Memphis Medical News October 2015

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PHYSICIAN SPOTLIGHT PAGE 3

Paul Hill, MD ON ROUNDS

Two Memphis Surgeons Performing New Heart, Chest, Lung Procedures

BY BETH SIMKANIN

Good Shepherd’s Aim: MissionMinded; Not MoneyFocused After two years of planning – and untold prayers of petition – Philip J. Baker, Pharm. D., witnessed a mission come to life when Good Shepherd Health opened on September 9 ... 4

Doctor’s Company Coaches Clients on Lifestyle Changes David Wright’s Adventia Does What PCPs ‘Don’t Have Time to Do’ For David Wright, MD, the guiding principles for both his medical practice and the ultimate creation of his health management company, Adventia, started to form in 1979 and took years to come to fruition ... 5

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Two Mid-South surgeons with Baptist Medical Group now are using the skills learned in cardiovascular and thoracic surgery fellowship training in Boston to offer alternatives to open heart surgery which in some cases save lives and enhance patients’ recovery from surgery.

John Craig, MD, a cardiovascular surgeon, and Christopher Mutrie, MD, a cardiac thoracic surgeon, are performing minimally invasive procedures and treatments not available a decade ago for adults with chest, heart and lung issues.

The two physicians met during their cardiothoracic fellowship at Massachusetts General Hospital in Boston in 2010 and established a strong friendship. Craig, a native Memphian, relocated to Memphis in 2012 and began a cardiothoracic practice with Baptist Medical Group. He recruited Mutrie, a native of Boston, to the practice in 2013.

The two physicians offer a unique set of skills that are rare in the MidSouth.

“These procedures and treatments are being performed in major cities in the U.S., but to my knowledge we are the only physicians to offer them in the Memphis area,” Craig said.

Mutrie performs the Nuss procedure, which is a minimally invasive technique that treats pectus excavatum, a deformity in which the chest wall is concave. It is the most common chest wall deformity in the United States.

(CONTINUED ON PAGE 10)

Dr. John M. Craig (left) and Dr. Christopher J. Mutrie

HealthcareLeader

Frederick Boop Continues to Unravel Secrets in a Three-Pound Universe

BY JUDY OTTO

Scientists sometimes call the human brain a “three-pound universe.” In the case of Frederick Boop, MD, it’s a universe where he is still blazing trails, discovering marvels and extracting secrets.

Boop is on staff at the Semmes Murphey Clinic PC, a professor and chair of neurosurgery at the University of Tennessee Health Science

Don’t Miss the Big Event

Center and chief of pediatric neurosurgery at St. Jude Children’s Research Hospital.

His current research is focused on the study of molecular genetic events that cause brain tumors, and of the molecular genetics of epilepsy, and he is also involved in multi-center clinical trials of brain tumor treatments.

“There are times,” he said, “when genetics (CONTINUED ON PAGE 14)

From industry conferences and continuing educational units to fun ways to support the area’s many non profits ... check the online calendar for healthcare happenings. www.MemphisMedicalNews.com

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PhysicianSpotlight

Hill Points Out Need for More Who Do What He Does

Geriatric Psychiatrist’s Work Formed by Admiration for Older People

BY RON COBB

To put it simply, Paul Hill is a geriatric psychiatrist because he likes older people. He always has.

When he was a boy growing up in midtown Memphis, his father’s mother lived with the family toward the end of her life. When Hill’s brothers went off to school, his grandmother was his playmate.

“So I had that early-life positive experience with an older adult,” Hill said.

“And who knows, maybe other people don’t have those early experiences. But I certainly did.”

After some 22 years in private practice, including 18 with Memphis Psychiatry Group, Hill now is teaching full-time at the University of Tennessee Health Science Center (UTHSC), where he did his internship and where he has maintained an affiliation throughout his career. He is one of a small number of geriatric psychiatrists in the Memphis area.

“What an interesting area to work in,” he said, “getting to know the kind of people who came before me, in terms of helping to make Memphis a better place to live, helping to make the nation the way it looks now.

“So it’s been a real pleasure getting to know my seniors and their families. Almost all of my experiences through geriatric medicine have been positive. I have a tendency to really like older people. I rarely find an older adult that I can’t connect with, that’s for sure.”

Hill counts himself and a small number of others as the only geriatric psychiatrists serving the Memphis area. Hill also would add his chairman at UTHSC, James Greene, MD, who works in parts of Tennessee treating patients by teletherapy.

“Right now the estimate is that we need about 8,000 more geriatric psychiatrists by 2020,” Hill said. “Unfortunately, we only make about 50 new geriatric psychiatrists a year, so we’re going to be pretty underserved in this area.”

The son of an investment banker and schoolteacher, Hill was first impressed with the practice of medicine when he injured his back playing high school football and received treatment in physical therapy. The summer after high school graduation from Evangelical Christian School, he worked at the old Campbell Clinic on Madison Avenue, doing whatever odd jobs they needed him to do.

“By then I knew I wanted to be in the medical field,” he said. “Being around sick people, or being around injured people or handicapped people didn’t bother me at all. It’s really the only kind of work I’ve memphismedicalnews

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ever done.”

He went off to college at UT in Knoxville, but he lasted only one semester there.

He was homesick and transferred to what was then Memphis State.

“Some people said, ‘Oh, you went to Knoxville and had too much fun there.’ I said, ‘Not really.’ I think I made a 3.75, so I didn’t come back because my grades were bad. I enjoyed living in Memphis, and I was following Memphis basketball,

and I wasn’t taken over by living in Knoxville and being a Tennessee Volunteer.”

A turning point for Hill came when he took a course at Memphis State called The Sociology of Aging. The instructor was Graves Enck, (PhD) who Hill describes as “a pretty famous teacher.” At that point Hill was inspired to become a geriatrician. The psychiatry part of the equation came when he did his internship at what is now UTHSC. His sole concern now is non-clinical teaching, but he plans to turn soon to clinical psychiatric medicine.

“We’re developing some geriatric psychiatric programs at the university,” he said, “and it’s going to be affiliated with some other hospital systems. It’s in the works right now.”

The most common problem that Hill sees among the elderly is depression, followed by neurocognitive disorder, or dementia, and then Alzheimer’s.

“One of my main professors was a guy named Bill Applegate,” said Hill. “He said something that I remember when I was a freshman in medical school. He said, ‘I’m interested in disorders of the aging brain.’

“And that was very intriguing to me, to think that these weren’t illnesses of the brain, they were illnesses of the aging

brain that made aging people susceptible.”

Hill sees good things in what he calls the assisted living movement and independent senior living. He believes older people need to be willing to accept change.

“I think the older adult needs to be open-minded to the idea that they may need to have other people live with them,” he said. “They may need to move into what we call a senior living situation, which is not a nursing home. It would be akin to what Trezevant does, what Kirby Pines does and what the Village at Germantown does.

“And the whole idea is that during the course of your lifetime, you have to continue to make new friends. You might have to be involved in a church activity with other seniors where you’re able to make friends. Or go to the community centers here in Memphis like the Lewis Senior Center, the Jewish Community Center – all these places available to them.

“The solution is for the older adult to have an open mind and not just focus on the change being more than they can handle, because they certainly can handle the change. Older adults are much more resilient than us younger folks anyway. Of course, they can handle change. They’ve been handling change their whole life.”

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Good Shepherd’s Aim: Mission-Minded; Not Money-Focused PHOTO BY SARA ANN GREEN PHOTOGRAPHY

BY JAMES DOWD Good Shepherd.

Here’s how it works.

After two years of planning Good Shepherd contracts with – and untold prayers of petition Dispensary of Hope for a fee of – Philip J. Baker, Pharm. D., wit$12,500 a year, and as part of the nessed a mission come to life when deal Good Shepherd receives mediGood Shepherd Health opened cations that manufacturers donate on September 9. for dispensing by such facilities. To The nonprofit pharmacy is receive prescriptions at Good Shepthe vision of Baker, who formerly herd, patients become “members” worked as director of the pharand pay monthly fees to receive free macy at Baptist Memorial Hospior at-cost medications. tal in Germantown, and arrives as Memberships are $5 per the newest facility to open in the month for patients under 18, $10 Bluff City to provide low-cost or per month for those 18-29, and free medications to those in need. then go up $10 for each subsequent But there’s more to Good decade (30-39, etc.) until age 59. PaShepherd than free meds. tients 60 and over pay a maximum “We want Good Shepherd membership of $50 per month.

Medication Management to be The pharmacy does not dispense more than just a pharmacy where narcotics, and is designed to serve Dr. Philip J. Baker observes as his daughter, Lucy, and Memphis Mayor A C Wharton prepare to cut the ribbon during grand opening ceremonies for Good patients come to get prescriptions the pharmaceutically uninsured, Shepherd. filled,” Baker said. “We want to or those with incomes at or below go beyond dispensing meds and 200 percent of the Federal Poverty sit down with patients and talk to them Guidelines, or $24,250 for a family of four. insured patients and those living in extreme about medication management. This is Good Shepherd is also a valuable poverty. The model takes cues from the not a quick stop to drop off prescriptions or service for seniors caught up in the MediDispensary of Hope in Nashville, founded pick up medicine.” care coverage gap, or donut hole, Baker in 2007 as a “charitable medication disGood Shepherd is mission-minded said. The gap occurs when Medicare pays tributor.” rather than money-focused, Baker said. $2,960 on the patient’s covered drugs (the That program now dispenses medicaThe venture was born out of a desire to amount increases to $3,310 in 2016). Betions to practices and pharmacies across provide free or low-cost medications to unyond that amount, Medicare patients pay the country, such as the newly opened

45 percent of the cost for brand-name prescription drugs.

