January/February 2023 Arkansas Medical News

ON ROUNDS

Innovation in Ophthalmology

Steven Vold bringing the industry’s best practices to Northwest Arkansas

Ophthalmologist Steven Vold is bringing the industry’s most innovative services to Northwest Arkansas. A world renowned destination for complex glaucoma and cataract surgeries, Vold Vision has provided clearer vision to patients visiting from all 50 states and more than 20 countries.

Article on page 2

Zubair Ahmed on Improvements in

Cardiovascular

Treatment in NWA

COVID has brought its own challenges

Zubair Ahmed, MD, an interventional cardiologist at Washington Regional Cardiovascular Clinic, part of the Walker Heart Institute, was born and raised in Pakistan with three sisters.

Article on page 3

Please find more local Arkansas healthcare news beginning on page 8.

January/February 2023 >> $5

December 2009 >> $5

Baptist Health First in State to Adopt SherpaPak® Cardiac Transport System

By BECKy GILLETTE

The Baptist Health Heart Failure and Transplant Institute has performed almost 320 heart transplants in its 32-year history. Starting this past September, Baptist Health became the first transplant center in Arkansas to adopt the use of the SherpaPak ® Cardiac Transport System (CTS) from Paragonix Technologies that is easier for medical personnel to use to prepare the heart for transport and less damaging to the organ.

Baptist Health Transplant Institute Program Director John Ransom, MD, said given the scarcity of donor hearts, it is vitally important to do everything possible to preserve hearts during transport.

“This device allows us to preserve the heart in a more natural state, ultimately better serving the patient with improved technology,” Ransom said.

The previous method of transporting hearts was in a bag of solution surrounded by ice.

“The major advantage of this device is that the organ is suspended in a solution and surrounded by the SherpaPaks, which maintain a constant temperature between 4-6 degrees Celsius, which is ideal for the transport of the heart,” said Karol Mudy, MD, heart transplant surgical director, Baptist Health Heart Failure and Transplant Institute.

The No Surprises Act is Full of Surprises

Legislation had problems from the get-go

By LyNNE JETER

The No Surprises Act (NSA), which went into effect Jan. 1, 2022, to protect patients from an estimated 12 million surprise bills annually, has been fraught with challenges, with medical professionals calling at least one of its processes flawed and ineffective.

“While the goals of consumer protection, price transparency, and

cost concessions are important and necessary, the legislation is starting to present real challenges to practices’ financial stability,” said Dan D’Orazio, CEO of Sage Growth Partners, a national consulting firm for healthcare organizations.

The NSA applies to employersponsored health plans for certain

(CONTINUED ON PAGE 6)

PhysicianSpotlight

Innovation in Ophthalmology

Steven Vold bringing the industry’s best practices to Northwest Arkansas

By MELANIE KILGORE-HILL

Ophthalmologist Steven Vold is bringing the industry’s most innovative services to Northwest Arkansas. A world renowned destination for complex glaucoma and cataract surgeries, Vold Vision has provided clearer vision to patients visiting from all 50 states and more than 20 countries.

Starting out

A native of rural South Dakota, Vold was introduced to the world of medicine in junior high while working as a nursing home orderly. “As a minister, my dad knew a lot of doctors and introduced me to an ophthalmologist,” he said. “I liked how it was a technological field that transformed people's lives. It was a perfect fit for me.” After graduating from Concordia College in Moorhead, Minnesota with a bachelor’s degree in biology, Vold attended the University of Minnesota Medical School in Minneapolis, graduating as a member of the Alpha Omega Alpha Honor Medical Society, a group that recognizes the top ten percent of medical students in the nation. He then completed an ophthalmology residency and a glaucoma fellowship at the Northwestern University Medical School in Chicago, where he also earned a Physician CEO™ MBA.

The road to Arkansas

Vold went on to serve as vice chairman of the Department of Ophthalmology at Baylor Scott & White Medical Center in Temple, Texas, before trading the academic setting for private practice. His search landed the young ophthalmologist at Rogers’ BoozmanHof Eye Clinic, where he served as CEO from 2008 to 2011. “It was a fantastic experience, and I learned about how to run a private practice and was able to cast my own vision for how I wanted to impact Northwest Arkansas,” he said.

Vold Vision

In 2011 he launched Vold Vision, a state-of-the-art medical facility that has been named one of the few Zeiss Centers of Excellence in the country. Staffed by ophthalmologists Vold, Dwight H. Capps, pediatric ophthalmologist Sharon Napier, and optometrists Michael McFarland, Emma Holden, Annie Avalez and Kim Santillen, Vold Vision includes a 24,000 square-foot office in Fayetteville that has become a training destination for physicians worldwide and offers

15 to 20 FDA-approved clinical trials annually. Their Bentonville office will expand in size by spring 2023. Vold Vision is consistently among the first practices in the nation to offer new ophthalmology technology and procedures in glaucoma, cornea, cataract and refractive surgery arenas, and prides itself on providing an outstanding patient experience. Vold has been the first U.S. surgeon to perform many of the new minimally invasive glaucoma procedures now available to glaucoma patients, and is known as an innovator in glaucoma, cataract and corneal refractive surgery. Vold also previously served as the Chief Medical Editor of Glaucoma

Today, the leading national publication for physicians, and co-founded the American-European Congress of Ophthalmic Surgery. He has several medical patents on devices currently being commonly utilized in surgery internationally.

Sharing his vision

In speaking to the greater medical community, Vold stresses the importance of reminding patients to schedule their regular eye exams. “Eyes are a window into a person’s health, because we look directly at the blood vessels,” explained Vold, whose exams have led to diagnoses including diabetes, leukemia and even liver cancers. “It’s a really important part of the systemic health of patients.” Vold also tells providers that eye conditions like macular degeneration, floaters and diabetic retinopathy can be treated with much more advanced care than in the traditional past.

Microstents and glaucoma

As one of the world’s leaders in minimally invasive glaucoma surgery and a lead investigator in the treatment of glaucoma, Vold is changing the stigma around a diagnosis that once meant a lifetime of medication, eye drops and poor vision. “In years past, the goal of glaucoma surgery was to keep patients from going blind, but we really want them to have better vision,” he said. Vold now offers what he calls the 20/20 experience using minimally invasive microstents that allow glaucoma patients to get back on their feet almost overnight. Vold credits the technology for revolutionizing ocular health over the past few years. Operating in 3D glasses on a big screen, surgeons can measure and look at the histology of the eye in the middle of surgery. “New technology is changing how surgery is done,” he said. “Surgeries that took hours in the past now only take a few minutes to complete. It’s pretty unbelievable.”

