Orlando Medical News May 2013

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PHYSICIAN SPOTLIGHT PAGE 3

Terry Mamounas, MD, MPH ON ROUNDS

High-Tech TLC

Nemours’ new Clinical Logistics Center works ‘like well-oiled machine’

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It’s going to revolutionize the way we provide healthcare in Florida.

– Al Torres, MD, chief of critical care and medical director of clinical logistics for Nemours Children’s Hospital.

By LyNNE JETER

Gearing Up for the Alzheimer’s Burden Orlando providers discuss challenges in research, legislative advocacy ... 10

IT Acceleration MedEvolve finds ‘sweet spot’ niche providing PM and EMR software and RCM services to physician practices nationwide ... 5

Succession Planning

How to concoct a good exit strategy ... 9

When examining a patient in a room at Nemours Children’s Hospital, a nurse in the medical/surgery unit discovered her young charge was having difficulty breathing, and discreetly pushed the orange Rapid Response Team (RRT) button on a panel in the room.

With that instantaneous motion, the nurse summoned highly-trained paramedics to monitor the patient’s vital signs,

while also viewing their electronic medical record. The call-to-action could have resulted in various actions, including requesting radiology bedside, initiating a transfer, or summoning a doctor.

From day one, The Logistics Center (TLC) at Nemours has worked “like a well-oiled machine,” said Daniela Melendez, nurse manager for TLC’s Clinical Operations Center at Nemours.

Another example of TLC in action: (CONTINUED ON PAGE 4)

Taking the Next Step UCF COM charter class students prepare for residency; William Kang follows family’s footsteps

By LyNNE JETER

On Match Day, William Kang stood with 35 fellow charter class students at the University of Central Florida (UCF) College of Medicine in front of an overhead banner, where gold-glittered clothespins held sealed white envelopes. The same ceremony was taking place March 15 at 12 p.m. EST among 40,000 medical students nationwide.

Each envelope held a letter telling them where they had placed. As the medical school clock tower struck

William Kang with his “adoptive” parents, David and Judy Albertson, on Match Day.

noon, the students, their families, donors, faculty and staff began counting down from 10. At “1,” students tore into their envelopes to get the news.

Except William Kang, who handed his envelope to his Orlando adoptive parents, David and Judy Albertson.

“After they opened it, they smiled. They knew I was going home,” said Kang, a 31-year-old professional violinist, who was assigned to Ochsner Clinic in New (CONTINUED ON PAGE 6)

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PhysicianSpotlight

Terry Mamounas, MD, MPH

Medical Director, Comprehensive Breast Program, MD Anderson Cancer Center

By JEFF WEBB

ORLANDO - Whether he is wielding a stethoscope at his full-time job, or a paintbrush at his full-time hobby, Terry Mamounas is doing what he loves. And, much to the delight of his boss, he’s doing it in Orlando.

“I’ve known Terry 20 years. We sort of grew up together,” said Mark Roh, president of MD Anderson Cancer Center Orlando, noting that he and Mamounas have “had a lot of overlap” in professional organizations like the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the American Society of Clinical Oncology.

So, perhaps it is not surprising that when Roh was looking for a colleague to lead MD Anderson’s Comprehensive Breast Program, he turned to Mamounas.

“I went after him,” said Roh. “We had a great need here and Terry has the fire in the belly, the experience, the connections and the personality that fit perfectly” with Roh’s vision for this approach to cancer care and research, he said.

Mamounas arrived in January to be medical director of the breast program, which combines the expertise of more than a dozen medical specialties to treat and assist breast cancer patients from the day of diagnosis to the last follow-up appointment, and hopefully remission.

Mamounas said the team already has more than 15 physicians and that number is growing. Their specialties include surgical, radiation and medical oncologists, plastic and reconstructive surgery, genetics, pathology and clinical research. Others services available in the breast program physical rehabilitation, nutrition, counseling and complimentary/alternative therapies.

“This is a great program that is truly comprehensive. The physicians are very collegial and work well together,” said Mamounas, whose diverse experience is steeped in clinical research at teaching institutions. “I’ve worked in university systems, but the depth and width of the program here is tremendous. It really is larger and more comprehensive than you might expect in a specialty care center,” he said. “It really does parallel other major cancer care programs in bigger cities in the United States.”

Roh explained that the key to this effort is patient-centered. “On every level, day to day, it’s how we treat the patients and put them into the process so we can begin therapy in a quick, efficient and effective manner,” Roh said. “All the docs come to the patient, not the other way around. It’s a little overwhelming, but then again, having cancer is overwhelming. The patients really like (the way the program is organized). They get their treatment plan

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and strategy. And the docs are talking about their specific case, sharing information,” said Roh, adding that usually it is only 7-10 days from the time of diagnosis to the beginning of therapy. The feedback from patients, he said, has been “how refreshing and emotionally comforting it is to have their treatment expedited.”

Mamounas brings not only a world of experience, but a world view, to his new job.

A native of Athens, Greece, Mamounas, said he excelled in academics and also was high jumper for the Greek National track and field team. His parents were able to provide him with private school education and enroll him in several out-of-school educational activities, such as foreign languages, music lessons and painting lessons, he said. A 5th-grade art teacher began to teach him English and cultivated Mamounas’ existing love for painting. “It has been a great source of relaxation and fun for me.

It almost became my career choice as I was graduating from high-school (first in his class) and trying to choose my path, but my love for medicine won,” he said.

Along the way, he became fluent in French and even considered attending medical school in France. Instead, he enrolled at the University of Athens Medical School and earned his MD in 1983. During that time he had the opportunity to come to the U.S. for a surgical rotation at a Yale

University-affiliated hospital in Connecticut. “I was exposed more to patients than I was in Greece and had the opportunity for more clinical work. I was so fascinated I had to come back here,” he said.

During a surgical residency in Pittsburgh and while attending the Graduate School of Public Health for a Masters in Epidemiology, Mamounas met and eventually worked closely with a pioneer in breast cancer research, Bernard Fisher,

MD. “Dr. Fisher’s research, from his laboratory experiments to the conduct of major randomized clinical trials, revolutionized the way we understand and treat breast cancer. ... To say (Fisher) defined my career path is an understatement,” he said.

After working as a research fellow in Fisher’s lab and clinical research group (the NSABP) for two years, and after completing a surgical oncology fellowship at Roswell Park Cancer Institute in Buffalo, N.Y., Mamounas returned to the University of Pittsburgh to work again with Dr. Fisher and the NSABP. In 1997, he became director of the Breast Care Center at Mt. Sinai Hospital in Cleveland, and was elected chairman of the NSABP Breast Cancer Committee, “a position that I still hold today,” he said.

In that capacity, Mamounas said, he has had “the opportunity to play an important role in the development and implementation of many of the NSABP national clinical trials for breast cancer.

These trials have contributed considerably in shaping the paradigm of breast cancer biology and treatment.”

