Houston Medical Times

Serving Harris, Galveston, Brazoria, Fort Bend and Montgomery Counties

HOUSTON

Volume 9 | Issue 1

Inside This Issue

January 2019

Memorial Hermann Life Flight® Working with Novel Mobile App To Reduce Distracted Driving Motor Vehicle Collisions In Greater Houston Area

M New Discoveries Predict Ability to Forecast Dementia from Single Molecule See pg. 11

INDEX Legal Matters........................ pg.3 Financial Outlook............... pg.4 Mental Health...................... pg.5 Oncology Research......... pg.6 Healthy Heart....................... pg.7 New Technology................ pg.8

Cullen Trust For Higher Education $5 Million Gift to Dell Medical School See pg. 12

emorial Hermann Life Flight® is working with the SAFE 2 SAVE mobile app to reward drivers who put their mobile devices down and keep their eyes on the road. The sponsorship is part of Memorial Hermann Health System’s ongoing educational and targeted prevention efforts to drive change in behaviors and reverse the startling rise in distracted driving motor vehicle collisions in the Greater Houston Area.

Deaths related to distracted driving motor vehicle collisions rose 62 percent in Harris County from 2016 to 2017, according to the Texas Department of Transportation. In 2017, more than 19 percent of motor vehicle collisions in Texas involved distracted driving, resulting in 444 deaths and more than 2,800 serious injuries, according to TxDOT. The Houston Chronicle recently labeled the Greater Houston Area’s driving conditions as the country’s most distracted and deadliest, based on its analysis of National Highway Traffic Safety Administration data.

Many distracted driving motor vehicle collisions are preventable.

“Part of our role as trusted providers of high-quality trauma care for our community is to educate and empower people across the region to change behaviors that cause preventable traumas,” said Tom Flanagan, Vice President of Trauma Service Line and System Integration at Memorial Hermann. “We are tapping into the technology that has become such a large part of people’s lives and coincidentally, a major part of distracted driving.”

Memorial Hermann will serve as the presenting sponsor of SAFE 2 SAVE in the Houston market. SAFE 2 SAVE rewards drivers for not using mobile

In 2017, more than 19% of motor vehicle collisions in Texas involved distracted driving, resulting in 444 deaths & more than 2,800 serious injuries, according to TxDOT. devices while driving. For every minute a driver does not touch their mobile device while driving, they receive points that can be redeemed at select Houston area businesses such as Chick-fil-A®, Papa John’s Pizza®, Dave & Buster’s® and Rooftop Cinema Club®.

“We are thrilled to partner with Memorial Hermann Life Flight® on

bringing SAFE 2 SAVE to the Houston market,” said Marci Cory, Owner & Founder of SAFE 2 SAVE. “With this partnership we hope to reach every Houstonian and serve as a driving force in reversing the rising trend of distracted driving impacting the Houston, Harris County and surrounding areas.”

On average, one-third of the patients who come to Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center, one of the busiest Level I trauma centers in the country, are involved in motor vehicle, auto-pedestrian or bicycle collisions. Red Duke Trauma Institute has engaged students and adults in the Houston community through distracted driving prevention education programs for nearly a decade, including: ∙∙ Live Your DREAMS - A safety program tailored for high-school students that uses education

see Life Flight... page 13

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Legal Matters CMS’ 2019 PFS Payment Policies for Telehealth Services

By Mark S. Armstrong, J.D.

T

he Centers for Medicare and Medicaid Services (“CMS”) recently published its final rule regarding payment policies under the Physician Fee Schedule (“PFS”).

CMS’ final rule approves and pays under the PFS for a discrete set of new patient services that are provided via remote communication technology and increases access for Medicare beneficiaries to physicians by recognizing the following services that involve the use of communication technology.

1. Brief Communication TechnologyBased Service, e.g. Virtual Check-In .

Beginning January 1, 2019, CMS will pay physicians for a newly defined type of service furnished using

communication technology.

This service is billable when a physician or other qualified health care professional has a brief non-face-to-face check-in with a patient via communication technology, to assess whether the patient’s condition necessitates an office visit. CMS’ final rule approves payment for virtual check-ins under the following circumstances: • Utilizes real-time audio-only telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission. (Telephone calls that involve only clinical staff cannot be billed under code be billed using HCPCS code G2012 since the code explicitly describes (and requires) direct interaction between the patient and the billing practitioner.)

