Mississippi Medical News October 2015

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PHYSICIAN SPOTLIGHT PAGE 2

Greg Oden, MD

ON ROUNDS HIMSS Analytics Honors North Mississippi Health Services with EMR Stage 6 Recognition HIMSS Analytics recently announced that North Mississippi Health Services (NMHS) has achieved Stage 6 on the EMR Adoption Model. Stage 6 is the next to highest recognition designated in the HIMSS model ... 3

Using Deep Brain Stimulation to Treat OCD Patients Neurologists Worldwide Using Neurosurgeon’s Commercial Infrastructure ‘Very Accurately, Precisely, and Safely’ ST. LOUIS–On July 6, worldrenowned 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 ... 5

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Protecting Medical Records from Hackers

By CHRISTOPHER CUSSAT

With sweeping and successful database hacks on large corporations like Sony and Target, not to mention the Federal Government, it is somewhat naïve to think that any industry is shielded from and not susceptible to future and even more encompassing high-tech attacks.

Medical data has at least as much, if not more, intrinsic value as personnel employment information, credit card numbers, and unreleased Hollywood movies. The Identity Theft Resource Center recently produced a survey showing that 43 percent of all identity theft was medical related. This percentage is even greater than cyber-theft numbers in the banking industry or the government. The U.S. Department of Health and Human Services reports that since it started keeping records in 2009, some type of medical records from between 27.8 million and 67.7 million people have been breached.

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WHO’S TENDING OUR DOCTORS?

Streamlining Prescription Management 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 multispecialty 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 (CONTINUED ON PAGE 8)

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PhysicianSpotlight

Merit Health CMO Brings Clinical Perspective to Leadership Table Greg Oden, MD

By LUCY SCHULTZE

As pleased as Greg Oden, MD, is to be serving as chief medical officer for one of the largest healthcare systems in Mississippi, he’s also glad to know that his title means something different than it would have a decade ago.

“We’ve come a long way since the time when doctors who were on the administrative side of things were viewed by other physicians as the voice of the insurance company or the hospital,” said Oden, who in March became CMO for Merit Health’s central Mississippi region.

Oden has served in administrative roles since 2000 and had spent the previous nine years as CMO for what was Central Mississippi Medical Center (CMMC), now Merit Health Central. He comes from a background in internal medicine with a focus on inpatient care.

“When I was on the clinical side, I was always trying to talk the CMO into allowing the patient to have access to care or trying to justify the medical decisions I made,” he said. “It’s not like that now.

The whole system is based on quality and evidence-based results.

“Healthcare companies see that they need the clinical perspective within their leadership in order to meet these quality goals.”

For Oden, assuming that role has meant serving as a two-way communication link between Merit Health’s leadership and the network’s healthcare providers.

He has been spending time with employed providers in each of the region’s facilities and asking them how the system can better serve both them and their patients.

“This process is giving physicians a tighter connection to what Merit Health represents and lets them know they have a voice in the ‘C suite,’” Oden said.

“It’s important to have the clinical perspective informing every decision, and Merit Health has represented that well.

I’m in every leadership meeting where a decision is made, from how we move

forward strategically to how we need to expand our service lines to meet needs for our communities. There’s never been a time when I’ve felt unwelcome within the leadership in helping to make these decisions.”

Merit Health’s central Mississippi region encompasses six hospitals, 44 clinics and nearly 100 employed providers in primary care and all specialty areas.

“Merit Health is by no means a small organization,” Oden said. “Having the chance to help all these different pieces work together to provide the best care we can for our patients is very exciting to me.”

A native of Pontotoc, Oden was raised the son of a health insurance professional and an English teacher. He moved with his family to Brandon in his youth, and was drawn to medicine at an early age.

“I found myself drawn to the hospital and volunteered there in any area I could,” he said. “I was fortunate to have friends whose fathers were surgeons and primarycare providers, so I spent a good deal of time with those folks. They were kind enough to let me into their practices and help me discover what I was interested in.”

Oden completed his undergraduate degree from Harding University in Searcy, Ark., before returning to Jackson to attend the University of Mississippi Medical Center. He completed his internal medicine training at Methodist Hospital in Mem-

St. Dominic’S internal meDicine iS P leaSeD to W elcome

Kristen Crawford, M.D. Dr. Crawford will begin serving patients with the Internal Medicine group at St. Dominic’s this fall.

Dr. Crawford attended Mississippi College before attending medical school at the University of Mississippi School of Medicine, where she completed her internship and residency in Internal Medicine. She will sit for her Board Certification in Internal Medicine this summer.

Dr. Crawford grew up in the small Mississippi Delta town of Rolling Fork where she learned the value of serving others and her community. She brings these virtues with her to her medical practice, striving to give each patient the personal attention they deserve.