Mamounas said his experience in Florida “has been great.” After spending the past 29 years in Pittsburgh, Cleveland and Buffalo, he and wife Lisa, a retired nurse and mother of their three grown (CONTINUED ON PAGE 5)

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High-Tech TLC, continued from page 1 a young boy with chronic kidney disease (CKD) had been at Nemours for several days when paramedics noticed the Phillips cardiac monitor began displaying arrhythmias. A physician completed a quick bedside assessment and ordered labs, which showed a high level of potassium, a common side effect in CKD patients. Medication was administered to bring down the patient’s potassium level.

“No pediatric hospital in Florida has a facility like this one,” said Melendez. “Some adult facilities have remote monitoring with video capability for adult ICUs monitored by physicians. Our facility is pediatric-spe-

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cific. It’s amazing!”

TLC is located inside the new academic, freestanding children’s hospital that opened Oct. 22 in Lake Nona Medical City. The 137-bed children’s hospital – the total number of beds will top 250 when the second phase is completed – houses critical care services including 10 PICU beds, 13 NICU beds, and expansion for up to 46 ICU beds on the third floor.

“The basic idea of TLC is like a command (center) you’d find at an airport or on

a cruise ship,” said Al Torres, MD, chief of critical care and medical director of clinical logistics for Nemours. “Besides communication and security, which are obviously very important to the hospital, we also have clinical logistics so every child is monitored. We have highly trained para-

medics who watch the children 24/7 and act like the eyes and ears for nurses when they’re not with patients.”

The creation of TLC was made well before the hospital was built. “Our leaders wanted to make a huge difference, and by not making TLC remote and also by adding the clinical logistics backup component, they did just that,” said Melendez.

Nicole Johnson, RN, MSN, director of emergency room services for clinical logistics, explained that many organizations claim a central information hub.

“This (particular) concept is revolutionary for healthcare,” she said. “We’re taking info from all over hospital into one place, integrating it through technology, and pushing it back to the bedside nurses to help them provide better care. When children come into a hospital, depending on their vital signs and diagnosis, clinical logistics will look over them a little more carefully.”

Alerts outside predetermined parameters go to a nurse’s handheld device. If the nurse is in the middle of a task, such as starting an IV on a patient, clinical logistics will activate their protocols to involve other medical professionals.

“Our EMR incorporates lots of information – lab work, patient history, specialty clinic reports – that paramedics can see by signing into one area. It has the ability to pull data from the patient’s record and display it in a way that makes it easy to follow, spot trends, and identify problems,” said Torres. “It’s going to revolutionize the way we provide healthcare in Florida.”

When Melendez gave a presentation of TLC’s capabilities – and its potential outside the medical/surgery unit – as a safety mechanism for pediatric patients to the Family Advisory Council, one of the first remarks was, “Oh, so I’m going to be videoed all the time?”

“I clarify that no, the only time video is turned on in the room is when the child’s health is in danger,” she said. “It’s not a situation where Big Brother is watching all the time.”

Torres has been impressed by TLC’s effectiveness.

“It’s nice to know when I’m not here, someone’s watching,” he said.

Melendez, a mother of 10-year-old Amber and 5-year-old Jorge (pronounced George), who has asthma complicated by allergies, said she’s relieved to know TLC has a bird’s eye view.

“We’ve not had to be admitted yet for my son’s asthma, but I imagine our luck will run out one of these days,” she said. “If he’s here, he’ll absolutely be in great hands.

TLC will never replace nurses or the human touch. It’s just another way to make sure the kids we’re caring for are safe and getting the best care. Everyone would be taking part in their safety and care, and I don’t see how with this plan anything could be missed.” orlandomedicalnews

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IT Acceleration

MedEvolve finds ‘sweet spot’ niche providing PM and EMR software and RCM services to physician practices nationwide

By LyNNE JETER

LITTLE ROCK – When Bill Hefley, MD, was a junior partner at a Little Rock orthopedic practice more than two decades ago, he was tasked with choosing a new information technol- Dr. Bill Hefley ogy (IT) system to replace an antiquated one. After completing due diligence on various options, he played it safe and purchased a new system from the nation’s largest vendor.

“It was a complete disaster,” recalled Hefley, noting the software was different than the demonstration version, the trainer was “preoccupied and disinterested,” and customer support was practically non-existent. “Our practice collections soon approached zero. I knew there had to be a better way.”

A hobbyist computer programmer, Hefley devoted his energies to filling the void in the marketplace. From it, he established MedEvolve as a truly collaborative industry partner to solidify the IT backbone of medical practices. The success of MedEvolve’s practice management (PM) software – it not only organizes patient databases, scheduling and billing, but also allows extensive data reporting – led to the launch of its revenue cycle management (RCM) division. In a fairly crowded field of

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With specialization, scale, and great software, we’ve been able to produce some of the best results in the industry – 97 percent first-pass claims success, 27 percent average increase in practice revenue and a 38 percent average reduction in accounts receivable days…

- Bill Hefley, MD, President and CEO of MedEvolve.

’’

practice management software companies, MedEvolve stands out not only in software performance, but especially in a vital yet often overlooked area – customer service.

The Drawing Board In searching for a better solution in the early 1990s, Hefley connected with Pat Cline, president of Clinitec International Inc., then a startup company based in Horsham, Pa., and a pioneer in the emerging field of electronic medical records (EMR).

“Intrigued, I became an early investor and a development partner focused on orthopedic clinical content,” he said, noting that a small public company acquired Clinitec, which became known as NextGen

Healthcare, now one of the world’s leading healthcare IT companies. Hefley, an orthopedic specialist in minimally invasive surgeries for the knee, hip and shoulder using arthroscopic and joint replacement procedures, became a development partner with NextGen in 1994, working on the development of clinical content for orthopedists.

“By 1997, I felt opportunities still existed in the physician PM software industry. While most physician practices were utilizing computerized billing and scheduling, the available systems were DOS- or Unix-based and not taking advantage of the Windows GUI interface, much less the Internet. More importantly, healthcare IT vendors in the physician sector remained notoriously atro-

cious in delivering support and customer service. I frequently heard my physician friends and colleagues recount horror stories of flawed software systems with dismal support that were making it impossible to run their practices successfully. I remembered my personal bad experience with the large national vendor and the stellar reputation of a small local firm, MBS (Medical Business Services Inc.), which I’d also checked out.”

In 1998, Hefley and Steve Pierce of MBS, a 9-year-old IT firm with a mature DOS-based PM software product, founded MedEvolve with the vision of becoming the first Windows-based physician PM system that employed the Internet and delivered impeccable support and customer service.

“My practice became the beta site for the first version of our new Windows-based PM system,” recalled Hefley, MedEvolve’s president and CEO. “We began to sell our product regionally initially and eventually throughout the United States. We integrated our PM product with several specialty-specific EMR systems to reach more physician practices. We continually worked to upgrade the software and deliver new, innovative functionality. By our tenth year, we had several thousand users nationwide.”

