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PHYSICIAN SPOTLIGHT PAGE 2
Jim Meadows, MD ON ROUNDS
Personalized Messaging A targeted approach is often used to promote improved patient outcomes but is rarely employed when it comes time to promote a facility or provider expertise to improve income. If precision medicine works, why not precision marketing? ... 8
Personal & Precise
The Continued Push Toward Targeted Therapies By CINDy SANDERS
In his recent State of the Union address and again a few days later at the White House, President Barack Obama outlined his $215 million Precision Medicine Initiative. The president’s hope is that with increased funding and attention, scientific research will continue to progress so that providers can deliver “the right treatments, at the right time, every time to the right person.” Such a push to understand and treat disease on a molecular level isn’t new to the Nashville community. With robust oncology programs at Vanderbilt and Sarah Cannon, the area’s researchers and physician-scientists have been actively involved in an array of new discoveries and drug development for many years. Recently, Holli Hutcheson Dilks, PhD, director of Personalized Medicine Operations for Sarah Cannon Research Institute (SCRI) and Andy Corts, chief information officer at SCRI, discussed the merging of science and technology to target treatment protocols and match patients to clinical trials. Asked to explain the difference between ‘personalized medicine’ and ‘precision medicine,’ Dilks said the terms, along with molecular profiling and genomics, are sometimes used interchangeably, depending on the institution. At Sarah Cannon, however, Dilks said she thinks of precision medicine as being very specific or precise to a particular tumor or genetic variation. It’s medicine on the molecular level. Personalized medicine, she continued, is the larger umbrella (CONTINUED ON PAGE 6)
March of Dimes Celebrates Outstanding Community Nurses at Annual Gala
Marketing & the Media Avoiding Mixed Messages in Healthcare Communications By MELANIE KILGORE-HILL
Nurses from across Middle Tennessee gathered to honor outstanding colleagues during the fifth annual March of Dimes Nurse of the Year Awards ... 10 Rosemary Plorin
ONLINE: NASHVILLE MEDICAL NEWS.COM
From tweets and blogs to newspapers and websites, more channels for communication mean more room for error in healthcare marketing. In a time where audiences – and editors – are bombarded with messages 24/7, how do you make your company’s news stand out? To better understand the do’s and don’ts of corporate communication, we turned to Rosemary Plorin, president of Nashville-based Lovell Communications. “The most common communication mistakes apply in all relationships, whether business-related or talking to your grandmother or kids,” said Plorin, who leads Lovell’s healthcare division. “If you want to convince someone they need to think about something, the same principles apply to all audiences, including journalists.” (CONTINUED ON PAGE 8)
To promote your business or practice in this high profile spot, contact Jamie McPherson at Nashville Medical News. jmcpherson@southcomm.com • 615-844-9410 PRINTED ON RECYCLED PAPER
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PhysicianSpotlight
The Push to Palliate Cancer Symptoms Jim Meadows, MD, Leads the Charge for Tennessee Oncology By LARRy MCCLAIN
While studying medicine in southern California, Jim Meadows, MD, balanced the demands of education with activities such as rock climbing and motorcycle trips through the high desert – things that might surprise many of his patients. And while some of his cancer patients might not share those same interests, they know better than anyone the need to have quality in their lives. It’s that goal that brings Meadows, a board-certified palliative care physician with Tennessee Oncology, into their care plan. Palliative medicine is a rapidly growing specialty that focuses on treating medical symptoms – such as pain, depression and insomnia – in patients with serious health issues. Tennessee Oncology’s palliative care team, primarily consisting of Meadows and two full-time nurse practitioners, is based at TriStar Centennial Medical Center, with a new location opening this month at Saint Thomas West. The team also draws on the talents of two staff psychologists, as well as Tennessee Oncology patient advocates. Palliative care appointments typically coincide with oncology visits, which is an added convenience patients appreciate. Local and national momentum for palliative care continues to grow for many reasons, including unmet patient needs, unnecessary ER visits for issues such as pain, and research that continues to highlight the benefits of palliative involvement. In fact, a recent New England Journal of Medicine study found that when lung cancer patients received concurrent oncology and palliative care therapy, patients
experienced greater symptom control and better survival versus oncology treatment alone. Meadows explained, “We don’t receive adequate symptom management education in medical school. And despite study after study demonstrating that patients suffer with unnecessary symptoms, we continue to undertreat. There are many reasons for this.” He continued, “Fortunately, cancer therapy is rapidly improving, but patients still have significant needs. We attempt to treat all symptoms in our program. The most common are fatigue, pain, and psychological burdens such as anxiety and depression. Some patients also experience insomnia, bowel issues, nausea, and poor
appetite. We tell our patients, ‘No symptom is off-limits.’ It’s not uncommon for me to hand a patient prescriptions for both pain and erectile dysfunction medication. If it’s a quality of life issue that is affected by their disease, it’s pertinent.” Meadows emphasized that palliative care across the U.S. is often misunderstood and underused. “Patients don’t know much about palliative care so most don’t ask for it,” he said. “Some clinicians are unfamiliar with its full scope and perceive that a patient must be terminal or have debilitating issues before getting a palliative care team involved, but research consistently shows that palliative medicine is most effective when utilized early,” he noted. Meadows added palliative care and hospice care are often linked in clinicians’ minds, partly because board certification is the same for both disciplines. “They share primary goals – to improve quality of life – but hospice care must be tied to prognosis, while palliative care does not,” he said. “There are many patients in complete cancer remission that still see us because of lingering symptoms.” Meadows said he is grateful Tennessee Oncology’s leadership has enthusiastically continued to support and expand the palliative care program since its launch three years ago. “It’s rare to see a practice invest the way Tennessee Oncology has to build a palliative care department. It reflects our group’s primary focus – to surpass the needs and expectations of our patients.” Besides the national lack of palliative clinicians, the greatest obstacle facing palliative care growth is poor reimburse-
ment for their services. “Providing good palliative care takes time … lots of time,” said Meadows. “An hour-long visit is not uncommon in my clinic. Historically, the healthcare system doesn’t compensate adequately for invested time, but I’m optimistic this will improve because of valuebased care and quality metrics. Palliative care can greatly reduce costs, in part because so many ER visits are caused by poorly controlled symptoms.” Meadows, who grew up in Sumner and Robertson counties before attending Lipscomb University for undergrad and Loma Linda for medical school, returned to Tennessee in 2005 after a decade in California. “Yeah, the weather was nice and there were lots of outdoor activities,” Meadows jokingly said, “but I love Nashville. It’s my home.” These days, Meadows admits to enjoying less intense activities such as woodworking and photography. “I actually recommend creative hobbies to my patients, as well. It’s an invaluable therapy.” He’s quick to say, though, that the greatest quality in his life comes from being with his 3-year-old daughter and 10-yearold son.
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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.
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FromthePublisher Highly targeted and intensely personal. Those words apply to so much of this month’s edition of Medical News. The focus is on maximizing outcomes … from the push to narrow down cancer types to better understand how to target an individual’s treatment … to the realization that healthcare marketing requires a different approach from ‘one size fits all’ when it comes to allocating tight budgets to the greatest effect. The words also aptly describe Medical News. With publications in 11 markets, primarily in the Southeast, Medical News has grown to be an invaluable source of clinical and business information impacting the healthcare industry. Our readership is pretty evenly split in each market between clinicians and the executives leading health systems, practices, entrepreneurial business ventures, industry associations, and allied consulting firms covering legal, financial, technology and other industry concerns. Someone recently asked me about our model of covering both business and clinical news. The reason, as all of you know, is simple. In today’s healthcare landscape, the two are inextricably connected. Physicians and researchers must work with an eye toward achieving the best outcomes in the most efficient, cost effective manner. Similarly, administrators recognize reimbursement is increasingly tied to patient outcomes, quality and safety. And, of course, it’s all wrapped in a maze of regulatory compliance issues that impact all sides of the equation. In total, our readership delivers the key decision-makers that address quality, improve patient outcomes, educate the next generation of clinicians, advance the science, create disruptive technologies, provide solutions, and otherwise transform the healthcare industry. If these are the people you wish to reach, we’d love to discuss sales and partnership opportunities to help you deliver your message in a highly effective, targeted manner. Please contact Jamie McPherson, 615.844.9410, jmcpherson@southcomm.com. We look forward to working with you. Patrick Rains Group Publisher, Medical News
Best Case Scenarios CorrectChemo Measures Cancer’s Response to Therapeutic Agents By CINDY SANDERS
While the patented technology might be complex, the premise behind it is straightforward … not every chemotherapy agent is equal in every patient. CorrectChemo® offered by Franklinbased DiaTech Oncology is a predictive drug response profiling test that helps providers personalize cancer treatment by ranking which chemotherapy agents, individually or in combination, are most effective in fighting a specific patient’s cancer. Robert E. Henry, president and CEO of DiaTech Oncology, said, “The test tracks apoptosis (cell death) to provide oncologists with additional data to help inform decisions about the best Robert E. way to move forward for Henry a patient.” How it Works A sample from a biopsy of a solid tumor or fluid from a blood cancer is sent to the DiaTech lab within 24 hours of collection for the CorrectChemo test (also known as Microculture-Kinetic or MiCK) to be performed. “That tissue has to remain alive in order for us to run the test,” Henry said. “We isolate the cancer cells down to 98 percent pure. We separate the cells out and plate them in a well tray. Then we make sure they are stable and alive. It does us no good to run the test on dead cells.” He continued, “Once we do that, we apply the chemotherapy agents to those cells.” Henry said the agents used are per the National Comprehensive Cancer Network (NCCN) Guidelines for cancer treatments by site. For example, he noted, there are some 30 drugs approved for nonsmall cell lung cancer (NSCL) so each well in the tray with a NSCL sample would be tested against a different approved drug or combination of drugs. Using a spectrophotometer, Henry said their system measures the change
in cells’ optical density every five minutes over 48 hours. “We’re reading optical density changes and measuring the amount of light going through the cells.” He continued, “The cells interact with the drugs and go through apoptosis. When that happens, the cells start to bleb, and the blebbing changes the optical density, reducing the amount of light received by the spectrophotometer.” At the end of two days, each chemotherapy agent or combination of agents produces a KU response value. “Our assay rank orders the drugs based on the kinetic unit,” Henry said, adding the result is a chart showing which tested agents had the highest kill value for that specific patient’s cancer cells down to the agents with the lowest response. Physicians receive results within 72 hours of the sample being sent to DiaTech. The Data An article about the role of the apoptosis test in drug development and clinical care cited improved response and survival rates. The August 2012 piece published in Cancer Research, a journal of the American Association for Cancer Research, stated: “Blinded clinical trials have shown higher response rates and longer survival in groups of patients with acute myelocytic leukemia and epithelial ovarian cancer who have been treated with drugs that show high apoptosis in the MiCK assay. Unblinded clinical trials in multiple tumor types have shown that the assay will be used frequently by clinicians to determine treatment, and when used, results in higher response rates, longer times to relapse, and longer survivals.” By knowing what works and what doesn’t, Henry said, physicians and patients could avoid the expense and frustration of wasting time and money on a treatment course that ultimately isn’t very effective. And for patients with growing tumors, time isn’t a luxury. Henry was quick to add the CorrectChemo test doesn’t supersede physician knowledge and judgment. The (CONTINUED ON PAGE 13)
Cancer cells from a breast tissue sample going through apoptosis in reaction to doxorubicin.