Evo Lens

Vold also was the first in the state to offer Evo Visian ICL Lens for patients who’ve not been a good candidate for refractive surgery in the past. “Evo lenses are for those who are moderately to severely nearsighted and whose corneas are often thin,” he explained. “With Evo you put a little reversible lens in and can get the most nearsighted patients out of glasses.”

More options for patients

In 2016, Vold became the first eye surgeon in Arkansas to offer SMILE (Small Incision Lenticule Extraction) advanced laser treatment for astigmatism and nearsightedness. “It’s a mind-boggling procedure that only

requires a two to three millimeter incision without a corneal flap, no down time and is extremely safe,” he explained. Vold Vision also offers laser retina surgery, corneal transplantation, oculoplastic surgery and pediatric surgical procedures in addition to the most advanced surgical technology in glaucoma, cataract/lens and refractive surgery available. Clear lens exchange is performed in less than 10 minutes per eye and often gets patients in their 40s and 50s out of glasses for good.

“It’s been a complete game changer for patients,” Vold said.

A healthcare destination

Vold’s commitment to innovation places the Arkansas practice among the nation’s most elite, often drawing patients from prestigious academic medical centers. “Patients are willing to drive here from across the U.S. to obtain surgical procedures not available at even the most prestigious academic institutions,” said Vold, an international speaker who has performed surgeries in more than 20 countries. “Patients and tech companies also prefer a smaller practice, where you don’t have to jump through so many hoops to participate in FDAapproved clinical trials. We are often more cost effective for patients as well.” And while Vold’s commitment to innovation draws patients worldwide, his dedication to the local community has made the ophthalmologist a household name. Vold Vision has served as the official eye care provider of the Arkansas Razorbacks as well as the Northwest Arkansas Naturals, the region’s Minor League Baseball club, for a decade. “Taking care of all these athletes and coaches is an incredible privilege,” he said. “It’s been an unreal ride.”

Giving back

Vold also believes in giving back to the community his family calls home. The Vold Vision Foundation helps fund eye care services for those who might otherwise go without. The father of six also founded special needs non-profit Sarah’s Song in honor of his daughter with Down Syndrome and is developing a 35-acre retreat center in Yellville, Arkansas for team building, seminars and family workshops. “I’ve had a charmed life and it’s been really fun, but giving back is another way to care for other people and have an impact,” he said. “I want to really make a difference in people’s lives.”

In years past, the goal of glaucoma surgery was to keep patients from going blind, but we really want them to have better vision.

– Steven Vold

PhysicianSpotlight

Zubair Ahmed on Improvements in Cardiovascular Treatment in NWA

COVID has brought its own challenges

By BECKy GILLETTE

Zubair Ahmed, MD, an interventional cardiologist at Washington Regional Cardiovascular Clinic, part of the Walker Heart Institute, was born and raised in Pakistan with three sisters. As the only son, he went into medicine to fulfill his parents’ wishes.

“My father was a commander in the navy and worked as a software engineer,” Ahmed said. “My grandfather had a heart attack in the 1980s and the treatment offered was bed rest with pain medications. He did not survive 48 hours, which had a significant effect on our family. My father wished for me to be trained in the best place in the world to become a cardiologist and be able to serve people to make a difference in people’s lives. His belief was firm in, ‘And whoever saves a life it is as though he had saved the lives of all mankind.’ (Quran 5:32). This was my motivation to pursue medicine as a profession.”

Early in medical school, he was intrigued that the heart is remarkably simple to conceptualize as a pump, but has significant complex architecture ranging from electrical, mechanical and vascular components working in synchrony to maintain its function. A sudden change in normal functioning of the vasculature can lead to immediate cessation of heart function and death.

“Being able to intervene in a minimally invasive way to restore this function that is life-saving in an emergency is gratifying at a personal, professional and humane level,” Ahmed said. “The impact cardiology has on society appears to be the biggest, given the prevalence of cardiovascular disease, and it truly serves as a life-saving intervention. Being able to serve in that role as a cardiologist is a privilege that is rarely surpassed by other professions.”

After graduating among the top ten in a class of 260 at Nishtar Medical College in Pakistan, Ahmed completed his internal medicine residency at Quillen College of Medicine at East Tennessee State University where he served as chief medical resident. After completing residency, he completed a cardiology fellowship at the same institute and was appointed chief cardiology fellow. After completing the general cardiology fellowship, he trained as an interventional cardiologist at Baystate

Medical Center in Springfield, Mass., which at the time was part of Tufts University, and is now part of the University of Massachusetts Medical School.

“After finishing my interventional cardiology fellowship, I joined the University of Arkansas for Medical Sciences/Veteran Affairs Medical Center as assistant professor and director of cardiac catheterization laboratories,” Ahmed said. “After working for four years in Little Rock, I moved to Fayetteville and joined Washington Regional in 2016.”

Currently, he serves as the director of cardiac catheterization laboratories and practices as a structural/ interventional cardiologist at Washington Regional’s Walker Heart Institute. His scope of practice and interests include vascular interventions for arterial and venous disease, complex coronary interventions, minimally invasive heart valve replacement and repair including TAVR, MitraClip and septal defect closures.

Ahmed said among all medical fields, the cardiovascular specialty remains at the forefront for advancements in technologies with remarkable breakthroughs achieved across a wide spectrum extending from cardiovascular imaging to bioengineering mechanical products. Some examples include minimally invasive procedures like transcatheter aortic valve replacement (TAVR) where a new heart valve is implanted without open heart surgery, and the patient is typically able to go home the next day with a new heart valve and without a scar.

“Other breakthroughs are in procedures like MitraClip for patients with a malfunctioning mitral valve who otherwise would have no options left,” Ahmed said. “This minimally invasive technique leads to mechanical repairs done just with access through a vein in the leg. For patients who are at high risk of stroke due to atrial

fibrillation not caused by a heart valve problem, the WATCHMAN™ Implant is a minimally invasive procedure that gives patients a permanent alternative to blood thinners.

“There are also lasers, mechanical drills and stents to open up blockages in blood vessels of the heart and limbs which allow the blood supply to be restored. These technologies allow the vessels to be accessed through a 2 mm entry point in the wrist or groin. Artificial heart pumps continue to be miniaturized and can be temporarily placed in emergency situations through blood vessels in the groin. Within minutes of placement, these devices can take over the pumping function of the heart. These are only some of the technologies that have evolved in recent years.” There are concerns about people who can have long-lasting health problems from a COVID infection. Ahmed said although the percentage of people affected with symptoms of long COVID beyond a year is low, this becomes a sizable group because of the large number of people who have been infected.