With the success of MedEvolve’s PM product, Hefley recognized a growing need among physician clients for expertise in RCM. “Physicians were struggling with in(CONTINUED ON PAGE 6)

PhysicianSpotlight

Terry Mamounas, MD continued from page 3 children, just enjoyed their “best winter ever in the U.S.,” he laughed. And the scenery is an inspiration for his painting, said Mamounas, 55.

“The lakes, the palm trees, sunsets, sunrises and the ocean, of course,” appeal to his talent as a landscape artist, although he also does still-lifes and portraits, he said. Much of his 100piece portfolio as a painter is in oils, but Mamounas said he has shifted toward watercolors in the interest of time and portability. He donates much of his artwork, he said, and hopes to one day have a solo exhibit, or perhaps even earn an art degree when – and if – he retires.

But for now, as it has been for the past quarter-century, his future is clinical research in breast cancer. “It is a passion I will continue to pursue ... and the continuous improvement in outcomes and quality of life of my breast cancer patients will drive my efforts at MD Anderson Orlando,” he said.

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Taking the Next Step, continued from page 1 Orleans, where his twin brother, Thomas, had completed surgical training. “The Albertsons really have been like surrogate parents to me. It seemed appropriate for them to open the envelope.”

Match Day represents the last major hurdle for medical students before graduation on May 17 and the start of their medical careers.

“I’m happy with our match results,” said Deborah German, MD, vice president for medical affairs and founding dean of the College of Medicine. “Our students reached for the stars in pursuing their dreams. They’ll continue their training in Florida and across the nation representing Central Florida as the first group of UCFeducated physicians.”

UCF College of Medicine seniors were selected from 4,307 applicants received before the school was opened and accredited.

The local community contributed more than $6.5 million to fund full scholarships for every student in the class of 2013, making UCF the first medical school in U.S. history to provide full scholarships to an entire class. The scholarships covered $160,000 for tuition, fees and living expenses for all four years of medical school.

The UCF College of Medicine also connected students with local families. For example, Kang met the Albertsons, a philanthropic couple known for volunteerism, at the White Coat Ceremony in 2009.

Happy UCF COM seniors on Match Day

“Throughout medical school, they’d take me out to dinner and ballgames, and heard me play a couple of times,” said Kang. “I appreciated that.”

Kang’s journey to medical school began later than traditional students. The son of Young Hee Kang, MD, a family practice physician in Welsh, La., and Young Bin Kang, MD, a retired family practitioner in Iowa, La., Kang and his twin brother grew up in rural Jefferson Davis Parish. From an early age, the twins accompanied their parents as they made nursing home rounds on the weekends, William on the violin and Thomas playing the piano.

“We’d play something to cheer them up,” he said. “It was part of our lives, and of course, we played Christmas music for

everyone during the holidays. We try to get back once a year to keep it up.”

After college graduation, Thomas Kang went straight through medical school and is now a general surgeon in Zachary.

William Kang earned a master’s degree in Cleveland, Ohio, and worked with symphonies in New Orleans and Tampa.

“I heard about UCF and luckily got it,” he said, noting that he was the last of four children to earn a medical degree.

His 8-years-older sister, Jane, is a psychiatrist; his 5-years-older sister, Nancy Kang Davis, is a pathologist.

Kang chose to specialize in orthopedic surgery because “I admire people with great hands, from musicians to surgeons. I appreciate how skillful people can be with

their hands. It was inevitable that I’d pursue it,” he said.

Even though he’s thrilled about completing his residency near his family, Kang would like to return to Central Florida to practice medicine.

“I moved to Florida for work and love it here,” he said. “In a perfect world, I’d dream of returning here to teach school.

But who knows where life will take you?”

Editor’s note: Next month, we’ll visit with Deborah German, MD, vice president for medical affairs and founding dean of the College of Medicine, about the first four years, graduating the charter class, and what’s ahead.

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creasingly complex third-party payor systems, growing documentation requirements, mounting government regulations, and threats of audits, fines and imprisonment,” said Hefley. “Practices were searching for a partner with expertise in these areas that could relieve them of the burden of constantly attempting to stay abreast of the ever-changing rules and regulations.

Physicians wanted to focus on the practice of medicine and leave the headaches to people that specialized in those matters.”

MedEvolve developed an RCM division, acquired three small RCM companies, and now has a division that includes experienced practice administrators and dozens of billing and coding specialists.

“With specialization, scale, and great software, we’ve been able to produce some of the best results in the industry – 97 percent first-pass claims success, 27 percent average increase in practice revenue, and a 38 percent average reduction in accounts receivable days through MedEvolve RCM services,” he said. “By switching to MedEvolve’s RCM service, providers immediately experience less hassle, lower costs and increased revenue that result in an improved bottom line and peace of mind.”

Health Reform Impact The 2009 American Recovery and Reinvestment Act (ARRA) authorized the Centers for Medicare & Medicaid Services (CMS) to award incentive payments to eligi-

ble professionals who demonstrated Meaningful Use of a certified electronic health record (EHR) system.

“With the new criteria defined, MedEvolve saw a need for a modern EHR product designed from the ground up to meet Meaningful Use mandates and finally deliver on the industry’s promise of a cutting edge, customized solution that helps practices save time and money and improve the quality of patient care,” said Hefley. “The resulting MedEvolve EHR is fully integrated with the MedEvolve PM system and is designed for the high volume practice with an emphasis on fewer clicks, fewer screens, faster data input and faster data retrieval.”

Hefley has placed a strong emphasis on customer service as the bedrock principle of MedEvolve. It’s not just a catchy slogan; he rewards employees for “outrageously excellent customer service” with WE (Whatever, whenever, Exceed expectations) awards.

The WE Award comes with a cash bonus and a new title on the employee’s email signature. As a result, employees strive to achieve the distinction of a “Four-time Recipient of the MedEvolve WE Award.”

“In the software business, that means several operators are at the ready for periods of peak call volume,” he said. “We maintain support-to-client ratios above the industry norm. We design our software to be intuitive with online help so that less support is necessary. In the RCM division, we work claims as much as necessary to ensure

our providers are fully paid for the services they’ve performed. We’re not some detached, impersonal entity; we partner with the practice in achieving their goals.”

Today, MedEvolve offers PM and EMR software and RCM services to physician partners, and also electronic prescribing, data analytics and other ancillary products and services. With four offices, the company covers all specialties and the entire United States, from solo practitioners to practices with more than 50 physicians. Commitment to service has garnered MedEvolve a reputation of trust among physician partners, allowing the company to rise above the scores of small physician IT companies nationwide.

By year’s end, MedEvolve will outgrow its new corporate headquarters in downtown Little Rock, a refurbished red brick bakery built circa 1919, necessitating yet another expansion.

