Nashville Medical News January 2016

FOCUS TOPICS OPHTHALMOLOGY HEALTHCARE DESIGN

January 2016 >> $5

PHYSICIAN SPOTLIGHT PAGE 2

Shari Barkin, MD, MSHS

ON ROUNDS

Tennessee Improves, but Still Near the Bottom, in Annual Health Rankings United Health Foundation Releases 26th Annual Report on Health in America

By CINDy SANDERS

Workforce Issues Take Center Stage in Healthcare The healthcare workforce will become the nation’s largest employment sector in the next decade, surpassing all other industries in job growth and representing one in four new jobs by 2024, according to recent data from the Bureau of Labor Statistics ... 5

TMA Outlines 2016 Legislative Priorities When the second year of the 109th General Assembly begins on Jan. 12, the Tennessee Medical Association will be ready to discuss legislation to help improve the healthcare environment for Tennessee doctors and patients ... 9

Last month, United Health Foundation released the 26th annual report on the state of health in the nation. Hawaii received top honors in “America’s Health Rankings®,” while Louisiana came in dead last. Although Tennessee moved up two spots from last year, the state still finished near the bottom at 43rd in the country.

With a starting position of 42nd in 1990, Tennessee hasn’t managed to gain much traction over the last 26 years despite increased attention and efforts to positively impact the determinants of health. The state’s worst showing came in 2005 with a rank of 49th, and the best was in 2011 at 41st.

Rankings were determined by weighting more than 60 core measures and supplemental measures across the broad topics of physical and behavioral health, access to care, clinical quality targets, environment, policy and (CONTINUED ON PAGE 4)

Evidence-based Design: Marrying Form & Function on the Front Line

By CINDy SANDERS

When is a painting much more than just a pretty picture?

When it promotes health and healing.

Designers and healthcare industry leaders from around the nation recently gathered in Washington, D.C. for the annual Healthcare Design Conference. Convened

by The Center for Health Design (CHD) and Healthcare Design Magazine, the four-day meeting and exposition unveiled the latest in evidence-based strategies and products.

Rosalyn Cama, president and CEO of Connecticut-based health design firm CAMA, Inc. and the immediate past chair of CHD summed up the conference experience as ‘awesome.’

“It’s rich in attendance with folks who are well-versed in the business of healthcare … not only how you design it, but how to build it and then manage it and sustain it over time,” Cama said of the multidisciplinary professionals in attendance.

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PhysicianSpotlight

Health in Action

Dr. Shari Barkin Focuses on Preventing Childhood Obesity One Family at a Time

us and vice versa, where we could develop ideas and test them,” she said of the North Carolina facility. “When I was recruited to Nashville in 2006, my vision was to expand that and build a series of collaboratives across the country to develop ideas to prevent obesity and increase public health.”

ation and former Mayor Bill Purcell.

“Mayor Purcell had doubled the number of community and recreation facilities, and wanted to focus on how they could be utilized to enhance wellness and health,” she explained.

In 2008, Barkin spearheaded a citywide effort to improve the health of families. Now in its eighth year, The Nashville Collaborative has received eight grants and been featured in 30-plus peer review publications.

Comprised of staff from Monroe Carell Jr. Children’s Hospital at Vanderbilt and Metro Parks and Recreation, the group works together to improve the health of local children. All of the initiatives are community-centered, family-based, sustainable, and have measurable results.

The Nashville Collaborative has received multiple awards from the Tennessee Association of Pediatrics, and Barkin has been invited to present the community health model in Italy, New Zealand and France. In 2014, Barkin was elected to serve as vice president of the Society for Pediatric Research, with succession to the presidency in 2016.

The Nashville Collaborative Once in Nashville, Barkin discovered a natural partner in Metro Parks and Recre-

Obesity Prevention in 2016 Barkin said there’s no golden ticket when it comes to obesity prevention. “We

By MELANIE KILGORE-HILL

For Shari Barkin, MD, MSHS, improving public health isn’t just a profession. It’s a passion.

As director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, Barkin has dedicated her practice to the prevention of childhood obesity – an epidemic plaguing 17 percent of American kids ages 2 to 19, according to the Centers for Disease Control and Prevention.

The Road to Research A Maryland native, Barkin earned her undergraduate degree at Duke University, her medical degree at the University of Cincinnati, and completed her pediatric residency at Children’s Hospital of Los Angeles. She was selected as a UCLA Robert Wood Johnson Clinical Scholar and completed a fellowship in Health Services Research.

“I started my research by looking at big public health issues and wondering what the role of the physician is in addressing these,” Barkin said.

While in Los Angeles, that meant working with teachers, parents and providers to identify ways to prevent violence.

After accepting an academic position at Wake Forest University, however, Barkin witnessed another dangerous epidemic unfolding among pediatric patients: obesity.

“At a macro level, I saw children walking through who were much larger than they had been a few years earlier,” Barkin said. “It made me ask questions, like why weight was outpacing height. What was different? It wasn’t sudden slothfulness, gluttony or technology, but a combination of many things.”

Barkin began writing grant proposals to fund research to understand early growth trajectories in children and to learn why some stay healthy while others veer off toward obesity. Her focus became one of prevention rather than weight loss.

Taking it Outside While Barkin attempted to answer some of her questions by studying children in medical practices, she found many under a physician’s care were already obese.

“Once I established that health happens in families and communities, I took my research out of doctors’ offices and developed a partnership between the university and the community, creating collaboratives to strengthen families and neighborhoods,” Barkin explained.

Among her accomplishments was development of a 90,000-square-foot learning center with teaching kitchens and space for health screenings and counseling. “It was a place for the community bring ideas to 2

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do ourselves a disservice if we look at only one factor at a time,” she said. “It’s most impactful when we consider the dynamic interaction between factors and understand that timing of these exposures matter, too.”

The problem is multi-faceted, from our western diets to the way we grow food and the size of our plates. And then there’s the simple lack of movement in both work and leisure environments, triggered by an abundance of technology … and oftentimes, a perception of danger when it comes to outdoor play.

Attitudes about how we interact with resources also are a contributing factor, Barkin said. Socioeconomic status and early stressors in life can change a child’s physiology and inflammatory pathways, which alters how fat is stored and partitioned. There is also the incredibly complex science behind microbiomes (think gut bacteria changes), genetics and the evolving nature of protein expression from exposure to environmental factors.

“Our bodies are in a dynamic interactive state, and addressing one factor doesn’t allow us to make strides in a large public health way,” Barkin said. “Often these types of health issues, like obesity prevention, are really a family-focused health endeavor. It’s not one child at a time; it’s one family at a time. We, as clinicians and pediatricians, have an opportunity to engage the whole family and develop family-based strategies for maximum health.”

The Nashville Collaborative Since 2008, more than 1,200 Nashville youth have walked, danced and eaten their way to healthier futures thanks to The Nashville Collaborative.

A project of Monroe Carell Jr. Children’s Hospital at Vanderbilt and Metro Parks and Recreation, the program brings the community together with researchers to create and test innovative programs aimed at keeping children healthy and active. Their goal is to help children maintain a healthy weight and to prevent chronic diseases like obesity and diabetes.

“Any projects we develop and test must meet four criteria,” said program founder Shari Barkin, MD, director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. “They must be community centered, family based, have the potential of sustainability, and be measurable.”

Their current Growing Right Onto Wellness trial (GROW) includes 610 parent/child dyads and is just one of many studies Dr. Shari Barkin, joined by then-Mayor Karl Dean, poses with a group of young participants in the underway in Middle Tennessee. Barkin said families often enroll interactive GROW project that engages both parent and child in wellness measures. additional siblings and family members once they realize the program’s added value. While educational, exercise and afterschool programs strive to prevent obesity in youth, parents also are picking up better habits, learning how better lifestyle choices impact the overall wellness of the entire family.