“Cardiac symptoms most commonly described are shortness of breath, fatigue, fast heart rates and chest pains,” Ahmed said. “While the incidence of true cardiac involvement as a direct effect of COVID remains low, it does lead to significant debility in both the short term and long term. Research is currently limited, but initial data suggests that people with more severe acute COVID infections have more risk of developing cardiac problems and that milder infections are less likely to cause long-term cardiac problems.”

As the medical community continues to learn and understand the long-term effects of COVID, there has been recent hope based on research that suggests continued improvement in long COVID symptoms even beyond a year. To support patients

experiencing symptoms, Ahmed encourages continued exercise to build endurance, pulmonary rehabilitation, a thorough cardiac evaluation and continued follow-up with caregivers.

Ahmed also works to encourage lifestyle changes in patients to encourage people to lose weight and better manage their cardiovascular health. His personal strategy to address this issue with patients includes providing education and helping patients build confidence.

“A positive outcome depends on patients understanding and accepting the fact that obesity contributes to numerous health issues, including cardiovascular disease,” Ahmed said. “Some patients mistakenly believe that decreasing their caloric intake alone can help them lose weight. Educating the patient about the need for diet with exercise is important. Setting realistic goals and expectations can go a long way in helping patients be persistent and persevere in creating long term overall lifestyle changes. Clearing myths about magical weight loss pills and other expensive dietary plans are also important.”

He is concerned that childhood obesity remains a pandemic. The earlier intervention occurs, the better from a cardiovascular standpoint.

Recent studies done by the Northwest Arkansas Council suggest that the number of medical specialists in the region, including cardiologists, is lower per 10,000 residents when compared to other areas across the country.

“As Northwest Arkansas has the state’s highest population growth, cardiology practices in our community are at times challenged, but Washington Regional’s Walker Heart Institute continues to grow with active recruitment strategies in place to keep up with the growth and demand,” Ahmed said.

“At Washington Regional’s Walker Heart Institute, we have a great group of cardiologists, advanced providers, nurses and support staff with a patient focused commitment to offer the latest and best in care to the community. It’s one big family here where individuals help each other out and make it a great place to be.”

Ahmed said his goal and vision to improve cardiovascular outcomes in Northwest Arkansas are supported by the administration.

(CONTINUED ON PAGE 7)

Zubair Ahmed

The SherpaPak ® CTS paired with the Paragonix app and web portal provides constant temperature and location tracking with realtime updates to the transplant team, information that is critical for this complicated surgery.

According to a recent report comparing post-transplant outcomes between the device and ice storage, investigators noted a one-year survival rate of 96.4 percent in patients where the Paragonix system was used, translating to an increase of 8.7 percent in one-year survival when compared to traditional ice transport.

Mudy said the heart does not keep beating during transport. It is considered cold ischemic time. The quicker the heart is transplanted into the recipient, the better. Mudy said they try to keep the time to under four hours.

In 2022, Baptist Health transplanted nine hearts as the state's only active adult heart transplant program. The center’s largest number to transplant in one year was 20.

Successful heart transplants can add many years to someone’s life while also improving their functioning and enjoyment of life. “Many of our transplanted patients live a normal, quality life,” Mudy said.

There are currently an estimated 3,400 people in the U.S. waiting on a heart transplant. In 2022, there were 4,111 heart transplants across the country. About one in three transplants were done with the SherpaPak® CTS transport system.

Ransom encourages people to consider signing up to be an organ donor.

“Hearts have always been a precious resource,” Ransom said. “Giving someone else the gift of life is one of the most selfless things a human can do. All it takes is answering one question on your driver's license, ‘Yes’."

There have been concerns about some people having long-lasting cardiac effects after coming down with COVID-19. Ransom said the aging population is currently identified as a greater factor of need than COVID. However, he said we do not yet fully know or understand all of the lasting effects COVID has had on the population.

Baptist Health has the only program in the state offering all advanced heart failure therapies to adults in the state. One other option is the left ventricular assist device (LVAD) device that helps keep someone’s heart beating.

“To us, there are no disadvantages to the LVAD,” Ransom said. “Currently the success rate of LVADs, even though not quite equal, are approaching the success rates

of transplant. Both advanced heart failure therapies help save lives and both carry inherent risk. The LVAD is a mechanical pump that helps keep your blood pumping through your body when your native heart is failing. A heart transplant is putting a foreign object in your body, which is naturally designed to reject it. Both are excellent therapies, which give us choices on how to help the individual with the best option at the time.”

Ransom has been performing cardiac surgery at Baptist Health for over 40 years. He became interested in heart transplants in the late 1980s when he saw the need to better help patients in Arkansas. He helped perform the state's first heart transplant in 1989.

As the need kept growing to save these patients, Ransom looked for ways to help bridge the patients to a transplant. In 1999, he implanted the first mechanical circulatory support device (MCS). As the heart failure population started growing, he saw the need to increase the use of MCS devices with bridge therapy and destination therapy. In 2008, he implanted the first HeartMate 2 in Arkansas as a destination therapy for heart failure

patients. Then in 2015, seeing the need grow further, Ransom became a part of developing the next generation of HeartMate, the HeartMate 3. As part of this clinical trial, Baptist Health was a Top 5 enroller of the trial and has been instrumental in its development.

For as long as he can remember, Mudy has dreamt of becoming a heart surgeon. “This desire cleared and solidified even more during my

clinical rotations while at medical school and in residency training,” he says. “I believe that no single person is more important than the team, learning starts outside your comfort zone, and the single most important trait of a good surgeon is humility.”

For more information about Baptist Health heart health services, call Baptist Health HealthLine at 1-888-BAPTIST or visit BaptistHealth.com

1

John Ransom Karol Mudy

According to a recent report comparing post-transplant outcomes between the device and ice storage, investigators noted a one-year survival rate of 96.4 percent in patients where the Paragonix system was used, translating to an increase of 8.7 percent in one-year survival when compared to traditional ice transport.

IMPROVING ACCESS TO TREATMENT IMPROVING ACCESS TO TREATMENT

for oPIoID USE DISorDEr

In collaboration with the Arkansas Department of Human Services, the UAMS Center for Addiction Services and Treatment (CAST) is providing funds to facilities across Arkansas offering medication-assisted treatment to patients with opioid use disorder. The money will allow medical providers to offer treatment to patients without insurance or the ability to pay for services.

Medication-assisted treatment involves the use of medication to relieve cravings and withdrawal symptoms along with counseling and support to overcome the

use of opioids. This includes methadone, which can only be dispensed through an opiate treatment program, products containing buprenorphine that require a federal waiver for prescribers and injectable naltrexone, which does not require special qualifications for prescribing.