“We’re now in that sweet spot where we have the expertise and resources to meet our clients’ every need, and yet we remain nimble and able to move quickly in a rapidly changing healthcare environment,” he said. “We’re proud to be privately held so that we aren’t a slave to our stock price and quarterly reports, but rather free to do what’s right for our client. Our foremost concern remains the principles upon which the company was founded – elegant, user-friendly software and unparalleled customer service.” orlandomedicalnews

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Succession Planning How to concoct a good exit strategy

imize gains in these areas depending on your corporate goals – max dollars from a sale in three years – versus personal goals – wanting to maintain the company and minimize the estate gap.”

By LYNNE JETER

In uncertain economic times, planning for the future – retirement, selling a company, or transitioning a family business into the next generation – is critical to maintaining financial stability in a medical practice.

Despite industry projections reflecting that half the nation’s active doctors will reach traditional retirement age by 2020, and physicians typically live into their early eighties, very few practitioners are succession ready.

Plan Ahead Plan years in advance to mitigate risks associated with succession planning.

“The earlier, the better,” said Ted Sheppe, senior vice president and commercial banking ex- Ted Sheppe ecutive for Fifth Third Bank (Central and North Florida affiliate).

“One to three years is short and the bare minimum. Sometimes, depending on the complexity of the issues at hand, it can be 5 to 10 years in the making.”

Why? The legal, financial and tax implications of succession planning can be extremely complex, based on the organizational structure of the business, composition of ownership, and whether the business will be sold to employees, a third party, or transferred within the family.

Trying to resolve issues just prior to a sale or transfer is virtually impossible to do properly. There’s too much value at stake,” said Sheppe. “You should start early and over the years make changes as the business evolves. It’s not unusual to start down one path and then course correct as conditions change. As an example, by starting earlier, you’re able to diversify the business, which can add significant value. And if competitive landscape changes, you can be prepared to move quickly … whether your goal is to sell, exit, acquire or grow. Without early planning, and on-going maintenance of that plan, it will be more difficult to achieve your goal.”

Find the Right Wealth Management Advisor Accountants and attorneys often recommend involving a wealth management advisor to the succession team to provide critical financial planning advice prior to the business transition.

“A wealth advisor can identify and help rectify potential issues that result in significant estate tax savings and help avoid potential conflicts between family members,” said Sheppe. “If the goal is to sell the company, business owners need to work with someone savvy in their industry. This has many advantages, including having the network and inside knowledge to take that business to the correct potential buyers.

Having a bank with specialty in the healthcare industry, for example, will help docorlandomedicalnews

.com

Succession Planning Involves Determining How One Will Transfer Wealth To The Future Generation.

“That game plan changes frequently, depending on life events,” explained Ted Sheppe, senior vice president and commercial banking executive for Fifth Third Bank (Central and North Florida affiliate). “For instance, a 35-year-old with young kids should make sure they have very good insurance coverage. Once children are through college and the company matures, the focus should turn to the next step – succession planning. Anyone who owns a company should be thinking about the long-term position of their business.”

tors better understand the process and may bring major players in the industry to the table to garner maximum dollars possible.”

Ask about the Money Succession planning isn’t very expensive. Compared to the value created, the process becomes quite affordable.

“Providing solutions could get expensive, but doesn’t need to be,” explained Sheppe. “Imagine having a lawn overgrown with weeds and vines. The longer you let it go, the tougher and more expensive it’ll be to get it back into shape. But if you maintain it, the incremental investments are much smaller. Depending on how active you are with managing personal affairs, it could be simple adjustments, but if we undo years of neglect, it can potentially grow into a complex and intensive project.

The bottom line is start early and maintain often – you won’t regret it.”

Be Candid According to the Institute for Family Business, about one-third of family businesses survive into the second generation.

Roughly 12 percent remain viable into the third generation. Yet only 3 percent operate into the fourth generation or beyond!

“From what I’ve seen, you usually have a founder with a strong entrepreneurial gene who has created an idea or product,” said Sheppe. “They then build a company around it. In most instances, they hope and pray that the kids share the same entrepreneurial gene and want to continue the family business. However, that’s not always the case.”

Even though it’s rare, sometimes children come into a family business with the energy and talent -- matched with an entrepreneurial gene – to improve it.

“If handing the business off to a

family member isn’t in the cards, you still have other options for the business to flourish,” said Sheppe. “You can find talented components, such as hiring a professional CEO, and build the company/infrastructure around it. For some, this might be a better route, but then one must consider how to build an estate instead of counting on the business.”

Cover the Bases Having business partners makes it even more important to have a plan in place so all parties are prepared for succession, noted Sheppe.

“With partners involved, it can be very complicated,” he said. “It’s incredibly important to have candid conversations with them in a business to discuss what would become of a company if something unfortunate happened to one of its owners. Sometimes, the business has to be sold to cover estate taxes if a partner dies. Stakeholders in multi-physician practices need to be prepared. What happens if one of them leaves, dies or is injured?”

Therefore, having the right insurance program, including life and disability coverage is a critical component to a succession plan.

“Injury, as opposed to death, is a higher risk, higher probability scenario for many,” explained Sheppe. “For instance, a surgeon who hurts his hand won’t be able to perform his job.”

Reconcile Goals “Have a realistic picture of what your company’s worth if you’re considering selling it,” said Sheppe. “Going through an advisor can help develop a capital strategy plan based on the end goal. It’s important to get a true valuation of company.

Business owners need experts to help max-

Pay Attention to Trends Right now, hospitals are snapping up physician practices.

“Physicians Associates recently sold to Orlando Health, an example of this (consolidation) trend playing out locally,” said Sheppe. “I see this trend continuing and physicians should be proactive to maximize their transaction by starting to plan early. If practitioners are thinking about selling to a hospital and they haven’t gone through the process of succession planning and business positioning, they need to now.”

Be a Good Client Avoid the frequent phrase: “I’m too busy.”

“Estate and wealth planning deserves high priority and can be very risky should you leave it uncared for,” said Sheppe. “We help them think through it, but we bring solutions to the table so they don’t have to figure it out by themselves. Some might believe the process of facing one’s mortality and putting a plan in place is uncomfortable … but at the end, they’re always relieved.”

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Gearing Up for the Alzheimer’s Burden Orlando providers discuss challenges in research, legislative advocacy SAVE-THE-DATES

By LYNNE JETER

The statistics for Alzheimer’s disease in Florida are staggering.

The sunshine state houses the nation’s second largest population of patients suffering from the devastating malady for which there is no cure.

The University of Michigan Health System and RAND estimates it as the highest-cost disease for care. A 2011 MetLife study estimated that wage losses incurred by caregivers, who are usually in their prime earning years at the time they’re needed, average more than $300,000.

“As the percentage of elderly Americans rises, so does the number of people with Alzheimer’s disease,” said Mariana B. Dangiolo, MD, a board-certified family physician specializing in geriatric medicine at UCF Pegasus Health. “Because Florida is a state highly favored for retirement, we get not only the effect of the aging of our longtime residents, but also we get an additional influx of elderly citizens due to retirement.”