The program has received international attention, with Barkin now a sought-after speaker across the globe. To date, The Nashville Collaborative has received $15 million in grants, most of that focused on programs in Middle Tennessee. The Nashville Collaborative meets monthly to develop ideas that meet their four criteria, write grants and disseminate information.

Barkin said they’re constantly looking for avenues and strategies to spread the information they’ve learned – not only to improve the health of Nashvillians but also to export the program beyond Tennessee’s borders. A recent grant from the National Cancer Institute will allow Barkin to expand one of their first projects, Salud con la Familia (Health with the Family), to four more states. The study, which was focused on reducing childhood obesity in Latino populations, showed that a simple 12-week program could improve early childhood growth and keep kids on a healthy growth curve.

“What’s exciting is that we have the potential to export these programs across parks and recreation to more than 230 million Americans,” Barkin said. “We’re really focused on that, and we believe it puts Nashville in a really good place.” nashvillemedicalnews

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HealthcareEnterprise

The New Healthcare Marketplace Lucro is Redefining How Buyers, Sellers of Healthcare Solutions Connect party insights into a fuller context to inform more comprehensive decision-making.

“We found most buyers don’t care about vendor websites. They care about what their trusted peers in their role at other hospitals are doing,” Brandes said. “’They want to know, ‘How are you solving this problem?’

Right now they’re doing that through hallway conversations and trade shows, which aren’t comprehensive.”

By MELANIE KILGORE-HILL

If the name “Lucro” is new to you, it won’t be for long.

Backed by Nashville-based Martin Ventures, Lucro is an online marketplace for buyers and sellers of healthcare solutions with the potential to truly disrupt the status quo in an industry overwhelmed by financial and regulatory pressures.

Lucro officially launches spring 2016 but is already being utilized by more than 1,000 early adopters including HCA, Community Health Systems and Tenet Health where decision-makers have embraced the new outlet to discover, compare and collaborate with peers around innovative industry solutions.

New Ideas for a New Marketplace Lucro’s groundwork traces back to 2009, when company founder and CEO Bruce Brandes found himself on the West Coast as a keynote speaker behind Steve Jobs. Soon, he was collaborating with Silicon Valley’s top techies.

Brandes later teamed with Martin Ventures – which provides capital, operational support and mentoring primarily for healthcare and technology entrepreneurs – as a Bruce managing director and Brandes served on the company’s investment committee.

“Through my experience, I made a couple of observations,” explained Brandes, a healthcare IT veteran. “Healthcare is a market that has been oversold and under delivered, and the industry has the scars to show for it.”

Brandes regularly saw companies approach Martin Ventures in need of capital – not to invest in a product … but to hire pricey sales execs. Brandes contended a better way for companies to grow was to redirect those dollars to help products and clients succeed.

Then, he made another observation.

“As we went around talking to major healthcare executives about Martin Ventures, everyone had the same question: ‘Can you help us filter the universe of shiny things?’ There’s an explosion in the number of new vendors out there, and no one knows how to filter through it all,” Brandes said.

“Either they’re wasting a lot of time in meetings with companies that aren’t a fit, or they’ve put up a wall to keep them out and then worry about innovations they might be missing out on,” he noted.

Simply put, they needed help executing innovation with greater clarity and lower risk. It became clear the industry-disrupting task ahead was bigger nashvillemedicalnews

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than Martin Ventures itself. Brandes approached his West Coast comrades to see what could be learned from other multisided platforms – top websites that shift the advantage to the buyers to make decision faster and cheaper.

“We know the way in which we buy a car or plan a vacation is radically different now than a couple years ago,” Brandes said. “How do we take those principles and apply them to healthcare where the mission is much more important than saving $10 on a hotel room?”

Conversations took place between world-class web developers and the nation’s top healthcare executives to identify missing links in the healthcare marketplace. Before long, Brandes had a well designed website and a network of early adopters eager to help bring vendors on board.

“Vendors want to grow their business but can’t get in front of the right people,” Brandes said. “We’re giving them a vehicle to raise visibility and access solutions. It’s a new ecosystem with advantages to both sides, helping healthcare organizations to innovate faster with lower risk and giving the companies that should succeed a chance to build better solutions and be shared.”

So, What is Lucro?

In a nutshell, Lucro is an online marketplace where providers, vendors and third party associates have a voice. It’s a single site where vendors can be rated and reviewed, ideas can be pinned and private groups can be created for peer discussion.

Lucro’s capabilities include: • A comprehensive catalog of established and emerging companies and their products for healthcare, • The ability to organize individual products within project boards, enabling the pinning of individual products to be grouped into a comprehensive solution, • Insights from colleagues through ratings, reviews and polling, • Private group collaboration to raise consistent best practices enterprise-wide, and • Aggregation of specific, valuable third

A Call to Vendors To that end, Lucro’s staff members are attempting to create a vendor profile solution card for every company selling into the healthcare marketplace. Of the 22,000 vendors identified, more than 10,000 cards have already been entered based on publicly available facts.

Now, Lucro is putting a call out to vendors to connect to the marketplace, curate their solution cards, and provide details about specific services and capabilities – information that will expedite buyers’

searches. There is no charge for buyers or sellers to participate, which Brandes hopes will avoid friction in building out the Lucro community. He also hopes to reach out to third-party professional organizations, industry analysts and other experts who have earned a trusted place as advisors in the healthcare community.

A Community Effort In building a truly comprehensive, non-biased healthcare marketplace, Lucro has compiled a diverse board of advisors that includes Scott Becker, publisher of Becker’s Hospital Review, and board members and executives from RAND Health, Tenet Health, Oxeon Partners and Ascension Health.

“This is a community effort. It’s not taking the place of something that already exists and is working,” Brandes said. “We’re well positioned to do something very significant in the industry, but it will only succeed if people look at how to align rather than protect their own turf on a legacy piece.

The problem we’re striving to solve is a problem for everyone.”

For more information or to become a part of the Lucro community, go online to lucromarketplace.com

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Tennessee Improves, but Still Near the Bottom, continued from page 1 other societal factors including education and poverty levels. Among core measures, Tennessee makes a good showing in several categories, including having a high rate of high school graduates and low prevalence of excessive drinking. However, we rank in the bottom third for obesity and physical inactivity and at or near the very bottom for diabetes (48), poor mental health days (50), smoking (47), and violent crime (47).

In the supplemental measures, the state ranks among the best for issues related to binge and chronic drinking and having cholesterol checked. Unfortunately, knowing those lipid numbers haven’t done much to impact the rate of high cholesterol (30), or to slow down heart attacks (46) and heart disease (45). Tennesseans seemingly are among the worst for eating fruits (49) and administering the HPV immunization for females (50).

Unfortunately, Tennessee saw a 20 percent increase in poor mental health days over the last two years and an 11 percent increase in violent crime since the rankings were launched in 1990. With 591 violent offenses per 100,000 population, Tennessee fares far worse than the top state of Vermont with only 121.1 such offenses per 100,000. Tennessee also compares unfavorably with much larger states often portrayed as having big city dangers, including New York (393.7) and California (402.1).

Only Nevada (603), New Mexico (613), and Alaska (640.4), have a bigger issue with violent crime than Tennessee.

On the plus side, cardiovascular deaths are down 22 percent over the past decade from 382.3 to 299 per 100,000 population. That’s still a far cry from the best state, Minnesota, which has a rate of 186.5 deaths per 100,000. Other positives include a 26 percent decrease in preventable hospitalizations over the past five years from 87.7 to 64.8 per 1,000 Medicare beneficiaries, and a significant decrease of 28 percent over the last year in physical inactivity, which is down from 37.2 percent to 26.8 percent of adults self-reporting as inactive.

The State Weighs In In light of the recent metrics, a spokesperson with the Tennessee Department of Health offered the following commentary on the pluses and minuses of the state’s recent ranking with specific attention to the change in physical activity.

