch was chosen after a nationwide search co-chaired by Leon L. Haley Jr., MD, MHSA, dean of the UF College of Medicine-Jacksonville and CEO of UF Health Jacksonville, and Julie Johnson, PharmD, dean of the UF College of Pharmacy and a distinguished professor. Koch serves on the board of trustees of the International Anesthesia Research Society, where she is also past chair of the executive committee of the board of trustees. She is a member of the board of directors for the Kennedy Krieger Institute, which is an internationally recognized organization dedicated to improving the lives of individuals with disorders of the brain, spinal cord and musculoskeletal system. She serves on that board’s education subcommittee, helping to develop employment opportunities for neurodiverse individuals in the Baltimore community. In addition, she is a fellow of the American College of Cardiology, the American Heart Association and the American Society of Anesthesiologists. Koch received her medical degree from the University of Cincinnati and her training in anesthesiology from Harvard Medical School’s Brigham and Women’s Hospital. She earned a master’s degree in clinical research design and statistical analysis from the University of Michigan and a master’s in business administration from Case Western Reserve University. “In appreciation for the confidence UF has demonstrated by affording me this opportunity to push the boundaries in research, education and clinical care, I look forward to advancing the college’s vision for the medical enterprise, focused growth and innovative strategies by providing ever greater value to our patients, our community and the field of medical science,” Koch said.
EAST ORLANDO CHAMBER OF COMMERCE
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Welcome to June: Professional Wellness Month
Coffee Club East
JUNE 3, 2021 | 8:30 AM
Bonefish Grill Waterford Lakes “Small Group Day” Free EOCC members | $10 non-members
BY DOROTHY HARDEE, EAST ORLANDO CHAMBER DIRECTOR OF OPERATIONS
Legislative Update Florida Politics Breakfast
June brings delicious fruits, vegetables, bouquets and the urge to get outside to enjoy the sunshine.
JUNE 8, 2021 | 7:30 AM
The Celeste Hotel Orlando $35 EOCC Members | $45 Non-members
OPTIC: AI & The Social Dilemma
It is also, Professional Wellness Month throwing a light on the importance of creating an accomplished environment for employees. What makes this year so different from all the rest is that after a year of shutdowns and being shut in, 15 percent of Americans are afraid to leave their homes. Many employees are emotionally on edge and physically worn out, making this the best time to focus on celebrating wellness in the workplace. Adults spend a significant amount of time working in their offices or, now, remotely making a healthy balance so important for overall well-being. Corporate Wellness Magazine explained that chronic disease is one of the biggest challenges facing employee health and productivity at work. “More than 150 million American adults in the workforce have at least one chronic disease: including heart disease, arthritis, diabetes and mental health disorders.” Chronic disease, financial stress and psychosocial stressors at work limit performance, promotes absence, ability to carry out tasks and ultimately cost employers significantly. In fact, chronic physical and mental issues have accounted for more than $136 billion (about $420 per person in the US) in health-related loss. The Centers for Disease Control (CDC) explains that, Health-Related Quality of Life is associated with many health, job, family, and economically related benefits. The greater well-being equals decreased risk of disease, illness and injury. It also means that employees who experience higher levels of well-being, made up of a good exercise routine, healthy diet, sleep patterns, etc. are also more productive, community conscious and an asset to an organization. Organizations need to step up their game creating an environment where employees can thrive and be happy and healthy. An effective wellness program educates employees and creates a culture of health, while aiming to help workers develop health behaviors. The benefits of the program include: • Improved productivity • Saves cost. • Promotes teamwork and collaboration.
JUNE 11, 2021 | 9:00 AM
VIRTUALLY hosted by Full Sail University FREE EOCC Members | $10 Non-members
Business & Bowling Afterhours at Boardwalk Bowl JUNE 15, 2021 | 5:30 PM
Boardwalk Bowl Entertainment Center $15 Per Person includes one game, drink ticket, appetizers & networking.
Coffee Club Nona
JUNE 17, 2021 | 8:30 AM
Sam’s Club Lake Nona “Trash Talk” Exploring Recycling & Sustainability programs Free EOCC members | $10 non-members
Healthcare Collaborative Afterhours JUNE 24, 2021 | 6:00 PM
The 5th Floor at Avalon Park Featuring Dr. Angela Mazza, DO (Metabolic Center for Wellness) $10 Per Person
W.I.S.E. (Women in Successful Endeavors)
AUGUST 4, 2021 | 11:30 AM
The Celeste Hotel Featuring “Women in Transportation” including Diane Sears (I4 Biz); Laura Kelley (CFX); Christine Kefauver (Brightline); Robyn Willson Hattaway (Canaveral Port Authority); Kathleen Sharman (GOAA) $40 EOCC Members | $50 Non-members
Working Mother highlighted 10 companies providing outstanding office health and wellness benefits to enhance employee health while on the job with impressive “wellness zones” in their offices. From Unilever’s Quiet Room for meditation, Nike’s fitness center including the “Bo Jackson Center” featuring indoor basketball court and turf field, to Microsoft’s paid gym memberships, workout facilities on campus, multiple restaurants, free health screenings, diet counseling and wellness coaching, may have you dusting off your résumé. Who else made the top ten? Google, General Mills, Zappos, Rodale, Inc., Genentech, SAS and Twitter. Workplace wellness is not a new concept but has become a popular benefit for companies to offer supplying a positive impact for your organization. A wellness
EOCC 75th Anniversary Commemorative Golf Tournament
OCTOBER 22, 2021 | 7:30 AM Rio Pinar Country Club $125 Individual | $400 Foursome | $500 Foursome & Hole Sign Check out sponsorship and added opportunities available at eocc.org
Visit EOCC.org for a complete listing of June events
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program is more than counting steps on a fitness band or offering free fruit. A well-thought-out program is a set of activities and initiatives promoting employee wellbeing and encourages staff to prioritize their health and fitness. Before dismissing the thought of incorporating a program for your organization, consider the benefits: Improved employee satisfaction & ability to attract talented employees. Starting a wellness program that delivers measurable results and tangible benefits can be as simple as these fivesteps shared by the blueprint (A Motley Fool Service): • Get support from management who will not only be on board but serve as a champion. • Survey employees to make sure the program initiatives match what your employees are looking for and they are on board with the program. • Make it a game with leaderboards and prizes so employees can compete and get extra motivation for taking part. • Set goals, tracking and planning everything to ensure the initiatives succeed and contribute to business growth. • Tap into your HR Software, many of which include wellness functionality. Wellness modules “allow you to track the wellness of employees over time, asking them to input information such as sleep patterns and how much they are using technology such as their phones.”