Even though Alzheimer’s disease attracts publicity, Dangiolo said it’s doubtful that the state is fully prepared for the “double whammy” effect of an aging

population, combined with the inflow of elderly residents, all of whom are living longer.

“We feel that new and innovative strategies are needed to care for the increases in patients with Alzheimer’s disease,” said Dangiolo, also an assistant professor of clinical sciences and director of the geriatrics and palliative care curriculum at the UCF College of Medicine at Lake Nona in Orlando.

declines, Alzheimer’s deaths continue to rise, increasing 68 percent Alzheimer’s Association-Central & North in the first decade of this century.

Florida Chapter Fundraising Events: Without the development of medical breakthroughs that pre• May 22: vent, slow or stop the disease, anaReason to Hope Orlando lysts have anticipated the number of Interlachen Country Club 2245 Interlachen Court people with Alzheimer’s disease by Winter Park, Florida 32792 2050 could reach 16 million, and in11:30 a.m. – 1 p.m. crease healthcare costs related to the disease could rise by 500 percent to Walk to End Alzheimer’s®: $1.2 trillion.

• Sept. 7: Flagler County and Ocala “Unfortunately, today there • Sept. 21: Fernandina Beach and the Space Coast are no Alzheimer’s survivors. If you • Oct. 5: Tallahassee, Vero Beach and Volusia County • Oct. 19: Gainesville have Alzheimer’s disease, you ei• Oct. 26: Orlando ther die from it or die with it,” said • Nov. 16: Jacksonville Alzheimer’s AssoSOURCE: Alzheimer’s Association-Florida Chapter. ciation CEO Harry Johns. “Urgent, meaningful action Earlier this year, the national Alis necessary, particularly zheimer’s Association published new as more and more people recommendations for primary care phyage into greater risk for sicians on how to assess cognition during developing a disease that Harry Johns the Medicare annual wellness visit. Soon today has no cure and no after, the 2013 Alzheimer’s Disease Facts way to slow or stop its progression.” and Figures was released, revealing that The burden of Alzheimer’s disease one in three seniors dies with Alzheimer’s so strains the nation’s healthcare system or another dementia in the United States. and government programs that President Even though deaths from other major disBarack Obama spoke of the need for “ineases continue to experience significant (CONTINUED ON PAGE 12)

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Pay or Play … What Makes Sense for Your Company?

Preparing for the Affordable Care Act Implementation in 2014

By CHARLES EGERTON

When it comes to health benefits, the rules are about to change dramatically for companies with 50 or more full-time employees. The so-called “employer mandate” of the Patient Protection and Affordable Care Act (ACA) includes so-called “pay or play” regulations, which will soon begin imposing significant penalties on those who fail to offer “adequate and affordable” health insurance coverage.

Understanding the Penalties After December 31, 2013, ACA provisions levy penalties on “applicable large employers” – those with more than 50 full-time workers – that don’t offer employees and their dependents the chance to enroll in a minimum essential coverage health plan. The fine for noncompliance is $166.67 per month per employee, except for the first 30 employees. For a business with 60 employees, the penalty would add up to $5,000 each month, or $60,000 each year, beginning in 2014. And a 600-per-

son company that failed to comply with the law would be fined $95,000 a month, or $1.14 million a year.

Penalties are even less forgiving when it comes to the “affordable” aspect of the law, which prohibits the cost for coverage to employees from exceeding 9.5 percent of their household income. Employers that don’t offer a “qualified health plan” and premium assistance to employees to keep their cost below 9.5 percent will be subject to this penalty. The fine is $250 per month, multiplied by the total number of full-time employees who buy coverage through a Health Insurance Exchange (not just those in excess of the first 30, as with the other aspect of the law). In other words, if your company attempts to offer a plan, but it doesn’t measure up to federal standards – the penalty can be as much as $3,000 per employee. This second penalty cannot exceed the total amount of the first penalty.

Both of the law’s penalty provisions will be adjusted for inflation each year.

The ACA penalties that go into effect next year can represent a significant cost

Penalties are even less forgiving when it comes to the “affordable” aspect of the law, which prohibits the cost for coverage to employees from exceeding 9.5 percent of their household income. for a business of any size. But since offering health insurance is typically more expensive than that, some businesses are considering whether to simply pay the fines. As a financial professional, how should you advise your company … pay or play?

Evaluating Your Company’s Standing as an Employer The first step is to determine whether the federal government will regard your organization as an “applicable large employer.” Your company is exempt from the law if it has less than an average of 50 full-

time employees. But defining a full-time employee is complicated; especially for companies that employ lots of part-time or seasonal workers.

Simply put, according to the ACA regulations, a full-time employee is one who works an average of at least 30 hours per week. This news won’t come as a shock to many human resources professionals, who have long used the 30-hour mark as a litmus test for determining whether an employee was considered full-time and eligible for healthcare coverage. But beginning (CONTINUED ON PAGE 12)

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Pay or Play … What Makes Sense, continued from page 11 in January 2013, companies must also take into consideration the average amount of hours logged by all workers within a calendar month. The statute requires businesses to determine their number of “full-time equivalent” employees. To get this figure, add the hours of all of your company’s part-time employees and divide by 120, or a month’s worth of hours for one full-time employee at 30 hours per week.

This provision was included to prevent businesses from trying to circumvent

the law by cutting their employees’ hours to less than 30. Similarly, the ACA prohibits companies from subdividing their business into separate companies to create the appearance of multiple employers with less than 50 full-time workers. The law was written so no matter whether companies “pay or play,” they must play fairly.

Weighing the Options If you establish that your company is affected by the ACA regulations, you must

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then weigh the consequences of either offering healthcare coverage that complies with the law or paying the penalties. From a fundamental business standpoint, many organizations would certainly save money by paying $2,000 per full-time employee rather than offering employee health benefits. But there are intangible considerations – such as employee relations, morale among workers and the company’s public image – which must be evaluated.

The bottom line? This is a complex

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vestments in science and innovation,” with specific reference to Alzheimer’s disease, in his inaugural second-term State of the Union address.

“With baby boomers reaching the age of elevated risk, we don’t have time to do what we’ve always done,” said Robert Egge, vice president of public policy for Robert Egge the Alzheimer’s Association. “The National Institutes of Health needs to reset its priorities and focus its resources on the crisis at our doorstep, and Congress must fully fund implementation of the National Alzheimer’s Plan to solve the crisis.”

Recently, Johns outlined a clear case for increased resources to address the Alzheimer’s epidemic at a recent hearing of the Subcommittee on Labor, Health and Human Services, Education and Related Agencies Committee on Appropriations. He pointed out that even though the National Alzheimer’s Project Act that was passed unanimously with bipartisan congressional support in 2010, the first National Alzheimer’s Plan has been developed and submitted to Congress — consistent with the goals established by the National Alzheimer’s Project Act, with the promise of important progress when fully implemented. However, to achieve the plan’s ambitious goal to prevent and effectively treat Alzheimer’s disease by 2025, smart commitment of resources must be made.