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By the Numbers: The Latest Stats on Cancer By CINDY SANDERS
As the ‘official sponsor of birthdays,’ the American Cancer Society (ACS) found a reason to rejoice in their latest report – Cancer Facts & Figures 2015. Since hitting a peak in 1991, cancer deaths have fallen 22 percent over two decades in the United States, which means more than 1.5 million deaths have been avoided … and more birthdays celebrated. An ACS infographic showed 3.3 million cancer survivors in the United States in 1973. Today, there are more than 14.5 million cancer survivors, and that number is projected to jump to 18.9 million by 2024. Each year, the ACS compiles the most recent data on cancer incidence, mortality and survival using data from a variety of sources including the National Cancer Institute, National Center for Health Statistics and the Centers for Disease Control and Prevention. The most recent five-year data (2007-2011) showed the overall cancer incidence rate held steady in women and declined by 1.8 percent per year in men. The decrease in men was attributed to rapid declines in colorectal cancer (3.6 percent per year), lung cancer (3 percent per year) and prostate cancer (2.1 percent per year). During the same time period, the average annual decline in cancer death rates was 1.8 percent in men and 1.4 percent in women. Lung cancer, while still the deadliest form of the disease, has declined 36 percent between 1990 and 2011 among men. Women have also seen double digit declines attributable to reduced tobacco use. On another happy note, breast cancer death rates for women are down more 35 percent from peak rates, and prostate and colorectal cancer deaths are down by
nearly half (47 percent). Despite the good news, though, ACS officials also noted there is much more work to be done. “The continuing drops we’re seeing in cancer mortality are reason to celebrate, but not stop,” stated John R. Seffrin, PhD, chief executive officer for ACS, when the report was released in January. He added cancer was still responsible for nearly one in four deaths in the United States in 2011. Furthermore, Seffrin noted the country’s second leading cause of death overall is actually Dr. John the top cause of death Seffrin among adults ages 40 to 79. Looking to this year, the ACS has projected 1.658 million new cancer cases will be diagnosed in 2015, and 589,430 Americans will lose their battle with the disease. Of the new cases, the estimate is that men will account for about 848,000 diagnoses across all sites and women 810,000. Prostate, lung and colorectal cancers will account for about half of all cases in men with prostate cancer accounting for around 25 percent of all new diagnoses. Among women, it is anticipated the three most common diagnoses in 2015 will be breast, lung and colorectal cancers. Of those, breast cancer is expected to account for 29 percent of all new cancers for women this year. Of the 589,430 estimated deaths in 2015, the gender breakdown is 312,150 men and 277,280 women. The most common causes of cancer death are lung, prostate, colorectal and breast cancer with these four accounting for almost half of all cancer deaths. More than a quarter of all cancer
Blood Test for Prostate Cancer Vanderbilt researcher William Mitchell, MD, PhD, and colleagues in Germany and Canada have demonstrated a method for detecting ‘cell-free’ tumor DNA in the bloodstream. The group published their findings in the January issue of Clinical Chemistry. In the large retrospective study of blood samples, serum was collected from more than 200 patients with prostate cancer and more than 200 controls. The samples included PSA levels and prostate tissue biopsy grading, known as the Gleason score. The researchers used a “liquid biopsy” to accurately distinguish prostate cancer from normal controls without prior knowledge of the genetic signature of the tumors, and they did so with more than three times the sensitivity of current PSA screening. They reported the technique distinguished prostate cancer from normal controls with 84-percent accuracy and differentiated cancer from benign hyperplasia and prostatitis with an accuracy of 91 percent. “Based on the reported data and work in progress, I believe the ‘liquid biopsy’ will revolutionize cancer diagnostics, not only before a patient begins therapy but also following patient responses to therapy,” said Mitchell, the paper’s corresponding author and professor of Pathology, Microbiology and Immunology. “Since cell-free DNA has a relatively short half-life in the circulation, sequencing of cell-free DNA soon after therapy may be used to detect minimal residual disease in solid tumors,” he added. The method is called ‘liquid biopsy’ because it quantifies the inherent chromosomal instability of cancer and can be followed as a function of time without having to do an invasive tissue biopsy. It’s been known for many years that dying cells, including tumor cells, shed DNA into the bloodstream. But only recently has technology, notably “next-generation sequencing,” made it possible to reliably distinguish and quantify cancer-specific DNA from normal controls by the identification and chromosomal location of billions of specific DNA fragments present in blood as cell-free DNA.
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deaths (27 percent) will be attributable to lung cancer. While death rates have declined, the report noted mortality improvements aren’t equal from coast-to-coast. In fact, cancer death rates vary by state and region with the Southeast being on the lower end of improvement scale (15 percent decline in overall cancer mortality) and the Northeast on the higher end (between 25-30 percent decline). The variation has been attributed to a number of reasons including risk factor patterns (such as the number of smokers), distribution of poverty, and access to healthcare.
Risk Awareness A recent survey by the American Institute for Cancer Research found there is an ‘alarmingly low’ awareness of key cancer risk factors, and many Americans put fear before facts. The Cancer Risk Awareness Survey, released on Feb. 4 in conjunction with World Cancer Day, found Americans worry about factors over which they have little or no control … such as genetic risks or food additives … with less than half recognizing the correlation between an increased risk of cancer and alcohol, obesity, lack of physical activity and poor diet. The findings of the biennial survey give providers and other health experts an idea of whether or not cancer messaging is being heard by the American public. This year’s results were decidedly mixed.
Only 42 percent surveyed were aware a diet low in vegetables and fruit increases cancer risk. This number has trended downward since 2009, when it stood at 52 percent. Only 43 percent knew alcohol increases cancer risk, an increase of five percentage points since the 2013 survey. And only about 1 in 3 Americans (35 percent) realized diets high in red meat have been convincingly linked to colon cancer. This figure has not changed since the survey was last conducted in 2013. Awareness that carrying excess body fat is a cancer risk factor is rising. In this latest survey, 52 percent realized obesity and overweight impact cancer risk, a rise of 4 percentage points. Awareness that being inactive increases cancer risk jumped 6 percentage points, from 36 percent in 2013 to 42 percent in 2015. There was a high recognition of several known risk factors for cancer including 94 percent of those surveyed correctly identifying tobacco use and 84 percent citing excessive sun exposure as risks. However, a significant number of those surveyed also worried about risks for which research has yet to provide a definitive answer. Pesticide residue on produce (74 percent), food additives (62 percent), genetically modified foods (56 percent), stress (55 percent), and hormones in beef (55 percent) were all cited as concerns.
