Austin Medical Times by Rick Delarosa

April Issue 2019

Inside This Issue

Dell Medical School, OnlineMedEd Providing Online Courses to Teach High-Value Care Delivery to Current, Future Doctors

I Helping Vets Deal with Chronic Pain Without Opioids See pg. 9

INDEX Financial Forecast............. pg.3 Legal Matters........................ pg.4 Oncology Research......... pg.5 Mental Health...................... pg.6

Texas HHS Pushes Innovations in Making Aging Friendly Communities See pg. 11

n a shared effort to improve the value of care that is delivered in today’s health care system, Dell Medical School at The University of Texas at Austin and medical education platform OnlineMedEd are teaming up to teach medical students, residents and other providers about value-based care through online teaching modules, now available at https://onlinemeded. org/vbhc. The Discovering Value-Based Health Care learning modules, which are developed by Dell Med faculty members and students, focus on maximizing health outcomes that matter to patients while lowering costs in health care. “Most medical schools don’t teach students about how to reduce waste or what certain procedures and treatments cost for patients – knowledge that helps doctors and patients have more meaningful conversations about treatment options and avoiding harm,” said Christopher Moriates, M.D., Dell Med’s assistant dean for health care value and an associate professor in its Department of Internal Medicine. “We hope that by spreading what we’ve learned about providing high-value care through online modules, this will make these critical lessons more accessible and useful to faculty and students alike,” he said. “Most importantly, the ultimate benefit of focusing on and teaching value-based health care is we have the potential to shift the quality of health care delivered by an entire generation of medical trainees.” A 2013 survey of medical students conducted by the Association of American Medical Colleges showed

that only 15 percent of internal medicine residency programs reported encountering any curricula related to costs or value. “While many medical schools have

than 150,000 learners every month and is one of the largest online communities of medical students and professionals in the world. Although the Value-Based Health Care course supports students and residents, it is also designed to help physician assistants, faculty members and other clinicians to improve health care value. “OnlineMedEd shares a common goal with Dell Medical School to make better medical education as widely available and accessible as possible,” Dustyn Williams, M.D., lead educator of OnlineMedEd. “I’m thrilled to work with Dell Medical School to deliver world-class content in value-based care.” D e l l Med’s Texas Health CoLab, a hub for product innovation and entrepreneurship, orchestrated the sharing of these training modules with OnlineMedEd in an effort to transform the culture, strategy and goals of organizations to deliver high-value care.

Most medical schools don’t teach students about how to reduce waste or what certain procedures and treatments cost for patients – knowledge that helps doctors and patients have more meaningful conversations about treatment options and avoiding harm —Christopher Moriates, M.D. since begun to integrate programs about value in health care, there’s still a global need for robust training programs for medical students and residents,” Moriates said. OnlineMedEd is used by more

see Dell Medical ... page 14

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April 2019

Austin Medical Times

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Financial Forecast Credit Cards on File to Reduce Time in Practice Receivables By Reed Tinsley, CPA CVA, CFP, CHBC

• The patient’s name

re you facing an increase in A/R costs? Changing your processes to include electronically storing patient credit card numbers could help you to reverse that trend. This could potentially trim days in A/R from 90 to 30. By the time the insurance company responds to a claim, you may already be approaching 90 days in A/R. But for the out-of-pocket portion, having a card on file can reduce days in A/R to only 30. A card on file can also automate patient payment plans, and an online payment portal provides an added convenience for patients. How to craft your financial policy Having a card on file removes an obstacle to receiving payment, and patients knowing that a card is on file adds a layer of financial responsibility. They can’t just ignore the balance. Make sure that your patients sign a pre-authorization form. Your form should include:

• Type of credit card • Billing address • Credit card number • CVV on the back • Expiration date The form can also allow the patient to elect to be billed by a mailed paper statement with the stipulation that if payment is not received by the due date, then the credit card on file will be charged. Got more questions about getting cards on file? Here are some answers: Keep it simple and direct. To avoid offending your patients, put it in your financial policy in bold print and explain it as a service to help avoid billing hassles when the remaining balance comes due. Inform patients of account balances. After the insurance responds and to avoid surprising patients with charges, let them know that you would

like to bill for a balance to the card within 48 hours. Treat it as a courtesy and give them time to provide another form of payment. Scan credit card information into your EHR. Then, destroy hard copies for an added layer of security. Call your merchant services company (the one that gave you the card readers) to ask about features that protect stored information. This not only streamlines the process but also transfers the

security responsibility. Be firm and consistent. Don’t present the policy as an option but be willing to address it on a case-by-case basis. Some patients aren’t certain of their future financial stability and simply will not comply with the policy. Avoid opposition. Have them sign a financial responsibility form that promises to pay within 15 days of receiving the bill.