The funds will cover expenses including the cost of medication, hiring peer support specialists, providing treatment services and even travel costs for patients using medication-assisted treatment.

To learn more about these funds and how to receive them: call (501) 526-8459 or (833) 872-7404 or e-mail Anner Douglas at ADouglas2@uams.edu.

The No Surprises Act, continued from page 1

emergency services and those received from out-of-network providers at innetwork facilities regarding balanced billing. The act doesn’t apply to outof-network providers at out-of-network facilities. Providers risk a penalty of up to $10,000 per violation.

“If a patient requests it, even physician offices are required to provide a good faith estimate,” said Matt Clements, CFO of Sage Infusion, a Type 1 diabetic well-versed in clinical visits. “One day soon, upfront pricing may be a requirement for all practices.”

The Benefit Claim Process

The benefit claim process is wieldy and time-sensitive and -consuming. When negotiation doesn’t resolve the dispute, the NSA provides for an arbitration process, Independent Dispute Resolutions (IDR).

The Centers for Medicare and Medicaid Services (CMS) anticipated 22,000 IDR appeals in 2022. Yet within the first six months of the law going into effect, more than 90,000 IDR appeals were initiated. What’s more, only 3,500 determinations had been made by mid-December.

The Trouble with IDRs

Under the IDR process, a strictly controlled baseball-style arbitration for disputing unreasonable reimbursement amounts with insurers, a provider must initiate open negotiations within 30 days of receipt of the payment or notice of denial.

“If open negotiations fail, then the IDR process is initiated within four days of the end of the 30-day open negotiation period,” said Michael Lowe, a board-certified health law attorney at Lowe & Evander, PA, in Florida. “IDR is initiated by issuing notice to the other party and the HHS Secretary. The parties have three business days from the initiation of the IDR process to jointly select (the arbitrator). If the parties fail to agree on the IDR entity, then the HHS Secretary shall select the IDR entity within six business days from the initiation of the IDR process. After the IDR entity is selected, within 10 days from the selection, the parties must submit the amount(s) desired -- their offer -- along with any supporting evidence or documentation required. After the submission, the IDR entity must choose one of the two offer amounts.”

Here’s the rub: “There are only 13 IDR entities (arbitrators) and only 11 accepting new disputes, which is simply not enough,” said Christine Cooper, CEO of aequum LLC and the co-managing member of Koehler Fitzgerald LLC, a law firm with a national practice. “The IDR process is also occurring piecemeal. Appeals are initiated in

the federal portal; every other step is managed by the IDR entity. Each IDR entity manages the process differently, some by email, some by their own portal. Progress is difficult to track and monitor, and some IDR entities have failed to follow deadlines. Rather, they pause the acceptance of offers upon receipt of new disputes. It’s been very difficult to communicate with the IDR entities, as most don’t respond to phone calls or emails.”

Physicians will not only need to become savvy at submitting bids to receive more favorable reimbursements, but also because the loser in the arbitration may be required to cover fees for both parties, said D’Orazio.

To add to the uncertainty, the IDR rules keep changing.

“Early (in 2022), several state medical associations and air ambulance companies filed suits about the interim final rule that bases appropriate reimbursements on insurers’ qualifying payment amounts (QPA),” he said. “In April, CMS retracted its stance on just how much weight QPAs should carry in arbitrators’ decision-making.”

More Legal Woes

Last February, Eastern District of Texas Judge Jeremy Kernodle agreed with the Texas Medical Association that the Department of Health and Human Services (HHS) interim final rule governing the IDR process conflicted with the NSA statute when it created a rebuttable presumption that the QPA was the correct out-ofnetwork rate for purposes of the IDR process, explained Cooper.

In September, the Tennessee Advisory Commission on Intergovernmental Relations revealed that it was studying “the overall effect on health insurance prices when reference-based pricing is used.” Tennessee may be the latest state to adopt reference-based pricing to control healthcare costs, noted Cooper. (The final report had not been presented by press time.)

“Several other states have adopted reference-based pricing and are successfully using it,” said Cooper. “The most well-known is Montana, which became the first state to use referencebased pricing for all of its employees’ health benefits. Other states that have adopted reference-based pricing include California, Oregon, Colorado, and Washington. Each of these states was armed with the experience of Montana.”

Reference-based pricing is a way to avoid the uncertainty the NSA is creating, said Cooper.

“We anticipate seeing a broader adoption of reference-based pricing plan design both for public entities and

private corporations,” she said. “It’s a true cost control mechanism that brings uncertainty to the plans and the providers.”

Woes Before NSA Became Law

In November 2021, congressional doctors, their medical associations and members of Congress led the charge that the rule released by the Biden Administration two months earlier for implementing the law, favored insurers and didn’t follow the spirit of the legislation, wrote Michael McAuliff for Kaiser Health News.

“The Administration’s recently proposed regulation to begin implementing the law doesn’t uphold Congressional intent and could incentivize insurance companies to set artificially low payment rates, which would narrow provider networks and potentially force small practices to close, thus limiting patients’ access to care,” wrote Rep. Larry Bucshon (R-Indiana). Roughly half of the 152 lawmakers who signed the letter were Democrats.

“The doctors in Congress are furious about this,” a staff member told McAuliff.

Cooper said it was clear that providers would take issue with the language in the Rule creating a rebuttable presumption that the payor’s median contracted rate is the proper reimbursement rate for claims governed by the NSA, ignoring the other factors listed in the NSA.

“The median contracted rate is solely within control of the payors and it stripped the providers of any say,” said Cooper. “In addition, the providers likely understood that the IDR entities would naturally select the offer closest to the median contracted rate because they’re on a tight timeline and couldn’t reasonably process the number of claims they would be receiving if they had to evaluate each factor

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listed in the NSA and provide a written opinion as to why they deviated from the median contracted rate.”

Reference-based pricing is a way to avoid the uncertainty the NSA is creating.

– Christine Cooper, CEO, Aequum LLC, Co-Managing Member, Koehler Fitzgerald LLC

Zubair Ahmed, continued from page 3

Letter To The Editor

Dear Editor,

My name is James Raker and I have been a chiropractic physician for 35 years, practicing at the Ark-La-Tex Health Center in Texarkana, Arkansas. I have personally witnessed the benefit of spinal manipulations on patients and know that they have been able to avoid drugs & surgery because of chiropractic treatments.

I am reaching out to Arkansas Medical News readers who I understand to be primarily physicians and nurses and asking, do you refer patients to chiropractic care? I have worked with and treated several physicians in my practice. Those I do treat, know the benefits. For your patients, appropriate conditions for referral would be those with low back pain, neck pain, headaches and pain/tingling into the arms and legs.