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Addressing Burnout in Radiology Take a look at what AI can do in your practice BY MICHAEL KELLEHER, MD
with data still being populated or missing. The results have been significant. By cutting the amount of time spent on administrative burden and workflow inefficiencies, our radiologists are not feeling overwhelmed. Their communication with our engineers — which occurs in real time — gives them the comfort of knowing that any obstacles or change that comes up will quickly be resolved. As president of our radiology group, I am always collaborating with engineers and radiologists looking for nuances to improve our processes. I am an active part of the reading radiologist rotation, so I know the impact that AI can deliver. Compared to traditional radiology workstations, I read 40 percent more efficiently on the Nines platform and feel less fatigued at the end of my shift, despite reading more studies. Most physicians embrace change. We have always learned to adapt to new approaches to care, consider new therapies, and apply innovations. However, our workload has significantly increased and the administrative burden that is now required of us has chipped away the time we spend helping improve patient outcomes. By focusing on the causes of physician stressors and finding new innovative ways to decrease burnout, practice leaders can help reignite our passion for better patient care. We chose to utilize artificial intelligence and a team of talented engineers to reduce burnout.
Recently, the Journal of the American College of Radiology (JACR) published a full-length article entitled, How Radiology Leaders Can Address Burnout. The article emphasizes the role leaders play in burnout and that moving forward, we will be held accountable and expected to address the topic with our team. While case overload is commonly linked to burnout, we now know that this is not the primary cause. Several medical associations note that the stress and pressure we feel is connected to our desire to help patients. However, the reality is, we don’t have the time to do what we do best. We’re overwhelmed with the demand for our time, the growing administrative functions required of us, and working on outdated equipment. I’ll share a perspective based on my prior experience working at two private practices and training at a few academic medical centers. I believe this perspective is common in the radiologist community. In each of these prior settings I felt frustrated working with archaic systems that constantly crashed, knowing that each time I’d have to wait 10-15 minutes for it to restart. The pressure rose when I had to complete a report quickly because patients are waiting. Commiserating with others on our team rarely happened because most of us were constantly working. I usually arrived early, left late, and worked through lunch. I was exhausted by the time my shift ended. Radiologists historically have been regarded as a specialty that encourages quality of life, together with emergency medicine, ophthalmology, anesthesiology, and dermatology. However, because of rising burnout, job fulfillment has plummeted, and a growing percentage are seriously considering leaving the field for a different career. The JACR article highlighting the pressures physicians face is a first step to acknowledging the problem. Another step is to find a solution to fix the problem. I believe that technology, particularly artificial intelligence (AI), could solve much of the administrative tasks that have held us back from our most important role — caring for our patients. We’re seeing this in my current practice at Nines Radiology. We apply AI and machine learning to help our radiologists regain their love for medicine. We brought on full-time engineers and had them work with our radiologists to uncover new ways of improving clinical workflows. Together, they harnessed the power of machine learning to develop a solution for batching reports so radiologists are not wasting time looking for various studies. Our team also developed an “always ready” worklist so radiologists can work on those reports that include all necessary information, and not be distracted by the ones
Michael Kelleher, MD, is a radiologist and president of Nines Radiology, a teleradiology practice using AI-based tools. Previously he was vice chair of Radiology at Middlesex Health and COO of Guilford Radiology. He graduated from the University of Connecticut School of Medicine and completed his residency and pediatric radiology fellowship at Yale Medical School.
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Post Pandemic, the Pivot for Medical Practice will be Tracking Complications of COVID-19 Syndrome BY TONY COWAN
As COVID-19 and its mutations continue to criss-cross the globe, medical practices and public health workers have dealt with alternating medical surge events and empty exam rooms. This has caused both an increase in healthcare costs and a dramatic reduction in typical healthcare reimbursements. As the COVID-19 focus pivots from response to recovery, medical practices will need to start generating new revenue as they work to better understand and care for what NIH is calling COVID-19 Syndrome. It is now well known that the consequences of becoming infected by the virus caused by SARS-CoV-2 has the potential of causing long-term health issues. Practices that set themselves up to identify these issues prior to them becoming chronic will be critical to keeping treatment costs down. As reported by Justine Coleman (2021), during a hearing for a House Energy and Commerce subcommittee, NIH Director Francis Collins cited preliminary research that found ten percent to thirty percent of people who had COVID-19 may develop long-term health issues. With more than 34 million confirmed cases in the U.S. in the past year, that could amount to millions dealing with COVID-19 for some time to come. “Some of you have been suffering for more than a year, with no answers, no treatment options, not even a forecast of what your future may hold,” Director Francis said. “Some of you have even faced skepticism about whether your symptoms are real. I want to assure you that we at NIH hear you and believe you” (Coleman, 2021). A significant opportunity for new reimbursable tests exists for medical practices across the country if they embrace new diagnostic options that will help detect presymptomatic issues and keep lower-cost treatment options open. This is the ideal match where both quality care and new revenue streams come together. The question ‘Do you ever fully recover from COVID-19?’ is terrifying and needs to be answered. Dr Phil Mongelluzzo, Jr., the Chief Medical Officer with the medical device company that conducts pre-symptomatic screenings called Pulse4Pulse™ said, “We already know of ongoing complications of COVID-19 including, a systemic inflammatory response that at the current time is unknown in duration and has widespread effects on multiple organ systems. COVID-19 causes disruption of the microvascular system and the systems that maintain balance in our bodies. We need to implement a tracking system and fortunately Pulse4Pulse™ can define and identify endothelial dysfunction (smallest blood vessel disease in our bodies) and autonomic dysfunction (an alteration in our body’s ability to maintain balance. The importance of this cannot be understated – our bodies are amazing at maintaining order and we do not become symptomatic until it is too far along in the process. We need to know about issues while they are still asymptomatic” (Mongelluzzo, Jr., 2021). Dr. Mongelluzzo’s point is magnified by a recent article in the Cardiac Failure Review “Mechanisms Underlying the Occurrence” (Montone, R.A., et. al., 2020). This graphic from that article helps illustrate the current connections from the viruses to the complications arising from it. The ability to capture pre-symptomatic evidence of these diseases creates the ability to address them with