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April 2019

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Legal Matters The OIG Approves Complimentary Follow-up Care Arrangements for Chronic Conditions Lauryn Anthony Pollard, J.D.

Polsinelli, PC

n March 6, 2019, the Department of Health & Human Services, Office of the Inspector General (“OIG”) published a new advisory opinion, No. 19-03 addressing a medical center’s proposed arrangement to provide free post-discharge support to patients currently with congestive heart failure and an expansion to include certain individuals with chronic obstructive pulmonary disease. The OIG considered the arrangement and decided it would not impose sanctions under the Civil Monetary Penalties law (“CMP”) or the federal Anti-Kickback Statute (“AKS”). However, the OIG did assert that the proposed arrangement would not fall within the “promotes access to care” exception to the CMP.

Proposed Arrangement The requestor, a nonprofit medical center that currently offers free, in home follow-up services to patients with congestive heart failure, wants to expand services to patients with chronic obstructive pulmonary disease. The goal of these services is to encourage compliance with discharge plans, improve patient health, and help reduce unnecessary hospital inpatient admissions and readmissions. As a result, this would help decrease utilization of services and costs. The requestor proposed limiting the program to patients who have a current or recent inpatient admission, have been identified by treating clinicians as at high risk for readmission, have scheduled follow-up care at the requestor’s facilities, and who live in a residence or assisted living facility within the hospital’s service area. Health insurance status or ability to pay would not be considered factors in eligibility for the program. Patients in the program would receive

two visits per week for approximately 30 days from a community paramedic employed by the medical center. OIG Analysis The OIG began by noting that the follow-up care services constitute a “significant benefit to patients” and would constitute remuneration for purposes of the federal fraud and abuse laws. While the OIG noted that the program would be limited to patients who had selected the requestor for follow-up care for their congestive heart failure or chronic obstructive pulmonary disease, the OIG determined that free services could still influence patients to seek out the requestor for other services covered under federal health care programs.

As a result, the arrangement would implicate the beneficiary inducement provision of the CMP. Next, the OIG determined that the proposed arrangement would not qualify for the CMP exception to “promotes access to care,” because the exception excludes from the definition of “remuneration” certain remuneration that improves a beneficiary’s ability to obtain healthcare items or services that pose a low risk of harm to patients and federal healthcare programs. While the OIG cited its own commentary that “some forms of remuneration that remove impediments to compliance with a treatment plan” and some types see Legal Matters...page 12

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Austin Medical Times

Oncology Research The Rise in Colon Cancer Among Younger Adults: What You Should Know By Rebecca Wiatrek, M.D., Texas Oncology Surgical Specialists– Austin Central

taying healthy is important at any age – and it could save your life. Case in point: Recent studies are shedding light on a concerning trend among those under the age of 50: a sharp rise in incidences of colon cancer. People born around 1990 have more than twice the risk of a colon cancer diagnosis compared to those born around 1950, according to a study by the American Cancer Society. What’s more, cases in younger adults tend to be diagnosed as late-stage colon cancer attributed to a delay in seeing a doctor to address symptoms. According to the ACS data, adults younger than 55 are 58 percent more likely to be diagnosed with the late-stage disease than older adults. It’s never too late to develop

healthy habits. Make a plan to protect yourself and your family through awareness, education, and prevention. • Tune in to what your body is telling you. Don’t let a lack of awareness determine your fate. While colon cancer rates are increasing in younger adults, the signs and symptoms are consistent no matter your age. The most common signs of colorectal cancer include a change in bowel habits, rectal bleeding, the feeling that the bowel doesn’t empty all the way, unintentional weight loss, frequent bloating, gas, or cramps, and stools that are narrower than normal. If something seems concerning or you notice changes, reach out to your primary care physician. • Don’t wait for tomorrow when you can develop healthy habits today. Take steps to lower your cancer risk today. Maintaining a healthy weight and avoiding weight gain in the midsection can lower your risk. Adding fiber to your diet by eating vegetables, fruit, and whole