• If the service originates from a related E/M services provided within the previous 7 days by the same physician or other qualified health care professional the service is considered

bundled into the previous service.

• Verbal consent is noted in the patient’s medical record for each billed service.

• The service is limited to established patients.

(CPT defines an established patient as one who has received professional services from the physician or qualified health care professional or another physician or qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past 3 years.)

• There are no frequency limits on the use of the code.

• There are no specific documentation requirements for this service; however, the services must be medically reasonable and necessary.

2.

Remote Evaluation of Pre-Recorded Patient Information.

Beginning January 1, 2019, CMS will also pay physicians for the remote professional evaluation of patient transmitted information conducted via pre-recorded “store and forward” video or image technology, provided, however, that the service is

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not separately billable if there is no resulting E/M office visit and there is no related E/M office visit within the previous 7 days of the remote service being furnished.

CMS’ final rule approves separate payment for remote evaluation of recorded video and/or images submitted by the patient under code G2010 under the following conditions: • The service is limited to established patients.

• Beneficiary consent that could be verbal or written, including electronic confirmation that is note in the patient’s medical record for each billed service.

see Legal Matters...page 13

January 2019

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Financial Outlook Financial Resolutions for the Medical Practice Owner

By Claudia Mollerup-Madsen Vice President, Wealth Management Stanley Morgan

I

f you are a physician or other medical professional who owns your own practice, you know the challenges of running a business. As someone who graduated from medical school, chances are you spent most of your time studying medicine and not business administration. The start of the new year is an excellent time to re-examine your business plan and incorporate bottom line financial resolutions.

Review your cash flow projections You most likely drafted a cash flow forecast when you first started your practice. A cash flow forecast is a document that shows what money will be flowing into your business (receivables) and how much will be going out (payables). This January is good time to re-visit your forecast

and make adjustments where needed.

Do not be too optimistic about your receivables or make assumptions that may, or may not, occur; be realistic and stick to real numbers.

Evaluate your burn rate Pay attention to your burn rate – your spending rate per month – if you are looking to borrow money this year or have venture capital invested in your practice, lenders will be particularly interested in this figure. Take time to re-evaluate your burn rate and cash on hand to see where your business can make adjustments, if necessary.

Enlist financial guidance Business owners with a financial mentor are three times more likely to be top performers in their industry. A mentor can be a colleague with more experience in the medical field or a financial advisor.

Business owners with a mentor have been found to be more confident and make decisions more quickly. If you have not had financial guidance in the past, take some time this new year to bring in an expert opinion on how you are doing in

your practice.

Plan for emergencies and save for retirement Plan for contingencies; I utter these words often to my clients and friends. Ensure you are putting money into an emergency fund. Take some time this month to think about the negative things that could happen to your business and plan for them. For example, a supplier might increase prices, a natural disaster could interrupt your daily schedule of seeing patients or your health could unexpectedly change impacting your ability to see patients. If you do not have a cash reserve to pay for slow cycles in your business, start planning today. Your cash flow statement will help guide you for the amount need in your business reserves. Furthermore, be sure you keep the equivalent of two to three months’ salary in an emergency fund for your

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own personal expenses.

While you are setting aside money for your emergency fund, re-evaluate what you are putting into your retirement accounts. As a small business owner, do not neglect to save for your own retirement. Only three out of five households headed by someone between the ages of 45 and 54 have a retirement account. Do not be one of those left out. You have options such as setting up a 401(k) program for your employees and contributing yourself or contributing to a Traditional or Roth IRA. Take some time this new year to tweak your cash flow where necessary and save additional cash for the hard times that might come. Adopting these financial resolutions is a way to start the year strong.

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Mental Health Training to Reverse Opioid Overdoses Texas A&M First in Nation to Train All Health Sciences Students on Opioid Overdose Reversal

By Christina Sumners

W

ith more than 130 Americans dying each day from opioid overdose, the Texas A&M University Health Science Center is responding, advancing training and education in pain management and substance abuse in innovative ways. Texas A&M is the first health science center in the nation to commit to train every health professions student to administer a reversal agent to opioid overdose victims, and save lives.