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ONcology Rounds: Breast Cancer By CINDY SANDERS
New Drug Seen as Possible ‘Game Changer’ Last month, Pfizer Inc. received Food and Drug Administration accelerated approval of Ibrance® (palbociclib) in combination with letrozole for the treatment of postmenopausal women with estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer as first-line endocrine-based therapy for their metastatic disease. Erika P. Hamilton, MD, associate director of the Breast and Gynecologic Cancer Program at Sarah Cannon Research Institute said the approval was based on results of the Phase 2 PALOMOA-1 trial and continued approval might be contingent upon clinical benefit verification from Dr. Erika P. Hamilton the Phase 3 PALOMA-2 trial, which is fully enrolled. In the PALOMA-1 trial, Hamilton said, “The progression-free survival from 10.2 to 20.2 months was almost a doubling.” Hamilton, a medical oncologist with Tennessee Oncology, explained palbociclib is a first-in-class cyclin-dependent
kinase (CDK) 4/6 inhibitor and is taken in combination with letrozole, which is a non-steroidal aromatase inhibitor. “It’s hitting the cancer cell in two completely different ways,” she said. Hamilton explained the palbociclib blocks a signal for the cancer cell to grow and divide while the letrozole decreases the levels of estrogen in the body that feed the cancer. She said it is a benefit that both drugs are (L-R) Drs. Carlos Arteaga, Justin Balko, and Luis Schwarz oral, which makes it easier for women to take at home. “I think that’s an attractive opPALOMA-2 trial, said it is completely tion for patients,” she noted, adding the enrolled and just waiting to report out. letrozole is taken daily, and the palboci“I think if PALOMA-2 shows what clib is taken three weeks on followed by PALOMA-1 did, this will be the new stanone week off. dard for first-line patients,” she said. “The One caution, she noted, is that this biggest side effect is neutropenia, and in has been approved as a first-line therapy general, that’s asymptomatic in patients.” in ER+/HER2- patients. “You want to The early indications have been posiuse that option for as many patients as you tive enough that Hamilton said research can because if it’s not used in the first-line is moving forward to look at use in other setting, you lose the opportunity to use settings for ER+ breast cancer and to see palbociclib.” if there are additional combination theraHamilton, who is involved in the pies to enhance outcomes. “There are
Personal & Precise, continued from page 1 taking in all facets of what is best for a particular patient, which includes the entire phenotype … personal preferences, comorbid conditions, molecular information, psycho-social considerations, and more. “At Sarah Cannon, we’ve been practicing personalized medicine since our inception,” Dilks said. The precision medicine focus is somewhat newer. “We started a molecular profiling program about two-and-aDr. Holli half years ago. We look Dilks at the DNA sequence of people’s tumors to determine if there is a mutation, and if so, is there standard-ofcare therapy or a clinical trial,” she said of trying to match patients to newer treatments and trials if they exist. Dilks said treating disease on a molecular level has quickly gained momentum over the last few years, particularly in the field of oncology. “Six of the last 22 FDA-approved new molecular entities for solid tumors are targeted therapies,” she noted. Traditional therapies have typically been directed at rapidly dividing cells. While Dilks, a human geneticist, said many of those are cancer cells, not all of them are (think hair follicles, skin cells). When cutting a wide swath in the quest to kill the rogue cells, there can be collateral damage to healthy cells. With precision medicine, the therapy is targeted specifi6
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cally to address a particular mutation and the collateral damage lessened. “It’s really exciting for patients because these options are more specific, have lower side effects and are more powerful than some of the traditional therapies,” Dilks said. “Now you’re going in with a scalpel instead of a sledgehammer.” Dilks noted that about 30-35 percent of clinical trials, both at Sarah Cannon and across the industry, are for targeted therapies … a number she expects to only increase. However, Dilks was quick to add more research needs to be done not only to discover additional therapies but also to figure out how to circumvent relapses. To this end, she said the field is moving into studying the effects of combination therapy to attack cancer on various fronts. “We have to have this learning system. Everyone benefits from that,” Corts said. Dilks added, “Right now – with this rapidly changing field – for some types of cancer, a clinical trial should really be the first line of therapy … the first thought, not the last.” However, what holds the most promise can also cause the most headaches as clinicians try to keep pace with the latest findings and trials. That, Corts said, is where technology steps in to help. “From an IT perspective, this is such an exciting time to be in healthcare as healthcare and clinical care are becoming more data driven,” he said. Daunting amounts of data come in daily, but it is just a bunch of facts and figures unless it can be put to use. In the
fourth quarter of last year, Corts said SCRI selected Syapse, a precision medicine software provider, to help them harness that information and deploy it across Sarah Cannon’s network of cancer centers throughout the United States and United Kingdom. “What they bring to the table is a genomic data model … a way to digest all that information,” Corts said. He added, “We also needed an information databank where we could access new discoveries as they occur.” In addition to being able to pinpoint the best clinical trial for a patient given his or her specific Andy Corts genomic profile, Corts is also excited about the ability Syapse offers to do correlated analysis of trials. “Let’s say we put 100 people on a clinical trial … 90 did great, but 10 did poorly … but they all had the same biomarker so we need to drill into other pieces of the data,” he explained. “By mining that data, you can correlate different factors that led to that outcome.” Ultimately, the rapidly expanding world of precision medicine has led to a growing national will … both scientifically and politically … to translate that knowledge into clinical care. “We have these capabilities, now it’s time to harness them and give patients the appropriate treatment at the right time,” Dilks concluded.
trials right now looking at triplet therapy,” she said. “We have two studies at Sarah Cannon looking at adding a PI3 kinase inhibitor to make further strides.”
Gene Mutation Linked to Therapy Resistance A group of Vanderbilt-led investigators has identified a new gene mutation that could explain why some breast cancer patients do not respond to anti-hormone therapy. The study, published online late last year in the Journal of Clinical Investigation, was led by senior author Carlos Arteaga, MD, director of the Breast Cancer Program and the Center for Cancer Targeted Therapies at Vanderbilt-Ingram Cancer Center, with Luis Schwarz, MD, and Emily Fox, PhD, serving as co-first authors, along with colleagues at M.D. Anderson in Houston and Emory University in Atlanta. A significant portion of women with estrogen receptor positive (ER+) metastatic breast cancer don’t respond to endocrine therapy because their tumors are initially resistant or acquire resistance after an initial response to anti-estrogens. Profiling ER+ breast tumors from four patients who did not respond to letrozole prior to mastectomy, the investigators performed deep sequencing on the tumors and identified a novel mutation (D189Y) in a gene of the Src family of kinases called LYN. The team also identified other LYN mutations in breast tumors that increased the activity of the LYN protein. “Src family kinases like LYN are known to be associated with carcinogenesis, cancer cell invasion and metastatic progression,” said Luis Schwarz, MD, postdoctoral research fellow at VICC. “When present in ER+ breast cancer cells, these mutations induce an advantage in proliferation of cells as well as resistance to anti-estrogen therapies,” he continued. “To the best of our knowledge, no one had previously described how these LYN mutations work.” The authors tested assays in three cell lines and in a mouse model to identify potential therapies for ER+ breast cancers harboring D189Y LYN. They tested two Src inhibitors and identified the drug dasatinib as the most effective. Since it is already approved for another form of cancer, dasatinib could be adapted for testing in breast cancer. However, the authors noted the agent is not an ideal drug because it is not a pure LYN inhibitor. The hope is their identification of the new LYN mutation will spur development of a LYN inhibitor for testing in patients with breast cancer.
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The Evolution of Hospital Marketing Jarrard’s Intriguing Look into a Shifting Industry By MELANIE KILGORE-HILL
Ever wonder how your hospital’s marketing efforts stack up to competitors? If so, you’re not alone. Recently, healthcare communications firm Jarrard Phillips Cate & Hancock set out to find common denominators among hospital marketing departments nationwide. Their study included interviews with chief communication officers from 20 participating organizations including Saint Thomas Health. “We wanted to talk to those in sophisticated, larger systems to learn how they’re thinking – folks who are innovators and big players,” said Kim Fox, vice president and co-author of the company’s white paper, “Healthcare Communications and Marketing in the Kim Fox Brave New World.” Fox and her colleagues discussed concepts like staffing, structure and budgets in today’s world of value re-engineering, new reimbursement models, mergers and acquisitions, health and wellness programs, and other transformative initiatives. “We thought we’d come to more ‘Here’s how everyone’s doing it,’ conclusions, but we just didn’t,” Fox explained. “The most surprising finding is that as much as we’d like to think we can benchmark each other, each health system is so different. There’s no ‘one size fits all’ in healthcare or healthcare communications.” Looking Inside The firm did, however, identify definite trends across the continuum including a need for increased employee engagement. “Several told us if they could just emphasize one thing, it would be internal communications,” Fox said. That stems from the many complicated messages employers must continually share with employees … explaining the transition to less inpatient and more outpatient staff, or why frequent retraining is so critical. “We know where healthcare is going and why, and there’s a quandary of explaining complex things to employees right now,” Fox said. “They need to know you believe in where you’re going, and good communication releases the stress of uncertainty. We need that in healthcare now more than ever.” According to the report, other trends for internal communications include: • Concerted efforts to arm managers and supervisors with the right tools so that messages can be cascaded more effectively, • Multiple, overlapping methods of communication, • A combination of online and print materials that are accessible at home, as well as in the workplace, • Facebook-like platforms such as Yammer or Jive, • Public-facing internal communicanashvillemedicalnews
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tions platforms so that both internal and external audiences see the same messages. Evolving Functions Today’s marketing department is much more than newsletters and press releases. In fact, the role of a hospital communications department is evolving as quickly as the industry itself. According to the report, “The lines between the traditional functions of marketing, public relations and communications are blurring, reflecting the move from hospitals to integrated health networks. So, too, are the functions for which we are responsible. Not only must we lead traditional communications and marketing disciplines, but several organizations have charged their CCOs with leading - or at least playing a key role in - patient engagement, patient portals, data management, employee satisfaction and physician communications.” Structure and Staffing Fox and her colleagues found that titles, reporting relationships and staffing models are in flux as a result of mergers, acquisitions and partnerships and the changing role of communications. They also discovered health systems are “demanding an unprecedented level of coordination and
sophistication from their communications and marketing teams, putting increased demands on staff recruitment, training and retention.” Departments varied in size from a few to nearly 100 staffers. While size can matter, one organization created an impressive social presence with only one person. Marketing Budgets A lack in industry standard among marketing budgets also took the Jarrard team by surprise, Fox said, with numbers ranging from $2 million to $30 million. However, departments reported fewer budget cuts than might be expected in a postACA world. In fact, most budgets remained fairly consistent year to year, although more was often expected of staff. For example, they found human resources and communications departments are coordinating efforts much more than in years past due to the substantial amount of information employers are required to share with staff. Their research did reveal some overriding themes, including: Budgets are flat. Budget restraints do not allow systems to add new staff. If a department requires additional staffing in emerging areas like digital or employee communications, they
are retraining existing staff members and re-engineering the current workload. CCOs are trying to prioritize work in order to make room for additional or new assignments, but “project creep” persists, the demand for traditional advertising and newsletters has not abated, and the realities of organizational politics continue. Sponsorships – large and small – continue as major line items in most budgets. Measuring Returns When it came to measuring return on marketing investments, participants identified some keys to success: • Collaborate with operations and finance to ensure your goals are aligned with their goals, • Determine how to track prior to the beginning of the campaign, and • Make sure to include all communications and marketing activities in the campaigns to be tracked. The report closed with a glimpse into the future for healthcare communicators: “We see a changing role for communicators and marketers — a role that is deeper and broader and more strategic than ever. The tumultuous changes in the business of healthcare and in how consumers communicate today have created the perfect storm.”