grains is a great place to start. Being overweight or obese was associated with a 53 percent and 54 percent higher risks of colon cancer for men and women, respectively. Increasing your level of physical activity can also help lower your risk. • Smarten up about screenings. Screening provides the opportunity to find and remove polyps before they develop into cancer, which typically takes around 10 to 15 years. Screening also allows cancer to be found early when it is easiest to treat. Speak with your physician about which test is best for you, as there are various tests used to screen for colorectal cancer. The ACS recommends patients start with a screening colonoscopy at the age of 45; however, a family history of colon cancer or polyps suggests beginning screening at least 10 years prior to the age of the youngest family member at the time of their colon cancer diagnosis. • Ask questions and take the time to get familiar with your options. If you are diagnosed with colon cancer, the recommended treatment will vary according to stage, location of the cancer within the colon, and other factors. Tests will be performed to determine the

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extent and characteristics of the cancer. The treatment of colon cancer typically consists of surgery and/or chemotherapy, and may involve a care team of physicians, a surgeon, a gastroenterologist, and other specialists. A cancer diagnosis feels devastating at any age, and the rise in colon cancer among younger adults is a trend we should all be concerned about. As we continue to find new ways to diagnose and treat patients, I am encouraged by advancements and research that offers hope for generations to come. Rebecca Wiatrek, M.D., is a surgical oncologist at Texas Oncology Surgical Specialists–Austin Central, 6204 Balcones Drive in Austin, Texas. For more information, visit TexasOncology.com. 

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Mental Health PTSD After a Sexual Trauma What You Need to Know About Post-Traumatic Stress Disorder After Sexual Assault or Abuse By Mary Leigh Meyer

THE STRENGTH TO HEAL and get back to what I love about family medicine Do you remember why you became a family physician? When you practice in the Army or Army Reserve, you can focus on caring for our Soldiers and their Families. You’ll practice in an environment without concerns about your patients’ ability to pay or overhead expenses. Moreover, you’ll see your efforts making a difference.

To learn more about the Army or Army Reserve, call MAJ Tamela Mitchenor at 210-692-7376, or tamela.l.mitchenor.mil@mail.mil

April 2019

ost-traumatic stress disorder, or PTSD, is most well-known for its prevalence in the veteran population, but close to 50 percent of PTSD in the United States is due to physical or sexual violence. Furthermore, about 30 percent of all PTSD cases in the United States can be attributed to sexual violence alone. This statistic is alarming, especially considering that one in three women and one in six men experience some form of sexual violence in their lifetimes. Sexual assault has many definitions, some legal and some medical, but the most widely accepted definition is sexual contact or behavior that occurs without explicit consent. This definition includes actual and attempted rape, sexual touching and force or coercion of a person into unwanted sexual acts. Sexual assault can be a one-time traumatic event, or it can be a part of continuing abuse

“It is normal to have a very strong reaction to a traumatic episode. And its normal to have disruption to your day-to-day activities, especially within the first few days,” Downing said. “You may have trouble concentrating, eating, sleeping, but you need to give yourself time and permission to let yourself feel that way.” She emphasizes those are normal reactions to be expected, but if day-to-day life is still impacted after two weeks, then she suggests speaking to a local sexual assault resource center or health care provider for assistance, if they have not already done so. Health care providers cannot diagnose PTSD until four weeks after the trauma, so these natural reactions can be normal. If they persist and if they continue to impact day-to-day function, then it is important to seek help, as early intervention could potentially reduce the severity of symptoms.

stemming from domestic violence or human trafficking situations. Feelings of trauma The levels of trauma that result from sexual assaults are a little more difficult to define and conceptualize. “Trauma is really self-defined,” said Nancy Downing, PhD, RN, SANE-A, CP-SANE associate professor in the Forensic Nursing Programat the Texas A&M College of Nursing. “What is traumatic to one person may not necessarily be traumatic to another person.” While physical injuries may occur in sexual assault, they are typically minor injuries that heal quickly. Unfortunately, psychological injuries are more common and can have long-term negative impacts on survivors’ functioning and quality of life. Approximately 94 percent of women experienced symptoms of PTSD after an assault.