Through the intensive 90-minute Opioid Overdose Education and Naloxone Administration (OENA) program, the institution will train every Texas A&M Health Science Center student across the state— totaling more than 5,000 students from the colleges of dentistry, medicine, nursing, pharmacy and public health— to recognize an opioid overdose and administer naloxone, a drug that can be administered as a nasal spray or

injection to reverse the deadly effects of opioid overdoses.

The reversal agent is available as prescription medication, and some states, including Texas, allow naloxone to be distributed by pharmacists to the public without a prescription from a physician via a standing order. Texas also passed legislation allowing for community distribution of naloxone rescue kits by trained individuals to the general public in response to the rising crisis. Anyone is allowed to possess naloxone without a prescription, and use it in good faith to save the life of a person believed to be suffering from an opioid overdose.

“Naloxone is a life-saving treatment to help until emergency personnel arrive,” said Joy Alonzo, M. Engineering, PharmD, clinical assistant professor at the Texas A&M College of Pharmacy, who is leading the naloxone training effort at the Health Science Center. “The goal is to train our students how to administer

naloxone and also educate them about the health care needs of the opioid crisis and spread that awareness to others.”

Alonzo is a member of the institution’s Opioid Task Force, which was formed in 2018 to reduce burdens from the opioid epidemic through collaborative action in research, education and community outreach, across the health sciences. Training of all health professions students is an important component of both the education and community outreach initiatives of the task force.

“Whenever you’re faced with a crisis, you need creative solutions,” said Carrie L. Byington, MD, vice

chancellor for health services at The Texas A&M University System, senior vice president of the Texas A&M Health Science Center and dean of the Texas A&M College of Medicine.

“The best ideas come when multiple viewpoints are at the table, and that’s the idea behind our interprofessional Opioid Task Force. Together, we’re reducing the stigma associated with opioids, and empowering the next generation of health care professionals to become advocates for naloxone administration within their own communities, wherever they may see Mental Health...page 14

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Page 6

Oncology Research Finding Balance: 7 Life Hacks If Your Loved One Has Cancer

By Sanjay Sethi, M.D., Texas Oncology

C

aregivers are the unsung heroes of cancer care. They stand with patients to provide critical emotional and physical support and care that enables cancer patients to complete their treatments. The role of caregiver can be overwhelming at times, but by taking a few practical steps it’s possible to find balance.

Below are seven tips – or “life hacks” – to help simplify and create balance and efficiency for caregivers.

1. Start a schedule. This can eliminate some of the stress caregivers feel because it provides a sense of control and order. Start by listing your caregiving-related tasks and ordering them by importance. List the names and availability of family and friends

willing to help and the tasks with which they can assist.

2. Create a “caregiver’s” binder. Stay organized by keeping information in one place. Include contact information for healthcare providers, insurance cards, and a list of ongoing needs. Create an appointment tracker that includes details about past and upcoming visits, a list of prescriptions and dosing information, dietary restrictions, and a symptom tracker. Texas Oncology’s Care Guide provides a great foundation.

3. Pack a bag. Treatment and the days following can be grueling for cancer patients. Pack a bag with your loved one’s favorite things to offer a sense of comfort during long treatment days. It’ll help the hours go by a little more quickly for you, too. Books, magazines, tablets, adult coloring books, playing cards, and comfort items like blankets, and socks are great items to include. Have water, juice, or ginger ale, snacks, hard candies, and nausea relief medication at the ready.

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Bring along the caregiver’s binder so you can note upcoming appointments and special instructions you receive from the care team.

4. Check the pantry. During cancer, certain smells can cause nausea.

Remove foods that may trigger sickness and replace them with foods you know your loved one can eat to help ease the taste changes that often accompany cancer.

5. Meal prep for yourself and your loved one. Preparing meals in advance for both you and your loved one can help bring a sense of balance and reduce stress for those busy days when there’s little time to cook a homemade meal. Set aside time to choose recipes

together, then find a day for healthy meal planning and preparation.

6. Create a private social media group. Your loved one may have numerous people anxiously awaiting health updates. Some social media platforms, provide a central location for interaction with family, friends, and the community to receive updates and show support and love – either through open or closed groups. This also eliminates the overwhelming feeling to respond to multiple calls and text messages.