A Look Inside
How Internal Communications Can Make or Break Hospital Marketing By MELANIE KILGORE-HILL
How many employees comprise your marketing team? If your answer consists of the number of communications department staff, think again. Today’s marketing and communications efforts rely upon every employee in an organization, from hospitality to accounting. “Now more than before, we’re seeing a more diverse group of people involved in healthcare communications out of necessity,” said Nicole Cottrill, partner and healthcare specialist at DVL Seigenthaler. “We’re seeing a lot of diversification in facilities where communications once resided in the marketing department. Nicole Cottrill People are involved in a different way because so many changes are happening in hospitals that have to be rolled out across the facility.”
An Essential Piece of the Puzzle That evolution is due partly to increased government scrutiny. With reimbursement cuts on the line, staff communication means being transparent and keeping everyone ‘in the know,’ in good times and bad. For example, an employee
who hears about a pending investigation from the neighbor first will be caught off guard. On the other hand, staff who have been armed with information and answers on the front end can be an organization’s best defense. Employees also are the face of the organization. That means they can make or break a patient’s experience – something all the paid advertising in the world can’t do … or undo. “How staff talk about their employer at church or the store can make or break the community’s perception in a lot of ways,” Cottrill said.
Employee Satisfaction Matters Employee satisfaction affects the success of an organization so keeping them engaged is imperative. “Employees want to know what being part of your company means; how employment here is contributing to society and life; and how they matter in the overall scheme of things,” Cottrill said. “Getting everyone vested in your mission is key, especially when you consider the added pressures from healthcare reform. You have to get staff buy-in to make all that happen in a successful way.” Steps to Success So how does an organization create an inward focus? First, Cottrill said, make it a priority.
Second, be consistent. Don’t start at a speed you can’t maintain. Some companies can successfully generate a weekly employee newsletter, while others only have manpower to pull off a monthly edition. Whatever you decide, stick with it. “There can be range of tactics, from written communications to email and print,” Cottrill said. “It can be as easy as regular town hall or department meetings with executive rounding to check on each department to talk about new initiatives.” Efforts should be planned, consistent and measured, and not reliant on one person. Campaigns are most successful with a range of people involved: clinical messages should be coming from the chief medical officer or physicians, while the COO sends out operational messages. Third, find a way to make staff communication two-way. It might be as simple as a suggestion box in the cafeteria or scheduling small group discussions where administrators can openly discuss ideas and concerns with employees. In hospitals, the CEO might make an executive round at 3 a.m. to connect with staff. “It’s so important not only that employees can hear you … but that you can hear and interact with them,” Cottrill said. “It has to be very intentional because everyone has a role to play in the patient experience.” MARCH 2015
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Personalized Messaging A Marketing Manifesto By CINDY SANDERS
With better understanding of the human genome, physicians and researchers have opened up exciting new lines of personalized medicine to fit a patient’s unique needs. While a highly scientific, very targeted approach is often used to promote improved outcomes, it is rarely employed when it comes time to promote a facility or provider expertise to improve income. If precision medicine works, why not precision marketing?
A Call to Arms In his 2011 manifesto for transforming healthcare marketing, “Joe Public Doesn’t Care About Your Hospital,” author Chris Bevolo explored why the digital world had made it possible … and desirable … to change not only the message but also the manner in which it is delivered. His September 2014 follow-up, “Joe Public II: Embracing the New Paradigm,” offered practical strategies for making the move from mass marketing campaigns to much more precise digital and content Chris Bevolo marketing options. The norm, Bevolo pointed out, has been to take a shotgun approach via mass marketing. “It really was a call out to the industry to say, ‘This isn’t working … we need to stop this,’” he said of his first book. Change doesn’t come easily, pointed out Bevolo, executive vice president for healthcare marketing communications firm ReviveHealth. And just as the industry was beginning to get the hang of Facebook and Twitter, the digital landscape shifted again. “Social media is still important, although we’re beginning to see the limits of what it can do from a marketing standpoint,” said Bevolo. “Instead of a few big players, you’re seeing more and more players emerge,” he continued of the segmentation of social media. “It’s an important supportive tool, but I think there was a time when people thought it would totally revolutionize marketing.” Instead, it is one device in the bigger picture of digital marketing, which is revolutionizing the way the industry reaches its target audience. Bevolo said ‘search’ should be a primary driver of how customers … also known as patients … find you and your message. Whether by purchasing prime real estate in popular search engines or effectively using tags, it’s clearly a competitive advantage to be among the first few sites that pop up when someone looks for “urologist, Nashville,” or “safest hospitals, Tennessee.” Additionally, emerging technologies allow practices and health systems to really drill down and target specific messages to specific populations in a way that is timely 8
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and useful. “It has to be relevant, and it has to be relevant to what they need in the moment,” Bevolo stressed.
Content is King Bevolo said there is no question that people are facing information overload, and he noted research has shown individuals are hit by thousands of marketing messages daily but can only process about 100 of them. “How do you become one of the 100 out of 3,000 or 6,000?” he asked. “The key is relevancy.” Bevolo continued, “That’s the challenge for any marketer, but it’s particularly challenging for hospitals. What they have to offer is not relevant to the vast majority of people at any given time.” Expecting consumers to hone in on messages that don’t apply to them isn’t realistic, he said. “If you’re not in need of a doctor at this moment, you don’t care about awards, service lines or how great a hospital’s doctors are,” he pointed out. “Yet, we try to do broad marketing. Not only is it silly, it’s a waste of money and
time … and you don’t have time to waste, and you don’t have money to waste.” When patient volume is down, Bevolo said the gut reaction is to believe it’s because not enough people know about you and your wonderful services. The prevailing sentiment is that if you just get a message out there about how good you are, then people will a) hear it, b) care about it, and c) will take action on it. “All three are false, by and large,” he said. Bevolo continued, “That’s the fundamental breakdown in logic … that telling people how great you are will get people through your doors. I don’t care how good the billboard is, it’s not going to make me run in and have my gall bladder taken out if I don’t need it removed.” With limited resources, why pay to broadcast to a million people when only 30,000 need your message, he questioned. However, he added, targeting the 30,000 doesn’t mean you are giving up on the other 970,000. Instead, Bevolo continued, you just have to rethink the messages. “You’re missing a lot if you don’t focus
on people who do not need services today,” he said. “There’s an opportunity to connect with those people around something that is relevant to them.” Bevolo suggested using digital options such as blogs, channels, websites and apps to share messages about prevention, healthier living and other topical content. A young mother might not care that you are the top joint replacement hospital in the area, but she might really want to learn how to make quick, healthy lunches for her children. A retiree who isn’t interested in how many babies you delivered last year could be eager to learn about fall prevention measures. “That’s how you resonate with Joe Public … because you are the arbiter of health,” Bevolo shared. Instead of trying to target potential patients right before they need services, he said the idea is to reach out to them much earlier. “Those people will need care one day; and if you are the resource they turn to when they are healthy, you’ll be the one they turn to when they do need services.”
Marketing & the Media, continued from page 1 Communication 101 Start by asking key questions. Who do I want to talk to? What do I want to say, or what behavior do I want to bring about? How do I reach them? “Talking to news media is a conduit to an end audience,” Plorin said. “Oftentimes companies think announcements need to be in the form of a press release and shoot every one to all media, but that’s not how it works. In general, reporters are looking for news that’s significant, out of the ordinary, and timely.” Know Your Audience A common mistake is sending news that’s too internal or industry-specific to a very broad media audience. Plorin stressed distributed news should be relevant both geographically and to the industry. A new patent, for example, could be extremely important to an industry trade publication but might not be consumer news. On the other hand, a human-interest story could provide multiple opportunities on the consumer side. “You have to be opportunistic and smart about how to identify human interest stories,” Plorin said. Creating Newsworthy Stories Relocating offices? While the move itself might not be newsworthy, packaging the announcement with company growth and expansion is more likely to grab an editor’s attention. And don’t avoid numbers. While many companies go mum at requests for revenues, smart communicators show progress as percentages of financial or physical growth. Has the company experienced consistent annual growth, or
recently expanded into new states? “You can demonstrate growth without saying, ‘Here’s what happened revenue-wise,’” Plorin said. “It’s not just top or bottom line growth. There’s a lot of opportunity for telling that type of story.” Building Relationships Sharing news with media is about maintaining a relationship with them, in good times or bad. “If you approach a reporter with a half-baked idea and never had a relationship with them or haven’t returned their calls, that idea won’t get anywhere,” Plorin said. “However, if you’ve been responsive to the reporter in the past and shared good information, you’re much more likely to get a warmer reception and have a productive conversation.” The same applies in crisis situations. Conflict will always make the news, and if you haven’t maintained a relationship with key reporters, it’s unrealistic to expect any favors on their end. Timing is Everything In an age where news is reported by the second (and often misreported through the mixed blessing of social media), understanding timing of communication is much more complex than it used to be. Case in point: A hospital decides to close a unit, which ultimately means lost jobs. Since hospitals are 24/7 businesses, employees are never all onsite at the same time. Administrators must be thoughtful as to how to stage announcements and understand that what’s said to the first group will be on the Internet within minutes … and bad news travels fast. “You used to be able to make an 8 a.m. staff announcement and share it with
the news media later that day,” Plorin said. “Today, you’ll announce it to staff at 8 a.m. and receive a media inquiry by 9 a.m.” Plorin, who specializes in crisis communications, urges clients to be very tight and prepared when making major announcements. Arm staff and physicians with information ahead of time to prepare them to answer questions at work and in the community. If handled correctly, employees can become a company’s greatest advocates during a crisis. “I think a lot of organizations that haven’t gone through a major news event don’t really understand how quickly word travels,” she said. “It’s tough, especially as healthcare delivery becomes more geographically spread with integrated systems. It’s rare to have everyone under one roof at one time.” Healthcare: Like no Other Plorin said hospital administrators often don’t comprehend how very different their environment is than other industries, and those differences are often magnified during a crisis. “Hospitals are such unique work environments because they’re 24/7, so spread out, and such large employers,” Plorin said. “You’re also dealing with dangerous drugs and life-and-death situations. It’s a very rare nature of work and very challenging.” Her advice? Don’t be afraid to ask for outside help, especially during extraordinary events. “Whether it’s good or bad news, a rare kind of event is worth seeking outside professional help, as you would for legal counsel or medical malpractice,” Plorin said. nashvillemedicalnews
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March of Dimes: Making a Difference for Tiny Tennesseans In Chattanooga, Currin said a grant initiative is just wrapping up that addresses both disparities and tobacco cessation by utilizing churches, which play a prominent role in the black community, to bring about change. “They built partnerships with African-American churches and provided training on how to quit smoking to the leadership spearheaded by the ‘first lady’ of the church … the pastor’s wife,” she explained.