lower-cost prescriptions and treatment. This is great for the patient and great for keeping healthcare costs down. The Centers for Medicare & Medicaid Services already knows this because they have set up the Primary Care First Model Options (2021). They are literally rewarding the PCP who can capture and track the early diagnosis of pre-symptomatic issues that identify a compromised health profile (Centers for Medicare & Medicaid Services, 2021). There is real value in capturing the patient’s current health profile and tracking pre-symptomatic issues that, when not identified or treated, become chronic long term expensive treatments. This prioritizes both the patient, by emphasizing the doctor-patient relationship to keep the patient healthy, and saving money over the long term while increasing per visit reimbursements. With Medicare compensating practices for catching presymptomatic issues before they evolve, the same pan-
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demic that kept patients out of exam rooms could bring them back. The focus of the work now is to figure out how to mitigate the health complications of COVID-19 on a long-term or, as it is being called by the CDC, Long Covid (Centers for Disease Control and Prevention, 2021). This work is going to require a better solution than a medical practice having to wait until the patient presents with advanced symptoms of a disease they could have diagnosed in the earliest stages. Tony Cowan is the Administrative Director at www.weareibec.org a consortium of scientists, agencies and industries tackling the challenge of striving in the new normal, post lessons-learned from COVID-19. He has over twenty years of healthcare development experience and deployed the first FEMA Category “B” funded clinics to become licensed healthcare facilities after a disaster, supporting medical public health infrastructure long-term. He is also the Director of Emergency Response Technologies with www.Clinicsonwheels.com where they designed, manufactured, and deployed the first Cares Act eligible, mobile vaccine distribution unit for Seminole County, Florida. References available upon request from editor@orlandomedicalnews.com
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Choosing the Right Floor for Your Application BY LAUREN ODDO
Budget Whether you’re remodeling an existing building or home or starting brandnew, it’s time to make a decision! One of the most obvious things to base your flooring decision on is going to be cost or budget. But what does that mean? There’s so much more that goes into the cost of flooring than just the flooring itself! Perhaps you’ve heard the phrase from a painter, “only the rich can afford cheap paint”? Well, the same goes for flooring! When considering the cost of a floor you must factor in the cleaning and maintenance costs as well as the cost of flooring, install and any necessary installation and floor prep supplies. A great example that’s often used for a floor that is CHEAP to put in but expensive to maintain is commercial VCT (think Publix supermarkets, schools and cafeterias). VCT stands for Vinyl Composition Tile and is extremely inexpensive on the front side. That said, as soon as it’s installed, it has to have multiple coats of wax applied and re-applied throughout its lifespan to be maintained the way it is meant to be. Not only does waxing the floor add cost to the maintenance aspect of the floor, it also puts your floors out of commission for some time while the process is completed. If your operations shut down at night, this may be a non-issue but if you’re running 24/7 this could create a logistics nightmare! If you’re looking for a floor that is fairly low cost on the
front AND backside luxury vinyl is the way to go. Starting as low as $1 per square foot and virtually no required maintenance process, it’s easy on the pocketbook before and after installation. Replacement is also fairly easy, especially for click-lock products. If you go even further and spend a bit more on the front side for an easy to maintain, extremely durable product like porcelain tile, the durability will allow the floor to outlive a product at a lesser cost and, while difficult to replace, it is unlikely you will ever need to because it will truly last a lifetime.
Durability Once you’ve determined a budget and have found a few options within the budget, the next thing to do is
determine how durable you need the product to be. In most applications, the more durable the better. That said, there are different types of durability to consider. For example: foot traffic, rolling loads, scratch resistance, dent resistance, etc. For example, while click-lock luxury vinyl is soft underfoot and perfect for high traffic areas, rolling loads tend to compromise the locking mechanism causing the floors to spread apart over time. Another thing to consider is the maintenance requirements the flooring manufacturer outlines to keep the look and durability of your flooring the same as the day you installed it. For example, a natural oil wood will perform beautifully in a residential application but in a high traffic commercial application, the floor will need to be reoiled so often that it will be difficult to keep up with the maintenance and will look dull and unfinished within a few months at most. Likewise, VCT is extremely durable unless maintained improperly, which will lead to scratching, stains, chipping, etc. While durability is important, on the opposite end of the spectrum is softness, and softness may also be something to looking for in a floor. And while tile is at the top of the list for durability, it’s at the bottom for softness! A great compromise between durability and softness is a click-lock luxury vinyl with an attached pad. While durable enough to withstand heavy foot traffic, it is also extremely soft underfoot.
Design Now that you’ve got a type of flooring figured out, now it’s time to focus on color, texture and design. One of the best things about luxury vinyl is that it has come a long way in the past 20 years. From wood, stone and tile looks to abstract and fabric textures, there are thousands of looks to choose from. Many manufacturers provide room scene visualizer tools to allow you to see their flooring in your space. This is a cool tool for anyone who has trouble envisioning things on a larger scale. The most common trend currently, especially in homes, is for the same flooring to go throughout all spaces in a home or workspace. That said, using different floors can help separate an otherwise open area. Overall, it is important to think of your flooring as the backwash for the rest of your design. Sometimes the backwash can to the talking, but in most cases you want it to be simple and complimentary to the rest of the details in the design. Now let’s pick some floors! Lauren Oddo has been with US Design Source for six years managing sales and specifying products. Upon graduating from the University of Central Florida with a bachelor’s degree in entrepreneurship, she sought a career that would allow her to combine her love for home design and education in entrepreneurship into one passion. The owners of US Design Source, Michael and Ginny Hill, have been part of the Orlando flooring and building industry for over 50 years. As a company, we’ve installed hundreds of thousands of square feet of flooring throughout Central Florida.
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New IRS Guidance on 2021 Employee Retention Credit business was not in existence as of the beginning of Q1 2019, then the election involves a comparison of Q1 2021 v. Q1 2020. • Most helpful is that the election can be made for either quarter and it does not need to be made for both quarters. This allows a taxpayer that meets the test for one quarter to qualify for two quarters of the 2021 ERC. For example, if a business has a Q1 2021 decline in gross receipts of more than 20%, then it can claim the ERC for Q1 2021, and Q2 2021 using the election. There was concern that the IRS would require an all-or-nothing approach to the election, but it did not and this is great news for businesses. • If a business was not in existence at the beginning of any calendar quarter in 2019, then the comparison is to the same quarter in 2020.