“While the Tennessee Department of Health is pleased to see data indicating an improvement in the number of residents who are self-reporting being more physically active, we must all understand annual fluctuations in calculations and periodic shifting of survey methodology are factors that must be considered when reviewing new numbers. The effort to im-

prove physical activity across Tennessee is an important component of the Big Three Plus One initiative to improve health for all residents. The components include: 1). Reducing excessive caloric intake to reduce overweight/obesity; 2). Improving physical activity among all residents; and 3). Reducing the number of Tennesseans who use tobacco products; plus reducing misuse/abuse of both prescribed and illicit drugs.”

Department of Health officials went on to point out that in addition to statistical changes that might have been impacted by the way the question was phrased, they believe improvement is also attributable to the contributions of several new programs across the state aimed at enhancing fitness, including: • Engaging in a partnership with Tennessee Department of Environment and Conservation to convene school running clubs across the state, providing non-competitive physical activity in an after-school setting to interested students.

• Funding for walking tracks at multiple schools across the state.

• Encouragement and support for Go Noodle, which provides fun, physical activities in classroom settings in over 1,000 Tennessee schools.

• Construction on walking trails and

greenways across the state.

• Implementing a program to provide free access to recreation centers, as well as an exercise coach for citizens wanting to reduce weight and improve health.

• Encouraging increased physical activity through a series of healthy actions and challenges as part of the Small Starts tools developed and offered by the Governor’s Foundation for Health and Wellness to engage Tennesseans at home, in the workplace and at worship.

• Statewide implementation of the Healthier Tennessee Communities initiative to motivate community-level ownership of population health and to support positive changes among fellow residents.

“These and other efforts focus on the importance of helping all individuals understand the importance of physical activity and encouraging them to take action to become more physically active in meaningful ways,” concluded the TDH official.

The Big Picture The interactive report, which also includes data specific to seniors, allows comparison of Tennessee to other states and national averages for the broad range of measurable metrics. Custom reports, state infographic and summary, and ‘take action’ resources to improve rankings are all available at AmericasHealthRankings.org.

Evidence-based Design: Marrying Form & Function, continued from page 1 No doubt the event also held special significance to Cama this year as she was presented with the Russ Coile Lifetime Achievement Award. Cama, who has served as CHD board chair for 14 years, was also named chair emeritus of the organization, which is dedicated to bringing together a community of designers, architects, executives, manufacturers and students to improve qualRosalyn ity of care and outcomes Cama through evidence-based design principles.

With dozens of educational tracks, facility tours, and keynote presentations, Cama said the conference covered a broad spectrum of topics and provided insights for veteran designers, as well as those newer to the field. “Because this is a research conference, they are revealing new data,” she noted. “You can’t think that what you heard five years ago is how you are going to operate. Demographics change, culture changes, operational models change. You have to stay current.”

One major change, she continued, is how technology is integrated into care and the built environment. “Technology is forcing us to change dramatically. It affects how care is delivered and how patients move through space and the system.”

While technology dominated many conversations on the acute side of the equation, Cama said, “On the ambulatory side, we heard a lot about patient experience – how to know your customers, deliver a more meaningful experience, and then measure 4

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it.” Additionally, she noted there were an increasing number of conversations centered on health and wellness and moving care from the hospital into the community.

Nature Equals Nurture Roger Ulrich, PhD, is often credited as the pioneering researcher whose work transformed how nature is viewed within the healthcare setting. Cama noted a landmark study Ulrich performed more than two decades ago underscored the difference in outcomes between patients whose rooms had a view of a brick wall compared to those who saw a stand of trees. In the study, patients recovering from abdominal surgery with a view of nature required less pain medication, had fewer complications, and were discharged from the hospital earlier than their counterparts viewing the brick wall.

The study, Cama continued, caused healthcare designers to really consider how to create environments that speak to the human condition … particularly when that condition is in a fragile and vulnerable state.

“Looking at a wall of technical outlets is not a calming view,” she pointed out.

However, Cama was quick to add that same clinical equipment is critical to quality care. Therefore, the task of the designer is to place technology in a way that is easily accessible to clinicians while preventing it from being the focal point for patients and families so as to lower their stress levels.

She said there are a number of ways to bring nature indoors – from rooftop gardens and water features to rooms with a view and artificial illumination that simulates natural lighting. Cama also pointed out these fea-

tures aren’t just for the benefit of patients but also speak to the needs of families and healthcare staff.

A Hint of Hospitality While much has been made of the hospitality industry’s influence on healthcare, Cama cautioned that it should only go so far. “It can look inviting and beautiful if that’s how one interprets ‘hospitality.’ But it can’t be fussy, and it has to be clean,” she stressed of healthcare design.

Cama added products have evolved over time to give healthcare designers many beautiful options that marry the twin needs of form and function. “The manufacturing industry has grown up with us. Now there are so many more choices that have been engineered for this setting. Our kit of parts is much broader,” she said.

Cama noted one of the highlights of the conference is that it introduces attendees to new and improved products each year.

Cama said there is now a luxury flooring product that truly has the look of hardwood.

“I’ll look at real wood now and say, ‘Is that vinyl?’” she laughed.

This year, the designer was actually one of the exhibitors, as well. The IOA Cama Bed Chair (pictured on page 1) debuted at the 2015 meeting. Although designed for use in any number of care settings, Cama said the idea really emerged out of conversations and requests from worried parents.

Her firm does a lot of design for pediatric hospitals. For nearly 20 years, she has heard parents say they wished they could just crawl in the hospital bed with their children to comfort them at night. Since that option is neither safe nor feasible with chil-

dren who might be hooked up to monitors, Cama came up with a stylish alternative – a chair that rises and reclines. At night, a parent can stretch out at equal height to the hospital bed and easily touch and comfort their child without disturbing critical equipment.

“The research around the power of touch, is compelling” Cama added, pointing to the work of Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami. Since the design conference, the Cama Bed Chair won the BOY (Best of Year) award in the Healthcare Furniture Category.

The Time Between In the inpatient setting, Cama noted that increasing attention is being focused on the ‘time between’ seeing clinicians, going for tests, or waiting for a loved one to come out of surgery. “There are long bits of time where you’re waiting. Where do we allow people to relax and be nourished?” she questioned.

Whether it’s by creating a chair, designing a curated program, incorporating a healing garden or botanical walk, or employing the power of local art to trigger pleasant memories, designers around the country are focused on enhancing outcomes by improving the outlook, even for a little while.

Mark Your Calendar The next Healthcare Design Conference is scheduled for Nov. 12-15, 2016 in Houston, Texas. For more information, go online to healthdesign.org.

nashvillemedicalnews

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Fourth Quarter Finishes with a Flourish The fourth quarter of 2015 was a busy one for a number of local healthcare companies with a national footprint.

AmSurg’s Physician Services Division, Sheridan, acquired Valley Anesthesiology & Pain Consultants in Phoenix. Valley is one of the country’s largest independent anesthesiology practices and has more than 240 physicians providing services to 21 hospitals and 25 ambulatory surgery centers. In December, the division also acquired Northside Anesthesiology Consultants in Atlanta.