By CINDY SANDERS
January is National Birth Defects Prevention Month. March is in the name. November is National Prematurity Awareness Month. But for the staff of March of Dimes Tennessee, every month … every day … is another opportunity to advocate on behalf of mothers and children to build a stronger, healthier state. Each year, one of eight babies in Tennessee is born prematurely. While the organization hosts a number of fundraisers, the premier event is March for Babies, and 76 percent of the money raised from those walking events across the state goes to fund research and programs supporting the mission. Tamara Currin, MS, MCHES, associate director of Program Services and lead for Advocacy & Government Affairs for MOD Tennessee, noted, “For our program plan, we have three main initiatives that we’re looking at for at least three years.” She added the key objectives focus on Tamara early elective deliveries, Currin tobacco usage in women of childbearing age, and disparities in preterm birth. Early Elective Deliveries Currin said March of Dimes nationally spearheaded a partnership with the Tennessee Department of Health, Tennessee Hospital Association, Tennessee Initiative for Perinatal Quality Care (TIPQC) and other interested entities in 2012 to address the issue of elective early inductions. She noted the ‘Healthy Babies are Worth the Wait’ campaign has been a successful example of how collaborative efforts can really make a difference. Although babies are born prematurely every day naturally, Currin said the concern is over those times when labor is electively induced. “We know that the longer babies are in mom’s body, the healthier they will be,” she said. “The lungs and the brain are some of the last things to develop in utero.” An infant’s brain at 35 weeks weighs only two-thirds what it will at 39 to 40 weeks. Even being born just a few weeks early could hamper a newborn’s ability to coordinate sucking, swallowing and breathing. Currin credited the partnership for building awareness among the healthcare community. A letter was sent to birthing centers across the state asking them to pledge to put in a ‘hard stop’ for scheduled inductions before 39 weeks. Currin explained clinicians now have to speak with a designated physician in the facility to explain why an early induction is medically necessary. Other efforts have included awarenashvillemedicalnews
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ness campaigns for consumers. The ‘Don’t Rush Your Baby’s Birth Day’ public service announcement encourages moms with healthy pregnancies to allow labor to begin naturally. The results have been stunning. In 2012, Tennessee ranked poorly nationally with close to 15 percent of all births being early elective inductions. By 2014, the average between January and August had fallen to around 2 percent. “This is just a remarkable improvement and much credit to the partnership,” Currin said. Tobacco Cessation “We have 23 percent of women of childbearing age who smoke in Tennessee,” said Currin. “That’s a leading risk factor for prematurity and low birth weight.” In addition to MOD programming, she said the organization also has a statewide community grant-funding effort to target specific areas or objectives. “We actually have a grant we’re funding in Johnson County,” she said of an effort in Upper East Tennessee. “As a part of a prenatal program, they are providing Baby & Me: Tobacco Free, an evidence-based approach to primarily cessation, but it also addresses the environment and other smokers in the home.” The goal is to achieve a 20 percent quit rate among participants. Currin noted the Tennessee Department of Health also provides funding to a number of local health departments across the state to host smoking cessation programs for pregnant women. Addressing Disparities While Hispanic and Caucasian women in Tennessee have preterm rates of 11.4 percent and 11.3 percent respectively, African-American women have a prematurity rate of 17.2 percent. Currin said MOD is currently funding two community grants in the Memphis area. One targets pregnant women who are homeless. The second, Fit4Me, addresses obesity among women of childbearing age and looks at a healthy body weight before and between pregnancies with a focus on overall nutrition.
Healthy Babies, Healthy Business Phil Toothman, state director of Communications and Marketing for March of Dimes, said the organization is attacking the problem of prematurity from multiple angles. Knowing businesses wind up absorbing the cost of prematurity in terms of increased health premiums, lost productivity and absenteeism, the hope is to enlist the help of state businesses to help spread the word about the importance of prenatal health. “The average cost of caring for a preterm baby versus a healthy, full-term baby is 12 times,” Currin Phil said. “The healthy baby Toothman
is $4,389 on average, and a preterm baby is $54,194,” Toothman added of medical costs. He also noted the medical costs could soar to $1 million or more for the tiniest babies who required months of hospitalization. MOD estimates preventing prematurity in Tennessee could equal an annual savings of up to $515 million. Making Progress Although there is a long way to go, Toothman and Currin said Tennessee has made measurable progress over the last several years led by the impressive improvement in the rate of elective early deliveries. After a number of years with a failing grade, Tennessee moved to a ‘D’ on the national Premature Birth Report Card in 2012 and received a ‘C’ in 2014. Although the state’s overall prematurity rate of 12.5 percent is still higher than MOD would like to see, Toothman noted, “We’ve experienced six years of improvement in that number.” For an organization that works hard to support Tennessee’s tiniest residents, the staff knows baby steps are something to celebrate.
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Where advanced cytogenetic technology meets old-fashioned service www.geneticsassociates.com MARCH 2015
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In practice for five years, she tries to lead by example with a focus on quality to improve patient outcomes without ever losing sight of the unique individual in need of care. While Jackson always hopes to be a blessing to her patients, she said she so often finds they are a bigger blessing to her.
Hospice & Palliative Care Carey McDonald, MSN, APRN, CPNP-AC Monroe Carell Jr. Children’s Hospital at Vanderbilt
March of Dimes Celebrates Outstanding Community Nurses at Annual Gala By CINDY SANDERS Nurses from across Middle Tennessee gathered to honor outstanding colleagues during the fifth annual March of Dimes Nurse of the Year Awards. Marilyn Dubree, MSN, RN, NEBC, executive chief nursing officer at Vanderbilt University Medical Center, served as chair of the awards gala, and Chris Clarke, RN, BSN, senior vice president of the Tennessee Hospital Association, was the event’s honorary chair. The gala enjoyed broad community support with more than a dozen corporate sponsors, including Lipscomb University School of Nursing as the gold sponsor. Continuing tradition, Nashville Medical News served as media sponsor, and Dan Thomas of WSMV - Channel 4 was the evening’s emcee. Top honors were awarded in 17 categories from a long list of highly accomplished nominees who live out the mission of the March of Dimes to support children and families.
Advanced Practice Sponsored by Vanderbilt University Medical Center Beth Davidson, DNP, RN, ACNP, CCRN TriStar Centennial Medical Center Educate and advocate could be Davidson’s motto. Those who nominated the advanced practice nurse with expertise in heart failure noted the huge impact she has had at the hospital. Her patients have benefitted from her heartfelt caring and clinical expertise honed over 26 years of practice. Not only does she advocate on behalf of her patients and
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work tirelessly to educate them about living with a chronic condition, she also provides outreach in outlying areas to promote heart failure services and education and teaches an eight-week review course for nurses specializing in the care of heart failure patients.
Behavioral Health Megan Simmons, DNP, RN, PMHNP-BC Vanderbilt University School of Nursing In her nine-year career, Simmons has already contributed substantially to the field of behavioral health with a clinical practice as a psychiatric mental health provider and as an assistant professor at VUSN. She is passionate about increasing student awareness of the need for committed professionals to care for the vulnerable population of older adults with mental illness and provides dementia education for healthcare workers in skilled nursing facilities. Her doctoral project has been featured at national conferences and has led Simmons to serve as a national reviewer of geriatric pharmaceutical practice guidelines for the Gerontological Advanced Practice Nurses Association.
Critical Care Sponsored by Sumner Regional Medical Center Amy Charlton, RN, BSN, CCRN TriStar Centennial Medical Center This nurse of more than 15 years integrates her critical care talents into all facets of her practice including modeling the critical thinking skills vital
to caring for the very ill. A mentor and friend to young nurses, she leads by example. Her caring nature has led Charlton to travel to Uganda to lead hundreds of volunteers in efforts to improve health and education so that children will have an opportunity to reach their full potential.
Emergency Sponsored by Maury Regional Medical Center Joey Kerrigan, RN, TNCC, ENPC Sumner Regional Medical Center Calm under the pressure of providing emergency care, Kerrigan is proud of her role as a preceptor for nursing students to help train the next generation of emergency nurses. Passionate about patients, she is active in implementing quality improvement projects and focuses on improving processes aimed at preventing errors and increasing patient satisfaction. Her colleagues note that Kerrigan, who has been in practice for five years, is just the type of caring professional they would hope to encounter if the need arose.
General Medical Sponsored by NorthCrest Medical Center Sherrie Jackson, RN, BS, BLS, ACLS, PALS TriStar Skyline Medical Center Recognizing the best care is integrated care provided by a professional team, Jackson has been known to point out there is no “I” in NURSE, but you can find a “US.”