BY DANIEL MAYO
The employee retention credit (ERC) is turning into the gift that keeps on giving. It was enacted on March 27, 2020 as part of the CARES Act, and then was expanded greatly on December 27, 2020 by the Consolidated Appropriations Act, 2021, which among other things eliminated the ban on the ERC if a taxpayer received a paycheck protection program (PPP) loan. Congress then expanded the ERC to the last two quarters of 2021 in the American Rescue Plan Act of 2021, enacted on March 11, 2021, and added a new section to the Internal Revenue Code, §3134. The IRS has weighed in on the ERC too. It issued 94 frequently asked questions (FAQs) on its website and a 102-page notice, Notice 2021-20, on March 1, 2020, explaining the workings of the 2020 ERC. Most recently, on April 2, 2021, the IRS issued Notice 2021-23 (Notice) concerning the ERC for the first two quarters of 2021. At 17 pages, it is a light read compared to the previous 102-page notice. According to the IRS press release accompanying Notice 2021-23, the Notice explains the changes to the ERC for the first two quarters of 2021, including:
Amount of the ERC – • The ERC is 70% of eligible wages and healthcare costs up to $10,000 per employee for the relevant calendar quarter. This means that the ERC resets each quarter; thus, the maximum credit per employee is $14,000 for the first two quarters of 2021.
Qualified wages – • As expected, the amount depends on the monthly average of full-time employees during 2019. Thus, if a business had on average 500 or less full-time employees in 2019 (a “small eligible employer”), then eligible wages include wages paid to all employees
• the increase in the maximum credit amount, • the expansion of the category of employers that may be eligible to claim the credit,
(i.e., for time providing services and for time not providing services) even if the employer has more than 500 employees in 2021. Recall this threshold is 100 employees for the 2020 ERC. • If a business had more than 500 full-time employees in 2019 (a “large eligible employer”), then qualified wages are limited to those wages paid to employees for time they did not perform services. • It remains unclear whether part-time employees are included in the determination of the number of “fulltime employees.” The Bluebook to the CARES Act, prepared by the Joint Committee on Taxation, states at footnote 145 that part-time employees are included in the calculation, but the IRS has addressed the issue multiple times and refuses to state with clarity whether part-time employees are included, referring generally to §4980H. In Notice 2021-23, however, the IRS went further than it has previously – it referenced §4980H(c) (4), the section that includes full-time employees, instead
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• modifications to the gross receipts test,
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• revisions to the definition of qualified wages, and • new restrictions on the ability of eligible employers to request an advance payment of the credit. The IRS also stated that it will provide further guidance regarding the ERC for the third and fourth quarters of 2021. Let’s now discuss the details and practical implications of Notice 2021-23.
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• The Notice states that tax-exempt organizations qualify for the ERC, and adds that public colleges and universities qualify, as well as governmental entities whose principal purpose or function is to provide medical or hospital care, provided they satisfy the other requirement of an eligible employer. This is good news for these organizations, but it is also welcome news for tax-exempt elementary and secondary schools. While it is unclear exactly how the partial shutdown rules apply to these organizations, at least the IRS acknowledges
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that educational organizations can qualify.
Decline in gross receipts – • Decline in gross receipts threshold is reduced from 50% for the 2020 ERC to 20% for the 2021 ERC. • Comparison is 2021 v. 2019, so Q1 2021 v. Q1 2019, and Q2 2021 v. Q2 2019. • Businesses can elect to qualify using gross receipts from the immediately-preceding calendar quarter. • For Q1 2021, the election involves a comparison of Q4 2020 v. Q4 2019. If a business was not in existence as of the beginning of Q4 2019, then the election cannot be made. • For Q2 2021, the election involves a comparison of Q1 2021 v. Q1 2019. If a
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Boosting Healthcare Revenues Automated phone payments could be the answer BY MARTIN TRAUTSCHOLD
means using an electronic payment method, whether online or by phone, that they can utilize at 2pm or 2am. Managing the entire patient experience, before treatment, during treatment and throughout the billing and collection process is critical. Some healthcare providers are selling their debt to third parties, who then undertake the effort to collect the debt. Introducing a third party causes the healthcare provider to lose all control of the “patient experience” in that debt collection process. If the third-party debt collector ends up doing something upsetting to the patient, the healthcare provider can risk losing all future revenue from that patient as they choose to go elsewhere. Traditionally, many healthcare providers have relied solely on patient billing and payment aspects of their electronic medical and practice management systems such as Epic Systems. Epic alone (like many systems) doesn’t allow for a completely self-service patient payment experience. The Epic patient web portal, called “My Chart,” offers a great self-service online payment method, however there is no built-in self-service phone automated payment method with Epic. That is where healthcare providers need to look to third party providers to be able to provide 24/7 self-service phone payment systems.
In the vein of solving one problem, creating another, patients who have health insurance are seeing a strong trend toward lower premiums with the accompanying higher deductibles. This trend, accelerated and exacerbated by Covid-related job losses, means that some insured individuals are disincentivized to seek care and/or obtain vital medication—thus costing both the patient and the insurer more down the line. And for those who were fully insured via their jobs, but who were laid off and must now pay out of pocket for coverage, well, they are naturally homing in on the cheapest plans (read highest deductibles). This trend, say some (1), can be traced to the 2008 recession, which led business owners to consider high-deductible plans as an alternative to layoffs. And this movement doesn’t seem to be slowing down.
Patient Bill Pay Expectations are Ever-Changing As patients are required to play a more active role in paying for their care, they are also paying closer attention to the financial details of that care. Increasingly thought of as “consumers,” patients want to know how much money they will have to expend for their care—before they walk in the door. In addition, they are fed up with complicated or confusing statements. Finally, they are looking for extreme convenience when it comes to payments—this sometimes
Patients Want to Pay on Their Schedule One example of how practices lose money is that many patients want to pay their bills on their own time, in the evenings or on the weekends, but when the practices or billing offices are closed. Ideally, an automated system that could handle such payments so that staff could
refocus its efforts on responding to patient needs and increasing patient satisfaction. Tackling the convenience issue in a way that is compliant with Payment Card Industry Data Security Standards and HIPAA can be a headache for medical providers already straining under the weight of Covid. Collecting payments from hundreds or thousands of patients necessitates that any such system be fully integrated with the patient’s financial system and credit card processor.