“We’ve been able to offer many ‘firsts’ in the region,” he said. “Examples range from the successful launch of minimally invasive structural heart interventions like TAVR and Watchman appendage closures in the past few years, to being the largest cardiovascular center in Northwest Arkansas in terms of volume and providing these technologies to our patients. In late January, we had the first mitral valve repair done with a minimally invasive mitral clip procedure in Northwest Arkansas, another milestone and achievement only made

possible by the support of the dedicated staff and colleagues at Washington Regional. The opportunity to help start these programs and then be part of the journey is a blessing and matter of pride professionally.”

Ahmed has been married for 15 years to Umbar Ghaffar, MD, a nephrologist at Renal Specialists of Northwest Arkansas. They have a daughter, Mishaal, 14, in the 9th grade at Haas Hall Academy and a son, Musa, 11, in the 6th grade at The New School. In his free time, Ahmed likes to travel and read fiction.

Here’s some history you may or may not be aware of. In the 1970's the American Medical Association (AMA) tried to destroy the chiropractic profession by literally branding them quacks and telling all member MD's that to associate with a DC (Doctor of Chiropractic) in any way would result in a loss of hospital privileges, expulsion from any medical society, and other consequential actions. After a decade long court battle titled Wilk vs AMA, the Illinois Supreme Court found the AMA, AOA, ACR, and AHA all guilty of conspiring to illegally boycott and eliminate the chiropractic profession and ordered a permanent injunction against further activity.

Where does that leave the U.S. medical system some 40 years later? Somewhat better. However, even though the AMA later published that "spinal manipulation" was an accepted treatment of spinal conditions, and every medical guideline written since the 1990's from the U.S., England, Australia, Europe, etc... including the most recent one by the American College of Physicians in 2017, have stated the same treatment recommendations for low back pain which are:

• First: NSAIDS and manipulation.

• Second: opioids and other meds.

• Third: injections.

• Fourth: surgery

BUT how is this done in real life? Often the first recommendation is skipped and we go for the second through fourth recommendations. This, in part, has contributed to the opioid crisis that has plagued our nation the last few years. One way to turn that around is consider referring patients to chiropractic care.

Consider this: Chiropractic Physicians are just that - physicians with general practitioner skills specializing in musculoskeletal problems. They are working within the VA Hospital system and active military bases abroad. DCs are accepted as providers by the Federal Work Comp, Medicare, Medicaid, all commercial insurances. They are accepted to do Federal Dept of Transportation physicals, and private pilot physicals. Many DCs are even board certified in Radiology, Internal Medicine, Occupational Medicine, etc.... DCs are working in hospitals, on the Olympic Medical Team, and most pro sport teams have DCs on staff.

I’m asking Arkansas medical professionals to consider sending more patient referrals to DCs. If we work together, we can help certain patients avoid opioids and surgery. DC malpractice insurance is cheaper than any other kind of doctor, so we know safety is not an issue. We are trained to take the musculoskeletal cases that most general practitioners hate, and do very well with them using the recommended treatment of manipulation (which physical therapists can't do legally) combined with exercise to have generally better results than other groups of practitioners.

I am well connected with DCs all over the state. I’d be happy to recommend a DC in your area who can help your patients who would benefit from chiropractic care. Please call or email me using the information below. I’d be happy to discuss how we can partner together to help some of your patients.

jraker@arklatexhealthclinic.com

James D. Raker, DC, FADP, CME, CWP 870-773-7246,

James Raker

Washington Regional TAVR team: Erick Isaacson, DO (anesthesiologist); Zubair Ahmed, MD (interventional cardiologist); Kari Schrank, APRN (structural heart program coordinator); Charles Cole, MD (cardiovascular and thoracic surgeon); Russell Wood, MD (cardiovascular and thoracic surgeon); Scott Chism, MD (interventional cardiologist)

GrandRounds

Dr. Michelle Krause to Lead UAMS Health System & Hospital; Dr. Ahmed Abuabdou Named Chief Clinical Officer

LITTLE ROCK — The University of Arkansas for Medical Sciences (UAMS) has named Michelle W. Krause, MD, MPH, senior vice chancellor for UAMS Health and chief executive officer for UAMS Medical Center, and Ahmed Abuabdou, MD, MBA, chief clinical officer for UAMS Medical Center. Both have been serving in these roles on an interim basis since September 2022.

“Dr. Krause has been at UAMS for more than 20 years and led both our COVID-19 testing and vaccination efforts and helped lead the implementation of our operational surge plans for caring for additional hospitalized COVID patients,” said UAMS Chancellor Cam Patterson, M.D., MBA. “Her clinical expertise, administrative experience and institutional knowledge make her the ideal leader for our statewide health system. She is well versed on the health care needs across Arkansas.

“We are fortunate to have two established leaders from within UAMS to step into these roles,” he said. “Their leadership and perspectives will be particularly valuable in our efforts to achieve our strategic goals to make Arkansas a healthier state and grow our national reputation for excellence.”

Krause is responsible for UAMS Health’s 535-bed hospital, outpatient clinics in central Arkansas, digital health services and clinics at eight regional campuses across the state. She serves as chair of the board of directors of the Baptist Health-UAMS Accountable Care Alliance and is also a professor in the UAMS College of Medicine.

Krause joined UAMS in 2002 and served in several administrative roles including ambulatory medical director and vice chair for Clinical Programs of the Department of Internal Medicine before being named director of the Integrated Medicine Service Line in 2015. In April 2022, she was named chief clinical officer and served in this capacity before taking on her current role.

She received her medical degree from the University of Cincinnati College of Medicine and completed her internal medicine residency at the

University of North Carolina. She completed fellowships in nephrology and research nephrology at the University of North Carolina and earned her master’s in public health in epidemiology at the University of North Carolina School of Public Health.

As chief clinical officer, Abuabdou will facilitate medical staff interactions with UAMS Health leadership and among service lines to ensure effective and efficient care delivery. He also has executive operational oversight of the clinical service lines and chairs the Clinical Leadership Council.

“Dr. Abuabdou has served in this new role on an interim basis for the past four months and has strong relationships with staff at all levels that help ensure we provide excellent patient care to all patients at all times,” said Krause. “As a trusted member of the UAMS Health leadership team, he will play an essential role in navigating our clinical operations through the opportunities ahead.”