Symptoms of PTSD The severity and type of symptoms can vary greatly among survivors of sexual assault and abuse, but there are a few common symptoms: • Depression • Anxiety • Flashbacks or hyper-reactivity to stimulus like sounds or colors that reminds them of the trauma • Intrusive symptoms like random thoughts which will drastically change their demeanor • Avoidance of thoughts or things that remind the person of the trauma • Hyper-sensitivity and easily triggered feelings • Detrimental impact on their ability to function day-to-day Families and loved ones may notice increased irritability, feelings

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see Mental Health...page 14

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Healthy Heart Move More in April By Joel Rice Executive Director American Heart Association

pril is Move More Month and it’s the best time to start your goal of moving more! Are you fitting in at least 150 minutes (2.5 hours) of heartpumping physical activity per week? If not, you’re not alone. Only about one in five adults and teens get enough exercise to maintain good health. Being more active can help all people think, feel and sleep better while performing daily tasks more easily. If you’re sedentary, sitting less is a great place to start. If you work in an office, there are a myriad of ways to move more during the work day. Take the stairs instead of the elevator for at least a floor or two. Once that gets easier, add another floor. If you sit at a desk, make it a habit to stand up every time you

April 2019

make or answer a phone call. March in place or pace in a circle to keep moving. Stuck on a long call or need an energizing break? Stand up and do some basic strength and balance exercises, like squats, desk push-ups, wall sits, calf raises, tree pose and chair pose. Walk to a coworker’s desk or office to talk instead of using email, IM or the phone. The personal interaction is an added bonus! Schedule walking meetings for informal discussions and brainstorming. Use a voice memo app on your phone to capture notes. You may find you’re more creative on your feet! Explore your options for using a standing desk, treadmill desk or sitstand desk riser. Alternate sitting and standing throughout the day, with lots of walking and stretching breaks. You may be saying this would never work at my office, so here are some tips to make it a little easier to transition to standing and moving more at work: • Wear comfortable shoes and

clothing you can move in easily or keep a pair of sneakers at your desk. • Use a cushioned floor mat and other support to avoid foot and leg fatigue when standing. • Ask a coworker to be your “work out at work” partner. Remind and support each other to move more throughout the day. You’ll help keep each other accountable and motivated! • Schedule physical activity time on your work calendar — and treat it

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like an important appointment. Is your workplace interested in getting employees more active? A worksite physical activity program and a culture of activity can increase productivity, reduce absenteeism, lower turnover and reduce healthcare costs. Find out more information about the American Heart Association’s Workplace Health Solutions - https:// www.heart.org/en/professional/workplacehealth . see Healthy Heart...page 12

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Helping Vets Deal with Chronic Pain Without Opioids Virtual Reality Program Provides Real Results

double amputee Veteran looks through his special headset and suddenly is scuba diving under the sea, and sees fish swimming all around. Another Veteran in a wheelchair is mountain climbing and can see trails and wild animals along the way. And another Veteran suffering from chronic pain is fishing and can be seen casting his lines in the water. These are a few examples of how Veterans dealing with various injuries are experiencing a special virtual reality rehabilitation therapy program

from the limitations they face in everyday life.” Special apps and computer programs are utilized through virtual reality headsets in the Virtual Reality Clinic and at the patient’s bedside. Veterans can choose from 20 scenarios, ranging from mountains and oceans. Veterans can fish, ski, go scuba diving or even play golf. One of the main goals is to help Veterans who suffer from chronic pain reduce their reliance on medications, such as opioids. Relaxation and guided

that is proving to be successful in helping them cope with their physical, cognitive and psychosocial issues.

imagery programs are also used to address stress, anxiety, frustration, anger, and pain. Heart rate and self-reporting from the Veteran are used to determine effectiveness. The measures, taken at the beginning and end of each session, have proven to reduce an average of 5 to 7 heart beats per minute while pain levels dropped 2-3 levels during the 10-minute use. “What is truly exciting is that it is showing measurable results in helping reduce chronic pain while using the program,” Kaplan said. Kaplan said the idea came about through his interest in computer-based video games. He extended the idea based on video games to develop the virtual reality scenarios. At first, virtual reality was targeted for use by younger Veterans who are more proficient in the use of technology and social media. However, older Veterans are embracing its use as well. About 200 Veterans, both inpatient and outpatient, have gone through the program.