The Evolution of Healthcare Automation As payment plans evolve, we are seeing more strategic undertakings on the part of healthcare entities. For example, patients are sometimes offered the chance to divide their bills into multiple payments over a period of months (or years). In other cases, healthcare providers are urging patients to pay prior to treatment. We are seeing this trend because so many providers get stuck with mountains of unpaid debt. At times, patients may be asked to establish a regular monthly amount that is to be completed via an automated payment method. Those in healthcare should also keep an eye on a fundamental shift in consumer spending, namely, the Buy Now Pay Later trend. If financially overextended patients can establish a manageable monthly payment plan for healthcare spending, then that would benefit all parties. With Buy-Now-Pay-Later, healthcare practices improve their cash flow and patient satisfaction improves as they are given a reprieve from a massive, one-time, bill. The ultimate solution to help manage the patient experience and expectations is a system that frees up staff time (no more manual calls or payment processing), offers to split up the entire bill into manageable monthly payments, provides an easy solution for the patient (24/7 phone automated payments or web portal payment options), and is completely secure. Martin Trautschold is CEO of 1-800 Notify, a healthcare communications firm that is fully HIPAA and PCI compliant, an Epic App Orchard Partner and integrates with many systems. 1-800 Notify reduces no-shows and boosts collections by supporting millions of inbound Payment IVR phone calls, patient balance due reminders, two-way appointment reminders, and patient wellness and broadcast messages.
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More Cannabis Dispensaries Equaling Fewer Opioid Deaths BY MICHAEL C. PATTERSON
A recent study in the British Medical Association Journal (BMJ) shows increasing access to marijuana dispensaries is associated with a significant reduction in opioid-related deaths.
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Welcome to June: Professional Wellness Month Encourage employees to take part, stressing the importance of the benefit, but do not make it mandatory. Finally, remember to communicate the benefit clearly and ask if there are any changes that can be made to accommodate them. Ready to celebrate “National Employee Wellness month”? Here are a few ideas addressing one of the six key dimensions of well-being: emotion, financial, occupational, social, physical and purpose. • Emotional Well-being: Teach Mindfulness • Financial Well-being: Supply Resources • Occupational Well-being: Focus on the Future • Social Well-being: Host Virtual Events
Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study | The BMJ Researchers reviewed opioid mortality and cannabis dispensary prevalence in 23 U.S. states from 2014 to 2018. The study concluded that counties where the number of legal marijuana shops increased from one to two experienced a 17 percent reduction in opioid-related fatalities. Increasing the dispensary count from two to three was linked to an additional 8.5 percent decrease in opioid deaths. “Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl.” Per the study, it’s a finding that “holds for both medical and recreational dispensaries.” “While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates,” the researchers wrote. “This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.” “Our findings suggest that increasing availability of legal cannabis (modeled through the presence of medical and recreational dispensary operations) is associated with a decrease in deaths associated with the T40.4 class of opioids, which include the highly potent synthetic opioid fentanyl. This finding is especially important because fentanyl related deaths have become the most common opioid related cause of death.”
• Physical Well-being: Introduce a Wellness Challenge
Analysis This study is one of many that continues to demonstrate that cannabis is a benefit to society not a detriment. Most states that have legal medical cannabis programs allow use of cannabis as a substitute for the use of opiates. Opiate addiction and deaths in the USA have destroyed countless lives, families, and communities. The lies regarding the safety of opiate use by Pharmaceutical companies are now coming out in litigation across the country by US States demanding restitution from the many effects of the opioid plague. There has never been a single recorded death in human history associated with the use of cannabis, and it is still illegal based on US federal law. Meanwhile, the opiate death toll for 2020 is expected to exceed 70,000 people, and opiates are legal via prescription. Society is tired of being lied to about cannabis. They are tired of politicians protecting the illegality of cannabis, and pharmaceutical companies pitching drugs that have side effects worse than the disease or condition for treatment. As more and more facts and data emerge on the positive benefits to society and health that cannabis offers, the legalization trend of cannabis will continue in the USA and globally. Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com
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• Purpose: Encourage Mission Statements Looking for more ways to celebrate the month? Consider walking meetings, naps and sleep time, fitness breaks, healthy menu options, goal setting, signposts and supply health information regulatory. For the health of your business reach out to the East Orlando Chamber for a menu of unique offerings elevating your businesses visibility and connect you with others helping your business thrive. We are the first in the state offering traditional Health Insurance plans, as well as supplemental products including dental, vision, critical illness, accidental and more. Hear from our local lobbyists Tuesday, June 8th as we present, “Florida Politics 2021” at the Celeste Hotel Orlando, sponsored by University of Central Florida. Fred Kittinger, Sr. Associate VP University Relations (UCF (University of Central Florida) will moderate our distinguished panel including Chris Carmody, Gray Robinson, PA; David Mic, Jr., Florida Hospital Association; Janet Owen, University of Central Florida; & Sharon Smoley, Orlando Economic Partnership. Breakfast opens at 7:30 AM with the program following at 8:00. Register at eocc.org. Do you know what happens when most of the work you are doing can be done instantly, accurately and cheaply with Artificial Intelligence? What are the ethical and legal concerns? Find out this and more when OPTIC (Orlando’s Professional Technology & Innovation Collaborative) presents, “AI & The Social Dilemma” June 11, 2021, at 9:00 AM, presented by EOCC and hosted by Full Sail University. This virtual presentation is moderated by Ean Meyer, Full Sail University. Our panel of experts include Werner Barkhuizen, PhD (RWENRB Holdings); Ian Johnson (Losey PLLC); Haifa Maamar, PhD (Full Sail University) and Kunal Patel (BrandXR). Free for EOCC members and $10 for non-members. Our Healthcare collaborative afterhours will feature Dr. Angela D. Mazza, DO, double board-certified in endocrinology and internal medicine with Metabolic Center for Wellness discussing Radiofrequency Ablation of Thyroid Nodules. Radiofrequency Ablation is a safe scarless alternative to in-patient surgery. The Healthcare Collaborative Afterhours is Thursday, June 24 at 6:00 PM at The 5th Floor in Avalon Park. Your $10 registration fee includes drinks, appetizers and valuable information. For more information or to register call (407) 2775951 or visit our website at eocc.org. The East Orlando Chamber of Commerce everywhere East of I-4.
ORLANDO || GRAND ROUNDS UCF Lake Nona Medical Center Welcomes 100th Baby
Orlando Health to Open New Emergency Room in East Orlando
A long-anticipated move that expands access to high-quality health care in east Orlando will happen on June 7 when the new Orlando Health Emergency Room – Randal Park opens its doors for those living, working and playing in this community. Located on a 15-acre campus at the northeast corner of Dowden Road and Randal Park Boulevard, near State Road 417, the new facility will provide emergency outpatient care to meet the increasing needs of the region.