Workforce Issues Take Center Stage in Healthcare The healthcare workforce will bement grew in unprecedented numbers come the nation’s largest employment sec– nearly a 500,000 jobs in the last year. tor in the next decade, surpassing all other However, job openings are growing at an industries in job growth and representing even faster pace than job hires, creating a one in four new jobs by 2024, according widening gap of unfilled healthcare jobs. to recent data from the Bureau of Labor Demand for quality healthcare professionStatistics. als is growing due to the increase of people The year 2016, however, is when with health insurance under the Affordhealthcare providers will need to come to able Care Act, the aging of the U.S. poputerms with the growing workforce challation, and other forces at work. lenge – how will they recruit and manage The need for workforce planning to the healthcare professionals they need in become a strategic initiative throughout an era of rising patient demand and inthe industry is underscored by the fact that creasing clinician shortages that plague labor is the largest budget item for nearly the industry? any healthcare enterprise, comprising more Healthcare workforce experts recently than half of operating expenses. Technolgathered in Nashville to search for answers ogy-enabled strategic planning services are to the challenge. The 2015 Healthcare now available in healthcare to accurately Workforce Summit was a collaborative, inpredict patient demand and workforce novation-focused forum of the most influneeds up to three months in advance and ential leaders in the healthcare workforce to apply advanced labor management techindustry – including C-suite executives; niques to meet those staffing needs. leaders from human resources and fiSince Millennials will comprise half nance; and nursing, physicians and allied of the workforce in 2020 and three-quarleadership. ters of it by 2030, healthcare Susan Salka, president providers need to analyze and CEO of AMN Healthcurrent generational democare, the leading sponsor of graphics and their impact on the Healthcare Workforce workforce planning. MillenniSummit, explained to the auals, who are used to working dience that healthcare added in teams, might be well suited nearly a half million jobs from to new care delivery and payer November 2014 to Novemmodels. Millennials have ber 2015, an unprecedented proven they can acclimate to era of growth. She added this new team-based healthcare Susan Salka high-demand environment for approaches, and their affinity healthcare professionals is expected to confor integrated technology could be partinue. Since workforce supply cannot keep ticularly well suited to the strong IT comup with demand, she noted, “business as ponent of accountable care. usual just won’t work.”

The need to focus more attention on Instead, Salka said new and innovaworkforce challenges facing healthcare betive solutions must be developed. The two came even more evident with the Decemdays of panel discussions, presentations ber release of new employment projections and networking included: by the U.S. Bureau of Labor Statistics.

Release of the AMN “2015 Survey of Total job openings for healthcare will exRegistered Nurses,” which revealed for the ceed 5 million from 2014-2024. For regisfirst time that the surge in nurse retirements tered nurses alone, there will be nearly 1.1 might be about to happen. The survey of million jobs that need to be filled. nearly 9,000 nurses showed that about In concluding the healthcare worktwo-thirds of Baby Boomer nurses are conforce summit, Salka said healthcare sidering retirement now that the recession providers would increasingly find they is over. Of those experienced nurses concouldn’t go it alone as workforce chalsidering retirement, 62 percent said they lenges become too great. Partnerships would retire within the next three years. between providers and workforce experts A presentation on workforce supply will become essential to the healthcare inand demand showed healthcare employdustry, she concluded. nashvillemedicalnews

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Capella Healthcare completed the transition to make KershawHealth officially part of the Capella-MUSC Health Network in South Carolina.

Community Health Systems, which previously announced the plan to spin off Quorum Health Corporation, unveiled the executive team over the fall. Thomas Miller will serve as CEO, Michael Culotta as CFO, and Martin Smith as executive vice president of Operations. During the fourth quarter, CHS also announced the divestiture of the 72-bed Barstow Regional Medical Center in Florida and the 126bed Memorial Hospital of Salem County in New Jersey. In other news, H. James Williams, PhD, the former president of Fisk University joined the CHS board for a one-year term, and 118 CHS-affiliated hospitals got the nod from The Joint Commission as “Top Performers on Key Quality Measures®.”

HCA acquired 14 urgent care centers in Las Vegas with the purchase of Urgent Care Extra’s Nevada operations. The company also announced Jonathan B. Perlin, MD, president of clinical services and chief medical officer, was honored with election into membership in the National Academy of Medicine (formerly the Institute of Medicine). Additionally, The Joint Commission recognized 106 of HCA’s licensed hospitals, 78 percent of the company’s U.S. hospitals, as “Top Performers on Key Quality Measures®.”

Dr. Jonathan B. Perlin

LifePoint Health agreed to acquire the struggling 376-bed St. Francis Hospital in Columbus, Ga. Duke LifePoint and Tenet Healthcare reached an agreement for the sale of Tenet’s North Carolina hospitals and affiliated operations. Additionally, 18 LifePoint facilities were recognized by The Joint Commission as “Top Performers on Key Quality Measures®.”

RegionalCare Hospital Partners, led by chairman and CEO Marty Rash, signed a definitive agreement in November to be acquired by Apollo Global Management. Day-to-day operations, however, were not anticipated to change for the eight-hospital system.

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A Clearer Picture: Imaging Rhodopsin Could Shed Light on Retinal Disorders

By CINDY SANDERS

A collaborative effort between Bascom Palmer Eye Institute and Florida International University (FIU) has resulted in what the team of biomedical engineers and physician-scientists believe to be a true breakthrough in retinal imaging.

Building on the foundation of traditional optical coherence tomography (OCT), the group created technology to image the light-sensitive receptor protein rhodopsin. Three years of hard work recently culminated in the successful test of the first technology based on visible-light optical coherence tomography (VISOCT).

Shuliang Jiao, PhD, an associate professor of biomedical engineering at FIU who led the project, said OCT is an established imaging technique that has been used extensively in clinical settings and allows ophthalmologists to map and measure layers of the retina.

Yet, OCT on its Dr. Shuliang Jiao own has limits to the information it can yield. Byron Lam, MD, and Rong Wen, MD, PhD, both profes-

sors of ophthalmology at Bascom Palmer and key members of the research team, said OCT is very good at uncovering the anatomy of the retina but cannot tell whether a cell is functional or not.

Dr. Byron Lam Assessing Functionality Wen explained the photoreceptors in the retina that convert light signals to the neuronal signals degenerate at rates that vary by patient and condition. Currently one of the most common ways to assess the extent of vision loss is to simply ask a patient ‘what’ and ‘how well’ they see. As Dr. Rong Wen Wen pointed out, it’s a reasonable test but also a subjective one. “We wanted to come up with an objective way to tell if the photoreceptors are functional,” he said.

To assess functionality, the research team focused on rhodopsin, also known as visual purple, which converts light into electrical signals and is exclusively found in the photoreceptors of the retina. Wen

explained rhodopsin has two states – dark adapted and light adapted.

“Rhodopsin will flip a switch after it absorbs a photon, and that flip of the switch starts a process called phototransduction that will send out a signal to the brain. In that flip of the switch,” he continued, “rhodopsin’s optical absorption spectrum changes.”

Lam added, “It’s really the first step of how we see. It’s the cornerstone of the visual process.”

It’s also measurable. Lam explained that by quantifying the efficiency of photon absorption, it should be feasible to assess the functionality of rod photoreceptors in the retina. By calculating the difference between the two states of rhodopsin – light adapted and dark adapted – the theory was that the research team should be able to accurately determine the amount of rhodopsin in the retina … thus providing an objective answer to the question of visual acuity.

“When you want to detect rhodopsin, you want to use the wavelengths at the peak of the absorption spectrum,” Wen continued. “That particular wavelength for rhodopsin is around 500 nanometers.

We actually used 520 nm.”

Noting that visible light isn’t easy

to handle, Wen explained conventional OCT uses the much longer wavelength near-infrared light, whereas VIS-OCT employs green light.

Jiao added that in order to see the difference in dark-adapted absorption and light-adapted absorption, it was imperative to have both resolution and contrast, which necessitates the use of shorter wavelengths in the visible spectrum. “The intensity of the reflection from photoreceptors is affected by the bleaching state of rhodopsin,” he noted.

Crunching the Numbers Obtaining an objective measure of rhodopsin is the first step in being able to improve diagnostics and treatment of retinal disease, Lam said. “The important clinical implication is that it can give you a gauge of how the photoreceptors are functioning,” he noted.

That, in turn, could give ophthalmologists a new diagnostic tool and a baseline number to assess how disease is progressing and to evaluate therapeutic effectiveness. “It also gives you a topographical map so you also know the specific areas where rhodopsin is functioning … or not,” Lam added.