“We’ve consulted with patients and cut many of their monthly prescription costs in half,” Baker said. “We’re working with one woman who was paying more than $400 a month for her prescriptions, and we’ve got that down to about $80. It makes a huge difference.”

The rising costs of prescriptions are out of control, Baker said, and contribute to a lower standard of living when patients are unable to afford medications. The Good Shepherd model counteracts that through its relationship with Dispensary of Hope, and because of its nonprofit status, the facility does not depend on charging dispensing fees or marking up meds to stay afloat.

“Most people don’t realize how remarkably cheap medications are and how phenomenally much they’re marked up,” Baker said. “We eliminate as many of those costs as possible because our mission is to serve people, not make a lot of money.”

Dispensary of Hope receives its medications from more than 1,000 medical practices across the country that donate samples of brand-name drugs, as well as from manufacturers. Because the donation model depends on medications sent by physicians and manufacturers, Good Shep(CONTINUED ON PAGE 12)

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Doctor’s Company Coaches Clients on Lifestyle Changes David Wright’s Adventia Does What PCPs ‘Don’t Have Time to Do’

BY LANCE WIEDOWER

For David Wright, MD, the guiding principles for both his medical practice and the ultimate creation of his health management company, Adventia, started to form in 1979 and took years to come to fruition.

Today, Adventia provides software, training and education to corporate and clinical clients. The software for corporate clients was created in 2013, and in 2014 for clinic settings. Wright closed his practice in 2014 as his focus shifted to Adventia.

Back in 1979, while Wright was in Memphis for his residency in internal medicine at Baptist Hospital, his father had a heart attack back home in Florida. He was 52.

Wright realized heart problems could not only affect him but his children. After finishing residency in 1982 and a stint in the Air Force, Wright returned to Memphis in 1985 to practice internal medicine, focusing on patients dealing with heart attacks, stroke and diabetes.

His frustration built while watching patients continue to have events even as medicine advanced. Wright implemented prevention as part of his treatment, and patients began improving. But it’s more than just advising patients to lose weight, eat better and get more exercise.

“It requires the person to do things,” Wright said. “That’s one of the challenges in medicine. How do you engage the person in the changes they need to make? We need to find a better way to have people get engaged. That was from the science of motivational interviewing that was developed in the drug and alcohol treatment world.

Researchers in that field said if we ask questions differently, we can improve the likelihood they will change.

“We try to create those ‘ah ha’ moments. People really are nutritionally illiterate and activity illiterate. What we do is use better information to reveal better what their risks are. And, if they are heading toward a heart attack, stroke or diabetes, get

them on that road to change.”

Clinical providers, hospital systems, physician practices and providers can use Adventia’s software to help patients create a plan that gives them a better chance to prevent health problems years before they need to be treated. Employees can use the corporate model to take control of their

wellness in much the same way.

Wright points to Varsity Brands, a Memphis-based company that first used the software in 2011. He said 20 percent of the company’s employees lost more than 2.5 inches on their waistline.

Among 650 participating employees, 28 percent lowered total cholesterol an average of 20 points, more than 30 percent lowered blood pressure an average of 10 points, 31 percent lost an average of 8.5 pounds, 34 percent lowered bad cholesterol an average of 17 points and 44 percent raised good cholesterol an average of nine points.

“This is without drugs,” Wright said.

“It’s having better information to help them make decisions. Lots of folks made dramatic changes just by having this information.”

Adventia’s model isn’t smoking cessation or weight loss programs. But what it does provide is tailored information that helps people create individual plans that naturally lead to better lifestyle choices.

The first part of the process is a health risk assessment. Clients learn levels of risk based on factors they can’t change such as age or gender as well as factors they can change.

The next step is a lab report that goes into detail on waist measurement, blood pressure and levels of triglycerides, HDL cholesterol and glucose and what the specific risk levels are for each.

An examination of the carotid arteries is next to determine levels of plaque buildup. The artery age can help determine the lifetime risk for heart attack and stroke.

Finally, a personalized treatment plan goes beyond instructions to eat healthier; it now includes specifics on diet. People with higher risks also receive health coaching.

The next step for Adventia is getting the software in more physician practices and corporate settings so more people can prevent heart episodes.

“Prevention evidence has exploded in the last decade, but doctors are busy taking care of sick people,” Wright said. “Keeping people healthy isn’t in the front of our minds. We’re taking care of urgent problems in front of us. … It struck me I know how to do this. I’ve refined it just to take care of my patients. The software is a clinical decision tool. It simplifies the doctor’s practice.”

It makes sense to start in Memphis, a (CONTINUED ON PAGE 15)

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THA 2015 Conference Overview

THA’s 77th Annual Conference Addressed Industry Challenges, Shortfalls

BY MELANIE KILGORE-HILL

Each year, more than 1,000 healthcare professionals from Memphis to the Tri-Cities converge in Nashville for the Tennessee Hospital Association’s annual meeting. The 2015 conference, “Mission Innovation: The Power of People,” took place Sept. 30 – Oct. 2 at the Gaylord Opryland Resort & Convention Center. This year’s event focused on navigating trends and overcoming shortfalls in an evolving healthcare delivery system.

A Changing Industry

“A lot of the meeting has to do with the sharing of information and best practices, and it’s really important for attendees to hear from national speakers to help them continue to improve on quality indicators,” explained THA President Craig Becker.

He said the biggest change facing hospitals is the evolution of reimbursement. “We’ve done Craig Becker things the same way for 50 years, and now we’re seeing a significant swing in how we’ll be paid,” Becker explained in a late-September interview with Medical News. “We have to be able to provide care in a much more

cost effective way, and we have to do more for less. We want to use innovation but not leave behind the people who have to do the innovating,” he said, referencing the event’s theme.

Becker readily admitted there are many ways to accomplish that, with “population-based health” being an especially popular buzzword that’s garnered lots of conversation but no concrete answers. Becker said the difficulty is populations vary by state, region and hospital. “Still, we wanted to get speakers to get people to think about how to best take care of our populations,” Becker said. “We need leaders to understand that things aren’t staying the same … and if you’re standing still, you’re going to get run over.”

Quality, Safety, Value

Few speakers can communicate the challenges of the quality, safety and value movement like THA’s leadership summit keynote speaker Robert M. Wachter, MD. Wachter serves as professor and interim chairman of the Department of Medicine at the University of California, San Francisco and Dr. Robert M. Wachter is chief of the Division of

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“It’s become a relatively familiar refrain that we’re now being pressured to improve quality, safety, patient experience and cost effectiveness in ways we never have before,” Wachter said in a pre-conference interview. “People get that. In some ways we’re getting better at it, but we’re beginning to understand how hard it is.”

Among today’s challenges are the added pressures on clinicians. “In the beginning of value-based care, there was a feeling that you could load this responsibility up on top of a clinician’s existing work,” Wachter said. “While some can be baked into existing work, we’ve come to realize that if you have an overwhelmed, overworked group of clinicians, it’s hard to have them engaged.”

He continued, “We have a new appreciation and understanding of the importance of training clinicians and making sure they have bandwidth and enthusiasm to do this well.”

Wachter said it was also naïve to believe information technology would solve all the problems. He admits advances have been more beneficial than harmful but said many unintended IT-related consequences are still coming to light. “Innovation and technology should ultimately help, but when you just throw technology at a dysfunctional process, you speed up dysfunction,” Wachter said.

Bottom line, he added, is everybody is overwhelmed.

“What we’ve done is said to everybody in the healthcare system, ‘Keep doing what you’ve been doing in terms of volume …

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and layer on top of that a huge number of new imperatives,’” he explained, pointing to the growing numbers of signatures and committee involvement required of each provider. “In a vacuum it doesn’t sound bad, but in the big picture it’s 1,000 ‘one more things,’” Wachter said.

“I tell students all the time, what’s weird isn’t that we’re being asked to improve quality, safety and efficiency.

What’s weird is that we’re just being asked to do it today, where it hasn’t traditionally been expected in the healthcare system,” he concluded.

Engaging Your Board

The types of changes impacting healthcare have trickled up from patient rooms to boardrooms, and that’s where THA guest speaker Kimberly McNally, MN, RN, focused her attention in her conference presentation, “Strategies to Engage your Board as Quality Champions.”

The president of Seattle-based McNally & Associates told Medical News common safety and quality challenges are facing hospital boards nationwide. “Boards Kimberly should include a triad of McNally collaborative leadership – meaning the board, executive team and physician leaders working together,” she said. “Their influences are connected so it’s important to have all three sides of the triangle working collaboratively.”

Not unlike clinicians, the biggest obstacles for board members are busy schedules. That’s why having a shared understanding of direction is critical.

“Without that, it’s very hard to get everyone pointed in the same direction,” she said, adding it begins with education and letting board members know why quality initiatives are important. “Education like that at THA is essential because people need to know why they’re doing what they’re doing,” McNally said. “People have to feel like they’re making a difference so meetings about safety and quality can be effective with clear roles.”

She noted common board mistakes include not being certain on the front end about intended pictures of success or not having clear metrics. “Oftentimes members aren’t prepared for the role they’re expected to be in, and board members aren’t typically people with clinical training,” she said.

McNally also urged hospitals to seek board members from industries with a shared focus on quality and safety. She said she also encourages the use of patient stories to help set a tone for a meeting, to avoid using insider medical jargon, and to ensure lay explanations are given for industry terms. “Invest in leadership development so members can make their optimal contribution,” McNally said. memphismedicalnews

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Do Something End Slavery Tennessee Calls for Awareness, Action

BY CINDY SANDERS

During the third annual luncheon benefitting End Slavery Tennessee on Sept. 22 in Nashville, nearly 800 audience members listened in stunned silence as guest speakers detailed the state’s slave trade. Far from being a history lesson about a past shame, the program outlined the very real … and very current … issue of human trafficking in the United States and Tennessee.