Dr. Crawford is married to her wonderful husband, Nick, and enjoys spending time with him and their beautiful one-year old son, Coy. She is actively involved with Fondren Church, and in her spare time, she enjoys playing tennis, hunting, fishing and swimming.

St. Dominic’s Internal Medicine Group 971 Lakeland Drive Suite 950 Jackson, MS 39216 601-200-4141

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phis, Tenn., and joined a multispecialty practice in Nashville in 1996.

At that time, the concept of an internist who practiced only in a hospital setting was just in its infancy. Oden created the role for himself.

“As a young internist, I was not very busy – but there were six family-practice doctors who had a decent census in the hospital and really wanted to focus on the clinic,” Oden said. “I asked them if I could handle their admissions while my practice was growing. That focused my interest and made me realize that at some point, I would like to focus just on the hospital side.”

In 2000, Oden returned to his home state as a hospitalist at Central Mississippi Medical Center.

“I was actually the first hospitalist hired by Health Management Associates in their entire company,” Oden said. “I was on call 24 hours a day, seven days a week for several months. But ultimately I was able to build a group in the way I wanted to do it.”

Since then, the role of hospitalists has become so well established, Oden said, it’s transformed the field of internal medicine.

“Over time the two worlds have become very separate,” he said. “If you hire an internist today, you’re going to talk to them about an inpatient practice or an outpatient practice. It’s very rare today that an individual would do both.”

That change has been to the benefit of patients, Oden said.

“Hospitalists are more efficient in our care, and studies show that,” he said.

“Generally, patients who are cared for by a hospitalist will have a length of stay in the hospital that’s one to one-and-a-half days shorter than if they are in the care of a doctor who’s also working in an outpatient practice.

“The reason is simple time management: I’m in the hospital all day, whereas that outpatient doctor is coming by before clinic or after clinic or at lunch. I may see the same patient three times in the same day, so I’m better able to stay on top of that patient’s care.”

Shortly after he arrived at CMMC, Oden had the opportunity to fill in for the hospital’s CMO while that administrator took a six-week medical leave. The experience sparked his interest in administration, and he volunteered to begin helping the CMO with case management, resource utilization and discharge planning. He took the reins himself as CMO in 2006.

“The role of physician administrators has changed so much, and it’s driven by the ongoing changes in the American healthcare system,” Oden said. “I applaud (CONTINUED ON PAGE 6)

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HIMSS Analytics Honors North Mississippi Health Services with EMR Stage 6 Recognition Electronic Medical Record Adoption Model

By CHRISTOPHER CUSSAT

HIMSS Analytics recently announced that North Mississippi Health Services (NMHS) has achieved Stage 6 on the EMR (electronic medical record) Adoption Model. Stage 6 is the next to highest recognition designated in the HIMSS model. Hospitals and clinics with this recognition are at the forefront of EMR adoption. This is an important indicator because it shows that Stage 6 designated organizations deliver high quality patient care with an interoperable electronic medical record system in place. As of this year, NMHS was among only 22 percent of hospitals that had achieved Stage 6.

HIMSS Analytics developed the EMR Adoption Model in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals. There are a total of eight stages (0-7) that measure a hospital’s implementation and utilization of information technology (IT) applications. The model automatically scores hospitals and compares them to peer facilities based on similar EMR capabilities.

NMHS and other Stage 6 hospitals have significantly invested in their EMR capabilities and have almost fully automated and gone paperless with medical records for inpatient care. According to HIMSS Analytics, “such facilities appear to have a significant advantage for patient safety and care delivery processes, as well as clinician support and recruitment.”

M. Shane Spees, president and chief executive officer of North Mississippi Health Services, acknowledges the hard work and dedication by all involved with this significant and important recognition.

“The healthcare team M. Shane of staff and physicians Spees across our system has worked diligently over the years to leverage technologies, such as an electronic

health record, to improve the quality, safety and efficiency of care provided to our patients.”

The sophisticated use of electronic medical records enables physicians to make better decisions regarding patient care, based on the disease process and real-time test results; this according to NMHS vice president and chief inforSlayton mation officer, Slayton Austria Austria. “It also helps to assure that the right medication is given to the right patient at the right time,” he adds.

“This achievement once again verifies that we are on the right track,” notes Vishal SaDr. Vishal Sachdev chdev, MD, a cardiotho-

racic surgeon who serves as NMHS’ chief medical information officer. “Our electronic medical record helps us do what is best for patient care – from preventing medical errors to making sure we meet national quality standards.”

Austria says that each HIMSS Analytics stage builds upon the next, and this progressively indicates that every stage achieved offers further assurance of quality care. “NMHS started the journey in December 2014, and we were able to rapidly achieve Stage 6 – a feat achieved by only a small percentage of hospitals.” He adds that NMHS is currently well on its way to attaining the highest level (Stage 7), which represents the most advanced electronic patient record for all areas of care: inpatient, outpatient, emergency department and medical clinic.