(CONTINUED ON PAGE 8)

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Field of Vision

Ophthalmic News from the Nashville Area

By CINDY SANDERS

VVRC Investigators Receive National Eye Institute Grant Vanderbilt Vision Research Center’s Kevin Dieter, PhD, and the lab of Randolph Blake, PhD, recently received a prestigious National Eye Institute NRSA grant for the project, “Psychophysical and Neural Correlates of Eye Dominance in Human Vision.”

Dr. Kevin The project, which Dieter builds on the recent discovery that sensory eye dominance (SED) might vary idiosyncratically throughout the visual field, investigates how patterns of SED vary and searches for influences of regional SED on binocular function.

Using functional magnetic resonance imaging, Dieter plans to investigate how neural activity underlying visual field regions with strong SED imbalance differ from those sub-serving regions where both eyes contribute equally. The hope is that the research could lead to a deeper understanding of typical and atypical binocular vision function, potentially leading to translational applications to improve diagnosis and treatment of binocular visual disorders.

In Print Nashville eye surgeon Ming Wang, MD, PhD, has recently published a new textbook, his eighth in the field of ophthalmology, on new treatment options for presbyopia.

Published by SLACK Inc., Wang was joined by more than 30 contributing experts – including Dr. Ming Tracy S. Swartz, OD, Wang MS, FAAO, who served as associate editor – in compiling the comprehensive Refractive Lens Exchange: A Surgical Treatment for Presbyopia.

The publishing house notes permanent surgical treatment for presbyopia remains “the hereto unconquered ‘last frontier’ in anterior segment surgery. Over the years, continuing innovations like Phacoemulsification, Radial Keratotomy, LASIK, and premium intraocular lenses have pushed toward this ultimate goal, but now anterior segment surgery is closer than ever with the advent of modern laser-assisted presbyopic lens implantation.”

Highlights of the textbook that is meant for ophthalmic surgeons, optometrists and technicians include: • Overview of all surgical treatments for presbyopia, • Dysfunctional lens syndrome and pathophysiology, • Patient education and preoperative assessment, • Assessing dysfunctional lens syndrome, • New technologies in mapping cornashvillemedicalnews

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nea and lens for refractive lens exchange, • Presbyopic lens types, indications, and contraindications for refractive lens exchange, • Postoperative care and complication management, and • Many other technology and treatment considerations.

Wang noted this is the first book to guide clinicians through “this exciting new field that is emerging as a safe and effective primary surgical treatment for presbyopia.”

On a personal note, Wang’s autobiography is also being published in January 2016. From Darkness to Sight: A Journey from Hardship to Healing features a forward

by Sen. William Frist, MD. From Wang’s escape from China’s Cultural Revolution to earning degrees from Harvard Medical School and MIT, the renowned eye surgeon said the point of the book is to share his deep appreciation of America and the opportunities that exist in this country.

Toyos Clinic Presents at AAO 2015 Tennessee ophthalmologist Rolando Toyos, MD, presented new treatments in dry eye, cataract, refractive lens exchange, blepharoplasty and facial rejuvenation at the recent American Academy of Ophthalmol- Dr. Rolando Toyos ogy (AAO) annual meet-

ing. He is the founder of the Toyos Clinic with locations in Middle and West Tennessee, as well as Mississippi.

Toyos, the inventor of Intense Pulse Light (IPL) for Dry Eye Disease (DED), has been presenting his research on the treatment for more than a decade at AAO. Last year, three papers were published in peer review journals on Dermamed Diamond IPL, which Toyos helped develop. At AAO 2015, he presented his current research utilizing the Dermamed Diamond IPL for DED. Additionally, Toyos presented information on his new at home LED treatment called the Q, which has taken six years to develop to help patients with DED find additional relief. The Q is intended for use in conjunction with IPL.

extenders in pediatric ophthalmology,” said Morrison. “They allow us to serve a larger patient population by measuring vision in preverbal children and accurately measuring eye alignment in pediatric and adult patients. They also improve quality of care by counseling families on appropriate treatment regimes for the physician.”

Morrison, who has been active on the AOC executive committee for several years, has already gotten to work. “To date, I have revised the testing system for orthoptists, transitioning to an electronic format for the written exam, as well as restructuring the oral/practical portion of the exam to include digital media such as videos demonstrating ophthalmic diseases and motility abnormalities,” he said.

Vanderbilt Physician Named President of National Orthoptic Group David Morrison, MD, associate professor of Ophthalmology and Pediatrics at Vanderbilt, has been named the new president of the American Orthoptic Council and will serve a two-year Dr. David term.

Morrison The AOC accredits and certifies orthoptists, who are trained to assist pediatric ophthalmologists in evaluating vision and alignment of children and adults with strabismus. Orthoptics is a twoyear, post-graduate certification.

“Orthoptists are critical as physician

Mark Your Calendars January: The Tennessee Academy of Ophthalmology is holding 2016 CODEquest/CPT Coding Seminar on Saturday, Jan. 16 at One Century Place Conference Center in Nashville. The half-day seminar is geared towards physicians and non-physician office staff with more than two years of coding and documentation experience.

Space is limited, and registration deadline is Jan. 14. For information or to register, go online to tneyemds.org.

August: The 39th Annual Midwest Glaucoma Symposium is set for Aug. 5-6, 2016 at the Nashville Marriott at Vanderbilt University. Featured speakers include Allen Beck, MD, of Emory Eye Center; Marlene Moster, MD, of Willis Eye Hospital; and Keith Barton, MD, FRCP, FRCS,

Women 20 16 T O W AT C H

Our annual Women to Watch issue is coming in May 2016, and we want your input on women in Middle Tennessee impacting healthcare at home and beyond.

Help us honor clinicians, researchers, administrators, policy makers, and other industry experts by nominating these outstanding professionals.

CALL FOR NOMINATIONS

To nominate, please visit nashvillemedicalnews.com and click the Women to Watch icon.

Nomination Deadline: Feb. 15, 2016

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Council Fellows Announces 2016 Class On Dec. 7, the Nashville Health Care Council, along with Fellows co-directors former U.S. Senate Majority Leader Bill Frist, MD, and healthcare economist Larry Van Horn, announced the 2016 class of the Council Fellows.

The 30 senior leaders from various sectors of the healthcare industry will address national Dr. Bill Frist challenges and collaborate to find transformative solutions. The group will participate in orientation later this month before beginning the first session in February. The year’s final session and graduation is slated for late May. The comprehensive curriculum will address issues such as the rise of the healthcare consumer, disruptive tech-

nology, integrated delivery networks, reimbursement shifts, population health management and globalization.

“As these new market drivers emerge, Fellows offers an opportunity to think differently about how we can create a better system,” said Van Horn, a leading expert in healthcare management and economics, and professor at Vanderbilt University’s Owen Graduate School of Management.

Larry Van Horn “Today’s healthcare decision-makers must be able to draw upon a diverse set of skills to effectively lead their organizations through the unprecedented changes our health system is facing,” said Frist in making the announcement. “This year’s cur-

Healthcare Execs Launch Emergency Physician Partners Last month, the seasoned healthcare team behind Emergency Physician Partners (EPP) announced the formation and launch of this new company focused exclusively on partnering with emergency medicine physicians. EPP plans to collaborate with leading emergency medicine practices nationwide to help physicians preserve clinical independence while being positioned for financial success in an ever-changing and highly regulated healthcare environment.

Claritas Capital Equity Group – a Nashville-based investment firm which primarily focuses on healthcare, technology, and business services companies –has granted the physician partnership organization access to more than $25 million to close the acquisition of emergency medicine physician practices, which is expected to start this first quarter of 2016.

“Successfully operating the administrative side of an emergency medicine practice has become more difficult and demanding in today’s complex healthcare environment,” said Christopher Kelly, EPP founder, chairman, president and CEO. “We founded EPP because we understand how valuable true partnership can Christopher Kelly be to physicians during these uncertain times. Our unique model allows emergency physicians to preserve their clinical independence, provide better quality care, and have an experienced business partner to handle the administrative burdens of running their practices.”