“Having a plan with measurable outcomes is important, but unless there are resources to implement the plan, we cannot hope to make much progress,” he said. “If we’re going to succeed in the fight against Alzheimer’s, Congress must provide the resources the scientists need.”

Nationally, industry leaders have also discussed disappointment that the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) panel doesn’t believe adequate evidence exists to determine whether PET imaging of brain beta amyloid changes health outcomes, and urged the Centers for Medicare & Medicaid Service (CMS) to review (CONTINUED ON PAGE 13)

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Gearing Up, continued from page 12 the evidence and make a positive determination about coverage.

“In Florida, we’re making advances toward earlier detection of Alzheimer’s, greater knowledge of dementia risk factors, and better treatments and prevention,” said Stephen A. Berman, MD, PhD, a board-certified neurologist with a special interest in the neurodegenerative diseases of aging who also practices at UCF Pegasus Health.

A few examples of ongoing Alzheimer’s research in Florida: • At UCF, a research team led by Kiminobu Sugaya, PhD, continues to make progress on neural stem cells by discovering a factor that helps them differentiate into neurons.

• At the University of Florida, Kelly Foote, MD, and Michael Okun, MD, are testing deep brain stimulation on Alzheimer’s disease patients.

• Significant research and “a lot of hope” in immunotherapy lies with intravenous immunoglobulin (IVIG), said Berman.

• Improved imaging technologies and updated diagnostic guidelines are enabling the detection of early changes in the brain that are consistent with what is now known as presymptomatic (or preclinical) Alzheimer’s.

• EVP-6124 is an experimental symptomatic drug with a different mechanism of action than the current FDA -approved Alzheimer’s drugs, which showed statistically significant benefits on two well-established measures of memory, language, attention and other cognitive abilities.

• Several new studies suggest a relationship between sleep quality and quantity and risk of cognitive decline, and also gait and balance impairment and dementia.

“There’s enough evidence that exercise training improves mental functioning and reduces risk for cognitive impairment and dementia,” explained Berman, an assistant professor at the UCF College of Medicine. “These new studies begin to clarify exactly which types of physical activity are most effective, how much needs to be done, and for how long. In particular, where previous research showed positive associations between aerobic activity, particularly walking, and cognitive health, these reports suggest that resistance training is emerging as particularly valuable for older adults. It’s generally accepted that regular physical activity is essential to healthy aging; it also may prove to be a strategy to delay or prevent the onset of cognitive impairment and dementia.”

At UCF, a chapter of the Society of Neurosciences was recently established, and a talk on Alzheimer’s disease by Dangiolo and Berman is planned, but a date has not yet been set.

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McDonald’s Corporation Rocked by Poor Customer Service Ratings Could your practice be a McDonald’s?

By ERIN SOMERS

Good help is hard to find regardless of what type of business you are in. But in today’s economy, even McDonald’s is having major trouble finding employees who can give good, strong service with a smile. Twenty percent of their complaints were related to worker’s attitudes and the number is increasing. As a medical consultant who visits more than thirty offices per week, I have found that too many practices have become the “McDonald’s” of medicine when it comes to how they treat their patients. Some of the things I have seen would knock your socks off (and not in a good way.)

Among the practices with these staffing challenges, some do recognize that there are customer service issues within their practice but many others have absolutely no clue. Either way these issues will cost patients and income if they are not

rectified, because strong customer service is vital.

(Let me hop in and tell you that I don’t like to call patients “customers.” They are patients. However to make my point, it is easier to use the term customer service.)

In the survey that hammered McDonald’s, rude or unprofessional employees topped the list of complaints. In another survey of the Top 10 food chains, McDonald’s came in last in the “Friendly, Pleasant Service” category. McDonalds’ has a major problem and they know it.

As medical professionals, we are here to help, heal & serve. Is your team serving your patients with kindness, efficiency and professionalism? These traits are more important than ever in today’s difficult times, as Central Florida has been hit especially hard during this global recession. We need to be aware and we need to be kind in our dealings with our patients. On the business side, patient retention is especially

imperative in this challenging economy. If your team isn’t treating your patients well, they will go to your competitor where they will be welcomed and cherished.

How strong is the customer service at your practice? As a CEO, office manager or managing physician do you honestly know? Customer service starts when your patient (or potential patient) calls your office inquiring about an appointment. A high quality of care and service must be maintained throughout the patient’s visit.

Your team is only as strong as its weakest link. This weak link could be your schedulers, front desk, MA’s, billers, checkout or even your providers! Yes, I said even your providers!

Within the medical practices that I consult for and train, all the physicians, ARNPs & PAs know that their bedside manner matters. They know that they need to have a smile on their face and warmth in their voice during their patient

exam. When I promote my clients I assure the referring offices that their patient will receive great patient care with compassion.

No patient should have to put up with an employee with a bad attitude or a doctor who is arrogant and uncaring. I don’t care how good they are supposed to be, there are always other excellent providers to choose from.

Also remember that when you refer out to another physician, the quality of their practice is a direct reflection on yours. If your patients are coming back with complaints regarding a doctor or the customer service of the facility you referred them to, listen to your patient. There may be something going on that you need to be aware of.

So here is the million dollar question: (CONTINUED ON PAGE 16)

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Are You Ready For Some Money?

Yes, there is money out there in the form of Medicare and Medicaid incentives!

By CAROL CARPENTER

Okay, so what’s the catch? Meaningful Use. By now most providers, and their staff, are quite familiar with this term. Meaningful Use is a set of criteria established by CMS that must be met using a certified ERH (electronic health record) system in order for eligible providers to receive incentive payments.

The ultimate goal of Meaningful Use is to improve patient care and most providers are already meeting most of these quality standards. It is now a question of recording these measures as structured data and providing CMS with the results via an online “attestation.”

Meaningful Use criteria is the same whether a provider is going for the Medicare or Medicaid incentive. There are 10 Core Measures all of which must be met and 10 Menu Measures of which 5 must be met. Some of these measures do have exclusions that can be claimed. In addition, there are Clinical Quality Measures that must be met. The path to payment, and the payment amounts, however, differ in the Medicare and Medicaid programs.

For Medicare providers, their first year of participation requires a 90 consecutive day period in which they must meet the criteria. Second year of participation requires a full 365 days of meeting criteria.

If their first year was 2011 or is 2012 they can receive up to a total of $44,000 over a 5 year period of time. Their first payment can be up to $18,000 and this is based on 75 percent of $24,000 in Medicare Part B charges. If they do not have a total of $24,000 for the year, they can still receive 75 percent of whatever amount the Part B charges were.

Some providers will not start their first year participation until 2013. This can be due to delayed decision of which certified software to adopt, or delays in implementation and other factors. In this case, their first payment would only be $15,000 and they would lose the last year’s participation payment of $2,000. Starting in 2014 brings total payments down even further, and if they wait until 2015, there is no reimbursement. Most important for Medicare providers to remember is that if they do not achieve Meaningful Use by 2015, there will be a payment adjustment to their Medicare reimbursement of 1% and this payment adjustment increases in

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subsequent years to a maximum of 5%.