Development of the 42,000-square-foot freestanding emergency room (ER) and future medical pavilion began in 2018. It will offer the same level of care and services as a hospital-based ER and will be open 24 hours a day, seven days a week. The new facility features 12 treatment rooms, diagnostic imaging – including CT scan, ultrasound and X-ray – and a full-service laboratory. There is also a helipad and ambulance bay that will allow patients requiring a higher level of care to be transported to Orlando Health Dr. P. Phillips Hospital, the Orlando Health facility to which this new site is affiliated. The new ER will be staffed by board-certified and board eligible emergency medicine doctors, and experienced nurses. The Orlando Health Emergency Room – Randal Park is located on the first floor of a three-story building that can expand to meet the needs of the community’s continued growth. Future expansion plans include a medical pavilion that will house physician offices and specialty services such as cardiology, oncology, orthopedics and more on the second and third floors.
MedAvail Opening First Four SpotRx Locations in Florida Less than three months after opening, UCF Lake Nona Medical Center welcomed its 100th baby, with the new hospital already outpacing its projected number of births. The hospital welcomed Lake Nona’s first babies, twins Liam and Teddy, who along with their mom were its first patients. Members of the local community are finding the beautiful advanced technology hospital, and are repeatedly turning to UCF Lake Nona Medical Center to bring their babies into the world close to home. Family Birthing Unit features include private labor, delivery and recovery family birthing suites, neonatologists available 24/7 through Nemours Children’s Hospital, OB hospitalists on-site 24/7, and a dedicated OR for C-sections. Additional patient amenities for new moms include birthing classes, a celebration meal, baby gift and to-go meal provided at discharge. The hospital also offers professional baby photography and mobile spa services on request. Ensuring that every family receives the highest quality of care is Sally Robertson, UCF Lake Nona Medical Center Director of Women’s Services. She leads the Family Birthing Unit, providing leadership to the team, serving patients and families, and welcoming every baby born. A mother of four, Robertson dedicated her life to raising her children, working for 15 years as an at-home mom. After her first child experienced a near-drowning incident, Robertson was drawn to the medical field. Her family spent 10 days in the pediatric intensive care unit, nursing her son back to health. “The nurses took great care of him, and even better care of me,” Robertson said. “The whole time I was there with him, I kept thinking this is what I want to do for other people. But I had made a commitment to be a stay-at-home mom for my family, and I knew the time was not right for me.” Her son fully recovered, and Robertson says she was forever indebted to the caregivers who not only brought her son through the experience, but also cared for her family so tenderly. When her youngest child started first grade, Robertson went back to school, earning her nursing degree at 39. She went on to get her master’s in 2010 and started as a director in Labor & Delivery in 2011. “I love that while my role is to lead people, I can still positively impact every single patient having a baby, and every single team member,” she said. “We don’t just deliver babies in our hospital. We take care of women at all ages and stages.”
MedAvail Holdings, Inc. (Nasdaq: MDVL) (MedAvail), a technology-enabled retail pharmacy company, will be opening its hub pharmacy in Orlando in July and its first four SpotRx locations in Florida, its fourth target state. In-clinic SpotRx kiosks and courier home delivery will be available to patients at four Cano Health clinic locations in the Orlando area. SpotRx Pharmacy is the retail pharmacy brand owned and operated by MedAvail in the United States, which deploys and operates the MedAvail MedCenters. “We are thrilled to begin our expansion into Florida with Cano Health, a partner who is equally passionate about optimizing patient outcomes,” said Ed Kilroy, Chief Executive Officer of MedAvail. “Our partnership with Cano Health is an exciting first step on our journey to serving Medicare patients in hundreds of potential clinics in Florida, where we have a total annual market opportunity of over
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$3.7 billion.” MedAvail’s SpotRx Pharmacy business is primarily focused on the Medicare (65+ year old) market and the medical clinics where they receive care. The SpotRx MedCenter allows patients to virtually consult with a pharmacist and fill their medications within clinics, eliminating the need to visit a pharmacy. SpotRx also provides patients the option to have their medications delivered to their homes free of charge. “Our partnership with SpotRx will enable us to provide a high touch pharmacy experience to our patients while also providing convenient on-site access to over-the-counter and prescription medications,” said Dr. Richard Aguilar, Chief Clinical Officer of Cano Health. “We want to ensure that our patients receive high quality, affordable care and medication adherence plays an important role in population health management.”
NORTH CENTRAL FLORIDA || GRAND ROUNDS CONTINUED ... New IRS Guidance on 2021 Employee Retention Credit
To celebrate National EMS Week, AdventHealth Ocala hosted several events throughout this week to thank our community heroes for their partnership in helping save lives. The hospital welcomed the incredible EMS team mem-
of providing a generic reference to §4980H, which includes a provision that seems to require the inclusion of part-time employees. Although not entirely clear, this suggests that part-time employees should not be included in the calculation. • The exclusion of part-time employees would expand the 2020 and 2021 ERCs dramatically. For example, if a business had 450 full-time employees and 800 part-time employees in 2019, and the same number of employees in 2021, then it could qualify for the 2021 ERC with respect to all the wages of its 1,250 employees.
bers from Ocala Fire Rescue and Marion County Fire Rescue with catered lunches and coffee from local businesses; and ended the week with a free barbeque from Sonny’s BBQ! AdventHealth is thankful to the many men and women who help us serve our community each and every day.
AdventHealth Launches Exclusive Pediatric Cardiology Services in Marion County AdventHealth Ocala is the only hospital in Marion County providing specialized pediatric cardiology services, helping families receive exceptional heart care close to home. According to the Centers for Disease Control and Prevention (CDC), nearly 40,000 infants in the United States are born with a congenital heart defect each year. Pediatric cardiologist Dr. Ashish Patel and his team at Children’s Specialty Clinic at AdventHealth Ocala are equipped with the most advanced care to help get even the tiniest hearts back on track. The team specializes in general pediatric cardiology and fetal cardiology, putting the smallest patients and their families at the heart of their care. Dr. Patel most recently provided EKG, ECG and stress tests as needed for Marion County high school students who received free sports physicals at AdventHealth Wellness Center Ocala. “We are excited to expand our expert cardiology care to our pediatric community,” said Dr. Michael Torres, Chief Medical Officer at AdventHealth Ocala. “Our community is continuously growing and so is our care to meet the needs of even our smallest patients. We look forward to being the first and only choice for expert heart care for families in our community.” Children’s Specialty Clinic at AdventHealth Ocala extends the connected AdventHealth network of care to provide continuity of pediatric care that doesn’t require families to transfer to other health care systems. AdventHealth Ocala the only hospital providing birthing services, level-2 NICU care, a dedicated children’s emergency department, and a pediatric inpatient unit for families in the area.