Kelly brings more than 20 years 8

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of senior management experience with healthcare companies, including AmSurg Corp., The Little Clinic, Quorum Health Resources and, most recently, U.S. Anesthesia Partners.

In addition to Kelly, EPP’s senior management team includes hospital financial management veteran Brady Sturgeon, who serves as founder, executive vice president and chief financial officer for the new company. Previously, Sturgeon was vice president of Development for LHP Hospital Group. In addition, founder Brian White will serve as executive vice president and chief operating officer. White was most recently founder and managing partner of Competitive Solutions, a management consulting firm specializing in hospital-employed physician management and physician practice operations.

EPP is the first single-specialty organization dedicated to partnering exclusively with emergency medicine physician groups. Today, approximately 20,000 of the country’s 45,000 emergency physicians remain independent. Hospital and payer consolidation have increased significantly following the passage of the Affordable Care Act, making the environment more difficult and uncertain for emergency medicine physicians.

“The emergency medicine space remains largely unconsolidated, with nearly 3,000 of the country’s 5,000 hospitals contracting directly with independent emergency physician groups,” said Don McLemore, founder and partner at Claritas. “We share EPP’s vision for the opportunity to strengthen these physician practices by bringing them together.”

riculum will provide a rare opportunity for the class to collaborate with innovators who are truly shaping our healthcare system. I am excited to see what we learn together.”

Members of the 2016 Fellows Class: Tim Bewley, first vice president, SunTrust Bank Hamilton Bowman, COO, EnableComp Barbara Brennan, RN, MSN, COO and chief nursing officer, Alive Hospice Denise Burke, partner, Waller Chip Chambers, MD, senior medical director, Cigna-HealthSpring Sam Chang, MD, professor of Urologic Surgery, Vanderbilt University Medical Center Mike Coggin, senior vice president and chief accounting officer, LifePoint Health Jana Dreyzehner, MD, behavioral health medical director, Amerigroup TN Mike Duffy, president, Hospital Solutions and Global Supply Chain, Cardinal Health Aaron Gani, enterprise vice president, Innovation, Humana Vic Gatto, CEO, Jumpstart Foundry Aron Goldfeld, vice president, Advocacy and Regulatory Affairs, TeamHealth Tammy Hawes, CEO and founder, Virsys12 Shannon Hooper, senior vice president and practice leader, ReviveHealth Eric Keen, general partner, Council Capital Daniel Lieber, COO, Altegra Health Brian Marger, COO, TriStar Centennial Medical Center Ricardo Martinez, MD, chief medical officer, North Highland Worldwide John McClellan, vice president, Operations, Division 5, Community

Health Systems Michele Molden, senior vice president and partner, The Advisory Board Company Neal Patel, MD, chief medical informatics officer, Vanderbilt University Medical Center Amy Rock, senior director, Regulatory and Scientific Affairs, Cumberland Pharmaceuticals Matthew Russell, chief technology officer, Digital Reasoning Dexter Samuels, PhD, senior vice president and executive director, Robert Wood Johnson Foundation for Health Policy, Meharry Medical College Mark Thompson, vice president, Operations Finance, Healthways Mike Uchrin, CEO, Health Choice Marc Watkins, MD, vice president and corporate medical director, The Little Clinic Morgan Wills, MD, president and CEO, Siloam Family Health Center Dakasha Winton, director, associate general counsel State Government Relations, BlueCross BlueShield of Tennessee Chris Wyatt, CFO, HCA Information Technology and Services, HCA “Fellows is a venture that could only take place here in Nashville, a $73 billion healthcare hub, where we have immediate access to the industry’s founders, as well as a host of respected healthcare experts, innovators and academic institutions,” said Hayley Hovious, Council president.

“When you consider the unmatched reach and diversity of our healthcare community, there’s no question why this is the place to hold these important conversations and inspire the advancements that will reshape our business.”

Council Fellows is presented in partnership with BlueCross BlueShield of Tennessee, Community Health Systems, HCA, Healthways, LifePoint Health, and Vanderbilt University Owen Graduate School of Management.

A Clearer Picture, continued from page 6 Wen, a photoreceptor cell biologist, also believes VIS-OCT could be useful to study future photoreceptor regeneration, including transplant stem cell-derived photoreceptors, gene therapies and neuroprotection therapies.

“The rapid development in regenerative medicine to restore vision has raised a hope that regeneration of photoreceptors and restoration of photoreceptor function will become reality in the near future,” Wen said. “When that time comes, this technology will be used to see whether the new photoreceptors are functional.”

Moving from Bench to Bedside While this first successful test was conducted in vivo on rats, Lam said it should be relatively easy to transition the imaging technique to humans. Wen stressed VIS-

OCT is “absolutely non-invasive” and that the ultimate goal is to make the test office-based and widely accessible.

To conduct the study, the research team designed and built a 3D retinal densitometry system. Jiao said he is currently modifying the design a bit to improve the prototype and make the system easier to use in a clinical setting.

While there is still a long way to go … and no one could commit to an exact timeframe … Wen said it was feasible this technology could be available within the next five years.

For those tasked with diagnosing and treating a range of conditions from retinitis pigmentosa to age-related macular degeneration, any new technology that could more accurately assess a patient’s condition should be a welcome addition to the toolkit. nashvillemedicalnews

.com

TMA Outlines 2016 Legislative Priorities When the second year of the 109th General Assembly begins on Jan. 12, the Tennessee Medical Association will be ready to discuss legislation to help improve the healthcare environment for Tennessee doctors and patients.

During the upcoming session, TMA will focus on an agenda to craft a system that is patient-centered and physician-led, make sure insurance companies are more accountable when changing fee schedules and payment policies, and protect medical malpractice caps, among other issues.

“TMA is looking out for the future of Tennessee healthcare, working to make sure it evolves in ways that allow doctors to provide the best care possible to their patients.

The issues on our 2016 agenda reflect our mission as an organization,” said TMA President Dr. John W. John W. Hale, Jr., MD. Hale, Jr. The full list of 2016 priorities is available at tnmed.org.

The Doctor as Team Leader One of the key pieces of legislation on TMA’s list of priorities is the Tennessee Healthcare Improvement Act. The bill would put in place a team-based healthcare delivery model with doctors as the team leader in patient care coordination.

It calls for collaboration between physicians and advanced practice nurses to make sure patients receive care from the appropriate providers with coordinated collaboration.

The TMA-backed bill is being offered as an alternative to the Nurse Independent Practice/Full Practice Authority Bill. The Tennessee Nurses Association has long advocated for legislation to remove scopeof-practice barriers, which has put the two major provider organizations at odds on this issue.

“Having the proper collaboration from a physician in diagnosing and treating a patient ensures the highest quality of care and patient safety,” stated Hale. “We want to knock down silos among providers, increase care collabo-

ration and create a model that supports the best possible patient outcomes. The Healthcare Improvement Act will allow advanced practice nurses to use the full extent of their training but make sure that a physician is involved in the care of every patient. It’s in the best interest of all Tennesseans.”

Reimbursement Stability TMA will also advocate for the Healthcare Provider Stability Act during the upcoming legislative session. The act, sponsored by Sen. Bo Watson (R-Hixson) and Rep. Jon Lundberg (R-Bristol), would limit how often insurance companies could change fee schedules and payment policies and require adequate notice of those changes to make the process more transparent.

“It’s impossible for a physician to make sure the business side of a practice runs smoothly when health plans can cut reimbursement mid-contract with no recourse for the physician,” Hale said.

Clarifying Malpractice Caps A third major initiative for TMA in the upcoming session is to work toward a constitutional amendment clarifying that the General Assembly has the authority to set caps on noneconomic damages in cases including medical liability actions.

A 2011 cap on noneconomic damages is currently being threatened by lawsuits. The proposed amendment must pass two separate General Assemblies before it goes on the ballot for a vote in 2018. If the amendment doesn’t pass the 2016 General Assembly, the earliest the issue could be up for a statewide vote would be 2022.