7. Take care of yourself. When you are giving so much in caring for

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Healthy Heart Choose Healthy Habits for New Year’s Resolutions Small Changes Can Improve Overall Health

By American Heart Association

A

s we celebrate the beginning of a new year, most of us are thinking about changes to make and resolutions to set. We all know the struggle of maintaining resolutions throughout the year. In 2019, be realistic by focusing on smaller, achievable goals.

The American Heart Association’s Healthy for Good pillars – eat smart, add color, move more and be well – are a great place to start when aiming to improve your overall health.

Eat Smart: Resolutions to maintain a healthier diet usually top the list. But the secret to sticking with nutritious eating isn’t a big, complex plan. Think of it as a gradual lifestyle change and set realistic goals toward achieving heart health and other long-term results.

Eating at home can be more nutritious than eating out. When you shop for groceries, stay around the perimeter of the store to find produce, meats and minimally processed foods.

Packaged foods with higher salt, sugar and fat are usually on center shelves and in the freezer.

When you eat out, be strategic.

Consider restaurants that will accommodate requests for using healthier oils like corn, soybean, olive and canola oils. Choose vegetables instead of fries or mashed potatoes and avoid heavy cream-based sauces.

Add Color: Add a little bit of fruit each day. It’s an easy place to start and may help gradually shift away from bad habits toward healthier eating.

Adding color to your meals with fruits and vegetables gives you a nutritional power boost, including vitamins, minerals, healthy fats, protein, calcium, fiber and antioxidants.

A diet that is rich in fruits and vegetables can help lower your risk of many serious health conditions, including heart disease, stroke, obesity, high blood pressure, high cholesterol, diabetes, kidney disease, osteoporosis and some types of cancer.

Move More: When setting

exercise goals, find something that fits in your current lifestyle, is easily accessible and is something you enjoy.

The U.S. Department of Health and Human Services recently released updated guidelines for physical activity that show how exercise benefits the body and mind.

Moving is good for you even in small amounts. Take the stairs, park farther away, or do jumping jacks during a conference call. These small actions add up to more overall movement and the minutes of physical activity you need for the day.

Be Well: We often give self-care the least amount of attention, especially during times of stress. When you need some down time, take a break. Choose relaxing activities like yoga, meditation

or spending time in nature.

Aim for 7-9 hours of sleep each night to stay in the healthy zone. Don’t let your wake-up time and bedtime get too far off your regular schedule. Nap when needed and ditch the digital devices at night.

When it comes to New Year’s resolutions, perspire and persevere.

Track your progress and reward your successes, but don’t be surprised or defeated if you slip up. Prepare for the long haul by cultivating social support, and don’t expect immediate results.

Here’s wishing all a happy New Year and success in making small steps that lead to longer, healthier lives.

Find more tips on maintaining healthy habits throughout the year at www. heart.org/en/healthy-living.

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New Technology 2019 Health Care Technology Outlook

READY, SET . . .

By Mark Johnson President, Xtrii

W

ith the beginning of a new year, let’s look at the key technologies that will most influence health care this year. Paper charts are out, and digital is in. Technology is changing at an incredible rate and there are many opportunities for applying technology to improve health care. The following topics are some of the top technologies that will have an impact:

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Electronic Medical Records Provide More Value In the early adoption stages of Electronic Medical Records (EMRs), while value was being derived overall within the health care organization, doctors and other care providers often felt like they were receiving very little benefits to justify their additional, required efforts.

Early versions of EMRs typically only

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Artificial Intelligence as something that just exists in Sci-Fi movies. But today, Artificial Intelligence is being applied across many industry and business types, and health care could be one of the biggest beneficiaries.

Traditionally, care providers relied on their training, experiences, ongoing studies and local peers for reference information. With that approach, how much relevant information can a single human brain digest, and properly recall at the time of a critical decision?

With the application of Artificial Intelligence, the reference sources are vastly increased, the symptoms, factors, treatment options, and outcomes can be quickly compared against millions of others, and the insight that is provided to the care provider is greatly enhanced.

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provided rudimentary information for care providers. Now with ongoing improvements that provide more timely insight, electronic orders, potential interactions, and an evergrowing depth of insight from better Artificial Intelligence, EMRs now provide tremendous new value for the care providers. This increase in value has helped improve EMR adoption and sentiment.