By legal definition, human trafficking is an act or attempted act of recruiting, transporting, transferring, harboring or receiving a person by means of force, abduction, fraud, coercion, purchase, sale, threats, or abuse of power for the purpose of exploitation.

“Human trafficking is the second – and fastest growing – crime on the planet after drug trafficking,” said Jeremy Finley, chief investigative reporter for Nashville’s local NBC affiliate, who opened the program.

In fact, those who have trafficked in drugs and weapons are finding it to be more profitable and less risky to sell humans. In sex slavery, an individual can be put on the market multiple times a day. In the case of labor slavery, goods are continuously produced without labor costs or laws hampering profitability.

But it isn’t a global problem that only happens elsewhere, Finley continued.

“Ninety-four minors a month, on average, are estimated to be trafficked right here in Tennessee.”

In 2011, 85 counties in Tennessee reported at least one case of human trafficking. In Nashville that same year, more than 100 cases of minor sex trafficking were reported in Davidson County, and a similar number was reported for adults. Since July of this year, just a few of the headlines tied to human trafficking arrests around the state have come out of Knoxville, Johnson City, Franklin, Jackson, Clarksville and Murfreesboro.

The average age of trafficked adolescents is 12 years old. “The average life expectancy for children and young people who are trafficked is seven years – trafficked at

12, dead at 19,” said Finley.

He added, “The number one vulnerability that traffickers target is the desire for love and acceptance and a place of belonging.” To battle back, Finley said everyone must ask, “What are we willing to do to make children in Tennessee feel loved?

What are we to do to help Tennessee’s children be less vulnerable?’”

Before turning the program over to Derri Smith, founder and executive director of End Slavery Tennessee, Finley noted the nonprofit organization is taking a lead role in answering those questions, helping survivors heal, and strategically confronting slavery within the state.

In her address, Smith recalled how she came to found the organization. “Once upon a time, Derri Smith I learned that 11- and 12-year-old children were being groomed and sold for sex right here in my beloved home state. There’s no way I could know that and not do something,” she said.

From educating the public and training professionals to providing victims and their advocates with a single point of contact for comprehensive, long-term services, the organization continues to grow and adapt its work to address needs.

“Even five years ago, our system of laws was an unintentional welcome mat for traffickers,” Smith said. “Most people thought trafficking didn’t happen here. Even many law enforcement agencies doubted it was a problem.”

Through work at the state level, letter and phone campaigns to legislators, and heightened community awareness, Tennessee now has some of the strongest trafficking laws in the nation. Smith pointed out, “In a few short years, Tennessee has gone from a mediocre response to human trafficking to a model state.”

One of the driving forces behind that change, she continued, is the work of Margie Quin of the Tennessee Bureau of Investiga-

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Red Flags There are a number of red flags that a person might be a victim of human trafficking. For a more comprehensive list of possible indicators, go online to endslaverytn.org/redflags. Below are a few that might be noticed by healthcare professionals in a clinical setting.

• Injuries/signs of physical abuse (that they may be reluctant to explain); • Untreated illnesses or infections such as diabetes, cancer, or tuberculosis (because they haven’t been able to see a healthcare provider regularly); • STDs, HIV/AIDS, pelvic pain or inflammation, rectal trauma, urinary difficulties, abdominal or genital trauma (and this is an even brighter red flag if the patient in question is a minor); • Emotional distress such as depression, submissiveness, anxiety, panic attacks, confusion, phobias, disorientation, self-inflicted injuries or suicide attempts; • Inconsistencies when describing and recounting events; • Unable or unwilling to give a local address or information about parents or a guardian; or • Presence or fear of another person (often an older male or boyfriend who seems controlling).

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MedicalEconomics

BY BILL APPLING

Healthcare Briefs • One-third of the total U.S. prescription-drug spending in 2014 went to specialty drugs which made spending grow by 27 percent to $124 billion.

Help us reshape the treatment for Alzheimer's disease Are you, or is someone you know, diagnosed with Alzheimer’s disease?

• The cost of insulin has increased by 325 percent over the past 4 years. This increase has and will hinder the efforts of preventative care and add to the cost and quality of life because limb amputation, heart disease, and the need for dialysis. I believe that it will take state and federal intervention regarding the rising cost of drugs in our country.

IMS Institute for Healthcare Informatics

• 28 percent of Americans who said obtaining cheaper or better health insurance would be a reason to relocate to another county or state. Do you hear this lawmakers?

Survey by financial news Website Bankrate

Why join the STARBEAM Study?

• You might be able to help with a clinical research study looking at a potential new treatment for mild-to-moderate Alzheimer’s disease • You will receive the best standard of study-related medical care • You may receive an investigational treatment, designed to help improve memory, thinking and reasoning • All study-related medicines and consultations during the study will be free of charge and reasonable travel, parking and food expenses will be paid

• An increase from $12,000 to $14,500 for a hospital stay for adults with multiple chronic conditions between 2003 and 2014.

Healthcare Costs and Utilization Project

• 6.4 percent...Physicians’ self-rating of their confidence level, on a 1 to 10 scale, in accurately diagnosing a difficult case, despite only 6 percent of them getting the diagnosis right.

Study published in JAMA Internal Medicine

To be able to join the STARBEAM study you must be: • diagnosed with probable Alzheimer’s disease • aged 50 years and over • able to communicate with study doctors • have a caregiver who can communicate with study doctors and will join you during every visit • able to walk, independently or assisted • free from other conditions which affect mental ability, such as schizophrenia or Parkinson’s disease • taking a drug containing donepezil for at least 6 monthst

If this is you, or someone you know, we would like to hear from you!

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• 7.7 percent increase in the availability of primary-care appointments for Medicaid beneficiaries after reimbursement levels were raised to Medicare levels.

New England Journal of Medicine

• 29 percent...increase in emergency visits from 103.1 million to 133.6 million from 2000 to 2013.

American College of Emergency Physicians, American Hospital Association

• 13 percent...increase in behavioral-health-related hospital emergency department visits between 2005 and 2012, while the number of inpatient psychiatric facilities declined 7.8 percent between 2005 and 2013.

American College of Emergency Physicians, American Hospital Association

• Financial markets have sent another signal that the coming era of precision or personalized medicine could wind up making cancer care unaffordable for millions of people.

Modern Healthcare March 9, 2015.

• 48,900…projected surplus of pharmacists by the year 2025, with an expected demand for 306,400.

Health Resources and Services Administration

• For the second year, that CMS has awarded bonuses to one in four accountable care organizations working under a Medicare model intended to spur providers to deliver lower-costs care. They will share $422 million out of the $833 million they collectively saved the government in 2014.

• ACO networks get to decide for themselves how to distribute the money

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and primary-care appear to be benefiting the most according to a review of disclosures by ACOs participating in Medicare Shared Savings published in August 31, 2015, Modern Healthcare.

• “We don’t have a good distribution model for ACO savings,” said Dr. Kavita Patel, managing director of clinical transformation at the Brookings Institute’s Center for Health Policy, citing a study published in August, 2015.

• Since, October of 2009, the HHS Office for Civil Rights has fined healthcare organizations 1142 times for data breaches affecting at least 500 people.

• Largest healthcare fraud settlements from 2014 1. DaVita Healthcare Partners $400.0 million 2. Endo Health Solutions and Endo Pharmaceuticals $ 192.7 million 3. Amedisys $150.0 million 4. Omnicare $124.2 million 5. GlaxoSmithKline $105.0 million 6. Community Health Systems $98.2 million • Healthcare’s biggest spenders on lobbying in 2014 1. American Hospital Association $20,763,146 2. American Medical Association $19,650,000 3. Pharmaceutical Research and Manufactures of America $16,640,000 4. America’s Health Insurance Plans $9,200,000 5. Amgen $8,560,000 6. Pfizer $8,470,000 7. Biotechnology Industry Organizations $8,280,000 8. Eli Lilly & Co. $8,216,000 9. Johnson & Johnson $7,667,500 10. Novartis $6,520,000 11. Bayer $6,180,000 12. Sanofi $5,973,000 13. Blue Cross and Blue Shield Association $5,880,000 14. Medtronic $$5,310,000 15. Roche Holdings $4,953,000 16. AbbVie $4,940,000 17. Merck & Co. $4,790,000 18. GlaxoSmithKline $4,370,000 19. DaVita Healthcare Partners $4,330,000 20. Fresenius Medical Care $4,075,000 Sources: Healthcare Prostitutes, J William Appling, U.S. Senate Lobbying Disclosure Act Database

Bill Appling, FACMPE, ACHE, is founder and president of J William Appling, LLC. He is a national speaker, presenter and a published author. He serves as an adjunct professor at the University of Memphis and is on the boards of Hope House and Life Blood. For more information contact Bill at j.william.appling@ outlook.com.

memphismedicalnews

.com

Using Deep Brain Stimulation to Treat OCD Patients

BY LYNNE JETER

ST. LOUIS–On July 6, world-renowned neurosurgeon Richard Bucholz, MD, led a team at SSM Health Saint Louis University Hospital in St. Louis, Mo., to perform deep brain stimulation (DBS) to treat obsessive compulsive disorder (OCD) for the first time in the Centers for Medicare & Medicaid Services’ (CMS) Region VII. “The outcome of this test case for the region has been extremely gratifying,” said Bucholz, vice chairman in the department of neurosurgery and K. R. Smith Endowed Chair in Neurosurgery at Saint Louis University (SLU), of the middle-age male patient, housebound by the disorder and unresponsive to medication. “This patient is rejoining society, not exhibiting previous compulsions, and seems to be doing extremely well.”