“The General Assembly needs to act now to prevent us from going backwards on the issue of a noneconomic damages cap,” said Hale. “The cap fosters growth in Tennessee’s healthcare industry by cutting back on frivolous lawsuits and the costs that come with them. I’m confident Tennessee voters will support it if given the chance to have their voices heard.”

GrandRounds Rice Named Chief Quality Officer for Capella Last month, officials with Capella Healthcare announced Dana Rice, RN, MHA, CCM, has been appointed senior vice president and chief quality officer. With more than 20 years of healthcare experience, Rice will be responsible for working Dana Rice with the company’s hospitals on clinical operations and quality performance.

Previously, Rice served as senior director of Hospital Operations for Kaiser Permanente, acting as an administrative liaison to 11 hospitals in the Colorado region, and as regional director of Resource Stewardship. Before joining Kaiser, Rice spent two years as COO for a Capella hospital in Olympia, Wash. She holds an associate’s degree in nursing, a bachelor’s in health services management, and a master’s in health administration.

Fre$h Savings Program Launched With $4.3 million in support from UnitedHealthcare and the USDA, the AARP Foundation and participating grocers and farmers markets have launched the Fre$h Savings program in Tennessee and Mississippi, which aims to help Supplemental Nutrition Assistance Program (SNAP) recipients live healthier lives by making fresh food more affordable.

The program, which debuted in late 2015, provides coupons for 50 percent off the future purchase of fresh fruits and vegetables whenever SNAP recipients buy fresh produce at select Kroger nashvillemedicalnews

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stores in West Tennessee and participating farmers markets in Memphis, Nashville, Murfreesboro, Chattanooga and Knoxville.

As noted in United Health Foundation’s America’s Health Rankings (see page 1), Tennessee ranks among the worst in the nation for the consumption of fruits and vegetables. Tennessee also ranks 47th in the nation in food insecurity among seniors, with approximately 21 percent of Tennessee seniors considered food insecure.

chairman-elect, effective this month. She will serve a year in her current position before taking over as chairman in January 2017. Other new board members be-

ginning terms this month include Jason Epstein, Jose Gonzalez, Angela Humphreys, Janet Miller, Chris Sloan, and Yiaway Yeh.

News from the Nashville Entrepreneur Center The Nashville Entrepreneur Center (EC) recently announced an 18-month engagement with the Kauffman Foundation to strengthen the city’s capacity to support entrepreneurs. One of only two cities selected for the award, an initial project is the new Diversity Initiative, which is also supported by Google for Entrepreneurs. The program has a focus on creating a more inclusive entrepreneurial environment in Nashville.

From a staffing standpoint, CEO Stuart McWhorter announced Sam Lingo as EC’s new president and COO. He has served as COO since July 1, 2011 and added his responsibilities as president last month. A Nashville native, Lingo earned his degree in economics from Sam Lingo Vanderbilt.

Also, John R. Ingram, board chair for EC, recently announced Beth R. Chase, founder and CEO of C3 Consulting, has been named EC’s Beth R. Chase

Neighborhood Health Opens New Clinics With the opening of two new clinics in Inglewood and Lebanon, Neighborhood Health now has a dozen locations serving Davidson, Wilson and Trousdale counties.

In December, Neighborhood Health at Lebanon celebrated the new location with a ribbon-cutting ceremony and community open house. A physician and nurse practitioner provide comprehensive preventive and primary care. A licensed behavioral health provider also is available for counseling. The clinic, which is located on East High Street, is projected to serve 2,500 individuals annually. The clinic was made possible by $495,000 in Affordable Care Act funding. The grant was part of a $101 million national initiative to fund 164 new community health centers across the nation.

In November, a similar ribbon-cutting ceremony was held for the Inglewood Clinic, located on Gallatin Pike, which brings access to care for this medically underserved area. Neighborhood Health cited need – nearly 40 percent of the residents are low-income; about 7,000 do not have access to affordable primary healthcare; and 20 percent of the children live in households under the poverty line – as the impetus for opening the new clinic.

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GrandRounds Let’s Give Them Something to Talk About!

Awards, Honors, Achievements The Society of Urologic Oncology has honored Joseph Smith, Jr., MD, professor of Urologic Surgery at Vanderbilt University Medical Center, with the prestigious Huggins Medal. The organization bestowed its highest honor upon Smith for his lifeDr. Joseph time contributions to the Smith, Jr. progress in treatment for patients with genitourinary neoplasms.

Steve Corbeil, president and CEO of HCA TriStar Division, was recently appointed to the Federation of American Hospitals Board of Directors. The FAH is the national representative of more than 1,000 investor-owned or managed community hospitals and health systems throughout the United States.

The Greater Nashville Affiliate of Susan G. Komen has named Justin Balko, PharmD, PhD, an assistant professor of Medicine and Cancer Biology at Vanderbilt-Ingram Cancer Center, a member of the 2016 Class of Pink Tie Guys. The honorees are community Dr. Justin Balko leaders who have a personal connection to breast cancer and are committed to making a difference in the effort to find a cure for the disease. Balko, who is Leader of Molecular Oncology in the Center for Cancer Targeted Therapies at VICC, has already received multi-year financial grants from Komen to support his breast cancer research.

For two decades, Publix Super Markets, Inc. has worked alongside the March of Dimes to give all babies a healthy start in life. This year, during their annual three week in-store March for Babies fundraising campaign, Publix customers and associates raised $6,050,470, an 18 percent increase from 2014, bringing their 20 year total to an impressive contribution of $57 million for stronger, healthier babies.

This fall, Saint Thomas Health hit a major milestone, serving the 10,000th patient through the “Our Mission in Motion” mobile mammography unit. Nearly half, 46 percent to be exact, of the mammograms were provided as charity care.

Dora Okine (center) poses with two mobile mammography technologists who have taken life-saving screenings on the road.

POZ magazine, an award-wining publication for people living with or affected by HIV/AIDS, recently honored 100 individuals from across the nation making a difference in the fight against HIV/AIDS. Joseph Interrante, PhD of Nashville CARES and Larry Frampton of Nashville Regional AIDS Planning Council have both been named to the POZ 100.

A. Bapsi Chakravarthy, MD, professor and residency director of Radiation Oncology, has been named a Fellow by the American Society for Radiation Oncology (ASTRO). She is one of 17 ASTRO members named to the 2015 class of Fellows.

Independent hospital watchdog The Leapfrog Group recently identified five TriStar Health hospitals as earning an ‘A’ grade for patient safety in this elite national ratings program. TriStar Centennial, TriStar Skyline, TriStar Southern Hills, TriStar StoneCrest and TriStar Summit medical centers all received top marks.

A clinical practice improvement module developed at the University of Tennessee Health Science Center (UTHSC) was one of five national winners in the inaugural Practice Innovation Challenge sponsored by the American Medical Association and the Medical Group Management Association. The UTHSC “SafeMed” module, which encourages safe and effective medication use in an outpatient setting, could be used in clinics around the country in the future through the AMA’s STEPS Forward initiative.

CapStar Adds Another Veteran to Healthcare Team

CapStar Bank continues to build its healthcare team with the addition of John Teasley as senior vice president. Teasley, who has nearly 15 years of corporate lending experience, was most recently with Fifth Third Bank. Before that, he spent a decade with SunTrust in various divisions. Teasley joins Buddy Bacon and Mark Mattson to spearhead healthcare efforts for CapStar.

ServisFirst Bank Nashville Names Vieira President Birmingham-based ServisFirst Bank, which first opened in Nashville in June 2013, has promoted Bradford Vieira to the role of president. The Nashville native will lead long-term strategy in Tennessee including oversight of banking operations including commercial, private and retail banking, along with cash management services. ServisFirst recently announced the opening of its new 10,400-squarefoot retail banking center and corporate office at Palmer Plaza, 1801 West End Ave., which is slated Bradford Vieira to open this month.