“These therapies build confidence and develop coping skills.” In the photo above, Jamie Kaplan, a recreation therapist who oversees the virtual program at the James Haley Tampa VA Medical Center, helps guide Veteran Geoff Hopkins through his chosen virtual reality scenario. The special program provides Veterans with varied medical issues resulting from traumatic brain jury, spinal cord injury, stroke, amputees, ALS or other similar areas with an alternative to the use of drugs such as opioids. They use a virtual reality headset or can watch on a large monitor screen to experience virtual scenic settings with music and narration individualized to each patient’s interests. “Virtual reality is able to take the user someplace else they’d rather be,” said Kaplan. “For example, virtual games and activities can allow the wheelchair user to experience freedom

see Helping Vets...page 12

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April 2019

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Ascension Texas announces new Chief Nursing Officer

scension Texas recently announced that Steven J. Brockman-Weber will serve as Chief Nursing Officer, Brockman-Weber is an experienced healthcare leader, serving in a chief nursing officer role the last 16 years of his career and with more than three decades of healthcare experience during his professional tenure. “I am excited that Steven will be

joining the Ascension Texas executive leadership team, and I look forward to his leadership and contributions with focus on patient safety, quality of care, and patient and family experience,” said Craig Cordola, President and CEO of Ascension Texas. “Steven has an extensive background in nursing, and he brings a unique perspective to our leadership team.” As Chief Nursing Officer of Ascension Texas, Brockman-Weber

will oversee and provide executive leadership to the nursing teams across all Ascension Texas sites of care, as well as develop an overall strategic nursing plan. In addition, he will work closely with nursing school partners to continue recruiting the next generation of nurses, as well as provide educational and leadership opportunities for all of the clinicians within Ascension Texas. Prior to joining Ascension Texas, Brockman-Weber worked in Illinois for Advocate Children’s Hospital, part of the Advocate/ Aurora Healthcare System, the largest not-for-profit, mission-based

St. David’s Healthcare Facilities Named Among Nation’s 100 Top Hospitals by IBM Watson Health

t. David’s Medical Center— including Heart Hospital of Austin and St. David’s Georgetown Hospital—was named among the nation’s 100 Top Hospitals by IBM Watson HealthTM. The Watson Health 100 Top Hospitals® study

independent and objective research to analyze hospital and health system performance in 10 clinical and operational areas addressing: • Risk-adjusted inpatient mortality index spotlights the top-performing hospitals • Risk-adjusted complications index healthcare-associated in the U.S. based on a balanced • Mean infection index scorecard of publicly available clinical, 30-day risk-adjusted operational, and patient satisfaction • Mean mortality rate metrics and data. 30-day risk-adjusted The study, which has been • Mean readmission rate conducted annually since 1993, uses

health system in the state. As Vice President and Chief Nurse Executive, he oversaw the state’s top integrated children’s network and created a f r a m e w o r k Steven J. Brockman-Weber around system strategy for pediatrics and neonatal nursing practices. While there, his accomplishments included reducing see Ascension Texas...page 14

• Severity-adjusted length of stay • • Mean emergency department throughput • Case mix- and wage-adjusted inpatient expense per discharge • Adjusted operating profit margin • Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score. (Patient rating of overall hospital performance.) see St. David’s...page 12

HELP US BUILD A HEALTHIER AUSTIN

Access to nutritious food is essential for a healthy, thriving community. Learn about how we’re leading the fight against hunger at centraltexasfoodbank.org.

April 2019

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Austin Medical Times

Live Well Age Well Texas HHS Pushes Innovations in Making Aging-Friendly Communities By Laura Marshall

o you ever think about how the community in which you live influences your health as you age? Age Well Live Well, a campaign by Texas Health and Human Services’ Office of Aging Service Coordination, promotes and supports initiatives to help make communities more livable for older adults. The walkability of streets, increased accommodations under the Americans with Disabilities Act and access to healthy food are important for people of all ages. But they are particularly important for older adults, because they allow greater independence. Age Well Live Well is sponsoring several AmeriCorps VISTA members throughout Texas who are identifying and

overcoming barriers to healthy aging. Mickey Taylor, a VISTA member in Harris County, works with the Houston Health Department and a local school to help older adults find fresh food through a series of community garden initiatives. Nutritious food is a key component of healthy aging. Mickey’s high school and older adult volunteers take care of a community garden and prepare “planter pots” for p e o p l e who are homebound. “ O u r p r o j e c t allows older adults and youth to d e vel o p s u s t a i n a bl e f o o d