Spees agrees and is proud of all his staff members and their continued diligence and focus on continually providing the highest standards of quality and care to NMHS patients. “Our team has changed, and continues to change, how we utilize technologies in order to improve the health of the people of our re(CONTINUED ON PAGE 8)

www.bcbsms.com Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.

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Opening Arms and Minds UMMC Offering Compassionate Care to the LGBT Community

By CHRISTOPHER CUSSAT

Between Bruce (Caitlyn) Jenner’s recent and very public transformation and the continuing national discussions about the legal and moral validity of gay marriage, it is no surprise some medical care facilities have begun reevaluating their professional interactions with the Lesbian, Gay, Bisexual and Transgender (LGBT) community.

The University of Mississippi Medical Center (UMMC) is one such institution that has taken a proactive step in reaching out specifically to the LGBT community.

This outreach perfectly coincides with UMMC’s missions “to improve the lives of Mississippians by educating tomorrow’s healthcare professionals, by conducting health sciences research, and by providing cutting-edge patient care.” In fact, one of UMMC’s primary goals is the elimination of differences in health status of Mississippians based on race, geography, income or social and economic standing.

Last month, the University’s Department of Psychiatry and Human Behavior launched an LGBT (mental health) Clinic at the Jackson Medical Mall Thad Cochran Center. The project is one of the first of its kind in Mississippi and is part of UMMC’s new Division of Gender, Sexuality and Health.

UMMC’s new LGBT Clinic is overseen by Dr. Scott Rodgers, left, chair of the Department of Psychiatry and Human Behavior, and Dr. Kim Gratz, who directs the LGBT Health and Women’s Health programs.

School of Medicine professor and director of the Division of Gender, Sexuality and Health, Kim Gratz, PhD, oversees the new program which is already considered to be a groundbreaking treatment center helping to fill a gap in mental health services for Mississippi’s lesbian, gay, bisex-

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“There is a perception that some physicians are homophobic and that makes some patients reluctant to come out.”

The LGBT Clinic is offering psychiatric care as well as psychotherapy to a population making up approximately two to five percent of the state’s inhabitants, according to Rodgers’ estimate. “We want them to know they can come to a place that is accepting and where they can get competent care,” Gratz added. She also notes that LGBT issues have not been ignored at UMMC, but the focus has primarily been on their physical, rather than their psychological needs.

There appears to be a growing need for mental healthcare among members of the LGBT community. Leandro Mena, MD, associate professor of medicine in UMMC’s Division of Infectious Diseases, says that while the majority of LGBT individuals maintain great mental health, an increased social stigma makes them more vulnerable. “LGBT individuals, particularly those with a conservative upbringing, tend to have more mental health problems, especially as they struggle with their sexual identity and their sense of right and wrong,” he explained. “So we welcome with great excitement the efforts of Dr.

ual and transgender community.

Scott Rodgers, MD, professor and chair of the Department of Psychiatry and Human Behavior discusses the inspiration behind the new clinic. “Dr. Gratz has a strong background in women’s health, and I have a background in LGBT health. We were sitting in my office months ago brainstorming what we could achieve if we worked together and decided that we should launch the new division with a focus on these two areas.” He says that the clinic’s goal is to provide meaningful and important clinical services while also educating the next generation of healthcare providers. “We felt that we were well positioned to achieve these goals,” he added.

The need for this offering was always an apparent and Leandro Mena is associate professor of medicine in UMMC’s Division of Infectious Diseases immediate one for Rodgers.

He describes how he and Gratz began the clinic’s implementation. “I arGratz and Dr. Rodgers with their clinic.” rived at UMMC nine months ago and Gratz mentions that the clinic will have been meeting regularly with faculty also serve as a research center for LGBT members to discuss new programming in health and it will train medical students the department. Both Dr. Gratz and I felt to provide what Rodgers calls “culturally that the time was right for the launch of competent care for this population.” He the division, given our respective backfurther explained, “We want the students grounds and interests.” to know the terms: ‘gender identity,’ One unfortunate reason that the need ‘transgender,’ and so forth – and to know exists for such a clinic is because somehow to treat these patients intelligently, times members of the LGBT community compassionately and thoughtfully.” feel discriminated against even with their The clinic has been well received by healthcare providers. Rodgers explained, the LGBT community and Rodgers says they have not received any negative feedback and have only received encourageFor more information on UMMC’s ment and support from that community.

LGBT Clinic, faculty members and “We hope that patients will read and hear healthcare providers may contact about the clinic through the media and Dr. Kim Gratz at KLGratz@umc. choose to come and get help if needed. edu. Patients wishing to schedule We plan to do our very best to provide an appointment should call outstanding care to anyone who crosses 601.984.6925. our threshold,” he concluded. mississippimedicalnews

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Using Deep Brain Stimulation to Treat OCD Patients

Neurologists Worldwide Using Neurosurgeon’s Commercial Infrastructure ‘Very Accurately, Precisely, and Safely’

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.