Improved Patient Access: Many health care organizations are now expanding and improving their EMRs to provide patients secure access to their medical information, the ability to schedule appointments online, to request prescription refills online, and other features that make access to health care services more timely and frictionless.

Electronic Health Records (EHR) Evolve

While the terms EMR and EHR are often used interchangeably, they are different. Electronic Medical Record (EMR) contains the clinical data collected by the medical provider, and an Electronic HEALTH Record (EHR) provides a broader view of the overall health of the patient by including information with other health care providers, such as laboratories, therapists, care takers and specialists.

Leveraging Blockchain technology for a better EHR/ EMR: Often people ask why their service history for their car, their home appliances and other items can be easily accessed by service providers nationwide, yet their personal medical history is still trapped within the walls of each health care provider.

Fortunately, we are now seeing regional groups of care providers sharing a common EMR system, which at see New Technology...page 13

Houston Medical Times

Texas Children’s Hospital West Campus Named a Top Children’s Hospital in The Nation by The Leapfrog Group

H

arris Texas Children’s Hospital West Campus is proud to receive the prestigious Leapfrog 2018 Top Children’s Hospital award

by The Leapfrog Group. This distinction recognizes outstanding accomplishments in areas such as safety, patient care and commitment to serving the community. This is the fifth time Texas Children’s Hospital West Campus earned this elite award.

Being designated as a Leapfrog Top Hospital is one of the most competitive and exclusive honors an American hospital can receive. Texas Children’s Hospital West Campus was recognized for meeting and exceeding

tirelessly to provide the highest-quality of care, in the safest environment, for our patients. We are proud to have our work recognized by the Leapfrog Group and we will continue to provide exemplary care for our community.”

The Leapfrog Group, an independent hospital watchdog organization, provides the only national, public comparison of hospitals across safety, quality and efficiency dimensions. Performance across many areas of hospital care is considered in establishing the qualifications for the award, including infection rates and the hospital’s capacity to prevent medication errors.

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“We are honored to receive the Leapfrog 2018 Top Children’s Hospital award again this year,” said Ivett Shah, vice president of Texas Children’s Hospital West Campus. “This award recognizes our team of physicians, nurses and employees who work

Texas Children’s Hospital West Campus was recognized as a Top Children’s Hospital, one of 13 children’s hospitals honored, and received the award alongside 100 other nationwide hospitals in four categories, including general, rural, teaching and children’s.

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Page 10

Despite Improvements to Surgical Procedures, Colon Surgery Still Carries Highest Risk

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large nationwide study led

by The University of Texas Medical Branch at Galveston has confirmed that among various surgical procedures, removing sections of the colon carries the highest risk of complications and has a 46 percent mortality rate, despite efforts to improve surgical outcomes at large. Shining light on this issue can guide advances and improvements targeted directly toward this procedure.

The findings are currently available in The American Journal of Surgery.

The American College of Surgeons works to improve the quality of surgeries throughout the U.S. and collects information on how well people recover as well as rates of complications, post-surgical hospital readmissions and surgery-related deaths. This study is the first to use the ACS data to identify advances in how well patients recover from surgery and opportunities for improvement.

The researchers compared the 2015 data from 885,502 surgical cases from 603 hospitals with the data from 2008. Of the 36 surgery procedures studied, 80 percent of complications were associated with 10 procedures.

They found that in both 2008 and 2015, colon resection, which is

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removal of a portion of the intestine, had the highest rates of issues despite the technical advances and enhanced recovery protocols made since 2008. Of the colon resection cases analyzed, 34 percent of patients had complications, 27 percent of patients needed to be readmitted to the hospital after going home to recover and had a mortality rate of 46 percent.

“It’s important that we’ve confirmed that colon resection has room for improvement,” said lead author Dr. Byron D. Hughes, UTMB resident in general surgery. “These data provide a valuable roadmap to target specific efforts to improve the results of this procedure.”

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Page 11

New Discoveries Predict Ability to Forecast Dementia from Single Molecule Team Joins National Network Focused on Neurodegenerative Disorders

By James Beltran

S

cientists who recently identified the molecular start of Alzheimer’s disease have used that finding to determine that it should be possible to forecast which type of dementia will develop over time – a form of personalized medicine for neurodegenerative diseases.

A new study from UT Southwestern shows that single toxic tau proteins that stick together and spread degeneration across the brains of dementia patients have different shapes. The folds of these molecules hold information that could help diagnose – and perhaps one day treat – neurodegeneration in its earliest stages.