Having spent her career in pediatric critical care units and the NICU, this palliative care professional has come to realize the skills most necessary in her field are also some of the hardest to teach … learning to listen carefully and counsel compassionately. McDonald said communicating with families facing incredibly difficult situations and treating symptoms in gravely ill children are subjects not routinely covered in standard medical education so she is particularly thankful to mentors who helped her hone her skills and is happy to mentor others interested in this specialized field.
Managed Care Sponsored by Cigna HealthSpring Corinna Dransfield, RN Amerigroup Corporation With 14 years of critical care nursing experience, the last six years in the managed care setting, Dransfield utilizes her range of clinical experience as an ER nurse case manager. Her motto has always been ‘positive in, positive out.’ To make positive changes in her profession, she believes in tracking and trending data to highlight successes and areas of need. Using those skills, Dransfield identified a patient with more than 100 ER visits and multiple inpatient psychiatric admissions and then collaborated with other departments and the client to address needs and barriers with remarkable results.
Nursing Administration Sponsored by Community Health Systems Diana Moses, RN, BSN, MBA, NE-BC TriStar Centennial Women’s & Children’s Hospital As administrative director of nursing, Moses finds it most rewarding to mentor new managers and help develop leadership skills. With three decades of nursing experience, she sets the bar high with a focus on excellence. A staunch advocate for nurses, children and families, Moses is always willing to listen and to speak up when needed. Equally, she manages to balance nashvillemedicalnews
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the needs of the hospital and larger healthcare system to help ensure the delivery of effective, efficient care.
Nursing Education Sponsored by Belmont University College of Health Sciences & Nursing Benjamin Smallheer, PhD, RN, ACNP-BC, CCRN Vanderbilt University School of Nursing
Washington, D.C. On a state level, Plummer has provided information used to inform policies on prescription drug abuse in Tennessee.
Quality and Risk Management Sponsored by Tennessee Hospital Association Karen Hande, DNP, MSN, RN, ANP-BC Vanderbilt University School of Nursing
A member of the VUSN faculty since 2006, Smallheer fosters an atmosphere of respect and professionalism that encourages free thinking where all questions are valid and opinions are honored. He remains active in clinical practice in the critical care arena and relishes seeing the spark in students’ eyes when classwork comes to life in the acute care environment. A champion for his students and a collaborative colleague, this 16-year veteran nurse is effectively preparing today’s students to meet the healthcare needs of tomorrow.
Pediatric Sponsored by Monroe Carell Jr. Children’s Hospital at Vanderbilt Catherine Norvell, MSN, RN Monroe Carell Jr. Children’s Hospital at Vanderbilt Norvell is always looking for areas of improvement to help the tiny, vulnerable population under her watch. Knowing that medicine and technology have advanced to the point where infants born at the limits of viability are surviving more often, Norvell recognized the care designed for preemies really didn’t translate to these ultra-tiny infants who require lengthy hospitalizations. To address this need, Norvell helped develop a curriculum where the babies receive more neurologic stimulation, including cuddling and reading, to help them developmentally track with healthy newborns.
Public & Community Health Sponsored by Amerigroup
An adult health nurse practitioner with 15 years experience, Hande is passionate about caring for the chronically ill and looking for ways to improve prevention and management. She designed and conducted a quality improvement project focused on colorectal cancer prevention with outcomes measured in three areas of clinical practice. Hande has had the opportunity to disseminate the findings of her work in a number of publications and at an international conference in Hong Kong.
Research Sponsored by Vanderbilt University School of Nursing Jie Deng, PhD, RN, OCN Vanderbilt University School of Nursing Since 2008, this nurse researcher has dedicated her investigations to the complications associated with treatment of head and neck cancers. Based on her findings, she has developed a tool with which oncology nurses and other clinicians can routinely assess and accurately document head and neck cancerrelated lymphedema. Her current research interests also include testing interventions for decreasing symptom burden and improving functional outcomes related to late effects of head and neck cancer treatment. Deng is extensively published and is part of the research committee for the National Lymphedema Network.
Student Nurse of the Year Undergraduate
Carrie Plummer, PhD, MSN, RN, ANP-BC Vanderbilt University School of Nursing
Sponsored by Lipscomb University School of Nursing
During her nineyear career, Plummer has discovered a passion for developing and leading interprofessional collaborations to effect positive community change. She has organized and implemented several community-based efforts to address prescription drug abuse and worked collaboratively with other universities, local law enforcement officials and the DEA. Plummer has also worked on the national level through an internship with the National Office of Drug Control Policy in
After earning a Master’s in Public Health, Brooks decided to pursue nursing to enhance the care she could provide to underserved communities. She believes nurses are not only providers of care but also a source of faith and symbol of reassurance. One of her favorite quotes states, “People don’t care how much you know until they know how much you care.” Her goal is to use her compassionate nursing
nashvillemedicalnews
Nicole Brooks, MSPH Lipscomb University School of Nursing
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skills to address health disparities both domestically and abroad.
Student Nurse of the Year Graduate Sponsored by Lipscomb University School of Nursing Megan Shifrin, MSN, RN, ACNP-BC Vanderbilt University School of Nursing Shifrin, who has been in practice for nine years, has a clinical background in ICU settings. She noticed nurses expressing feelings of professional inadequacy when caring for intensive care patients at the end of life, which prompted her to pursue her doctoral studies. In 2014, Shifrin designed an educational curriculum on end-of-life patient care specific to the ICU setting. This year, she is offering educational sessions to nurses in six adult ICUs. Her hope is to not only help improve patient and family care at the bedside but also to increase nursing confidence and competency.
Surgical Services Lori Patterson, RN, ONC Saint Thomas Rutherford Hospital Patterson earned her nursing degree just four years ago, becoming certified in orthopaedics in 2013. From the first clinical rotation in her specialty, she knew it was a field she loved and wanted to pursue. With her compassionate nature, it came as no surprise to her family when Patterson decided to leave her previous career and go back to nursing school. Her caring nature and excellent clinical skills resonate with patients and colleagues, alike. Both admire her professionalism, communications skills, efficiency and empathetic nature.
Women’s Health Sponsored by 100+ Women Who Care Middle Tennessee Mary Visceglia, RN, BSN, OCN TriStar Skyline Medical Center Visceglia, a nurse navigator, said she looks forward to coming to work every day because she doesn’t see it as ‘work.’ Instead, she believes nursing is about being part of something much greater as she helps patients diagnosed with breast cancer navigate the healthcare experience. She guides patients through their course of treatment, helps them manage the emotional and physical peaks and valleys, and makes sure they understand their diagnosis and care plan. One colleague noted Visceglia is more than a patient advocate … she is someone who empowers patients to advocate for themselves.
Mark Your Calendar Upcoming March of Dimes Events March of Dimes works yearround to bring awareness and funding to the organization’s mission of creating stronger, healthier babies. Mark your calendar for these upcoming events to support March of Dimes in Tennessee. March 17 • Advocacy Day • 8:30 am • The Capitol, Legislative Plaza: Each year volunteers and staff meet with state legislators to advocate on behalf of mothers and babies in Tennessee and to discuss pending legislation that impacts these populations. There is an advocacy day conference call training on Monday, March 16 from 10-11 am for those registered for the event and a Legislative reception that evening at 5:30 pm. For more information or to register, go to marchofdimes.org/tennessee. March 17 • Breakfast for Babies • Beginning 6 am • Noshville Deli Broadway & Hillsboro Circle Locations: What better time than Saint Patrick’s Day to enjoy green eggs and ham? Plenty of other breakfast treats are also available as Noshville Delicatessen teams up with Mix 92.9 FM for this annual Mach of Dimes fundraiser. No registration necessary, and this year will feature call-in orders and curbside pickup. April 18 • March for Babies Nashville • 9 am • LP Field: Thousands will gather to march … or walk … for babies on Saturday, April 18. “It’s a two-mile walk, and it’s a completely free event … anyone can come,” noted Phil Toothman, March of Dimes state director of communications and marketing. The premier fundraising event, individuals and corporations can go online to form a team and then encourage friends and colleagues to donate in honor of that team by check, cash, or online contribution. To help spread the news, Tootthman said there is an easy-to-use mobile and social network platform, as well. “Some teams have five people … some have well over 100,” Toothman said. “We had the largest family team in the nation right here in Nashville. Last year they raised $92,000.” In fact, he added, longtime volunteer Ashley Turner, who formed ‘Team Ellie’ in honor of her daughter who was born prematurely, has raised nearly $250,000 since participating in her first event in 2007. This year, Turner is serving as the 2015 March for Babies National Family Team Chair. Locally, more than 7,000 are expected to participate. John Krndl of LifePoint Hospitals is the 2015 Nashville chair and has a goal of raising $850,000. For more information, go to marchforbabies. org/event/nashvilletn.