Dr. Richard Bucholz with the OR team preparing for a DBS case.

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 (CONTINUED ON PAGE 7)

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Protecting Medical Records from Hackers, continued from page 1 Every practice, clinic and hospital is ultimately responsible for the security of their own protected health information (PHI). According to general manager at PerforMax Medical Management, Carlton Ingram, a risk analysis will help ensure the compliance of the hardware and software each practice or institution uses – including mobile devices and wireless encryption. “It will also ensure that your staff is knowledgeable Carlton and trained in security Ingram protocols and procedures as well as patient relations and communications.”

Such an analysis is required by HIPAA and must be updated on a yearly basis. HIPAA policy states that this annually should consist of analyzing all safeguards and implementing policies and procedures to limit the probability of a breach. It requires documentation of breaches and new policies created to correct any breach that occurred, as well as assigning a HIPAA officer and adequate training to all employees.

One recent example of the danger in failing to adhere to this requirement is last year’s case which occurred at Idaho State University’s Pocatello Family Medicine. The clinic failed to conduct a risk analysis properly and did not notice that a firewall on its server was disabled, leaving its PHI vulnerable and unprotected for 10 months. As a consequence, the clinic was fined $400,000.

Cyber-thieves and their techniques of obtaining protected health information evolve as quickly as the medical industry’s reliance on technology continues to expand. In the more recent past, most data thefts were due to “hard copy” and “physical” breaches like data taken directly from an unsecured computer, the improper disposal of data storage devices, or even improperly discarded paper re-

cords. To illustrate how much the risks have changed and how easily data can be accessed, just note the following statistic: today, more than half of all security breaches involve mobile devices.

Of course, the most common type of data breach currently is the internet-accessed cyber-attack. It is no surprise that healthcare providers have been uploading patient records online and insurance companies, in turn, have entirely automated their claims processing systems.

Because this information is now available to consumers, it is no longer “gated off;” it instead flows back and forth from consumers and third party vendors. Ingram notes that this also leaves most medical information vulnerable to hackers. Matt Comyns, global head of cyber security at executive search firm, Russell Reynolds Associates, says that cyber-attacks in recent years have become more frequent and more severe. “These attacks are getting worse with each passing year,” he adds.

Along with the increase of cyber-attacks in general, the instances of hackers targeting the medical industry specifically is growing as well. Ingram believes that cyber-thieves are moving toward the medical industry due to the fact that such information is very valuable. “The value of medical information can be much greater than even credit and debit card data. A single person’s private medical record is worth approximately 50 dollars per account whereas credit and debit card information is valued at little more than a dollar,” he explains. In fact, the average cost of data breaches has risen by 23 percent since 2013. During the past 12 years, there has been a 10,000-fold increase in the number of digital security threats – it is a $300 billion plus industry.

The biggest problem with most institution’s response to cyber-attacks is that it usually only happens after the breach has occurred. By then, of course, it is much too late and the damage is already done.

Medical and health-based companies and organizations can no longer continue trying to protect their information with an “after the fact” security policy. “These organizations are going to need to start using software built for the purpose of managing the vastly growing frequency of privacy and security incidents. This is a must for compliance in lieu of hiring full-time privacy officials,” says Ingram.

Although no organization will be 100 percent safe against cyber-attacks, certain strategies can be implemented to help limit the probability of one occurring. The 2015 Ponemon Institute Report stated that 65 percent of all healthcare organizations have experienced electronic, informationbased security incidents over the past two years. This data supports the frighteningly but realistic notion that all healthcare organizations should assume they have been infiltrated and thus develop security from an “already been breached” standpoint.

Healthcare and medical organizations have to immediately begin protecting their PHI against hackers. They should become proactive and investigative, determining what their greatest information technology risks are and where possible cyber-attacks may come from in the future. Cyber-security must also continually evolve and become preemptive, it cannot simply be a bandage after data and information start hemorrhaging. Cyber-criminals always seem to be one step ahead of defensive technology, so the medical industry must utilize all of the security avenues that are available: from purchasing specialized protective software to contracting third party cybersecurity vendors, and even implementing an organization-wide strategic defense plan internally. With due diligence and intelligent action plans, healthcare and medical organizations can do a much better job of not only protecting their own economic interests, but the privacy and confidence of those they help and heal everyday as well.

St. Dominic’S internal meDicine iS P leaSeD to W elcome

Merit Health CMO, continued from page 2 all phases of the healthcare industry for realizing that if you’re going to move forward, you need to have a clinical voice at the forefront helping you to make decisions on how you deliver patient care.”

Looking ahead, Oden is energized by taking part in how the nation’s healthcare system evolves.