The finding comes from a team of scientists appointed this month to a newly created network of international collaborators focused on improving treatment of neurodegenerative disorders. Funded by the Chan Zuckerberg Initiative, the

UT Southwestern group is tasked with using its recent discoveries of the tau protein to develop clinical diagnostic tools.

“Our expanded understanding of the tau protein structure changes how we think about detecting and treating Alzheimer’s disease and related dementias,” said Dr. Marc Diamond, Director of UT Southwestern’s Center for Alzheimer’s and Neurodegenerative Diseases. “The next step is to translate this knowledge into simple clinical tests that doctors will use to diagnose and eventually stop the neurodegeneration process at its earliest stages.”

Dr. Diamond’s new study expands on research published in July from his lab that documented a structural “genesis” of Alzheimer’s disease – the basis of how a healthy tau protein changes shape and is then capable of assembling with other tau molecules to kill brain cells.

The latest study published in eLife shows that harmful single tau molecules take different shapes that each correlates to a distinct type of larger assembly that will form and self-replicate across the brain. Dr. Diamond’s lab already established in a 2016 study that the structure of larger tau assemblies determines which type of dementia will occur – which regions of the brain will be affected and how quickly the disease will spread. But it was unknown what specified these larger structures. The new research reveals how a single tau molecule that changes shape at the beginning of the disease process contains the information that determines the configuration of the larger, toxic assemblies. This finding suggests that characterization of the

conformation of single tau molecules could predict what incipient disease is occurring – Alzheimer’s or other types of dementia.

Scientists made these discoveries by extracting tau protein from cultured cells and human brains, isolating them as single molecules and determining what types of pathological assemblies they would subsequently produce in cells and mice. They determined that contrary to prior ideas, a single tau molecule, rather than being without definable structure, in fact has multiple, stable structures that each determine what type of subsequent pathological assembly it will form. see Dementia...page 14

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Cullen Trust For Higher Education Driving Shift to Health Care Value with $5 Million Gift to Dell Medical School

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he Houston-based Cullen Trust for Higher Education, part of the Cullen Foundation, has pledged $5 million to Dell Medical School at The University of Texas at Austin to help accelerate the transformation to high-value health care delivery.

The gift will support the work of the Value Institute for Health and Care, a joint venture between Dell Med and UT Austin’s McCombs School of Business. The Value Institute works to redefine health care by accelerating adoption of high-value health care in practice, enabling measurement of meaningful health outcomes for individuals and families, and creating

simple,” Teisberg said. “The purpose of health care is improving health: capability, comfort and calm in the lives of the individuals and families we Trust for Higher Education. “The antiquated U.S. payment system is the highest cost in the world and yet it does not provide better outcomes.

We are proud of Dr. Teisberg, Dean Hartzell, and Dean Johnston’s efforts to deliver value to their patients’ good health,” said Robertson, a UT Austin Distinguished Alumnus who earned his undergraduate degree in business in 1969.

A New Hub for Innovation in Value-Based Health Care

distinctive educational programs in value-based care delivery and strategy.

Specifically, the gift will help to launch the Value Institute’s new, one-year Master of Science in Health Transformation program, which is jointly offered by the two schools and is currently accepting applications. It also creates the Cullen Trust for Higher Education Distinguished University Chair in Value-Based Care for Dell Medical School, which will be held

by Elizabeth Teisberg, Ph.D., executive director of the institute. Teisberg is an internationally recognized expert in transformational innovation and the implementation of high-value health care, and her groundbreaking book “Redefining Health Care,” co-authored in 2006 with Harvard Business School’s Michael Porter, introduced the concept of value to health care delivery.

“The challenges for transforming health care are huge, yet the goal is

“The Value Institute for Health and Care is an ideal bridge between the schools of business and medicine, and Dr. Teisberg and her team are positioning UT Austin as a new hub for value-based care,” said McCombs Dean Jay Hartzell. “The launch of a one-of-a-kind master’s degree program is a perfect example of that, and something we expect will have great impact on the industry.”

The M.S. in Health Care Transformation is designed for working health professionals, such as practicing physicians and other clinicians, as well as up-and-coming leaders across the health care sector. Dell Med students also can complete the yearlong master’s degree during their third year of medical school.