• The aggregation rules apply for purposes of determining the number of employees in 2019, and presumably for the eligibility determination and the determination of the maximum amount of credit per employee too. • The 2020 wage limitation for large eligible employers does not apply to the 2021 ERC. Recall this rule limits wages paid by large eligible employers to the amount paid during the 30 days preceding the period of the shutdown or the first day of the quarter in which there was a decline in gross receipts. • Just like with the 2020 ERC, wages used to support the 2021 ERC may not be used to claim credits under §§45S, 41, 45A, 45P, 51, and 1396; however, an employer can use the same wages to claim the 2021 ERC and the work opportunity credit under §51.
Claiming the credit • Businesses can access the 2021 ERC by withholding required deposits of federal income and payroll taxes. The IRS provided penalty relief in Notice 2020-22 for businesses that take this route. • If the amount of the ERC exceeds the quarterly withholding, then small eligible employers may request an advance on the credit by filing the Form 7200 or the new Form 941 (Rev. 3-2021). Note the amount of the advance generally is limited to 70% of the average quarterly wages paid in calendar year 2019, determined after applying the aggregation rules. Advance payments are not available to large eligible employers.
etectRx Announces Launch of MyTPill Study to Address Medication Adherence Among HIV+ Prescription Opioid Users
• Reports of delays in the refund process suggest that reductions in withholding may provide quicker access to ERC funds. Finally, although not mentioned in the Notice, recall that the amount of the 2021 ERC will be taxable in 2021 by virtue of expense disallowance, so businesses should keep this in mind when preparing quarterly estimates. Withum healthcare entity ERC refunds since March 2020 include $10M, $5M, $1.5M, and $350K. Find out if you’re eligible now.
GAINESVILLE – Digital health company, etectRx, Inc., has announced the launch of a study to monitor antiretroviral therapy adherence among prescription opioid users living with HIV. The study, dubbed “MyTPill,” will assess patient adherence using two electronic adherence tracking technologies: the ID-Cap™ System from etectRx and an electronic pill box. The study will provide insight on how digital pill systems can help patients who have significant health risks due to nonadherence. The MyTPill Study, which marks etectRx’s third NIH-sponsored study at Brigham and Women’s Hospital within the last two years, kicked off in March, and will include 80 patients over the next four years. Patients will track their use of HIV medication by using the ID-Cap System for three months and an electronic pill box for three months, with a short break in between. The research sites include leaders in HIV care at Fenway Health in Boston and at the University of Miami/Jackson Memorial HIV Clinic in Miami.
Daniel Mayo has more than 20 years of professional tax experience in federal, international and financial products taxation. He is a member of Withum’s National Tax Services Group and oversees the U.S. Federal income tax research, planning and review functions. He is experienced in mergers and acquisitions, capital markets and cross-border transactions. Daniel is a frequent author and speaker on U.S. Federal income tax and international tax topics. He received his Bachelor of Science in Accounting from Rutgers College, his Juris Doctor, cum laude, from Seton Hall University School of Law and an LL.M. in Tax from New York University School of Law. Email dmayo@withum.com with any questions and to determine your eligibility.
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Despite the widespread availability of antiretroviral medications for persons living with HIV in the United States, adherence remains suboptimal, especially among individuals taking opioids. This study gives etectRx and the clinical research team the ability to demonstrate the performance of digital health solutions in helping patients remain adherent to their medication. The ID-Cap System consists of a hard gelatin capsule with an embedded sensor, which sends a digital message from within the patient after it is ingested to a wearable reader. When used correctly, the system successfully recorded medication ingestions on 98 percent of occasions in a recent study and has recorded over 6,000 ingestions across 15 IRB-approved clinical studies. “Researchers at Brigham and Women’s Hospital and Fenway Health are using etectRx technology in studies to evaluate the value of digital pills to pharma” said Valerie Sullivan, CEO of etectRx. “At etectRx, we are committed to providing strong data that can make a difference in patients’ lives.”
Orlando Health Acquires FHV Health Effective April 12, 2021, Orlando Health completed its acquisition of FHV Health, a multi-specialty group with locations throughout Lake, Sumter and Marion Counties. FHV Health consists of 19 physicians and 10 locations including primary care, cardiology practices and urgent care facilities. “FHV Health has provided its patients with access to distinguished physicians and providers for more than two decades,” said David Strong, Orlando Health president and chief executive officer. “We’re honored to continue that legacy while also bringing to this community the highest quality of patient care for which Orlando Health team members and physicians are recognized.” “We are excited to join the Orlando Health family, which has a strong history of providing exceptional care to the communities it serves,” said Jose R. Rosado, MD, vice chairman of FHV Health. “Joining Orlando Health allows us to further advance our ability to provide innovative and quality services.” Founded almost 25 years ago, FHV Health brings together specialists in vascular surgery, primary care and cardiology to detect diseases earlier and treat them more effectively. The practice has provided access to world-renowned medical innovation and nationally recognized heart and vascular experts. FHV Health cardiologists were the first to bring procedures like cardiac catheterizations, coronary stenting as a superior alternative to traditional “clot-buster” therapy, and minimally invasive abdominal aortic aneurysm repair to the area, increasing patient options for lifesaving and diagnostic procedures. “The mission of FHV Health has always been to bring together the talents and expertise of leading physicians to our patients and this alignment with Orlando Health does just that,” said David C. Lew, MD, chairman of FHV Health. “We’re looking forward to increasing the positive health impacts we can make in our communities as we look to the future.”