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resources, sharing skills and bonding in the process,” Taylor said. ”We have managed to put together the planter pots through repurposing items and from local donations. The only requirement for this project is participation.” Melodía Gutiérrez of AARP advocates for Fort Worth’s Livable Communities plan, which encourages businesses to join an effort for increased accessibility. “We have a growing number of local businesses on board and we are advertising them as ‘age friendly,’” Gutiérrez said. “This means a safe place for people of all

abilities.” What does an age-friendly or accessible business look like? “Complete ADA compliance, larger print text, as well as improved lighting,” Gutiérrez said. Another feature is little or no music, so those who are sensitive to sound or hard-of-hearing can have a more relaxed experience. “We are hoping to grow our Age Friendly Business list to include over 100 businesses, ranging from banks to restaurants to law firms and stores,” Gutiérrez see Live Well...page 14

Subscribe to Our Digital Issue Now you can get the Austin Medical Times delivered straight to your inbox. Never miss an Issue of Austin’s Leading Local Healthcare News Online.

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Austin Medical Times

Legal Matters

Continued from page 4 of post-discharge support can promote access to care, it concluded that the exception did not protect the services offered under the medical center’s program. However, the OIG determined it would not subject the proposed arrangement to administrative sanctions because the “benefits outweigh any risk of inappropriate patient steering.” The following factors were considered by the OIG in making their determination: • The benefits to the patients would outweigh the risk of patient steering that the law was designed to prevent as only patients who

had already selected the requestor for follow-up care related to their congestive heart failure or chronic obstructive pulmonary disease would be eligible for program and patients could choose any provider for other services while enrolled in the program. • The requestor certified that no employees or contractors would be compensated based on the number of patients enrolled in the program which removes any interference with clinical decision making. • The program would be unlikely to lead to increased costs to

federal healthcare programs, as the program services would not be reimbursed by federal healthcare programs. • The requestor certified that it currently does not, and would not advertise or promote the program through their website marketing. • The ‘scope and duration’ of the services provided through the program appeared to be “reasonably tailored” to accomplish the requestor’s goals of increasing patient compliance with discharge plans, improving patient health, and reducing inpatient admissions

and readmissions. While the OIG’s advisory opinion is favorable for the proposed arrangement, it is noteworthy that this advisory opinion appears to be the first time the OIG has expressly concluded that the “access to care” exception is not available to protect a particular arrangement.

“Recreation therapy and creative arts therapy provide a spectrum of services, opportunities, and choice for Veterans to maximize their rehabilitation potential, increase independence and sustain a healthy and meaningful leisure lifestyle,” said Lucille Beck, Ph.D., VHA’s Deputy

Under Secretary for Health for Policy and Services. “These therapies provide opportunities to build confidence, develop coping skills, and integrate the skills learned in treatment settings into community settings.” Guided imagery, meditation, and relaxation programs promote decreased

muscle tension, stress, anxiety and blood pressures. This, in turn, can increase function abilities, decrease pain behaviors and increase activity.

Based on the results of this year’s study, if all Medicare inpatients received the same level of care as those treated in the 100 Top Hospitals: • More than 103,000 additional lives could be saved.

discharged patients would be • More than 38,000 additional readmitted within 30 days. patients could be free from The winning hospitals were complications. • More than $8.2 billion in inpatient announced in the March 4th edition of Modern Healthcare magazine.  costs could be saved. • Approximately 155,000 fewer

Heart Ball celebrates these efforts to build a foundation of health in our community and ensure everyone lives a longer healthier life. The evening festivities will include dinner, an opportunity to Open Your Heart and further support the mission, and an exciting live auction and band. The Heart Ball will be held at the JW Marriot, on Saturday, May 11, 2019 and

starts at 6pm. The 22nd anniversary Heart Ball of Austin is a black-tie gala that celebrates the AHA’s successes while raising funds for continuing research, education, advocacy, and outreach. A special thank you to our presenting sponsor - St. David’s HealthCare, our chair Bobby Dillard with Cielo Property Group, and our Life is Why Sponsors - Abbott, &

Helping Vets

Continued from page 9 The Virtual Reality program at James A. Haley VAMC is recognized in February as National Therapeutic Recreation Month. VHA has more than 900 recreation therapists and creative arts therapists serving Veterans.