In a DBS procedure, mostly known for treating Parkinson’s patients, speciallytrained neurosurgeons implant tiny electrodes through dime-sized incisions into areas of the brain that control movement.

In a second procedure, the electrodes are attached to an implanted generator that dispatches signals to the electrodes in the brain. Later, a neurologist programs the generator to determine the optimal setting for normalizing brain activity to alleviate tremors, stiffness, slowness, involuntary movements and gait problems.

“A tremor from Parkinson’s is an excess motor activity in the brain,” explained Bucholz. “Similarly, compulsions from OCD are excess thoughts in the brain. Suppressing those thoughts through DBS is very similar to what we’ve done for years in treating movement disorders.”

In 2009, the U.S. Food and Drug Administration (FDA) approved DBS for treating OCD. Last year, a group of experts published a clinical guideline in Neurosurgery, recommending DBS for cases of OCD unresponsive to medication.

“I wasn’t really surprised the FDA approved DBS for treating OCD because the benefits of intervention in this area have been well known for a long time,” said Bucholz. “Also, results from pilot studies in the few (U.S.) centers that have done this for several years have been quite remarkable. I was a bit surprised that Medtronic, the research sponsor, decided to put this out as a humanitarian device exception, a special way of releasing a product that can only be placed under research protocol and in approved centers, as opposed to a more general release.”

As a result of the special designation, Saint Louis University Hospital remains one of few academic centers in the nation allowed to perform DBS for OCD. “We’ve been enrolled in the study for some time and set up a committee to review potential candidates for this procedure,” he said. “It’s taken us a while to come up with individuals with all the apmemphismedicalnews

.com

propriate indications for intervention.”

Appropriate candidates are determined by refractoriness and incapacitation, said Bucholz, who at press time had additional cases scheduled by the end of September.

Whether the newly FDA-approved procedure will be covered by insurers has been highly debatable, said Bucholz.

“There’s never been a test case in the

regional group that covers St. Louis to determine reimbursement,” he explained.

“That’s proven a challenge. Other Medicare review groups for other geographic areas of the U.S. have demonstrated reimbursement for this intervention, given the suitability based on criteria. We’ll see whether this test case gets reimbursed.”

CMS Region VII covers Missouri, Kansas, Iowa and Nebraska.

Bucholz became world known for his invention of StealthStation, an imageguided navigational device to improve surgeons’ abilities to access the brain and navigate complex neural and vascular anatomy. Developed in his St. Louis garage in 1990, the platform was FDA-approved in 1996, the same year Medtronic acquired it. StealthStation, now in its sev-

Methodist Healthcare

(CONTINUED ON PAGE 15)

Mayo Clinic

Now working together for you.

Methodist Healthcare is working with Mayo Clinic by joining the Mayo Clinic Care Network.

This means you’re able to stay close to home with your trusted physician, while gaining additional expertise from Mayo Clinic specialists. This collaborative care comes at no added cost to you.

And it’s one more way Methodist Healthcare is improving the health of people in the Mid South.

To learn more, visit MethodistHealth.org/Mayo.

OCTOBER 2015

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Two Memphis Surgeons, continued from page 1

The Concussion Epidemic?

Concussions are in the news again. Frontline published data from the Boston University Center for the Study of Chronic Traumatic Encephalopathy, arguably the most vocal group investigating long term-effects of repetitive head injury. In the most recent data set, chronic traumatic encephalopathy (CTE) was identified in 131 of 165 individuals who had played football at any level (i.e., professionally, semi-pro, college, or high school). In the NFL cohort, CTE was found in 96% of the sample. These alarming statistics feed into what many have deemed “the concussion epidemic.” Yet, questions remain.

Concussions, or uncomplicated mild traumatic brain injury, make up the most common closed head injury in adults and children. The oft-cited CDC statistic suggests that – 1.6 to 3.8 million children suffer a concussion each year – a number that many consider an underestimate as this is primarily based on patients who present to the ED. Cumulative repetitive head trauma is the prevailing hypothesis in the development of CTE. CTE is described as “…a progressive neurodegeneration characterized by widespread deposition of hyperphosphoylated tau (p-tau) as neurofibrillary tangles” (McKee, et al., 2013). There is no in vivo test for CTE at this time. All cases in the literature have been identified via autopsy. One of the unusual aspects of CTE is that the pathophysiological entity has been proposed and defined in the absence of a clear clinical behavioral syndrome. Indeed, the behavioral syndrome associated with CTE is quite variable – including neuropsychiatric symptoms (e.g., irritability, depression, emotional dysregulation, poor impulse control), neurocognitive (e.g., memory loss, speech abnormalities, executive dysfunction, dementia) and focal or broad neurologic changes (e.g., Parkinsonism, motor neuron disease).

Further questions remain regarding CTE, including its true prevalence rate, is it modifiable or treatable, genetic contributions, etc.

Unfortunately, the slow emergence of empirical data has not thwarted media attention. This has led to litigation at nearly all levels of sport, including pop warner, the NCAA, and NFL/NHL. Participation in youth sports has also declined, which many believe is secondary to fear over long-term outcomes with repetitive head injury. For example, between 2010 and 2012, participation in Pop Warner football has declined by nearly 10%.

These data notwithstanding, methodologically rigorous studies have continued to show that a majority of concussive patients improve. In the largest high school and collegiate longitudinal studies, the mean time to recover ranges between 7-10 days (McCrea, et al., 2013), which align with Giza and Hovda’s seminal work on the neurometabolic cascade in concussive injuries (2001).

In practice, clinical management of concussion, both sports-related an non, is more complicated. While group data assist in understanding the injury at a broad level, it does not account for individual differences. Risk factors for prolonged concussion recovery fall into broad injury and non-injury factors. In the former, individuals at risk for prolonged recovery include: any loss of consciousness, presence of post-traumatic amnesia, and a high number of severe symptoms acutely.

Non-injury factors have been explored predominantly in children and adolescents.

These studies have revealed several risk factors, including: premorbid headache disorders, anxiety disorders, poor sleep, history of ADHD or learning disability, or previous history of concussion. Careful assessment of these factors is critical.

Effective management requires knowledge of concussion and risk factors. Objective cognitive measures, symptom screening, and vestibular tests can be helpful; however, there is no gold standard in this regard. Treatment often entails rest; however, prolonged bed rest or removal from specific activities (e.g., computer or phone screens, etc.) has not been thoroughly supported empirically. Resuming one’s normal routine following concussion is often associated with the best outcomes. Ultimately, if encountering concussion or mild TBI patients, education is critical. The CDC can be helpful in this regard (http://www.cdc.gov/headsup/).

In complicated cases, consultation with your local concussion specialist may be beneficial toward maximizing your patients’ outcomes.

Brandon C. Baughman, Ph.D., ABPP-CN Board Certified in Clinical Neuropsychology Semmes Murphey Clinic, PC Assistant Professor, Department of Neurosurgery University of Tennessee College of Medicine Dr. Baughman holds a clinical appointment in the Department of Neurosurgery at the University of Tennessee School of Medicine. He also holds an adjunct position in the Department of Psychology at the University of Tulsa. He is actively involved in research, most recently in studying the effects of sports concussion with a multidisciplinary team from the University of Memphis, UTHSC and SMC. Dr. Baughman is actively involved in community education and advocacy regarding sports concussion. Dr. Baughman serves as a practicum/extern supervisor for University of Memphis doctoral candidates, as well as a clinical and research supervisor for clinical neuropsychology fellows from the Memphis VA Medical Center. He is involved in national research program committees in the field of neuropsychology.

SPONSORED CONTENT

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“It is generally considered a cosmetic deformity, but it can cause chest pain, shortness of breath, fatigue and fainting episodes in patients,” Mutrie said. “It can be upsetting for the patient psychologically as well.

Most patients are born with the deformity and it worsens over time, so it gets harder to fix as the patient ages.”

The procedure involves inserting an infection-resistant titanium bar through two small incisions on either side of the chest.

Another small incision is made to insert a camera to allow the surgeon to see the inside of the chest during the operation.

According to Mutrie, the operation takes between an hour and an hour and a half to perform, and the patient is in the hospital for four to five days. The patient wears the bar for two years as it reforms the chest wall.

“The bones remodel and reshape, and a normal chest wall is achieved,” Mutrie said. “After two years, the bar is removed and the patient goes home the next day. The patient can resume a normal life with exercise without endangering the chest wall.”

Mutrie said that traditionally surgeons performed the Nuss procedure only on children, but due to technological advancements within the last 10 to 15 years, surgeons can perform the procedure on adults. According to Mutrie, the incision is much smaller, the hospital stay is shorter and the patient experiences less scar tissue than before.

“This procedure has gotten more popular in the last 10 years because we have learned more about the deformity, and technology has gotten better,” Mutrie said. “This procedure is a good alternative to reconstructive surgery and avoids excessive scar tissue. There are other ways to reconstruct the chest wall, but this is the most minimally invasive way. ” After Mutrie learned the procedure as part of his fellowship training in 2010, he brought this knowledge with him when he was recruited by Craig to relocate to Memphis. He performed 12 Nuss procedures last year. Other Mid-South cardio thoracic surgeons refer their patients to him because he performs the procedure.

“This is a fairly rare procedure, but it’s a good technique to have,” Mutrie said.

“With technological minimally invasive improvements, more surgeons are learning about the procedures in fellowship training.

In time, you will see more surgeons perform the procedure.”