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January 2019

5/29/2013 7:20:41 PM

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Houston Medical Times

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Life Flight

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and engagement of safe driving behaviors to reduce impaired and distracted driving.

Impaired Driving Simulators - In partnership with the Houston Fire Department, Memorial Hermann offers simulators that are used to

in motor vehicle collisions that are often caused by some distraction or impairment,” said Michelle McNutt, MD, Chief of Trauma at the Red Duke Trauma Institute at Memorial Hermann-TMC and McGovern Medical “We see so many patients involved School at UTHealth. “If we can change

the behaviors of Houstonians, we can help reduce the number of friends and families who experience the devastating toll these preventable collisions take on the community.”

internet, or electronic health record consultations furnished when a patient’s treating physician or other qualified healthcare professional requests the opinion and/or treatment advice of a consulting physician or qualified healthcare professional with specific specialty expertise to assist with the diagnosis and/or management of the patient’s problem without the need for the patient’s face-to-face contact with the consulting physician or qualified healthcare professional.

CMS is requiring the treating practitioner to obtain verbal beneficiary consent in advance of these services, which consent must be documented in the patient’s medical record.

In adopting these six codes, CMS is adapting to new trends involving comprehensive patient-centered care management, which particularly impacts patients with chronic conditions including heart disease, diabetes, respiratory disease, breast cancer, allergies, Alzheimer’s Disease,

and factors associated with obesity.

CMS’ final rule recognizes that virtual care may improve beneficiary access to high-quality services while lowering the cost of healthcare. By adopting these rules, CMS hopes to support innovation and provide a telehealth benefit without regard to certain geographic limitations.

Virtual reality (VR) and Augmented Reality (AR) are two technologies that are changing lives of patients and physicians. VR can be used to take training and education to a new level. By adding such a life-like experience, VR is a powerful tool.

fail to execute a timely transformation will be replaced.

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give users a firsthand, virtual reality experience of impaired driving.

Driving Change Pledge - An oath all Houstonians are encouraged to take to reduce distractions while driving.

Legal Matters

Continued from page 3 • Practitioner follow-up may take place by phone call, audio/video communication, secure texting messaging, email or patient portal communication, but must be compliant with HIPAA. 3. Interprofessional Internet Consultation.

CMS’ final rule approved six new CPT codes (99451, 99452, 99446, 99447, 99448 and 99449) that describe assessment and management services conducted through telephone,

New Technology

Continued from page 8 least provides a unified EMR among your local providers within that organization. Since it is unlikely that all health care providers worldwide will ever use the same EMR/EHR system, most likely the solution will require technologies that can improve the connections and ability to share data between disparate systems. Blockchain technology and/or its underlying concepts may finally provide the solution. It would allow the health care provider to maintain control over their portion of the medical record and provide a secure, easy method to share with other authorized constituents.

Other challenges, including business, political and non-technical barriers exist that will also have to be addressed.

Therefore, widescale adoption may still be many years away.

Virtual Reality (VR) Augmented Reality (AR)

and

Health care consumers are alarmed by the ongoing, extreme increases in health care costs and are searching for better options.

Technology is creating a more

Augmented Reality (AR) connected and informed health care differs from VR in two key respects. consumer who is more empowered to The AR user does not lose touch with select the best care and best overall reality, and AR puts information into value. eyesight to augment the view versus Digital transformation will touch all replacing the view like VR. Imagine areas of health care and greatly improve a surgeon using AR to have reference services such as: information displayed directly onto New health care access points: the procedure area. The surgeon still care will be delivered in new sees the area being treated, and the locations and new approaches that AR overlays helpful information to will improve the convenience, improve the outcome. quality and costs for consumers.

Digital Transformation Reshapes Telemedicine: while Health care Telemedicine has existed for many

Digital Transformation is years, recent improvements will reshaping every industry, including now bring it into the mainstream. health care. Digital Transformation For those that are unable to travel Leaders will transform health care, but to a provider, they can have the unfortunately many traditional health health care brought to them. care organizations are not prepared for Health care Internet of Things this major industry change. Health (IoT): Remote monitoring, care organizations that fail to engage wearables, smarter sensors, medical the right expertise and laggards that medicaltimesnews.com

device integration, and the everexpanding list of connected health care technology. The IoT will “connect the connected” for better insight and care.