Abuabdou joined UAMS in 2012. He is an associate professor of medicine at UAMS and previously served as associate chief medical officer. He also leads the UAMS Physician Advisor Group. He completed medical school at Gulf Medical College, United Arab Emirates, earning Bachelor of Medicine and Bachelor of Surgery degrees. He completed an internal medicine residency at St. Elizabeth Health Center in Youngstown, Ohio, and then completed a fellowship in blood banking and transfusion medicine at UAMS. He has a Master of Business Administration from the University of Arkansas at Little Rock. Nationally, Abuabdou serves as the vice president of operations for the American College of Physician Advisors.

Jefferson Regional Executives, Marketing Department Take Home AHA Awards

PINE BLUFF - Jefferson Regional in Pine Bluff was recently recognized with multiple awards at the 2022 meeting of the Arkansas Hospital Association (AHA).

Jefferson Regional President & CEO Brian Thomas received the Alan A. Weintraub Memorial Award, the AHA’s highest award bestowed on an individual. Senior Vice President/Chief Operating Officer Peter Austin received the ACHE Regent’s Award for Senior Level Healthcare Executive, and Quality Director Erin Bolton received the Distinguished Service Award for her leadership during the COVID pandemic.

Jefferson Regional also received two Diamond Awards, a competition sponsored by the AHA and the Arkansas Society for Healthcare Marketing and Public Relations (ASHMPR). Jefferson Regional won a Total Campaign award for development of a Radiology advertising campaign, and a Writing award for an article on COVID response for the AHA magazine.

Children’s Tumor Foundation, UAMS Open Country’s First Adult Neurofibromatosis Clinic

LITTLE ROCK — The Children’s Tumor Foundation (CTF) and the University of Arkansas for Medical Sciences (UAMS) announced the opening of the first CTF-sponsored, fully multidisciplinary clinic dedicated to the care of adults with neurofibromatosis (NF) at the UAMS Winthrop P. Rockefeller Cancer Institute.

“We are honored to be designated by the Children’s Tumor Foundation as the site of the first CTF-designated adult neurofibromatosis clinic in the country. We look forward to welcoming patients and

their families to our Cancer Institute, where patients already come from around the world to be treated for rare blood cancers and other diseases,” said UAMS Chancellor Cam Patterson, MD, MBA.

NF is a group of rare genetic disorders that cause tumors to grow on nerves throughout the body and affects 2.5 million people worldwide. Although there is no cure for NF, there are treatments that help manage the disease.

With a two-year commitment of $500,000 from the Children’s Tumor Foundation, the Adult NF Clinic at the UAMS Cancer Institute will be staffed with specialists who can address the complex medical needs of patients with neurofibromatosis as they navigate adulthood.

“Children with NF grow up to become adults with NF, and they experience different and complex issues that demand multidisciplinary practitioners knowledgeable to their particular needs,” said Annette Bakker, PhD, Children’s Tumor Foundation president.

“The Children’s Tumor Foundation is committed to establishing a high standard of care for NF patients across the country, and we’re excited and grateful to partner with the UAMS Winthrop P. Rockefeller Cancer Institute and Arkansas Children’s Hospital to ensure that at any given point in a NF patient’s care journey, there are resources and care options available that will improve lives,” she said.

“Until now, there was no dedicated clinic in Arkansas or surroundings states where an adult with NF could go to be treated by doctors who understood the unique challenges of their condition,” said Erika Santos Horta, MD, UAMS neuro-oncologist who specializes in brain and spine cancers and leads the UAMS Adult NF Clinic.

Piloted in October 2021, the clinic is now in full operation and treats patients 18 and older from Arkansas and neighboring states.

Among the challenges that adult NF patients face are increased risk of cancer or major tumor burden, visual and hearing deficits, bone abnormalities, pain and learning challenges. Patients may also need support with insuranceissues, job challenges, disability and many other health and quality-of-life issues.

“This new NF clinic provides a critical continuity in care for these patients, which has been desperately needed,” said Michael Birrer, MD, PhD, UAMS vice chancellor and director of the UAMS Winthrop P. Rockefeller Cancer Institute.

Adult NF care throughout the country is a significant unmet health

Michelle Krause

Jefferson Regional Quality Director Erin Bolton (left)with Jefferson Regional President & CEO Brian Thomas.

Jefferson Regional SVP/COO Peter Austin (left) with Greg Crain, ACHE Regent for Arkansas.

Ahmed Abuabdou

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care need. A majority of NF clinics in the U.S. provide care to pediatric patients, yet many adults living with NF do not have access to knowledgeable medical expertise oncethey leave the pediatric setting.

“The Adult NF Clinic at the UAMS Winthrop P. Rockefeller Cancer Institute is a 20-year dream come true," said Kathleen Sullivan, whose husband and two sons live with NF and struggled to find first-rate care as adults. “We had such excellent comprehensive care at the NF Clinic at Arkansas Children’s Hospital, but when my sons aged out and there was nothing, it was frustrating and scary. The Adult NF Clinic is an assurance of quality, comprehensive care for my family so they can lead the best life possible.”

Baptist Health Names Kelley Hamby as First System Chief Nursing Officer

LITTLE ROCK – Baptist Health has promoted longtime nursing leader Kelley Hamby to a newly created position, system chief nursing officer. Hamby most recently served as the chief nursing officer for Baptist Health Medical CenterNorth Little Rock.

Hamby began her career with Baptist Health in 1990 as a unit coordinator (IA) and in 1994 she completed the registered nurse program at Baptist Health College Little Rock and began her career as a nurse at Baptist Health Medical Center-Little Rock.

In her new role, Hamby will assist Baptist Health with strategy, standards and improving quality measures for nursing across the healing ministry.

Hamby received her Bachelor of Science in Nursing from University of Arkansas at Little Rock and Master of Science in Nursing from the Western Governors University.

Outside of her work, Hamby is active in the community, serving on the Arkansas Heart Association Board and the Workforce committee for the Arkansas Hospital Association. Additionally she serves as a member of the Arkansas Nurses Association, American Organization for Nursing Leadership (AONL) and the Arkansas Hospital Association (AHA).

Aaron Strobel, MD, Seeing Patients at Baptist Health Heart Institute/Arkansas Cardiology Clinic-Little Rock

LITTLE ROCK – Aaron Strobel, MD, is now seeing patients at Baptist Health Heart Institute/Arkansas Cardiology Clinic-Little Rock.

Dr. Strobel is a native of Little Rock. He attended college at the University of Arkansas, studying biological engineering, and then went on to earn his medical degree from the University of Arkansas for Medical Sciences.