Craig performs a procedure with a device called an AngioVac system, which removes blood clots in the circulatory system.

According to Craig, before the device was first used in 2009, the only other option to extract blood clots from the heart or lungs was through open-heart surgery, which involved opening the chest and stopping the heart.

“It works like a big vacuum cleaner and removes blood clots and other dangerous material from the heart,” Craig said. “Retrieving a clot used to require open heart surgery, resulting in longer hospitalization, recovery and rehabilitation times compared to this minimally invasive approach. It optimizes a patient’s quality of life and reduces the chance for infection.”

The AngioVac device employs large suction catheters capable of filtering all of the blood in the body through a cardiac by-

pass machine in as little as one minute. It removes blood clots and other foreign matter and returns the purified blood back to the patient. The entire procedure usually takes a couple of hours to perform, and the recovery time is minimal.

“Most patients are back at work within two to three days, whereas prior it would have been two to three months,” Craig said.

“We can accomplish the same results and now patients can walk the same day, are often home in less than 24 hours and fully recover in a few day’s time.”

Craig was introduced to the AngioVac system during his fellowship at Massachusetts General Hospital, which was one of the first test centers in the world to use the device and train surgeons to perform the procedure.

Craig performs five to 10 procedures with the AngioVac system per year, and while that is not many, Craig says he is the only physician currently using the device in the Mid-South.

“This technology is new, and the device is used in only a few major cities across the United States,” Craig said. “I hope that more physicians will learn about this new technology and its advantages.”

In addition to the AngioVac, Craig is trained in extracorporeal membrane oxygenation, or ECMO, which is a technique that provides both cardiac and respiratory support to patients whose heart and lungs are unable to work on their own.

“These patients are profoundly sick, and this is a last-ditch salvage attempt,” Craig said. “There is no other way to save them. At least 80 to 90 percent of the patients we support with the machine would die without it. It saves lives.”

ECMO works by removing blood from the patient’s body and artificially removing the carbon dioxide and oxygenating red blood cells.

“Typically, it is used to support patients with severe heart or lung failure due to an acute illness such as the flu or a heart attack, for example, “ Craig said. “It performs the function of the patient’s own heart and lungs so failing organs can heal. It’s like a secondstring quarterback coming in to play while the star quarterback is sidelined by an injury.”

According to Craig, a patient is on the machine usually for three to five days for heart support and 10 to 14 days for lung support. Craig says most adult ECMO centers see up to a 60 percent survival rate for lung failure and a 40 percent survival rate for heart failure in patients who would have otherwise died of their illness. Most survivors expect to make a full recovery.

“In some cases, ECMO gives patients a chance to heal so they can undergo major heart surgery and be strong enough to survive,” Craig said.

Traditionally used on children, the technique is now being used more on adults with cardiac and respiratory failure. He projects to treat 15 to 20 patients this year and has been using ECMO since he joined Baptist Medical Group in 2012.

“This is not a common treatment and has only been used with consistent success in adults for the last five to 10 years,” Craig said. “It is done so infrequently that not everyone knows it is available. Through education, we hope to raise awareness of this life-saving technology.” memphismedicalnews

.com

WHO’S TENDING OUR DOCTORS?

Streamlining Prescription Management

An Integrated Orthopaedic Group

Synchronizing Patient Prescriptions Could Save Practices an Hour Daily

BY LYNNE JETER

Editor’s Note: This article is part of a Medical News exclusive series, “Who’s Tending Our Doctors?” to focus on ways the industry can help alleviate physician stress and allow physicians to return to the joy of practicing medicine.

Consider a patient on multiple medications who might generate several phone calls throughout the year as each medication comes due for renewal. Multiply it by hundreds of patients with chronic illness seen by a typical primary care physician, and it could quickly add up to thousands of phone calls every year. At two or three minutes per call, demands on the staff to manage prescription renewals could easily add up to an hour daily of unnecessary work.

An easy solution: a streamlined approach to prescription management. Instructions on how to effectively manage the practice change are available online free via www.STEPSforward.org through the American Medical Association (AMA).

“Streamlining prescription management allowed me to go home earlier,” said Christine A. Sinsky, MD, FACP, an internist with Medical Associates Clinic, a mul-

tispecialty group practice with sites in Iowa, Wisconsin and Illinois, and the AMA point person for STEPS Forward, its ambitious new initiative offering physicians strategies to revitalize their medical practices and improve patient care. “It’s made a huge difference not only with my personal time, but it’s also meant less inconvenience to patients and more personal time for them to do things other than worry about getting prescriptions refilled.”

In a study published in 2012 by Sinsky and Thomas A. Sinsky, MD, “A Streamlined Approach to Prescription Management” in Family Practice Management, the top priority is to eliminate waste.

“The work of prescription renewal has become so ingrained in practice that many physicians no longer recognize it as waste,” said Sinsky. “In fact, physicians commonly renew scripts for an arbitrary number of refills, thus guaranteeing unnecessary work for themselves and their staff a few months later.”

Physicians often use prescriptions as a prompt for patients to schedule subsequent appointments, a practice that burdens itself with unnecessary phone calls for prescrip(CONTINUED ON PAGE 15)

State-by-State Prescription Refill Limits in Medical News Markets Alabama: Limits refills for controlled substances.

901.381.4MOG (4664) memphisorthogroup.com

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Arkansas: Limits refills for controlled substances and also prohibits refills on a non-controlled substance after one year from the date of issue of the original prescription.

Florida: Limits refills for controlled substances and also prohibits refills on a non-controlled substance after one year from the date of issue of the original prescription.

Kentucky: Limits refills for controlled substances and also allows prescriptions marked “prn” or “ad lib” to be refilled up to one year from the date of the original prescription. Also prohibits refilling a prescription after one year from the date of issue of the original prescription.

Louisiana: Limits refills for controlled substances and requires all prescriptions for drugs other than controlled dangerous substances to expire one year from the date of issue of the original prescription.

901.767.8662 tabororthopedics.com

OFFICE HOURS M – F | 8:30 AM – 4:30PM

MEMPHIS CLINIC 1244 Primacy Parkway Memphis, TN 38119 BARTLETT CLINIC 2996 Kate Bond Road Ste. 305 Bartlett, TN 38133

Mississippi: Limits refills for controlled substances and also prohibits refilling prescriptions after 12 months from the date of issue of the original prescription.

Missouri: Limits refills for controlled substances and also prohibits filling or refilling any prescription after one year from the date of issue of the original prescription without consulting the prescriber.

MSKGROUP.ORG

North Carolina: Limits refills for controlled substances and also allows prescriptions marked “prn” to be refilled up to one year from the date of the original prescription.

Tennessee: Limits refills for controlled substances and also prohibits prescriptions marked “refill at will” from being refilled after the expiration of time specified or one year from the date of the original prescription, whichever falls first.

MSK Group, P.C. is an integrated orthopaedic group of approximately 36 well-regarded physicians dedicated to comprehensive orthopaedic care. With multiple locations, you are sure to find a convenient location to take care of all your orthopaedic needs.

SOURCE: “A Streamlined Approach to Prescription Management” by Thomas A. Sinsky, MD, and Christine A. Sinsky, MD, FACP.

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Good Shepherd’s Aim: Mission-Minded; Not Money-Focused, continued from page 4 herd stocks 185 permanent medications, with another 100 meds that are available on a regular basis, but may sometimes be in limited availability.

Located in the 6,000-square-foot space at the Hickory Ridge Mall once occupied by Bath & Body Works, Good Shepherd currently is open for patient consultations from 9 a.m. to 5 p.m. on Mondays, Tuesdays and Thursdays. Baker and two other full-time staffers are also on site the two other weekdays to answer phones, manage orders, fill mail-order prescriptions and develop patient care plans. The plan is to be open to the public more days as the business grows.

On opening day, for example, Baker performed consultations and created pharmaceutical profiles for three walk-in patients, assisted another patient by phone, and filled another order via email. And that’s with relatively little advance notice about Good Shepherd’s opening. The practice is expected to grow significantly as more people discover it.

“We have the option to expand our square footage here, and we’re already approved to mail prescriptions to patients throughout Tennessee,” said Will Singleterry, director of sales and marketing for Good Shepherd. “We plan to be a nation-

wide mail-order service within a year, and see more patients at our location at Hickory Ridge Mall.”

Because of different state laws and regulations, Good Shepherd cannot immediately begin dispensing meds across the country, Singleterry said. Some states require specific registration and licensing for facilities that mail prescriptions, and plans are under way to meet all those requirements.

Good Shepherd’s success is important to the patients it serves, and a much-needed service in the community, said Carrie Ann Hogan, lead pharmacist at Baptist Hospi-

DAILY WALK-IN CLINIC MONDAY - FRIDAY 9am-4pm

tal’s Walnut Grove Plaza Pharmacy.

“We have a similar program for patients who can’t afford their medications and who meet with a social worker to register for our program,” Hogan said. “They primarily receive maintenance medications, and we work with them to get them signed up before they leave the hospital.”

The Baptist program, which also works with the Nashville-based organization that Good Shepherd utilizes, began in 2010. Last year more than 1,500 prescriptions were filled by Baptist’s program, serving more than 700 patients.

Kay Ryan, director of the Regional One pharmacy, said the hospital’s model historically was to offer free medications to patients unable to pay for them. The current model still allows for free meds for those who can’t pay, including many homeless patients, but also provides $3 prescriptions for those who can afford it.

“We dispense more than 600 prescriptions every day, and 55 percent of those are for patients who are uninsured, and we work as an advocate for patients to physicians to get them medications at low or no cost,” Ryan said. “I’m really excited that Good Shepherd is now in our community because it means more patients will be able to get the medications that many of them can’t afford.