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HealthcareEnterprise
Laser Focus: Alliance Oncology Partners with Hospitals, Providers to Offer Comprehensive Radiation Oncology Services By CINDY SANDERS
There’s no substitute for experience. And when it comes to extremely technical, highly specialized, very expensive propositions like launching a radiation therapy program, the more experience the better. That is a large part of the value proposition Alliance Oncology (AO) brings to the table when entering into joint ventures with hospitals and physicians across the nation. “We’re not a management services company … we’re a partnership company,” stated Greg Spurlock, president of Alliance Oncology. Spurlock joined the company in April 2011 when AO acquired U.S. Radiosurgery, where Spurlock previously served as chief adminis- Greg Spurlock trative officer and chief operating officer. Today, as president of AO, he oversees a growing team that is singularly focused on planning, developing and operating radiation oncology departments and radiosurgery facilities
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in partnership with providers. Nashvillebased Alliance Oncology is a division of Alliance Healthcare Services (NASDAQ: AIQ), which is headquartered in Newport Beach, California. Spurlock noted it is an ongoing struggle for administrators and providers …
whether from small rural hospitals or large academic medical centers … to offer stateof-the-art services without exhausting a capital budget that typically has more demands than available resources. “Every hospital in America has a capital list that is probably tenfold the dollars available,” he said. One cancer center, he added, could quickly eat up the budget meant for numerous projects spread across multiple departments. A joint venture with Alliance Oncology, Spurlock said, relieves some of that pressure. “Hospitals are worried about their debt-to-equity ratio,” he pointed out. “When we do a joint venture, we can put the capital cost into the joint venture so the hospitals benefit from off-books capital.” Furthermore, he continued, hospital partners are not required to provide guarantees for the building or equipment, which includes such advanced technologies as Intensity Modulated Radiation Therapy (IMRT), Image Guided Radiation Therapy (IGRT) and Stereotactic Radiosurgery (SRS). AO enters into joint ventures for both the establishment of new centers and upgrades to existing facilities, depending on the specific need in any given market. Spurlock also noted the partnerships are geographically diverse ranging from joint ventures in community hospitals in the Southeast to affiliations with urban facilities from Boston to San Diego, including several prestigious academic medical centers. Typically, the market partner does provide some starting capital, billing and collection functions, and the specialists required to staff the new department or facility. Spurlock added radiation oncologists are allowed by law to participate as a partner in these types of joint ventures, as well. Alliance Oncology provides the rest
of the necessary expertise from planning and building through daily operational management and marketing. Spurlock noted AO’s national buying power allows for savings on equipment and construction that would be difficult for an individual hospital to achieve on its own. “We work for the hospital in all operational aspects. We’re the full service clinical provider,” he said. Spurlock added AO has the benefit of tapping into the expertise of its sister organization, the Radiosurgical Research Institute. “As an organization, we have created a proprietary clinical benchmarking program the centers participate in. We track a multitude of clinical information and data points to create a best-in-class experience for patients and physicians,” he explained. Spurlock noted the company has received the highest award for patient satisfaction for seven years running by Avatar Solutions, a third party provider of patient satisfaction surveys. The honor is based on key survey items gauging patient expectation about quality of care, reliability, and willingness to recommend services to others. Another important element of operations, Spurlock added, is marketing the center. “Part of the problem today is hospitals won’t take any program and market it year-round. They can’t. They have too many service lines,” he said. As part of the joint venture, however, AO takes on that function and applies best practices to drive market share on an ongoing basis. He added consumers don’t care about a cancer center until they need it so it’s essential to keep the marketing message out front all year long. As of early 2015, Alliance Oncology had 31 radiation therapy centers in 17 states with more than half being dedicated radiosurgery facilities. “We grew significantly last year, and we plan to continue a significant growth strategy (in 2015),” Spurlock said. Unfortunately, growth stems from need. While the incidence rate in some cancers is down slightly, the expectation is a 20 percent increase in cancer diagnoses in the next 10 years, driven in part by an aging population. On the plus side, Spurlock pointed out, the number of cancer survivors is also anticipated to grow significantly. The latest data from the American Cancer Society projects more than a 30 percent increase in cancer survivors during that same timeframe … growing from 14.5 million survivors today to 18.9 million by 2024. “Treating cancer more accurately, faster and with smarter technology is allowing more people to survive longer,” Spurlock said. “The space is going to continue to grow so we feel like we are in a great position to help a lot of people and make a difference.” nashvillemedicalnews
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GrandRounds Mark Your Calendar
March 28 • Tennessee Kidney Foundation Spring Soirée • 6-11 pm • Omni Nashville Hotel: The evening’s events include a cocktail reception, dinner, entertainment, live auction and dancing with a late party following the main program. The event raises awareness and funds to help support the more than 500,000 Tennesseans considered at risk for chronic kidney disease. For more information or to reserve tickets, go to springsoiree.org.
Lung Cancer Specialist Johnson Joins SCRI
Melissa Johnson, MD, has recently joined Sarah Cannon Research Institute as associate director, Lung Cancer Research. Her responsibilities include supporting the growth of the Phase 2/3 lung program clinical trial portfolio, while also furDr. Melissa thering the development Johnson of early phase compounds for thoracic malignancies in the Drug Development Unit. Johnson, a medical oncologist with Tennessee Oncology, received her undergraduate degree from the University of North Carolina, Chapel Hill and her medical degree from the University of Pennsylvania. She completed her residency in internal medicine at New York Presbyterian/Weill Cornell Medical Cen-
Best Case, continued from page 4 highest ranked drug on the CorrectChemo assay might be bypassed, for example, if it had cardiac implications, and the patient in question had heart disease. He also said CorrectChemo isn’t in competition with molecular profiling of a tumor. Instead, he concluded, “It’s another unique tool for the oncologist to be armed with to help them evaluate what would be the best treatment options for patients.” About DiaTech DiaTech Oncology has the exclusive and perpetual licensing rights to the technology originally developed by researchers at Vanderbilt University as the MiCK® Assay, which is now marketed as CorrectChemo®. Founded in 2003, the privately held international life sciences company recently received CLIA approval to perform CorrectChemo testing at DiaTech’s Middle Tennessee lab, located adjacent to the corporate headquarters. The new lab will provide testing services for U.S. patients along with the lab in Montreal, which has been online since 2004. The company also recently announced a partnership with Cancer Hope in Ra’anana, Israel to make their test available in the Middle East. Cancer Hope currently has relationships with 14 medical centers throughout Israel. nashvillemedicalnews
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ter and her fellowship in medical oncology and hematology at Memorial Sloan Kettering Cancer Center. Johnson spent four years as a faculty member at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and Feinberg School of Medicine, where she was a founding member of the Northwestern Medical Developmental Therapeutics Institute (NMDTI) before joining SCRI. She is board certified in internal medicine and medical oncology.
Burner Joins Radiology Alliance
Kevin L. Burner, MD, who specializes in interventional and diagnostic radiology, has recently joined Radiology Alliance, PC, which is the exclusive market-wide radiology provider for inpatient and outpatient services at TriStar Health System’s 10 Dr. Kevin L. hospitals in Tennessee Burner and Kentucky. Since 2003, Burner has served as the medical director of Medical Imaging at TriStar Greenview Regional Hospital in Bowling Green, Ky., and the board certified radiologist will continue in this leadership role. He received his medical degree from Case Western Reserve University in Cleveland, Ohio and performed a diagnostic radiology residency with an emphasis on interventional radiology at University Hospitals of Cleveland.
Saint Thomas Health, Healthways Partner to Improve Diabetes Care
Saint Thomas Rutherford is partnering with Healthways, Inc. to improve the care of diabetic patients in the community. Healthways has offered comprehensive diabetes programs for more than 30 years and has been a part of a successful diabetes program at Saint Thomas Midtown since 1997, and more recently at Saint Thomas West. Beginning last month, a specially trained Advanced Nurse Practitioner has been made available for inpatient consult via computerized physician order entry (CPOE) for diabetes education or disease management. The pro-
gram will be under the direction of Matt Moody, with Dr. Cheryl Fassler, MD, providing oversight of the nurse practitioner. Healthways will assume leadership responsibility for the Saint Thomas Rutherford Outpatient Diabetes Center, providing a seamless transition of care for patients with diabetes.
Hulin to Become Next President of MTSA
Christopher P. Hulin, CRNA, DNP, the current dean and program administrator of the Middle Tennessee School of Anesthesia (MTSA) will become the fourth president in the school’s 65-year history. Hulin will assume his new role on July 1, 2015 upon the retirement of Kenneth L. Schwab, EdD, who has served as MTSA president since 2010. Hulin earned his doctor of nursing practice degree from Samford University in 2010. He earned his master’s with a focus in nurse anesthesia from MTSA in 2006. Hulin also holds an MBA from Regis University and a master’s in nursing administration from Vanderbilt University.
Let’s Give Them Something to Talk About! Awards, Honors, Achievements
Michael Greer, RN, MHA, CPHQ, CJCP has been named to the National Association for Healthcare Quality (NAHQ) Board of Directors. Greer, who is senior director of regulatory and accreditation for LifePoint Hospitals, is NAHQ’s president-elect. Carlos L. Arteaga, MD, director of the Center for Cancer Targeted Therapies; director of the Breast Cancer Program; and associate director for Clinical Research at Vanderbilt-Ingram Cancer Center is one of 11 luminaries in the field Dr. Carlos L. Arteaga of cancer research chosen for the 2015 class of fellows of the American Association for Cancer Research. Last year proved to be a recordbreaker for ReviveHealth, a Top 10 marketing communication agency for the health and healthcare industry. Last month, the company announced 62 percent growth for 2014, with $8.7
million in revenue, 42 new clients, 23 new professionals (doubling staff size), the addition of new digital capabilities, and acquisition of Minneapolis-based agency Interval and the opening of a new office in Minneapolis. The agency is on the short list for PRWeek’s Small Agency of the Year for 2015, which will be announced this month. Last month, Nashville-based Clearwater Compliance announced that its entire suite of solutions has earned the exclusive endorsement of the American Hospital Association (AHA). The endorsement, the first in Clearwater’s category, signals a growing awareness of the critical need for proven approaches to information privacy, security, compliance and risk. The AHA lauded the company’s “team of veteran experts in HIPAA/HITECH and information risk management who understand and exclusively serve the healthcare field.”