“The next phase is going to be about population health medicine – accountable care organizations, clinically integrated networks,” he said. “All of these things are about not just taking care of individual patients but rather taking care of entire communities.

“It’s a very exciting time, because all of these models are now being vetted out, and this is what’s necessary when you see such a major change to an industry. It’s like going from producing cars with all gas engines to all battery-powered. We’re going from a fee-for-service model to a population-health model, and we’re working out ways to financially incentivize all the players and improve the quality of healthcare for entire populations at the same time.”

Off hours, Oden enjoys reading and spends most of his time attending his sons’ baseball, soccer, football and basketball games. His family is also active in supporting the Juvenile Diabetes Research Foundation.

He and his wife, Beverly, are the parents of Gregory, Preston and Josh.

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Shanna B. Pettie, M.D. Dr. Pettie attended Tougaloo College before attending medical school at Wayne State University School of Medicine in Detroit, Michigan. After graduation, she joined the United States Army. She completed her internship and residency at William Beaumont Army Medical Center in Fort Bliss, Texas. She has since cared for active duty soldiers, spouses, dependents and retirees at Bayne Jones Army Community Hospital in Fort Polk, Louisiana and Reynolds Army Community Hospital in Fort Sill, Oklahoma.

to begin receiving Mississippi News in print or on your tablet or smartphone www.MississippiMedicalNews.com

Dr. Pettie grew up in Jackson, Mississippi where she learned the meaning of hard work and determination. She brings these values with her to her medical practice, striving to give each patient the personal attention they deserve.

Dr. Pettie is married to active duty physician assistant, CPT Christopher Alden, and enjoys spending time with their children, Christopher, Zoe and Parker. She is a member of Mount Calvary Missionary Baptist Church in Jackson, Mississippi, and in her spare time, she enjoys reading and spending time with her family.

St. Dominic’s Internal Medicine Group 971 Lakeland Drive Suite 250 Jackson, MS 39216 601-200-4860

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Industry Trend Alert

What to Ask Before Committing to the “Cloud”

By TODD GOODEN

All healthcare administrators know the importance of protecting their clinic’s critical data from a security, availability and compliance standpoint, but most don’t have the time, resources and ‘knowhow’ to ensure it’s being done properly while managing all of their other daily responsibilities.

For this reason, many clinics are migrating their IT infrastructure (in-full or partially) to The Cloud via customized cloud-hosted solutions enabling greater security, ease of backup and access, and greater value, when compared to the cost of full-time IT support in-house.

But while interest in The Cloud has never been greater, it’s important that administrators understand that when it comes to cloud-hosted solutions, doing a little homework before ‘signing the dotted line’ could save their clinic hundreds of thousands of dollars over the life of the agreement.

NAMED/ACCESS PRICING

OPTION A

OPTION B

CONCURRENT/USAGE PRICING $40/user x 30 users ($1,200/month)

$40/user x 50 users

($2,000/month

ANNUAL COST $24,000 36 MONTH COST $72,000 Buyer Beware Most clinic administrators are unaware that they have a choice when it comes to purchasing a cloud-hosted solution for their clinic. As a result, they enter into long-term agreements with providers requiring them to pay thousands of dollars more per month than necessary.

So how do you know if you’re paying too much for your cloud-hosted solution?

Ask yourself one simple question: Is my price based on number of ‘Named’ Users or ‘Concurrent’ Users?

Sample Illustration Let’s say you have 50 employees on

$14,400 $43,200

your staff, but never more than 30 employees working in your office and logged into your system at any given time.

With Named Pricing (or Access Pricing), you pay for ALL 50 employees to have access to your system – even the 20 not at work that day.

With Concurrent Pricing (or Usage Pricing), you pay only for those 30 employees at work and logged into your system that day.

The Shell Game As the graph below shows, Named Pricing is considerably more expensive than Concurrent Pricing. It’s also a com-

pletely unnecessary expense – equating to thousands of dollars annually in lost operating capital.

Protect Yourself Many nationally recognized solutions providers have been known to ‘steer’ the uninformed clinic administrator to the Named Pricing model automatically…as though there is no other alternative.

They’ll say it’s the only way to ensure every employee has a user name and real-time access to the system. This is not accurate. With Concurrent Pricing, every employee has a user name, and names may be easily added/removed for access purposes.

Bottom Line: When considering a ‘Hosted Solution’ for your clinic, do your homework…know the facts…you have a choice!

Todd Gooden is the CEO of The Solutions Team. Visit him at www.thesolutionsteam. com.

Using Deep Brain Stimulation to Treat OCD Patients, continued from page 5 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 appropriate 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 seventh 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.” mississippimedicalnews

.com

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 JNLMSMed-2 disease through theJNLMSMed-2 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 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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Streamlining Prescription Management, continued from page 1 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 prescription 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 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.