The need in our community is tremendous, but it’s encouraging to see programs like this that help those in greatest need.”

Do Something, continued from page 7

AT ALL LOCATIONS

901.381.4MOG (4664)

North - Germantown - Riverdale - East

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memphisorthogroup.com

tion. Smith presented Special Agent Quin with the First Annual End Slavery Tennessee Human Trafficking Impact Award.

Smith said human trafficking has become a major focus of the TBI largely because of Quin.

Grammy Award-winning musician Alison Kraus served as the event’s keynote speaker. In her talk, she passionately stated, “We live in a time where atrocity is often defined by arguing freedom against freedom, and I can’t tell you the privilege that I feel to be in the presence of people whose mission is to rescue and deliver those whose choices have been stolen from them.” She continued, “This organization is in a war not only against the loss of choice of freedom for these victims but against the devaluation of human beings.”

Although the current human trafficking crisis is often rooted in the sex industry, the loss of choice and devaluation of human life mirrors the slave trade of more than a century ago. Referencing a speech by British politician and abolitionist William Wilberforce before Parliament in 1789, End Slavery Tennessee Board President Bill Decker said hearing the story of those impacted by the slave trade forces you to make the choice to look away or to take action. ‘Do something’ was a recurring theme throughout the event.

In the healthcare setting, that could include being more alert to the red flags of trafficking (see box). For more information on the issue and how to be involved, go online to endslaverytn.org. If you suspect a case of human trafficking, call the Tennessee Human Trafficking Hotline: 855-558-6484. memphismedicalnews

.com

Covering the Healthcare Education Spectrum

BY CINDY SANDERS

By mandate and practical necessity, healthcare professionals are lifelong learners. Whether at the starting point of undergraduate or graduate education or further along in careers and looking to hone skills, a wide array of resources exist to help providers be better prepared to deliver effective, efficient care.

A number of national organizations are looking ahead to assess the way professional teams will need to interact within the delivery system of the future to dispense the highest quality of care, along with ways to help communities and patients take a more interactive role in managing their health.

AMA Expanding Med Ed Initiative

Less than two years after the American Medical Association (AMA) launched an initiative to reshape medical education in America, the national organization has announced funding for up to 20 additional medical schools to join the AMA’s Accelerating Change in the Medical Education Consortium.

The consortium was originally created in 2013 with an $11 million grant initiative to 11 of the country’s top medical schools. Each of the participants is looking at innovating curriculum redesign to better prepare medical students to deliver care in today’s evolving healthcare landscape.

At the Indiana University School of Medicine, leaders have created a virtual healthcare system (vHS) and are using a teaching electronic medic record to ensure competencies in system-, team- and population-based healthcare, as well as clinical decision-making. At Vanderbilt University Medical Center, the new curriculum looks to create master adaptive learners who will engage in self-assessment and adapt to change throughout their medical career.

The Vanderbilt program is also embedding students in the healthcare workplace from the earliest phases of undergraduate medical education. A synopsis of all 11 current programs is available at changemeded.org.

“In such a short amount of time, our consortium schools have made impressive strides toward creating the medical school of the future. Many of the schools have already implemented new curriculum models that are supporting innovative training for 7,000 medical students who will one day care for more than 12.2 million patients each year,” said AMA President Steven J. Stack, MD. He continued, “It is because of this tremendous progress that we’ve decided to collaborate with more medical schools and continue on the path to spreading innovation across the entire medical education system to close the gaps that exist between the way physicians are educated and how healthcare will be delivered in the future.”

As part of this second phase of the Accelerating Change in Medical Education initiative, the AMA is calling on medical schools to build upon and implement the education models created by the 11 foundmemphismedicalnews

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ing consortium schools, as well as offer unique projects that can be shared with medical schools nationwide. A national advisory panel is currently reviewing grant proposals, which were due last month. Proposals are being evaluated with an eye toward: • Developing flexible, competencybased pathways, • Teaching and/or assessing new content in healthcare delivery science, • Working with healthcare delivery systems in novel ways, • Making technology work to support learning and assessment, • Envisioning the master adaptive learner, and • Shaping tomorrow’s leaders.

“Bringing systemic change to our medical education system as we know it will require many more partners and many more schools,” said AMA Group Vice President for Medical Education Susan E. Skochelak, MD, MPH. “We are excited about the high level of interest that we’re seeing from medical schools for changing and enhancing medical education in our country and look forward to growing the community of innovation that we’ve created with new ideas and fresh perspectives from additional medical schools.”

Methodist Healthcare Foundation

presents ABC’s “Good Morning America” Anchor

ROBIN

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CANCER CENTER LUNCHEON

Friday, December 4, 2015 11:45 a.m The Peabody Hotel Memphis, TN For the Benefit of

AACN Futures Task Force

Last year, the American Association of Colleges of Nursing established the Futures Task Force with a broad charge to develop recommendations to ensure the nursing workforce meets future demands, and that the national organization stays at the forefront of innovation in nursing education.

The final report will be presented at the AACN’s fall meeting on Monday, Oct. 26.

For information on the findings, visit the organization’s website at aacn.nche.edu.

HCEA

The Health Care Education Association (HCEA) – a multi-disciplinary organization of professional healthcare educators who look to improve outcomes through evidence-based education for patients, families, staff and the community – is prepping for the organization’s 2015 conference Oct. 15-17 in Indianapolis.

“Education on the Fast Track: Transforming the Patient Experience” will focus on patient engagement and the ways in which educators and healthcare workers impact the healthcare experience. Among the 21 breakout sessions at the biannual meeting are discussions on generational diversity and teaching adolescents how to evaluate health information, explaining numbers and risk with patients, working with the LGBT community, and several sessions emphasizing health literacy strategies.

A conference roundup will be posted after the event, and past educational conference summaries are available online through the Education Center tab at hceainfo.org. In addition, the website’s Resources tab includes links to publications, educational tools, and the organization’s Learning Center Network.

Presenting Sponsor

To purchase tickets, visit www.methodisthealth.org/cancerluncheon or call 901-516-0500.

OCTOBER 2015

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Frederick Boop, continued from page 1

Divorce is a bad choice, but it may be the best choice.

The more you know about divorce, the better decisions you will make about divorce.

Twenty years ago, this philosophy led us to put our client guide to divorce on our website, aboutdivorce.com. We frequently update the information on the website.

Divorce is a tragedy. It is the end of a relationship that the parties intended to last a lifetime. That tragedy is compounded when a party comes to the process with inaccurate information. Whole books are written on some of the topics we treat with a few paragraphs.

Our hope is that neither you, nor anyone close to you, will need this information. The reality is that you probably know someone who needs this information so they can make a choice that is best for them.

We wrote the book on Divorce.

Larry Rice

Nick Rice

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plays a big role in what we do, and we’re learning more about that by the day . . . so quickly that our textbooks are out of date by the time they get into print. In my lifetime, we’ve gone from a 30 percent survival rate for most of our children with brain tumors to an 80 percent survival rate; and to be able to see that difference over your professional career is heartwarming.”

Boop applauds the neuroscientists at St. Jude to whom he sends tumor tissue samples. “They deserve all the credit for the molecular research,” he said.

“That program is so forward-thinking,” he added. “In their latest treatment paradigms, the kids not only get the molecular genetics of their tumor looked at, but they get their whole human genome sampled. Over 1,200 children, now, have had every bit of DNA in their whole body looked at — and what they’re learning from that is just incredible.”

One of four Semmes Murphey pediatric neurosurgeons who handle all brain tumor cases between Nashville and Jackson, Mississippi, Boop was recruited 16 years ago by Dr. Robert Sanford, a Semmes Murphey doctor who was then director of pediatric neurosurgery at St. Jude, and who trained Boop to fill his position.

Boop’s father, Dr. Warren Boop, was also a neurosurgeon. A Knoxville native, Warren at age 19 brought his bride to Memphis, where he attended UT Medical School and studied under the same Dr. Eustace Semmes who had founded the Semmes Murphey Clinic in 1912.

Years later, son Frederick graduated with honors in English from the University of Arkansas. Besides his jobs delivering newspapers and painting houses, his third job — monitoring a machine that measured brain waves during surgery at the Arkansas Children’s Hospital — allowed him to watch the surgeons at work, and inspired him to pursue a career in pediatric neurosurgery.

Although his father suggested there were better jobs, Boop earned his MD from the University of Arkansas for Medical Sciences, and completed his internship and neurosurgical residency at the University of Texas Health Science Center.

Neurosurgery is not a job, but a lifestyle, he said. “Your day doesn’t end at 5 or 9 or midnight. Particularly taking care of children, there are days when you lay awake at night; you can’t sleep and it rips your heart out.”

But the years have brought balance,

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in the form of graduation invitations, wedding announcements and baby pictures from his former surgical patients.

“I’m at a point now,” he said, “where I can look at a lot of pictures on a wall in my office – and those kids give me strength.”

A source of untapped potential and qualities beyond quantification, the brain still fascinates. Advances in neuro-radiology have been helpful, he said: “In our lifetime we’ve gone from CAT scans to MRIs to sophisticated neuroimaging studies where we can now have a kid move his hand, and the hand area of his brain will light up on the scan — or talk, and the speech area will light up.

“We’re starting to understand some of the complicated molecular pathways; drug companies and other researchers are developing targeted therapies that can disrupt those pathways. Tumors are starting to respond and go away, without all the sickness that comes with standard chemotherapy. By the time I die, a lot of these kids won’t have to have surgery anymore; they’ll be treated with a pill or a shot.”

Some of his greatest challenges involve reining in healthcare costs and the increasing regulation — and decisions by insurance companies on whether to let a child come to them for surgery.