Over the next decade, Dr. Strobel trained at the University of Colorado, where he completed his internal medicine residency, chief residency year, cardiovascular disease fellowship and was honored to be the chief cardiology fellow. Dr. Strobel stayed at the University of Colorado, completing a two-year interventional cardiology fellowship and concentrating on coronary, peripheral and structural interventions.

Dr. Strobel helps his patients in the decision-making for preventive cardiology, general cardiology, and invasive procedures including coronary stents, peripheral vascular intervention and structural heart disease.

Dr. Strobel is married with two children, and he enjoys hiking, fishing and spending time at the lake with his family. He also loves to cheer on the Arkansas Razorbacks.

To learn more about Dr. Strobel and the services he provides at Baptist Health Heart Institute/Arkansas Cardiology Clinic-Little Rock, visit Baptist-Health.com

You may need a referral from your primary care provider to schedule an appointment. If you need a primary care provider, please call Baptist Health HealthLine at (888)227-8478 to speak with a health advisor.

Dr. Allgood to Retire, Dr. Ko Welcomed

BATESVILLE –Dr. John Allgood, Radiation Oncologist at White River Health, has announced his retirement plans. As a Radiation Oncologist, he has dedicated his practice to specializing treatment plans for patients based on their individual needs. He is currently in practice at White River Health Cancer Center, previously known as WRMC Cancer Care Center.

Dr. Allgood has been practicing as a Radiation Oncologist for 22 years. Prior to his career as a physician, Dr. Allgood served in the Navy and then went on to become a Physical Therapist (PT). He worked as a PT for several years before going to medical school.

Dr. Allgood will continue seeing patients until the end of the year. Dr. Stephen Ko, Radiation Oncologist, will begin seeing patients at White River Health Cancer Center at the beginning of 2023. Patients established at the clinic do not need to take further action to transfer care. Dr. Allgood will remain at the clinic to assist Dr. Ko during the transition.

Dr. Ko has over 15 years of experience as a Radiation Oncologist working at the Mayo Clinic in Jacksonville, Florida. Dr. Ko attended the Biology Program at the University of Texas at Austin. He completed his Doctor of Medicine at the University of Texas Health Science Center at San Antonio. He completed an internship in the Department of Medicine at the University Hospital and Veterans Administration Hospital. His Residency was completed in the Department of Radiation Oncology at Irvine Medical Center at Irvine, CA. Dr. Ko is Board Certified in Radiation Oncology by the American Board of Radiology.

The White River Health Cancer Center is located at 525 Virginia Drive in Batesville. The clinic is open Monday through Thursday from 8AM to 5PM and Friday from 8AM to Noon. For more information or to make an appointment, call (870) 262-6200.

Cardiovascular Surgeon

Dr. Jay K. Bhama Joins St. Bernards, Bringing Region Unique Heart Services

JONESBORO – Cardiovascular

Surgeon Dr. Jay Bhama has joined the heart and vascular team practicing at St. Bernards Medical Center, specializing in complex surgical procedures involving the heart.

Bhama, a nationally recognized heart surgeon with significant cardiovascular experience, holds a special interest and expertise in complex, heart valve surgeries and mechanical circulatory support.

A thought leader in the field of cardiovascular surgery, Dr. Bhama previously served as Surgical Director of the Heart Center and Cardiovascular Service Line at the University of Arkansas for Medical Sciences (UAMS) in Little Rock. While there, he practiced as a Cardiovascular Surgeon and taught as a Professor in the Department of Surgery. Dr. Bhama also served as the Surgical Director of the Heart Failure and Transplant

Institute at Baptist Health in Little Rock and as the Extra-Corporeal Membrane Oxygenation (ECMO) program director at UAMS. He has practiced as a Cardiovascular Surgeon for two decades, including clinical leadership roles at the University of Pittsburgh Medical Center and the University of Iowa Health Care before coming to Arkansas in 2019.

Dr. Bhama said he sees a common thread throughout his time practicing medicine and surgery.

“Cardiovascular disease does not respect regions, ages, genders or ethnicities,” Dr. Bhama said, “but it has a particular predilection for people in Arkansas and the Mid-South region as a whole, where the incidence of heart failure deaths is steadily rising.”

The most recent CDC data cites nearly 700,000 Americans dying annually from heart disease—the leading cause of deaths nationwide at more than 20 percent. Arkansas, meanwhile, has the fourth-highest mortality rate from heart disease among all 50 states.

“Even more focused, Northeast Arkansas has some of the highest death rates from heart disease in the nation,” Dr. Bhama said. “As a surgeon, we operate at ‘Ground Zero’ in this fight, and we will employ every tool to guide patients toward better cardiovascular health. I’m proud to be part of the formidable team at St. Bernards helping patients here combat cardiovascular disease.”

St. Bernards Interventional Cardiologist Dr. Max Arroyo said Dr. Bhama joins the region’s top-ranked heart and vascular team.

“We talk about St. Bernards offering comprehensive heart and vascular services,” Dr. Arroyo said. “Regardless of the patient’s need, we have a team to meet it. Dr. Bhama has an incredible track record helping patients across the U.S., and we’re honored he chose to practice here.”

Dr. Bhama earned his medical degree from Baylor College of Medicine in Houston and completed a General Surgery residency in Baylor’s Michael E. DeBakey Department of Surgery. He completed Cardiothoracic Surgical training at George Washington University in Washington, D.C. and Johns Hopkins Hospital in Baltimore. He also completed an Advanced Cardiac Surgery fellowship at the Mayo Clinic in Rochester, Minn., and a fellowship in Cardiothoracic Transplant and Mechanical Circulatory Support at the University of Pittsburgh Medical Center.

Dr. Bhama is double board certified by the American Board of Surgery and the American Board of Thoracic Surgery. He is a Fellow of the American College of Surgeons (FACS), the American College of

Kelley Hamby

Aaron Strobel

John Allgood

Stephen Ko

Jay Bhama

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Cardiology (FACC) and the American College of Chest Physicians (FACP). He also holds a patent as a medical device inventor and serves as a reviewer for leading medical journals in his field. Dr. Bhama is Arkansas’ only Cardiothoracic Surgeon member of the nation’s prestigious American Association for Thoracic Surgery.

For more information, visit https:// stbernards.info or call the St. Bernards Healthline at 870.207.7300.

Joel C. Mosley, MD, Joins Washington Regional Emergency Department

FAYETTEVILLE — Joel “Cam” Mosley, MD, recently joined Washington Regional’s emergency department, where he specializes in treating patients with acute illnesses and injuries. He will also serve as the program director for the UAMS/Washington Regional emergency medicine residency program, which is currently being developed.

Mosley is originally from Fort Smith and previously served in Washington Regional’s emergency department from 2011 – 2014.