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 re-

newal 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.

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

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.

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.

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.

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

HIMSS Analytics Honors North Mississippi Health Services, continued from page 3 www.msbluesmarathon.com

presented by:

Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company, is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.

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OCTOBER 2015

gion. I am pleased that HIMSS Analytics is recognizing our team as one of the best implementers of technology in the nation, as well as one of the most prepared systems in the country for future changes in healthcare.”

HIMSS Analytics is a wholly owned, not-for-profit subsidiary of the Healthcare Information and Management Systems Society (HIMSS). It collects, analyzes and distributes essential healthcare data from more than 5,400 U.S. hospitals. Data collected is directly related to IT processes and environments, products, IS department composition and costs, IS department management metrics, healthcare trends and purchase-related decisions.

HIMSS Analytics delivers high quality data and analytical expertise to healthcare delivery organizations, healthcare IT

companies, government entities, financial organizations, pharmaceutical companies, and consulting firms.

HIMSS is a cause-based, global enterprise that produces health IT thought leadership, education, events, market research and media services around the world. Founded in 1961, HIMSS encompasses more than 52,000 individuals, of which more than two-thirds work in healthcare provider, governmental and not-for-profit organizations across the globe, plus over 600 corporations and 250 not-for-profit partner organizations, that share the cause of transforming health and healthcare through the best use of IT. Headquartered in Chicago, HIMSS serves the global health IT community with additional offices in the United States, Europe and Asia.

For more information, visit www.himssanalytics.org.

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.com

Finding Neuronal Needles in the Haystack Technology Opens the Door to More Data, Potentially More Answers

By CINDy SANDERS

With 100 billion neurons in the brain, singling one out can be a Herculean task – much like finding a needle in the haystack.

However, new technology by Utah-based Blackrock NeuroMed LLC can make that undertaking easier … and potentially help researchers find answers, or at least point to new questions to ask, in the quest to better understand a host of neurologic disorders.

“What makes us really unique is we have the capability of recording signals from individual neurons in the brain,” said Andy Gotshalk, CEO of Blackrock NeuroMed, a pioneering EEG monitoring technology company headquartered in Salt Lake City.

Andy Where standard Gotshalk EEG technology measures the energy of tens of thousands of neurons at once, Blackstock’s technology also measures and records signals from each tiny neuron, allowing clinicians and

Don’t Miss the Big Event

researchers unprecedented precision in identifying underlying causes of disruption in the brain’s natural circuitry.

Using a large forest with millions of trees as an analogy for the human brain, Gotshalk said traditional EEG alerts physicians and researchers if there is a fire in a large sector of the forest or if a disease has struck thousands of trees. The current standard of care picks up on those large signals, he explained.

“But if there was just one tree on fire or had a disease, traditional EEG would not pick that up … but our equipment can,” he said of being able to drill down to signals from a single neuron.

The Cervello® EEG/LTM systems combine research and clinical applications to allow data collection on epileptic patients with surgically implantable electrodes. While the electrodes aren’t anything new, Gotshalk said the way Blackrock’s amplifiers work to pickup extremely small signals and then get those signals from the brain to the computer display monitor without interference is unique. The system incorporates three primary technologies – an electroencephalogram, a high-definition video camera, and a data-recording device that can monitor the brain’s electrical activity.

And, Gotshalk continued, “It’s done with precise synchronization – these signals are very quick; they’re on a millisecond scale – making sure a clinician knows when these neurons are firing.”

Gotshalk noted there are already a significant number of epileptic patients being monitored across the country with implantable electrodes. The American Association of Neurological Surgeons

(AANS) estimates nearly 30 percent of patients with epilepsy are considered medically resistant and are not well controlled by diet and medication.

From this pool of patients, many will be evaluated through noninvasive monitoring, but a portion will go on to have subdural or depth electrodes implanted for more precise monitoring.

With the Blackrock technology, hours and hours of brain data collected while waiting for a seizure can now be processed with the hope that the information will offer new insights into how the brain works. Gotshalk said the technology could help clinicians better see when and where seizures are starting and how they are progressing across the brain.

However, the goal for the collected images and data is not only to impact the treatment of epilepsy but also other conditions including ALS, Alzheimer’s, depression, and Parkinson’s.

“Central to our company’s mission is unraveling the mystery of what causes different neurological disorders,” Gotshalk stated.

“It’s technology like ours that is going to give clinicians and researchers better data and a

much better understanding of how the diseases are manifesting themselves so we can provide better solutions.”