Regulators would prefer that every doctor perform every procedure exactly the same way, so it’s easy to measure and monitor, he observed. “But all of the things that advance the field come through innovation and change. If everybody does everything the same way ... we never get any better than we are right now.”

As president-elect of the American Association of Neurological Surgeons, Boop looks forward to taking over leadership next April and running its 2017 meeting in Los Angeles — an event that attracts surgeons internationally.

“It’s an interesting time in our field,” he said. “I can do a surgery today, record it on high definition 3D and send it free of charge to another surgeon in another country, so he can see how we do it here before he operates on a similar problem.”

He points to resources like the Rhoton Collection® -- 60,000 3D slides of neuroanatomy under the microscope, with accompanying lectures, freely accessible online. He promotes the sharing of knowledge through medical missions to Bosnia, and participates in an exchange program that recently brought a dozen medical students from Croatia to learn at Semmes Murphey.

Boop is proud to be affiliated with the “really special” Memphis medical community and all it has to offer that much larger cities can’t match — including programs for the poor and uninsured.

His greatest source of pride, however, is his marriage and children, who are continuing the family medical tradition. Boop’s daughter is working toward her Master’s degree in public health; his son started medical school this fall and may become the third “Dr. Boop, Neurosurgeon.”

“I told him to keep his options open,” Boop said with a laugh. memphismedicalnews

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Streamlining Prescription, continued from page 11 tion renewals and appointment scheduling, while also increasing the chances of patient non-adherence.

“A less organized approach to prescription renewal may have worked 20 years ago, when patients had fewer chronic conditions and took fewer medications,” said Sinsky. “Now, more than 40 percent of patients over age 65 are on five or more medications.”

Synchronizing prescriptions around the annual visit – providing sufficient refills to last until that time, and insuring the next annual visit is scheduled at the conclusion of the current annual visit – will take care of all those problems, said Sinsky.

“In our experience, it’s not uncommon for a group of six to eight primary care physicians to hire one full-time nurse whose main responsibility is prescription renewals,” she said. “This nursing time could be wisely deployed for advanced medical home activities, such as direct patient care, self-management support, or population management.”

A rough, conservative calculation suggests that if all practices implemented yearly, synchronized, bundled renewals, more than 46 million hours of primary care physician and staff time could be saved every year, noted Sinsky.

Most states limit prescription renewals to 12 months. A few states have a longer time period, such as a 15-month window,

which further streamlines prescription management.

Policy makers could facilitate the elimination of waste by modifying state regulations to allow prescription renewals for an interval longer than 365 days.

“Several states already provide this important expanded window for renewals: Idaho and Maine (15 months), Iowa (18 months), and Oregon and California (two years),” Sinsky pointed out. “This allows patients and their physicians to balance insurance coverage rules – mammograms can’t be obtained more than once every 365 days, for example – and patients’ personal schedules with prescription renewal constraints.”

In summary, simple prescription renewal workflow changes in primary care practices, accompanied by modification of some state pharmacy regulations, would go a long way toward eliminating a source of significant waste in the U.S. healthcare system, improving the work life of nurses and physicians, and increasing access to primary care services, said Sinsky.

A rough, conservative calculation suggests that if all practices implemented yearly, synchronized, bundled renewals, more than 46 million hours of primary care physician and staff time could be saved every year in the United States.

Using Deep Brain, continued from page 9 enth revision as the S7 Surgical Navigation System, is commonplace in operating rooms around the globe that routinely house cranial surgery.

“StealthStation is the necessary infrastructure to perform DBS very accurately, precisely, and safely,” he said. “This common instrument allows neurosurgeons to intervene in the brain with stimulators, viruses, tissues, implants … you name it.”

Among other innovations for Bucholz, a National Academy of Inventors (NAI) Fellow: a special collar that holds the patient’s head throughout the procedure in a way that makes patients who are awake during surgery feel more at ease.

The collar replaced the cumbersome frame used by some neurosurgeons.

Positive outcomes of DBS cases for OCD have opened the door to treating a variety of conditions in the burgeoning field of neuromodulation. Bucholz is working closely with a group to develop an implantable device to treat rheumatoid arthritis and Crohn’s disease through the use of a stimulator placed on a nerve. But potential DBS treatments of some conditions remain sidelined.

“For example, there’s extreme interest in using DBS for patients with debilitating depression, but controversy remains about where to place the electrode for maximum effect,” said Bucholz. “Two centers have proposed two different areas of the brain to stimulate, but for now, studies don’t support either location.”

Regardless of ongoing debates in medical circles about which conditions to memphismedicalnews

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Doctor’s, continued from page 5 city with many health problems among its residents. But one of the first expansions of the software’s use was in Alabama, a state that is 50th in diabetes and strokes, 49th in cardiovascular disease deaths and 47th in heart attack deaths. In August, Ivy Creek Healthcare opened three Alabama Wellness and Prevention Centers in communities outside Montgomery. Adventia’s software, training and education are at the heart of these clinics.

Wright said he wants the direct-to-consumer model to expand. The first opportunity comes this month with the opening of the Wellness and Prevention Center Memphis on Brookfield Road in East Memphis.

The clinic is staffed by a nurse practitioner who worked with Wright in private practice, and one of his former residents now in private practice will be supervising physician.

The stand-alone clinic is one of two ways Adventia’s technology is used in a consumer setting. The other way is to have doctors open clinics that are part of an existing private practice.

The first is in the works in North Carolina. Adventia will go on site to train a doctor’s staff on how to use the software. The physician will refer his patients to the clinic.

“Our strategy is to link arms with primary care doctors,” Wright said. “We don’t want to take the place of primary care doctors. We are there to link arms to extend the reach of the primary care doctor. We do what they don’t have time to do. They don’t have time to coach lifestyle.”

treat with DBS, Bucholz said it offers milestone relief for OCD sufferers.

“We know the target of the brain and it’s working quite well,” he said. “The more we learn about the brain, the more we can think about intervening to reverse debilitating conditions. It’s a rewarding time to see DBS transform the way people can lead their lives.”

Bucholz is the SLUCare functional neurosurgeon who leads DBS surgery at SLU Hospital; SLUCare neurosurgeon Pratap Chand, MD, who specializes in movement disorders, collaborated on the landmark surgery. The SLUCare Physician Group team also includes Lauren Schwarz, MD, a neuropsychologist who works with patients considering DBS.

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Contact Rita Kennedy at 731-228-2028 or e-mail to rita.kennedy@tn.gov.

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GrandRounds Dean of UTHSC College of Pharmacy Honored by Pharmaceutical Association Marie Chisholm-Burns, PharmD, MPH, MBA, FCCP, FASHP, dean and professor in the College of Pharmacy at the University of Tennessee Health Science Center has received the Chauncey I. Cooper Award from the National Pharmaceutical Association (NPhA).

The award is the highest recognition given by the nationwide organization of pharmacists founded in 1947 to promote excellence and uniformity among minority health professionals, improve the quality of health care in minority communities, and advance the standards Chisholm-Burns, with NPhA President-elect Erica Hanesworth, PharmD, of pharmaceutical care Marie left, and NPhA President Carlton Maxwell, PharmD, a graduate of the UTHSC among all practitio- College of Pharmacy. ners.

Bestowed at the 68th annual meeting of the NPhA in Orlando, the award is named for NPhA founder Chauncey I. Cooper, PhD. The award recognizes sustained and distinguished service to the profession of pharmacy.

A pharmacist since 1992, Chisholm-Burns became dean of the College of Pharmacy in 2012. Previously, she was a professor and head of the Department of Pharmacy Practice and Science for the College of Pharmacy at the University of Arizona.

She received her BS and PharmD degrees from the University of Georgia, her MPH from Emory University and her MBA from the University of Memphis.

Gupta-Ganguli Awarded Endocrine Certification in Neck Ultrasound Malini Gupta-Ganguli, MD, CCD, ECNU, has been awarded the prestigious Endocrine Certification in Neck Ultrasound designation by the American Association of Clinical Endocrinologists. The organization noted that she is the only endocrinologist with this certification in the Mid-South.

ECNU is a professional certification in the field of neck ultrasonography for physicians who perform consultations and diagnostic evaluations for thyroid and parathyroid disorders through both diagnostic ultrasound and ultrasoundguided fine needle aspiration (UGFNA).

Gupta-Ganguli’s practice, G2Endo, in East Memphis is a division of Consolidated Medical Practices of Memphis.

Memphis-based Lifeblood Has Become Part of Blood Systems Lifeblood, headquartered in Memphis and the region’s only non-profit volunteer blood center, has become part of Blood Systems, one of the nation’s oldest and largest non-profit transfusion medicine organizations.

The agreement was finalized October 1.

Susan Berry-Buckley, Lifeblood CEO, said union will allow Lifeblood to

continue delivering service to local hospitals, patients and donors, while also bringing the resources and research capabilities of Blood Systems to improve transfusion safety and patient care. Lifeblood has been the leading provider of blood and blood components to area hospitals, supplying more than 100,000 units for local patient transfusions each year.

Blood Systems is based in the Phoenix area and operates community blood centers serving more than 700 hospitals in 22 states. It also operates biological products distribution services, a quality consulting group, a world-renowned transfusion medicine research institute, and is a partner in the operation of four high-volume donor testing laboratories.

United Blood Services, with centers serving hospitals in 17 states, is the flagship of the Blood Systems Blood Centers Division. Other centers in the division include: Blood Centers of the Pacific and LifeStream (California); Inland Northwest Blood Center (Washington); Bonfils Blood Center (Colorado); LifeShare (Ohio); and Community Blood Services (New Jersey).