In order to avoid the 2015 payment adjustment the provider must attest no later than Oct 1, 2014 which means they must begin their 90 day EHR reporting period no later than July 2, 2014.

The good news for Medicaid eligible providers is that in their first year of participation they need only attest, through documentation, to having a certified EHR in place and they can receive $21,250 in that first year. Subsequent years, they will also have to meet the criteria that Medicare providers must meet in order to receive further payments. Each payment after the initial payment is $8,500 and over a 6 year period of time their total reimbursement can be $63,750.

The Medicaid program is not based

on charges submitted but rather on the percentage of Medicaid encounters within a 90 day period the previous year. In other words, if a provider wants to attest in 2012, documentation must be provided to AHCA showing that in 2011 during any 90 day period, of all encounters, at least 30% were Medicaid. Pediatricians need only have 20%, however, they will only receive a portion of the reimbursement if that is the case. Another difference in the programs is that Medicaid providers do not have to participate every year. They can skip a year without any penalty which is something Medicare providers cannot do. The Medicaid program runs through 2021 so a provider could start as late as 2016 and still receive full reimbursement.

There might have been some hesita-

tion and trepidation at the onset of the EHR Incentive Program. Why should I adopt an EHR? Again, the purpose of an EHR is to improve the quality of patient care. EHRs give one record of a patient’s health information enabling better coordination of health care. The ultimate goal being sharing of data provider to provider and provider to hospital, hospital to provider.

Is the money really there? According to the GAO, spending for the Medicare and Medicaid EHR incentive programs is estimated to total $30 billion from 2011 through 2019. In June the Department of Health & Human Services (HHS) reported that more than 110,000 eligible health care providers had been paid more than $5.7 billion.

The University of Central Florida Regional Extension Center is a valuable resource to help providers achieve Meaningful Use and receive the incentive. Being a member of the REC also provides a myriad of other benefits, but helping you receive the incentive is first and foremost.

For more information please go to our website www.ucf-rec.org.

Now, let’s go grab a chunk of that money!

Carol Carpenter is an account manager at UCF College of Medicine Regional Extension Center.

She can be reached at ccarpenter@ucf-rec.org

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       

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Health Information Technology and the Effect on Public Health

By AMBER BABYAK

Public health involves and affects everyone. From catching the common cold to the onset of a sudden, widespread disease—the health of the public is always an area of top concern. With the implementation of electronic health records, health information exchanges, and other tools of health information technology, the health and well-being of the masses can be positively impacted. Public health concerns communities, small and large, and how to keep them healthy. The integration of this innovative technology can have an effect on the health of such populations through reporting capabilities, connected local health systems, and large-scale connections.

With advanced technology, most specifically electronic health records, healthcare providers have the capability to generate crucial reports almost in minutes.

No longer does valuable information have to be searched for like a needle in a haystack; this needle being possibly life-saving data and the haystack a room full of paper

charts. Suppose a primary care doctor suspects a familiar ailment is present in a number of his or her patients; running a simple query in the EHR may assist in determining if this suspicion can be justified or not.

Moreover, the capability can be utilized further with more detailed reporting, such as searching by age, location, and/or past complications. In the end, the provider has a way to conclude if there is a sickness that is spreading and if action must be taken to control it. More proficient reporting helps to extrapolate data and transform it into information. Of course, different types of reporting mechanisms have been in available in the past. Now, the process has been

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MAY 2013

Amber Babyak is an account manager with the University of Central Florida’s Regional Extension Center which assists in electronic health record implementation. Contact can be made to ababyak@ucf-rec.org.

continued from page 14

STEP 1: Prospect searches

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Public health is no longer confined to your local region but an endless wire of connections. If an outbreak occurs in one state, another state may be able to search for familiar symptoms amongst their patient-base in hopes of halting the spread of an outbreak. Such broad connections can offer earlier detection of shared symptoms/illnesses, more rapid disbursement of information, and offer assistance through extreme and emergency situations. The possibilities are truly endless and this is only just the beginning. The Internet didn’t pop up one day and we were instantly linked like we never before thought we could be but eventually this did become a reality. Hopefully, the same can one day be said for the people’s health.

Our communities and their health and well-being should experience the same benefits that other aspects of life have realized through technology. Health information technology allows for an efficient conversation to take place between a patient’s healthcare providers including amongst those making integral decisions that help keep our communities as a whole safer and healthier. When one patient is healthier, the public is hence healthier as well. Reports can be run to pinpoint a virus that is being spread amongst a specific population, such information is transmitted to the health information exchange, public health officials take necessary steps, and the end-result is a benefit to public health. “An apple a day” is still a good notion, but combining that notion with technology that keeps patients healthy and data that is constantly being transferred amongst health professionals and officials is a prescription for the future.

McDonald’s Corporation,

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simplified and that much more useful.

Health information technology promotes a healthier community; one in which can be notified of common health trends and presented with better care. As health information exchanges come to fruition across the country, so will the concept of health and wellness communities that are connected like never before.

Suppose the caregiver in the previous example does notice similar tendencies among a certain population of their patients; this healthcare giver would then have the opportunity to extract information from a repository of comparable information and make their own contributions. Providers across the area are performing such actions and this shared information can be reviewed on a much larger scale. Officials conclude the public is at risk of this condition and take appropriate action to lessen the consequences of this ailment on their constituents. The response can become much more efficient and timelier precaution measures can be applied. Not only is information being shared, but used. Driving down Main Street U.S.A., one can see it is populated by healthcare offices which means numerous patients are present therefore bringing together insurmountable pieces of data that can be used to benefit these same patients. Data that is by the patients is used for the patients.

The possibilities are endless when it comes to how deeply our health data can be stored and most importantly, exchanged. If the health information exchange formerly mentioned has the opportunity to disperse its information to a state exchange and possibly one day nationally, the possibilities are endless.

With physicians being in clinic and practice managers being so busy, how do you really know what your team is doing when they think no one is watching?

Here’s the million dollar answer….

Mystery Shop your practice.

Mystery Shopping is not a massive financial investment, it’s probably much less than you think. However, your return will be priceless.

When I Mystery Shop for a client, the practice gets a complete report from the time I call to schedule the appointment until I’m out the door after my visit. You receive a full and accurate overview of what is happening with your entire team from start to finish.

Once you get your report you can go from there. It’s your starting point in

straightening out any customer service issues and it will guide you in the right direction for training, reassignment or replacement of any staff member. If you find any “weak links”, know that there are many good medical professionals who are in need of a job and willing to give 100 percent at work.

As for McDonald’s, I wish them good luck as Ronald and company are going to need it.