Wishes Granted
The HCA Foundation recently awarded Progress, Inc. a $300,000 grant funded over three years towards the agency’s capital campaign to fund a new building on Progress’s campus at 319 Ezell Pike. Progress, Inc. is a non-profit that has served people with disabilities and seniors for more than 43 years. Neighborhood Health has received a $65,000 grant from Baptist Healing Trust in the most recent grant cycle. The funding will help support services for over 2,500 Neighborhood Health patients who suffer with diabetes. Centerstone Research Institute has secured $19.8 million in grants and contracts from state and federal organizations to enable Centerstone and its partners to launch and expand community-based behavioral health programs serving individuals throughout Tennessee. The grant funding will allow for the implementation of programs designed to prevent and reduce rates of suicide, violence, disparities in prenatal care and homeless or soon-to-be homeless veteran families. Additionally, the programs will support foster children lacking safe housing and individuals within the criminal justice system who require treatment, recovery assistance and trauma care.
TriStar Skyline Offering O-Arm for Spine Surgery
PHOTO: Medtronic
TriStar Skyline Medical Center recently became the first hospital in Middle Tennessee to offer the O-arm® Intra-operative Imaging and Navigation System by Medtronic for spine surgeries. The advanced imaging and navigation systems enable surgeons to pre-operatively plan treatment and operate in the complex and delicate area of the spine by allowing surgeons to visualize the patient’s anatomy in 3D during surgery and see the precise position of their surgical instrumentation throughout the procedure. Potential benefits include smaller incisions, less pain, quicker recovery time, and a decreased chance of infection or other complications. “The O-arm technology is like having a GPS navigation system for spinal surgery,” said Brett Babat, MD, orthopaedic spine surgeon at TriStar Skyline. “The technology gives surgeons the ability to visualize and track in real-time the position of their surgical instruments and thus avoid critical structures such as the spinal cord.” MARCH 2015
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GrandRounds Certifications & Accreditations
Sarah Cannon at TriStar Health recently announced the Lung Cancer Alliance (LCA) has named five facilities Screening Centers of Excellence. Sarah Cannon at TriStar Centennial Medical Center, TriStar Skyline Medical Center, TriStar Summit Medical Center, TriStar Southern Hills Medical Center and TriStar Horizon Medical Center have been recognized for ensuring best practices developed by the American College of Radiology (ACR), the National Comprehensive Cancer Network (NCCN) and the International Early Lung Cancer Action Program (I-ELAP) for controlling screening quality, radiation dose and diagnostic procedures within an experienced, multi-disciplinary clinical setting.
h3gm Adds Two Associates Harwell Howard Hyne Gabbert & Manner, P.C. (h3gm) recently announced the addition of two associates. Brad Sayles, a member of the firm’s Healthcare Practice Group, assists providers with state and federal regulatory compliance, including defending both individual practitioners and large corporations facing allegations of noncompliance with the Stark Brad Sayles law, Anti-Kickback statute, 340B, and HIPAA. Sayles earned his law degree from The University of Kentucky School of Law. He comes to h3gm from a well-known Kentucky healthcare law firm where he represented some of the state’s largest providers in both state and federal court.
Nathaniel Greene is a member of the Corporate Practice Group, where he assists clients with a variety of complex legal issues including: secured and unsecured financing transactions; leasing, acquisition, disposition and financing of real estate Nathaniel Greene and commercial properties; and general contract negotiation. Greene earned his degree from the University of Tennessee College of Law where he was an articles editor for the Tennessee Law Review and a research editor for Transactions: The Tennessee Journal of Business Law.
Crosslin, STAT Solutions Promote Two STAT Solutions and Crosslin & Associates have promoted two team members within the companies. Kathi Carney has been named director of operations for STAT Solutions. She is a certified professional coder, certified coding instructor, certified professional medical auditor, and has 11 years of physician medical coding experience. Addition- Kathi Carney ally, she spent 19 years as a practice manager, billing manager, and business manager for physician practices. Elisabeth Harper has been promoted to forensic and valuation consultant. She has more than six years of experience in public accounting and Elizabeth holds a bachelor’s degree Harper
WMC Introduces Newest Member of the Surgical Team Officials with Williamson Medical Center, along with several of the area’s top orthopaedic surgeons, recently unveiled the hospital’s newest surgical assistant, the RIO® Robotic Arm Interactive Orthopaedic System. WMC is the only facility in Middle Tennessee offering the RIO System operated by fellowship-trained joint surgeons to offer a minimally invasive procedure for earlyto mid-stage osteoarthritis. Cory Calendine, MD, Colin Looney, MD, Brian Perkinson, MD, Christopher Stark, MD, and Paul Thomas, MD, each specializing in knee and hip replacement, are credentialed to use this new robotic technology, which allows for a smaller incision, less pain and scarring, a shorter hospital stay, improved range of motion, and quicker return to normal activity than traditional replacement surgery. Thomas said the equipment allows for better planning and execution. “It enables the surgeon to do a more thorough pre-operative evaluation, plan the most effective procedure and then execute it more precisely than ever,” he noted.
in economics from Furman University, an MBA from Middle Tennessee State University, and a law degree from the University of Memphis.
Senior Solutions Home Care Expansion Brentwood-based Senior Solutions At Home, Inc. (d/b/a Senior Solutions Home Care) has recently expanded its market into West Tennessee, becoming one of the largest non-medical home care providers in the state. The expansion makes services available in Jackson and the surrounding areas. With this expansion, the company, which was founded in 2010, grows to more than 300 caregivers.
HCA Announces Executive Appointments Nashville-based hospital giant HCA recently announced the appointment of Sam Hazen as the company’s chief operating officer. A 32-year company veteran, Hazen has served as president of operations for the company since 2011 with Sam Hazen oversight of HCA’s 166 hospitals and 113 freestanding surgery centers, domestically and in the United Kingdom. Prior to that, he served in a number of leadership roles at the company, most notably as president of HCA’s Western Group with responsibility for seven divisions and 63 hospitals in nine states. Hazen began his career in Humana’s Financial Management Training Program in 1983. He has served as CFO for hospitals in Georgia and Nevada and as a regional CFO in Kentucky. Hazen earned his bachelor’s degree in finance from the University of Kentucky and his MBA from the University of Nevada, Las Vegas. Lyn Ketelsen, RN, MBA has been named the company’s first chief patient experience officer. In this role, Ketelsen is responsible for leveraging best practices that have been developed at HCA’s 166 affiliated hospitals and other healthcare providLyn Ketelsen ers throughout the company to help ensure patients have the best experience possible. A registered nurse for more than 29 years, she has worked in a variety of healthcare settings and has clinical experience in pediatrics as well as neonatal intensive care. She holds an associate’s degree in nursing from Black Hawk College in Illinois, a bachelor’s degree in business administration from St. Ambrose University in Davenport, Iowa, and an MBA from the University of Iowa.
More Grand Rounds nashvillemedicalnews.com (L-R) Drs. Cory Calendine, Christopher Stark, Colin Looney, Paul Thomas, and Brian Perkinson
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GrandRounds TriStar Summit Welcomes Amin
TriStar Summit Medical Center recently announced the addition of Chirag J. Amin, MD, an oncologist with Tennessee Oncology, to the hospital’s medical staff. Amin received his medical degree from Indiana University in IndianapDr. Chirag J. olis. He then completed Amin his residency in internal medicine at the University of New Mexico in Albuquerque and his hematology/ oncology fellowship at the University of North Carolina, Chapel Hill.
Veteran Healthcare Banker Joins Avondale Partners
Stephen Scott recently joined Avondale Partners’ Investment Banking team as a managing director focusing on companies in the healthcare sector. Scott has almost 20 years of investment banking and healthcare experience and has completed 40 healthcare M&A advisory, equity, and debt transactions during his ca- Stephen Scott reer. Previously, he spent 8 years at Stephens Inc. most recently as a senior vice president of the Healthcare Investment Banking team. He has also worked in the Healthcare Investment Banking team at Jefferies & Co. and in corporate finance positions at HCA and PhyCor. Scott earned an MBA with Honors from Vanderbilt University and graduated summa cum laude from Miami University in Ohio.
Bounds Joins Nashville Vision Associates
Inez B. Bounds, MD, has joined the practice of Nashville Vision Associates, which now includes four board-certified ophthalmologists who perform cataract surgery, in addition to a range of other ophthalmic services. Bounds, who received Dr. Inez B. her medical degree at Bounds the University of Tennessee Health Science Center in Memphis, completed her internship at Methodist Hospital in Memphis followed by a fellowship at Vanderbilt. She is practicing at the Nashville Eye Center, adjacent to Saint Thomas West. Nashville Vision Associates also serves patients in Williamson County through their office at Brentwood Medical Center.
Means-Powell Joins Tennessee Oncology
Tennessee Oncology, one of the largest independent oncology practices in the country, recently announced the addition of Julie Means-Powell, MD, who will see patients in the Franklin and Springfield clinics. Previously, the board certified medical oncologist practiced at VanderbiltIngram Cancer Center for 10 years. nashvillemedicalnews
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Means-Powell’s special interest is in breast cancer, and she has researched and co-authored several studies about the disease. After medical school and internship at East Carolina Dr. Julie MeansPowell University in Greenville, NC, she completed her residency and a fellowship at Vanderbilt.
LBMC Security & Risk Adds Bennett
Sese Bennett has joined LBMC’s Security & Risk Services Practice, which
provides a wide range of services including compliance and IT security services to organizations of all sizes. Bennett joins the firm as a senior manager. He spent the last Sese Bennett eight years in an information security leadership role, most recently as the chief information security officer for the State of Tennessee. Other prior experience includes information security roles at Time Warner Cable Corporation and BlueCross BlueShield of North Carolina.
Motes Named Capella VP Capella Healthcare recently announced the appointment of Jane Motes as vice president of revenue cycle operations. With more than 20 years of healthcare experience, Motes most recently served as senior director, revenue cycle, at University of Arizona Health Network in Tucson. Prior to that, she served in a variety of roles at St. Luke’s Health System in Boise, Idaho. Motes earned a bachelor’s degree, focusing on public health, from Western Illinois University in Macomb.
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