According to Berry-Buckley, blood centers across the country during the past several years have been merging, affiliating and looking for new ways to work together in an ever changing healthcare environment.

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GrandRounds West Cancer Center Receives Multi-Million Dollar Gift from Moores West Cancer Center has received what officials call “a significant gift” from Jack and Betty Moore to The University of Tennessee/West Institute for Cancer Research, the fundraising arm of West Cancer Center. The commitment to the UT/West Institute’s Capital Campaign is in honor of West Clinic’s founder, and the Moore’s brother-in-law, William H. West, MD, who lost his mother to breast cancer. The gift will rename West’s and Methodist Healthcare’s Comprehensive Breast Centers to the Margaret West Comprehensive Breast Center.

The philanthropic gift, indicated to be in the “multi-million dollar” range, will provide much-needed funds to support research and initiatives within the UT/West Institute’s Center of Excellence in Women’s Cancers.

Methodist South Begins Expansion of Emergency Department in Whitehaven Methodist South has begun construction to expand its emergency department in the Whitehaven facility.

The expansion is a result of a certificate of need awarded to Methodist South by the Tennessee Health Services and Development Agency. The $8.75-million project will expand the facility from 9,950 square feet to approximately 22,750 square feet. The project will include larger, more private patient rooms, a larger waiting room and a streamlined admissions area.

In addition to adding more than 12000 square feet, the expansion will include a complete renovation of the existing emergency department, which

treats more than 60,000 emergency patients annually.

Resurrection Health Purchases Family Medicine Residency Program Resurrection Health, a faith-based, evangelical healthcare provider offering both adult and pediatric primary and inpatient care, has acquired a medicine residency program formerly hosted through Christ Community Health Services.

The three-year, fully integrated and individually tailored program, titled Resurrection Family Medicine, was funded through the Teaching Health Center Graduate Medical Education program, a $230 million, five-year initiative as part of the Patient Protection and Affordable Care Act, created to increase the number of primary care residents trained in community-based settings.

Resurrection Family Medicine has the capacity to train 24 residents annually in multiple disciplines along the family medicine and primary care spectrum, including surgery, obstetrics, and emergency and community medicine, among other areas of focus. Residents will train at three area “teaching hospitals” and healthcare providers, including Regional One Health, Baptist Memorial Healthcare and Delta Medical Center, during their time in Memphis.

The residency program’s base location will be at Resurrection Health’s current space at Delta Medical Center.

Resurrection Family Medicine welcomed eight first-year residents in July for a total of 22 current residents and boasts 12 physician faculty members plus non-medical staff.

In addition to a 24 hour Emergency Room, Delta also offers a Hyperbaric and Wound Care Center, Surgery, Sleep Services and Physical Therapy.

We have Staff Nursing positions available for both Medical Surgical and Behavioral Health • Clinical Lead/Head Nurse • Assistant Director - Mental Health Unit • Other positions available

UTHSC’s Michio Kurosu Receives $431,000 Grant from NIH Michio Kurosu, PhD, an associate professor in the Department of Pharmaceutical Sciences in the College of Pharmacy at the University of Tennessee Health Science Center, has received a grant totaling $431,000 from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

The grant will be used to develop new antibacterial agents for infections caused by deadly superbugs – bacteria that have become resistant to multiple antibiotics.

Kurosu, who has more than 20 years of experience as a synthetic and medicinal chemist, has engaged in a wide range of research projects associated with infectious diseases. This award, to be distributed over two years, will support a project titled, “Expansion of Spectrum of Activity of Pleuromutilin for MDR Gram-Negative Bacteria.”

Dr. Kurosu and his research team have discovered several new drug leads that are effective against multi-drug-resistant (MDR) diseases, such as Mycobacterium tuberculosis and its dormant form; and Gram–negative bacteria, such as Klebsiella pneumoniae, Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa. memphismedicalnews

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Call 901- 369-8530 if you are interested and need more information about a position.

You may also visit www.deltamedcenter.com for a full listing of available positions.

3000 Getwell | Memphis, Tennessee 38118 (901) 369-8100 | www.deltamedcenter.com

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GrandRounds Memphis Doctors’ Vaccine to be Used in Canadian Clinical Trial

7550 Wolf River Blvd., Suite 200 | Germantown, TN 38138 TrumbullLabs.com | 901.542.6800

StreptAnova® a vaccine invented by two Memphis doctors that is designed to prevent group A streptococcal (GAS) infections, will be used in a Phase 1 clinical trial to be conducted in Canada, according to a report from Business Wire.

StreptAnova was invented by James B. Dale, MD, Chief of the Division of Infectious Disease, and Gene H. Stollerman, MD, Endowed Professor in Medicine at the University of Tennessee Health Science Center, and Research Scientist at the Dr. James B. Dale Memphis Veterans Affairs Medical Center.

The main objective of the trial is to demonstrate that the novel vaccine is safe and well tolerated in humans. The trial will be conducted at the Canadian Center for Vaccinology in Halifax, Nova Scotia.

Pan-Provincial Vaccine Enterprise Inc. (PREVENT), a national Centre of Excellence for Commercialization and Research (CECR) located at the University of Saskatchewan and Memphis-based Vaxent announced the initiation of the clinical trial.

StreptAnova is being commercialized jointly by PREVENT and Vaxent, a company founded by Dr. Dale. StreptAnova is composed of four recombinant proteins containing protective peptides from 30 streptococcal serotypes that account for the vast majority of infections in North America and Europe.

Semmes Murphey Foundation Announces Watridge Endowment

(901) 753-7520

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Semmes Murphey Foundation announces the creation of the Clarence Watridge International Scholarship Program and Endowment honoring the former chairman of the clinic and foundation.

Dr. Watridge was integral in starting the Dr. Clarence Watridge Semmes Murphey Foundation in 2011. As the only Chairman of the Foundation upon his retirement, his vision was instrumental in laying the ground work for advances in patient care. This has been accomplished by educating the public, training the next generation of doctors, and providing new research and technology.

This scholarship will assist residents in international training, medical mission trips and more.

Donations may be mailed to The Semmes Murphey Foundation, Attention: Clarence Watridge International Scholars, 6325 Humphreys Blvd., Memphis TN. 38120 - 2300

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GrandRounds Greg L. Thompson Named President of LifeLinc Anesthesia Greg L. Thompson, MD, has been named president of Memphis-based LifeLinc Corporation, which manages anesthesia practices in 10 states under the LifeLinc Anesthesia banner.

Thompson, a boardcertified anesthesiologist with more than two decades of practice, has exDr. Greg L. Thompson tensive experience working with both clinicians and healthcare administrators. His previous leadership roles include serving as both president and chief of staff for Methodist Healthcare.

Thompson graduated from the University of Tennessee Health Science Center, College of Medicine and completed his residency in Anesthesiology at the University of Arkansas for Medical Sciences. He received a lifetime certification from the American Board of Anesthesiologists in 1994 and holds medical licenses in Mississippi and Tennessee. He is a member of the Memphis and Shelby County Medical Society, The American Society of Regional Anesthesia, Tennessee Medical Association, Tennessee Society of Anesthesiologists, American Society of Anesthesiologists, Mississippi Medical Association, and Mississippi Society of Anesthesiologists.

HIPAA Compliant SelfEncrypting Rx App In 2014, more than 4.02 billion prescriptions were filled at retail pharmacies in America. Writing and refilling prescriptions is a high-volume, repetitive task for physicians and their staff that can be time consuming both in and out of the office. A new mobile app, getRx, uses smart phones, tablets or PCs to connect patient, prescriber and pharmacy. The app is available in both a physician and a patient version and can be downloaded from ITunes, Google Play as well as Amazon and is compatible with Apple and Android smart phones, tablets and PC’s.

GetRx, is a tool that eliminates the need to call or fax a pharmacy, which saves a significant amount of time according to Dan Rudd, MD, in Murfreesboro who developed the app with software developer Metova Inc. The cloud-based app is a mobile prescription pad that is HIPAA compliant with encrypted texting within the app. It is linked to a medication database, which allows the physician to select from a drop down menu the medication and dosage. Google maps is also embedded in the app making selection of a convenient pharmacy easier when the patient is not at home.

More efficient than a traditional memphismedicalnews

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prescription pad, getRx lets physicians and their office staffs write and refill prescriptions and communicate with patients and pharmacies directly from a smart phone, tablet or PC. Prescriptions can be written and sent to the pharmacy of choice in 20 seconds. Once the prescription is sent, both the patient and the office receive written notification of the prescription, making charting easier. Any dialogue between patient and physician within the app is also sent to the office for placement in the patient’s

chart.

When open, getRx, looks like a prescription pad. As you type, drop down menus let you select the correct patient, medication and dosage so there is little margin for error. And there is no charting; the app does that for you by sending the script back to the office. The app even remembers my preferred prescribing patterns on medications which further reduces the time to complete prescriptions said Rudd.

For patients, the app is free. It con-

nects them to any and all of their physicians that use the getRx app. This allows the patient to request refills and communicate securely with their physician or their office in mere seconds, right from their smart phone, tablet or PC, which eliminates office staff time answering and returning phone calls for refills or prescriptions. Find more information at www.getrx.com

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GET YOU R NORMAL BACK Right: Christie Perkins, Semmes Murphey patient and mother of three who thought she would never run again until she met Dr. Cardenas. A painful ruptured and bulging disc in her back led to minimally invasive spine surgery, and now she’s back on the trail and ready for a half marathon!

SEMMES-MURPHEY.COM

Memphis Location: 6325 Humphreys Boulevard | Memphis, TN 38120 | Appt

: (901) 522-7722 | Office

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