While still in the early stages – the company was spun out from Blackrock Microsystems in 2012 – Gotshalk said there are already major installations throughout the Epilepsy Monitoring Units at Cedars-Sinai, Swedish Medical Center Seattle, Children’s Hospital of Wisconsin, and Children’s of Alabama in Birmingham. In addition, individual pieces of monitoring equipment are being used by a number of researchers, including some at UCLA. Recognizing this is new technology, Gotshalk said the company is moving slowly to ensure clinicians are comfortable with the system’s clinical use, which still allows them to view traditional EEG data while simultaneously giving them the new ability to monitor individual neuron signaling. However, he reiterated, the hope is absolutely that researchers and physician-scientists will take advantage of this expanded data with an eye toward impacting other neurological conditions.

“The goal is to get a much better understanding of how the brain is functioning … which hopefully will give us better insight when the brain isn’t functioning properly,” he concluded.

ST. DOMINIC’S RHEUMATOLOGY IS PLEASED TO WELCOME

Jason Taylor and Seth Compton TO THE MEDICAL STAFF. Choosing the right physician partner as early as possible will have an enormous effect on your quality of life in the long run when experiencing joint pain, arthritis or other painful conditions. St. Dominic’s Rheumatologists want to intervene, treat and improve the way you feel physically. Call 601-200-4530 to schedule your appointment. www.MississippiMedicalNews.com

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.

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GrandRounds Stone County Hospital Names Burkart As COO David Burkart joins Stone County Hospital in Wiggins, as the new Chief Operating Officer (COO).

Formerly of The Medical Oncology Group as Administrator and COO, Burkart brings 25 years of experience in health care administration.

David Burkart Burkart has successfully led and implemented initiatives at three major specialty clinics and one hospital system, spending the last 15 years on the Mississippi Gulf Coast.

Burkart began his career in health care in 1992 at Piedmont Hospital in Atlanta, Georgia. He moved to the Mississippi Gulf Coast in 2001, where he served as Administrator and CEO for Gulfport OB-Gyn Clinic.

He is a Certified Administrator in Physician Practice Management (CAPPM) and holds an Executive Fellowship in Practice Management with the American Academy of Medical Management. He is also a member of the American College of Healthcare Executives.

Burkart received his bachelor’s degree from Southeastern Louisiana State University in Hammond, Louisiana and his master’s degree from the University of Phoenix in Baton Rouge.

Martha Dempsey-Doan, MD, Joins Medical Staff of Merit Health Biloxi Martha Dempsey-Doan, MD, has joined the medical staff of Merit Health Biloxi.

Dempsey-Doan attended Mississippi State University where she graduated Summa cum Laude with a Bachelor of Science Dr. Martha in 2004. She attended Dempsey-Doan medical school at the University of Mississippi Medical Center where she obtained her Medical Degree and completed a residency in Family Medicine serving as Chief Resident.

Dempsey-Doan is certified by the American Board of Family Medicine, ATLS, ACLS, PALS, and TNCC. She has been affiliated with the Society of Teachers of Family Medicine since 2010. Dempsey-Doan will be located in D’Iberville.

Children’s Clinic Relocates Children’s Clinic, a service of Hattiesburg Clinic, has relocated to 4210 Lincoln Rd. from #5 Medical Blvd. in Hattiesburg.

The new 17,556 square foot facility allows for more convenient access to patients and room for expanded growth.

Theodore E. Atkinson, III, MD; Aprile C.

Gilmore, MD; Leigh A. Haden, MD; S. Kimble Love, MD; Yakeyla Naylor, MD; Susan L. Robbins, MD; Matthew C. Whittington, MD; Jeffrey C. Williams, MD; Pamela A.Love, CNP; and Amanda C. Whiddon, CNP, will continue to provide services at the new location.

Standard operating hours will remain Monday through Friday from 8:00 a.m. until 5:00 p.m.; Saturday from 8:00 a.m. until 12:00 p.m. and Sunday from 1:00 p.m. until 4:00 p.m.

Willow Anesthesia Expands with Greenwood Leflore Hospital Willow Anesthesia, a full-­service anesthesia provider, announced that it is the exclusive provider of anesthesia and obstetrical pain services at Greenwood Leflore Hospital in Greenwood, Mississippi.

Willow Anesthesia has a staff of 41 anesthesia providers, including Wilton L. “Bo” Marsalis, M.D., Ph.D., who serves as Chief Medical Director. Dr. Marsalis will be guiding the Greenwood Leflore team of eight CRNAs and two anesthesiologists to provide high quality, patient-­ centered services at the facility. A fundamental service at Greenwood Leflore is that which deals with acute pain. The Willow team at Greenwood provides regional analgesia by performing both continuous catheter placement as well as single dose injections. The goal of such therapy is to provide patients with significantly diminished pain after surgical procedures.

Dr. Marsalis, along with Paul Carpenter, CEO, and David McCullen, President, both Certified Registered Nurse Anesthetists, comprise the clinical leadership team for Willow Anesthesia.