VOLUSIA-BREVARD | | GRAND ROUNDS
AdventHealth Fish Memorial Opens New Patient Tower AdventHealth Fish Memorial has opened a new patient tower, a $100 million expansion that includes The Baby Place, a state-of-the-art unit that will bring expanded obstetric services to the region. Completion of the four-story, 72-bed tower, first announced in 2017, expands the size of the Orange City hospital’s emergency room, and allows all inpatient rooms throughout the hospital to be private. “We wanted to bring more of our world-class services closer to the growing number of young families in Volusia County,” said David Ottati, chief executive officer of AdventHealth hospitals in Volusia, Flagler and Lake counties. “This expansion establishes AdventHealth Fish Memorial as the
largest and most comprehensive hospital in West Volusia, and adds to our integrated network throughout the region.” The larger emergency department includes a special waiting area and exam rooms designed just for children. The expansion, which adds 180,000 square feet to the hospital’s footprint, also houses a new intensive care unit with 36 beds. The Baby Place at Fish Memorial is now West Volusia’s only personalized OB experience with luxury, all-private rooms and upgraded amenities. Beginning today, OB services will be transferred to Fish Memorial from AdventHealth DeLand. “It’s amazing – the unit is very bright and very welcom-
DispatchHealth Partners with AdventHealth to Deliver In-home Medical Care
D round of funding to help with these expansion plans. DispatchHealth also recently revealed an agreement with Humana to provide DispatchHealth’s Advanced Care to Humana Medicare Advantage members in select cities across the country. DispatchHealth is open seven days a week, 365 days a year, including holidays. For more information, visit DispatchHealth.com. DispatchHealth is building the world’s largest in-home care system in order to deliver trusted and compassionate care to all. DispatchHealth offers on-demand acute care and an advanced level of medical care for people of all ages in the comfort of their own homes. DispatchHealth’s emergency medicine and internal medicine trained medical teams are equipped with all the tools necessary to treat common to complex injuries and illnesses. DispatchHealth works closely with payers, providers, health systems, EMS, employer groups and others to deliver care in the home to reduce unnecessary emergency room visits, hospital stays and readmissions. Acute care medical teams are available seven days a week, evenings and holidays and can be requested via app, online or a quick phone call. DispatchHealth is partnered with most major insurance companies. For more information, visit DispatchHealth.com.
DispatchHealth, a provider of in-home medical care, today announced a partnership with AdventHealth, one of the nation’s largest faith-based health systems, to offer patients an expanded opportunity to receive care in the comfort of their own homes. The new service will help provide greater access, convenience and support for consumers and will initially be offered in several cities in Florida as well as the Kansas City metro area. DispatchHealth has built a complete platform for delivering, coordinating, and providing medical care to patients in their homes. AdventHealth patients and providers in the Florida cities of Daytona Beach, Ocala and Orlando, as well as in Kansas City will now be able to request DispatchHealth’s acute medical care for a wide range of common to complex injuries and illnesses including viral infections, COPD exacerbations, congestive heart failure and more. This partnership is an expansion of DispatchHealth’s current operations in Tampa, Florida where the two organizations have been working together to provide in-home medical care. In all of the locations, patients can request care via phone, DispatchHealth’s mobile app or website, and soon through the AdventHealth website and mobile app. Once requested, a medical team quickly arrives at the patient’s home equipped with the necessary tools and treatments, no referral needed. “Many health care providers have a strong desire to deliver home-based care, and DispatchHealth can provide a proven platform to quickly extend care outside of the typical clinic and hospital setting,” said Dr. Mark Prather, CEO, and co-founder of DispatchHealth. “We’re thrilled to be AdventHealth’s partner of choice in offering patients effective, convenient and affordable care at home. The developing partnership builds on AdventHealth’s commitment to value-based care, and we look forward to bringing the service to even more markets.” Since its founding in 2013, DispatchHealth’s unique model of care has proven to save an average of $1,1001,700 per Acute Care visit. DispatchHealth will expand its in-home medical services with AdventHealth to offer convenient, safe and lower-cost medical care to more consumers. “AdventHealth is driven to provide wholistic care to everyone and to remove any barriers that may prevent someone from receiving the care they need. We want to meet people where they are and bring personalized, high-acuity care to our patients’ living rooms,” said Lisa Musgrave, AdventHealth’s vice president of home care administration and post-acute services. “We are excited to expand our home-based alternative care offerings to include this high-quality, high-value service and to integrate it with other innovations and investments AdventHealth is making in home health.” DispatchHealth is rapidly scaling to bring its in-home medical care to additional markets across the U.S. The company recently announced a $200 million Series
Jess Parrish Medical Foundation and Parrish Medical Center Auxiliary Award Scholarships for Study in Healthcare and Medicine Jess Parrish Medical Foundation (JPMF) and Parrish Medical Center (PMC) Auxiliary awarded $23,500 in scholarships to 10 outstanding college students and graduating high school seniors that distinguished themselves through passionate dedication to their communities and a pursuit of studies in the fields of medicine or healthcare. Since 1990, JPMF has awarded more than $450,000 to deserving students. Brevard Indo-American Medical and Dental Association (BIMDA), generous donor to the JPMF scholarship program, and dedicated to supporting future generations of healthcare professionals, committed funds through 2021 allowing for additional scholarships to be awarded. This year’s scholarship winners include, from Astronaut High School, Kaylynn Gil and Emma Regan; Edgewood Jr./Sr. High awardee Arun Jagarlamudi; and Titusville High School recipients Paige Murrill and Julia Simonsen. College students awarded scholarships include Eboni Arnold, University of Miami; Maddalena Fairchild, Florida Institute of Technology; Brooke Kelleher, Florida Gulf Coast University; Gabriella Lloyd, University of North Carolina; and Kayla Ouellette from Eastern Florida State College. Thanks to BIMDA’s support, Eboni Arnold, Arun Jagarlamudi, Gabriella Lloyd, Paige Murrill and Julia Simonsen were each awarded additional scholarship funds. Scholarship committee chair Barbara Terhune led the committee through the process of evaluating applicants in the areas of academic performance, awards and honors,
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JUNE 2021
ing,” said Krysta Rhoades, who lives in Deltona and is due to deliver her first baby this month. “I love that the rooms have large, curved sinks so the parents can help bathe the baby for the first time. I’m really looking forward to that.” The Baby Place is designed to make mom and baby’s first hours together special in a convenient location for families.
extracurricular activities, leadership, community service and work experience, recommendation letters, application essay and PMC/JPMF affiliation. “This year’s scholarship recipients were again exceptional and we look to them to lead the next generation in shaping the future of healthcare,” said Matthew Morak, JPMF Director. “I would also like to extend heartfelt thanks to BIMDA; Ron Norris Honda, Ford, Buick & GMC; Barbara and Terry Terhune; and Rachel and Bill Terry for their generous scholarship gifts which allowed for additional students to be awarded.” Committee members include Santi Bulnes; Deborah Cox; Dot Hudson; Terry Lee; Bill McCarthy; Josh Norris; Howard Rinker, DDS; Natalie Sellers; Philip Simpson, PhD; and Barbara Terhune, committee chair. JPMF is investing in the future by awarding medical scholarships to residents in North Brevard County who are pursuing careers that one day will provide healing to our community.