Mosley earned his medical degree from Ross University School of Medicine in Portsmouth, Dominica. He completed a residency in emergency medicine at Louisiana State University School of Medicine in Baton Rouge and most recently served as a clinical assistant professor of medicine at LSU Health in New Orleans.

CHI St. Vincent Releases Community Health Needs Assessment

LITTLE ROCK – CHI St. Vincent, an Arkansas-based nonprofit health system with four hospitals and a network of clinics serving Central and Southwest Arkansas, has released its three-year Community Health Needs Assessment. The report identifies significant healthcare needs in the Arkansas communities the faith-based health system serves as well as specific plans to help address those needs over the coming three years.

“This document and the areas of need we identified will serve as the foundation for our healing ministry’s strategic healthcare initiatives for the coming years, “said CHI St. Vincent CEO Chad Aduddell. “We have learned from experience that by prioritizing and planning evidence-based solutions to meet those needs, we can make the greatest possible impact on the communities we serve.”

Previous Community Health Needs Assessments identified significant health challenges in the state like substance abuse and treatment, allowing CHI St. Vincent to focus resources into projects like establishing the Addiction Recovery Program at CHI St. Vincent Infirmary in Little Rock in 2021. The latest Community Health Needs Assessment identifies the following healthcare needs that the healing ministry will focus resources into addressing over the coming three years:

• Access to Primary Care

• Access to Mental Health Care

• Basic Health Knowledge and Awareness

• Chronic Condition Education

• Domestic Violence and Human Trafficking

• Food and Nutrition Education

• Substance Abuse Treatment and Education

Some initiatives to help address these needs include the establishment of a Southwest Little Rock Mission Clinic to provide primary care and access to community care for a severely medically underserved area in Southwest Little Rock; a Connected Community Network of social, medical and behavioral health services to provide easier access to post acute care, especially for poor and homeless communities; and expanding partnerships with local law enforcement to improve public awareness and response to the growing threat of violence and trafficking in local communities.

“These are significant challenges faced by the communities we serve and while they are certainly not the only challenges, this effort allows us to focus not just our healthcare resources, but also focus on building strong partnerships to make a notable impact in these areas together over the next three years,” said Aduddell. “CHI St. Vincent is fortunate to have strong local relationships with government agencies and other groups that truly care about the people of Arkansas. Now with additional regional and national support, like the CommonSpirit Health-Human Trafficking Initiative, we can further amplify the good work already taking place.”

To identify the healthcare needs in the assessment through 2024, CHI St. Vincent solicited primary feedback from communities through Personalized Community Surveys, online surveys, public feedback forms and publicly available research like the United Health Foundation’s 2021 Report which ranked Arkansas

43rd in the nation for Access to Care. The complete Community Health Needs Assessment and correlating implementation strategies are available on the CHI St. Vincent website: chistvincent.com/health-wellness/ community-needs-assessment

UAMS First in State to Use Advanced Liver Transplant Technology

LITTLE ROCK — A liver transplant recently performed at the University of Arkansas for Medical Sciences (UAMS) was the first in the state to use groundbreaking technology that preserves donor livers and keeps them viable for an extended period of time.

The new technology allowed a Cabot man to obtain a liver from a donor in Oklahoma only a week after being placed on the waiting list and then to return home a week following the surgery.

Patient Terry Fortner, 66, said he was told when he was placed on the transplant list Sept. 24 that it could take months, if not years, for a suitable donor liver to become available in close enough proximity to UAMS to remain viable during removal, transportation and re-implantation.

His UAMS transplant surgeon, Raj Patel, MD, credited the OrganOx metra device, which uses normothermic perfusion to preserve the liver with oxygen and nutrients and then maintains the organ at body temperature for up to 12 hours, with ensuring the organ remained in prime condition for implantation.

Patel said organs begin deteriorating rapidly upon removal, and their condition upon arrival affects the difficulty of the surgery and the extent of post-operative measures such as transfusions. He said the donor liver that Fortner received though LifeShare of Oklahoma, a nonprofit organ procurement organization, was in good shape after being driven to UAMS from Tulsa, which helped prevent any major complications during the six-hour surgery that began Sept. 30 and ended early Oct. 1.

Without the technology, Patel said, Fortner may have received the same donor liver but faced a rougher recovery that required a longer stay in the hospital. He said the perfusion technology not only keeps the donor liver oxygenated but also allows surgeons to test a liver before implanting it, reducing risk to the patient.

UAMS hopes to have its own OrganOx metra device in 2023, Patel said.

“Our main goal is to increase the number of livers available, so we can test livers and do more complicated liver transplants,” he said.

Fortner, senior pastor at Zion Hill Baptist Church in Cabot, said he was diagnosed five or six years ago with nonalcoholic fatty liver disease, an increasingly common condition worldwide that has been called an American epidemic and is linked to poor diet and obesity. He said he weighed 340 pounds before, in 2020, “my gastroenterologist convinced me to take this thing seriously.”

Dietary adjustments helped Fortner slowly lose weight while undergoing bloodwork every six months to monitor the disease’s progression. Then in July, the blood tests showed Fortner would soon need a liver transplant, and his doctor sent him to UAMS.

Fortner said the UAMS team “put me through every imaginable test” in preparation for being placed on the transplant list, which occurred while he was hospitalized for a fever and his situation suddenly worsened.

Patel said patients like Fortner who have lived with a liver disease diagnosis for several years often take a turn for the worse very quickly, and the situation is very precarious, with some patients eventually becoming too sick to receive a transplant.

Then on the night of Sept. 29, he heard the good news — “They said, ‘We’ve got a match.’”

Fortner and his family spent all day Sept. 30 waiting for the donor organ to arrive and be readied for transplant, and the surgery began late that night.

Five weeks later, and now down to 243 pounds, he said, “I feel amazingly well.”

Fortner said he and his wife, Robbie, have four grown children, five grandsons and one granddaughter, “and we’re all extremely happy that I’m still here.”

“I give God the credit for these answered prayers,” Fortner said. “He works miracles through these doctors. UAMS is full of absolutely wonderful, professional, caring people.”

“Even right down to the people that come in and clean the rooms,” added his wife, Robbie.

LifeShare is the first organ procurement organization in the United States to own and operate the OrganOx metra device, which was approved by the FDA in January for use in transplants and was first used in May in Oklahoma.

“LifeShare is proud of the work we have accomplished to advance liver perfusion in the donation and transplantation field to save more lives,” said Jeffrey Orlowski, president and chief executive officer of LifeShare. “It is partners like the University of Arkansas for Medical Sciences that make efforts possible.”

Joel "Cam" Mosley