Dawn Boggess Named Administrator Of Stone County Nursing & Rehabilitation Center Dawn Boggess, a Licensed Nursing Home Administrator with 20-years of experience in the healthcare arena, has been named the new Administrator of Stone County Nursing & Rehabilitation Center (SCNRC). She comes to SCNRC from Stone County Hospital & Clinics, where she previously served as the Chief Operating Officer.

Boggess earned her bachelor’s degree in Business Administration and Management from The University of Southern Mississippi. Highly skilled in healthcare financials, practice management, human resources, marketing, and business development, Boggess brings a wealth of experience to the administrative team at SCNRC. In addition to taking on this new role, she will continue to work with Stone County Hospital in business operations assisting with the revenue cycle.

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PUBLISHED BY: SouthComm Business Media, Inc. GROUP PUBLISHER Dennis Triola dtriola@southcomm.com 310.422.6637 ASSOCIATE PUBLISHER Kathy Arich karich@mississippimedicalnews.com Ad Sales: 601.941.3075 ACCOUNT EXECUTIVE Perry Patterson LaCour placour@mississippimedicalnews.com Ad Sales: 601.941.1603 NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com LOCAL EDITOR Lynne Jeter lynne@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley, Amy Gomoljak James Osborne, Christie Passarello CONTRIBUTING WRITERS Christopher Cussat, Lynne Jeter, Cindy Sanders, Lucy Schultze CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: editor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. • Suite 100 Nashville, TN 37203 615.244.7989 • (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 • Two years $78 SOUTHCOMM BUSINESS MEDIA, INC. Chief Executive Officer Chris Ferrell Chief Financial Officer Ed Tearman Chief Operating Officer Blair Johnson Director Of Financial Planning And Analysis Carla Simon Vice President Of Human Resources Ed Wood Vice President of Content Patrick Rains Vice President Of Production Operations Curt Pordes Chief Revenue Officer Dave Carter Director Of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce Mississippi Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm Business Media, Inc. ©2015 Medical News Communications.All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials.

All letters sent to Medical News will be considered Medical News property and therefore unconditionally assigned to Medical News for publication and copyright purposes.

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GrandRounds Robert Brasfield Smith, MD, Joins Digestive Health Specialists Digestive Health Specialists, P.A., announces that Robert Brasfield Smith, MD, has joined the practice as a gastroenterologist. Smith received a bachelor’s degree in Spanish from Davidson College in North Carolina.

He completed his Dr. Robert medical training at the Brasfield Smith Louisiana State University School of Medicine in New Orleans, and his internal medicine residency at Loui-

siana State University Health System in Baton Rouge where he served as Chief Resident.

He completed his fellowship in gastroenterology and hepatology at Ochsner Clinic and Alton Ochsner Medical Foundation in New Orleans, in June 2015.

Smith is a member of the American College of Gastroenterology, the American Society of Gastrointestinal Endoscopy, the American Medical Association and the American Gastroenterological Association. He is board certified by the American Board of Internal Medicine.

Lunch. Dinner...

Lunch. Dinner...

Did you miss out on our Foie Gras season?

Did you miss out on our Soft Shell Crab season?

Don’t miss out on our seasonal specials again!

We change our menu to feature the freshest local ingredients...

Memorial Hospital Serves as Academic Center and Teaching Facility August 2015 marks the fourth year Memorial has welcomed third and fourth-year medical students from William Carey University. Eighteen students will participate in the program at Memorial Hospital at Gulfport from August 2015 through July 2016.

William Carey University College of Osteopathic Medicine is the second medical school in Mississippi and the first in the region to focus on osteopathic medicine. The curriculum is discipline-based and is structured around the Core Competencies of the osteopathic profession in order to maximize the students’ opportunity to train for a career in Osteopathic Primary Care.

David Northington, DO, serves as Medical Director of the Preceptor program.

The physicians that serve as Preceptors are on the adjunct faculty of William Carey University.

Celebrations.

Celebrations.

Memorial Hospital at Gulfport Celebrates Decade of Growth Memorial recently completed new, modern patient rooms with nearly 50 percent more space than previous rooms, part of a massive infrastructure project adding floors 6 and 7 to the Main Patient Tower.

(L-R) Kay St. Amant, Blitch Knevel Architects; Linda Sherman, Memorial Board of Trustees; Carrolyn Hamilton, Vice-Chairman, Memorial Board of Trustees; Kathie Short, Secretary, Memorial Board of Trustees; Connie Rockco, President, Harrison County Board of Supervisors; Marvin Smith, Chairman, Memorial Board of Trustees; Billy Hewes, Mayor of Gulfport; Gary Marchand, President/CEO, Memorial Hospital at Gulfport; Roy Anderson, III, President/ CEO, Roy Anderson Corp; Mark McDaniel, Vice President, Roy Anderson Corp; and H.V. Nagendra, Roy Anderson Corp. mississippimedicalnews

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