St. David’s

Continued from page 10 This is the tenth year in a row that St. David’s Medical Center, including Heart Hospital of Austin and St. David’s Georgetown Hospital, has been recognized as one of the nation’s 100 Top Hospitals.

Healthy Heart

Continued from page 8 And remember, dancing is good for the heart too! And that’s why we’re encouraging you to join us in May at the 22nd annual Austin Heart Ball which is presented by St. David’s HealthCare. Heart Ball supporters help us to connect, innovate, influence and invest in advancing our efforts to change health outcomes as they relate to heart disease and stroke.

April 2019

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Texas Mutual Insurance Company. TICKETS & INFO: http:// austinheartball.heart.org 

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22ND ANNUAL

OF AUSTIN SATURDAY, MAY 11, 2019 AT THE JW MARRIOTT

On Saturday, May 11, 2019, the American Heart Association will host the 22ND Annual Heart Ball, the most exclusive and elegant evening in Austin. Join us for an evening of passion and fun that includes a hosted cocktail reception followed by dinner, live auction and a live musical performance. Presenting Sponsor

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April 2019

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Austin Medical Times

Dell Medical

Continued from page 1 “This kind of collaboration is critical to innovation,” said Mellie Price, managing director of Texas Health CoLab. “Our team is excited about working with organizations that

share a mission to educate in an effort to improve health.” Dell Med’s Value-Based Health Care learning modules were developed with generous support from the

Episcopal Health Foundation. 

Director of Media Sales Richard W DeLaRosa

Mental Health

Senior Designer Jamie Farquhar-Rizzo

Continued from page 6 of anger, feelings of numbness or substance abuse. Their loved ones may start to get into fights or have more angry outbursts. People also might also become less social, afraid to leave their homes and miss work or school. It is important to listen when they want to talk and steer them to get help. PTSD progression and risk factors “Most people who develop PTSD will have a spontaneous recovery, but about 10 percent will keep getting worse,” Downing said. “We do not know why this happens, but hormonal or genetic differences between people and the presence of past trauma, especially during childhood, tends to make people more likely to develop PTSD than others.” The focus of Downing’s current research is to identify who might be at greater risk for PTSD development

following sexual assault and potential interventions sexual assault nurse examiners (SANEs) can integrate into their care to prevent or reduce symptoms of PTSD. The American Psychological Association reports that woman are twice as likely to develop PTSD, experience a longer duration of posttraumatic symptoms and display more sensitivity to stimuli that reminds them of the trauma. Men and women who have experienced long term sexual abuse, like domestic violence or human trafficking, are also at high risk for PTSD. “Most women that endure domestic partner violence often also endure sexual assault at some point,” said Nora Montalvo-Liendo, RN, PhD, FAAN, an assistant professor at the

Texas A&M College of Nursing, who specializes in interpersonal and sexual violence among minority populations. “Studies have shown women of color are more likely to experience abuse. These women frequently speak about PTSD symptoms like feelings of numbness, poor sleep patterns and hyper-arousal in regards to their environment,” said Montalvo-Liendo. “One of the biggest challenges for some women with PTSD symptomology is the ability to show maternal warmth to their children. It is important for people who experience sexual trauma to get the help they need, so it does not impact those around them.”

University; a master’s in Health Service Administration from the University of Saint Francis, and a master’s in Nursing Administration from University of Phoenix and then earned his Doctorate of Nursing Practice from Rush University in

Chicago. Brockman-Weber is an avid walker, and he is excited to move to Austin with his family.

• Are your neighborhoods walkable? • Where can members of your community get affordable, nutritious food? If you’d like to discuss how your community can promote healthy aging initiatives and work with the Age Well Live Well campaign, call the Office

of Aging Service Coordination at 800-889-8595 or email them at AgeWellLiveWell@hhsc.state. tx.us.

Continued from page 10

Live Well

Continued from page 10 said. Here are things to think about when you are assessing your community’s livability for older adults: • What types of programs are available for older adults? • Are there opportunities for older adults to be socially engaged in the community? April 2019

Web Development Lorenzo Morales Distribution Brad Jander Accounting Liz Thachar Office: 512-203-3987 For Advertising advertising@ medicaltimesnews.com Editor editor@medicaltimesnews.com

Ascension Texas

the nurse vacancy rate, reducing the serious safety event rate and leading the Advocate system in health outcomes. Brockman-Weber received his nursing degree from Kentucky State University; his bachelor’s in Business Administration from Averett

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