We are living in exciting times for health care, and technology will play a key role in transforming and improving your health care.

Mark Johnson is a global technology leader that has helped some of the world’s top health care organizations achieve success. He currently serves as President of Xtrii, www.Xtrii.com.

For additional information on health care technology and to see more of Mark’s technology tips and insights, visit www.Xtrii. com.

January 2019

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Houston Medical Times

Mental Health

HOUSTON

Continued from page 5 practice after graduation.”

Students are already putting what they’ve learned to practice. Pharmacy students, who were trained early on through Operation Naloxone, are now actively training first responders and members of the community in how to recognize an overdose and administer naloxone.

“We have seen five reversals from trainings provided to communities,” Alonzo said. “We’re preventing overdose deaths in our communities, and providing opportunities for people with opioid use disorder to access treatment and recovery—saving lives.”

The task force’s efforts also translate well beyond Texas’ borders.

Task Force representatives, including Byington and Alonzo, are engaged at

Oncology

Continued from page 6 your loved one, it’s important to take time for yourself. Get in the habit of setting aside time for yourself each day. When possible, find someone else

the national level, with the American Medical Association Alliance and the Association of American Medical Colleges.

There’s also an evaluation component planned. “We’re going to survey the students on the effectiveness of the training, and then we’re going to re-survey them every 12 months until they graduate to see what sticks and how their attitudes about opioid use disorder changes,” Alonzo said.

“We need to change the perspective of the next generation of health care providers, and this initiative is one component of that.”

The ultimate goal is to destigmatize substance use disorders and teach providers—and society in general—to consider it a chronic health condition,

not a lack of willpower or a character flaw. Naloxone doesn’t solve the problem or help people overcome addiction, but it does save their lives so they have the opportunity to seek treatment.

“This sort of training should be very common, just like people are trained in CPR,” Alonzo said. “You may never need it, but if the situation does arise, you need to know how to do it right and feel confident that you can save a life.”

who can step in to help you, if only briefly. Whether it’s taking a long walk, relaxing quietly with a book, or a weekend trip away, your care is equally important as that of your loved one.

The role of the caregiver is critical in helping a loved one navigate cancer treatment. At Texas Oncology,

caregivers are an essential part of the treatment team. Whether caregiving is a new role or something you have done for many years, I hope these suggestions help you find the balance you need to care of yourself so that you care for your loved one.

promote their clearance from the brain.

A diagnostic test will be especially important once effective treatments are established to treat various forms of dementia, he said.

“It’s probably too late once the effects of neurodegeneration are manifest,” said Dr. Diamond, a leading dementia expert credited with determining that tau acts like a

prion – an infectious protein that can self-replicate. “We need to be able to diagnose the process early and know the specific type of neurodegeneration that is occurring, because that is the best chance we have to intervene with a personalized treatment. This is very analogous to how we currently use tumor genotyping to best diagnose and treat cancer.”

• accelerate research on organizations implementing high-value care; and • produce new knowledge about how teams and organizations measure outcomes ad successfully transition to value¬-based care.

The Cullen Trust for Higher Education is one of three trusts that are part of the larger Cullen Foundation, which has distributed more than $500 million in grants since being

established in 1947. The Cullen Trust for Higher Education has pledged more than $14 million to UT Austin since 1983, with gifts to date totaling nearly $10 million. 

Dell Medical

Continued from page 12

January 2019

Senior Designer Jamie Farquhar-Rizzo Web Development Lorenzo Morales Distribution Robert Cox

Office: 713-885-3808 Fax: 281-316-9403

Continued from page 11

program, support from the Cullen Trust for Higher Education will be used to: • expand an executive education curriculum that emphasizes how to implement and scale high-value health care strategies; • develop innovation insights to drive high-value care at UT Health Austin, Dell Med’s clinical practice;

Director of Media Sales Richard W DeLaRosa

Accounting Liz Thachar

Dementia

Dr. Diamond’s team is trying to translate these findings into clinical tests that examine a patient’s blood or spinal fluid to detect the first biological signs of the abnormal tau, before the symptoms of memory loss and cognitive decline become apparent. His lab is also working to develop treatments to stabilize shape-shifting tau molecules, prevent them from assembling, or

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January 2019

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