Prior to his new role, Vieira served

Read More Grand Rounds online.

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as senior vice president and commercial banking manager for ServisFirst and has been instrumental in the bank’s growth in Tennessee. Prior to ServisFirst, he was a vice president with Fifth Third Bank and began his career in the Healthcare Finance Division of First American National Bank. A graduate of Belmont University, he currently serves on the board of the Junior Diabetes Research Foundation of Middle Tennessee, Nashville Capital Network, Nashville Sports Council, and Belmont University Athletic Bruin Club.

NuSirt Receives FDA Fast Track Designation Last month, NuSirt Biopharma announced the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for its development program focused on non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).

“NAFLD and NASH represent serious unmet medical needs for which there are no approved therapies,” said Joseph C. Cook, Jr., president and executive chairman of the board of NuSirt Biopharma. “It is estimated that 75-100 million people in the U.S. have NAFLD, and 10-20 million have progressed to NASH.” NuSirt’s patented technology combines a naturally occurring amino acid, leucine, with existing pharmaceuticals. In pre-clinical studies, NuSirt’s triple combination of leucine, metformin and sildenafil showed the potential to reverse NAFLD, reduce symptoms of the disease, and prevent the onset of NAFLD and NASH. Additional animal studies have shown the triple combination could reverse obesity-induced liver fat accumulation, inflammation and fibrosis in mice. This research was presented at the American Association for the Study of Liver Diseases (AASLD)’s annual The Liver Meeting® in November 2015.

NuSirt also announced the start of enrollment for its Phase 2A clinical trial targeting this disease at nine U.S. research sites. The Phase 2A clinical trial, named TRIPLN, is a randomized, 16week, placebo-controlled, double-blind study. Initial results are expected in the second half of 2016.

Compassus Welcomes Wade Nashville-headquartered Compassus, a nationwide network of communitybased hospice programs and palliative care services, recently announced the addition of Dennis Wade as senior vice president of Human Resources and Organization Development.

Wade comes to Compassus from Corizon Health, where he served as executive vice president and chief human resources officer. There, he was accountable for the administration of personnel policies, programs, compensation and benefits for more than 12,000 employees in 27 states. Wade earned his bachelor’s degrees in business and psychology from Birmingham-Southern College.

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GrandRounds Herrington Joins Nashville Child & Family Wellness Pediatric psychologist, Katie Herrington, PhD, recently joined Nashville Child & Family Wellness, which offers an array of behavioral health services under one roof. She brings to the West Nashville practice a mission to help families and chilDr. Katie dren dealing with chronic Herrington stress. Where stress used to be mostly confined to the middleaged, overworked individuals, more and more psychologists are seeing children and adolescents dealing with anxiety.

Herrington earned a degree in child development and a doctorate in clinical psychology from Vanderbilt University. She fulfilled her clinical internship at the University of North Carolina School of Medicine at Chapel Hill and completed a post-doctoral fellowship at the Vanderbilt Kennedy Center Treatment and Research Institute for Autism Spectrum Disorders (TRIAD) and the Division of Developmental Medicine at Monroe Carell Jr. Children’s Hospital.

University/Barnes-Jewish Hospital in St. Louis.

Daniel Named CFO at PhyMed Healthcare Group Nashville-based PhyMed Healthcare Group, a physician-led and owned leader of anesthesia and pain management services, recently announced Sam E. Daniel has been named chief financial officer where he is responsible for all aspects of PhyMed’s financial operations and provides strategic financial guidance to drive growth.

Daniel brings more than 30 years of financial leadership with an emphasis on healthcare organizations to his new position at PhyMed. Previously, Daniel was CFO of Comprehensive Pharmacy Solutions, and also served as CFO at American Pathology Partners. Daniel has also held leadership roles at various laboratory and specialty pharmacy companies throughout his career. A certified public accountant, Daniel earned his accounting degree from Freed-Hardeman University.

Hagerty Named to Avondale Advisory Board

Avondale Partners has announced that William F. (Bill) Hagerty, former Tennessee Commissioner of Economic Development under Gov. Bill Haslam, has joined the firm’s Advisory Board.

Hagerty is managing director of Hagerty Peterson & Company, LLC, a Dr. Katie merchant bank and private Herrington equity investment firm that he co-founded. He served as a state commissioner through January 2015.

Mid-Tennessee Bone & Joint Welcomes Sykes Kenneth T. Sykes, MD, PhD, recently joined the practice of Mid-Tennessee Bone and Joint. Sykes, whose specialty is interventional pain management, takes an active role in treating patients with chronic pain through a multi-disciplinary apDr. Kenneth T. proach that includes Sykes advanced treatment options.

Sykes earned his medical degree from the University of Iowa Carver College of Medicine. He earned two doctorates in pharmacology and chemistry, and completed his pain management fellowship and anesthesia residency at Washington University School of Medicine in St. Louis. He is board certified in anesthesiology and pain medicine.

McDuffie Joins Tennessee Oncology Jeremy S. McDuffie, MD, a board certified medical oncologist and hematologist, recently joined Tennessee Oncology at the large, physicianowned practice’s Murfreesboro location.

Previously, McDuffie cared for patients at Dr. Jeremy S. Northwest Georgia OnMcDuffie cology Centers’ Marietta Cancer Center. He was also a researcher with the cancer practice’s William S. Gibbons Cancer Research Institute. McDuffie completed a fellowship in medical oncology/hematology at Vanderbilt University and his residency and internship in internal medicine at Washington

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The doctors’ doctor:

Dr. Ming Wang Harvard & MIT (MD, magna cum laude); PhD (laser physics) Performed surgeries on over 4,000 doctors Dr. Ming Wang, Harvard & MIT (MD, magna cum laude); PhD (laser physics), is one of the few cataract and LASIK surgeons in the world today who holds a doctorate degree in laser physics. He has performed over 55,000 procedures, including on over 4,000 doctors (hence he has been referred to as “the doctors’ doctor”).

Dr. Wang currently is the only surgeon in the state who offers 3D LASIK (age 18+), 3D Forever Young Lens surgery (age 40+) and 3D laser cataract surgery (age 60+). He has published 7 textbooks, over 100 papers including one in the world-renowned journal “Nature”, holds several U.S. patents and performed the world’s first laser-assisted artificial cornea implantation. He has received an achievement award from the American Academy of Ophthalmology, and a Lifetime Achievement Award from the American Chinese Physician Association.

Dr. Wang founded a 501c(3) nonprofit charity, the Wang Foundation for Sight Restoration (www.Wangfoundation.com), which to date has helped patients from over 40 states in the U.S. and 55 countries worldwide, with all sight restoration surgeries performed free-of-charge.

Amniotic membrane is obtained after the baby’s birth

Inventions & Patents 1. LASERACT: All-laser cataract surgery U.S. patent filed.

2. Phacoplasty U.S. patent filed.

3. Amniotic membrane contact lens for photoablated corneal tissue U.S. Patent Serial No 5,932,205.

4. Amniotic membrane contact lens for injured corneal tissue U.S. Patent Serial No 6,143,315.

5. Adaptive infrared retinoscopic device for detecting ocular aberrations U.S. Utility Patent Application Serial No. 11/642,226.

6. Digital eye bank for virtual clinical trial U.S. Utility Patent Application Serial No. 11/585,522.

7. Pulsed electromagnetic field therapy for nonhealing corneal ulcer U.S.patent filed.

8. A whole-genome method of assaying in vivo DNA protein interaction and gene expression regulation U.S. patent filed

AMNIOTIC MEMBRANE CONTACT LENS

Dr. Wang’s invention U.S. patents: 5,932,205 & 6,143,315

Used by over 1,000 eye doctors to restore sight.

Wang Vision 3D Cataract & LASIK Center 615.321.8881 | WangCataractLASIK.com