Erin Somers has a diverse medical background which includes marketing, customer service training, recruiting and more. Marketing is at the forefront of Erin Somers Consulting and her expertise includes increasing revenue for practices and medical companies during these challenging economic times.

Visit www.erinsomersconsulting.com or you can contact Erin at 407-451-9567 or erin.somers@ymail.com.

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GrandRounds Community Health Centers Announces Selection of Officers To The Board Of Directors Community Health Centers, Inc. (CHC) announced the election of officers to their Board of Directors for 2013-2014. Elected officers include: Mercedes Fonseca of Orlando, as Chairperson; Maria L. Rodriguez-Scott of Mt. Dora, as First Vice Chairperson; Pascale Vincent of Ocoee, as Second Vice Chairperson; Richard Reyes of Lake Mary, as Treasurer; Dr. Lauren Josephs of Orlando, as Secretary; and John Sanders of Winter Park, as Parliamentarian.

Current board members include: Ray Schleichkorn of Apopka; Chas Kelly of Orlando; Aracely Robledo of Altamonte Springs; andAdler Labossiere of Sorrento.

John Sanders

Lauren Josephs

Maria RodriquezScott

Mercedes Fonseca

Pascale Vincent

Richard Reyes

Florida Hospital East Orlando Breaks Ground on ED Expansion Surrounded by hundreds of flowers, Florida Hospital East Orlando recently held a groundbreaking ceremony to celebrate the growth of its emergency department. The expansion will double the size of the current emergency department to better meet the needs of the expanding community. As a symbol of the hospital’s roots in the East Orlando area, community and hospital leaders planted 260 flowers to represent the average number of patients seen on a daily basis

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MAY 2013

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in the emergency department.

In 2012, the Florida Hospital East Orlando emergency department treated more than 83,000 patients. As a result of the high demand for emergency care, the hospital plans to double the size of its emergency department from 36 to 65 beds. The expansion will also include several kid-friendly rooms with nature themes and LED lighting along with kid friendly waiting areas to provide a more calming environment for kids. Construction for the emergency department is expected to be complete in summer 2014. When the expansion is complete, Florida Hospital East Orlando will be able to treat 100,000 patients a year.

Florida Hospital East Orlando is also building out the fifth floor of its main patient tower. The expansion will add 40 private patient beds to expand surgical services offered at the hospital. This expansion is expected to be complete in July 2013.

Overall, the project will generate about 75 new construction jobs as well as new clinical jobs within the hospital.

Florida Hospital East Orlando is currently a 225-bed facility and has been a part of the East Orlando community since 1941. Adding 40 new beds will bring the total number of beds to 265.

Lake Nona to Construct 100,000 SF Medical Office Building Lake Nona has announced its plans to build the Lake Nona Gateway Building, a 100,000 square-foot medical office building on the northwest corner of Narcoossee Road and Tavistock Lakes Boulevard. Florida Hospital and UCF’s Pegasus Health will become anchor tenants in the new building.

Florida Hospital expects to establish a combination of services including a CentraCare urgent care center, imaging and diagnostics, an outpatient surgery center, and certain specialist services.

UCF’s College of Medicine will expand Pegasus Health, the College’s primary and multi-specialty practice, providing comprehensive patient focused care for the community.

The Lake Nona Gateway Building will complement the array of medical services offered at Lake Nona Medical City now and in the years ahead, while taking advantage of the rapidly growing residential and commercial activity along Narcoossee Road.

The Lake Nona Gateway Building is expected to break ground this fall with a projected opening in mid-2014.

Florida Hospital Launches First National Clinical Trial App for Smartphones Patients and physicians will now have information on life-saving clinical trials at the tap of an app. MD Trials is a first-of-its-kind clinical trials smartphone app created by Florida Hospital with in-

PUBLISHED BY: SouthComm, Inc. FLORIDA MARKET PUBLISHER John Kelly johnkelly@orlandomedicalnews.com AD SALES: John Kelly 407-701-7424 Tony Smothers 407-247-1308 Koreen Hart-Morales, 321-662-1660 Brenda Loyal, 407-462-6845 LOCAL EDITOR Lynne Jeter lynne@medicalnewsinc.com NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley Amy Gomoljak Christie Passarello ACCOUNTANT Kim Stangenberg kstangenberg@southcomm.com CIRCULATION subscriptions@southcomm.com CONTRIBUTING WRITERS Lynne Jeter, Cindy Sanders, Jeff Webb —— All editorial submissions and press releases should be emailed to: editor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. Suite 100 Nashville, TN 37203 615.244.7989 (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 Two years $78

SOUTHCOMM Chief Executive Officer Chris Ferrell Chief Financial Officer Patrick Min Chief Marketing Officer Susan Torregrossa Chief Technology Officer Matt Locke Business Manager Eric Norwood Director of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce Director of Content/Online Development Patrick Rains Orlando Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2012 Medical News Communications.All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials.

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

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GrandRounds

Shopping For Your Malpractice Insurance?

At Danna-Gracey, we do much more than just negotiate the best rates available. We make it our practice to genuinely care about yours.

Florida Hospital for Children recently dedicated 19 pediatric patient rooms on the 6th and 7th floors of the hospital thanks to the generosity of donors in the Central Florida community.

Community Comes Together to Dedicate 19 Patient Rooms at Florida Hospital for Children Florida Hospital for Children recently dedicated 19 pediatric patient rooms on the 6th and 7th floors of the hospital thanks to the generosity of donors in the Central Florida community. An event was held to celebrate the individuals that have contributed to the care of children in our community and unveil the new signage located in front of each room.

The dedication ceremony for the 19 general pediatric rooms was held in 7thfloor family area of Florida Hospital for Children. The small reception recognized each individual family or organization and concluded with the donors unveiling their room signage on the two nature themed patient floors. Each pediatric room is private and family centered with a dedicated medical staff located close by. formation on current clinical trials not only at Florida Hospital, but across the nation.

The featured trials come directly from the National Cancer Institute database. The free MD Trials app can be downloaded onto any iOS device (iPhone, iPad or iPod) from your app store.

Users will be able to view ongoing, upcoming and past trials taking place across America. The app will include eligibility requirements and closest location of the clinical trial you may be interested in. You will also be able to create a personal profile, favorites list and have the ability to share clinical trials that you or somebody you know will be interested in.

Clinical trials are used to expand options for patients and to provide access the latest in technology. With new advancements in research, clinical trials now include preventative measures to reduce the risk of cancer recurrence, depression treatment throughout chemotherapy, and other alternative medicine trials to treat the effects of cancer treatments.

To download the app, visit your app store and search for “MD Trials”.

Unlike Many US Clinics, Central Florida Cancer Care Center Is Still Able to Care for Medicare Patients Sequester budget cuts throughout the U.S. are forcing cancer treatment centers to turn away new Medicare patients. The cuts, effective April 1, are causing Medicare patients to scramble to find clinics that will treat them, and are affecting the way they are being treated, because some clinics cannot afford to administer expensive cancer treatments, and stay in business. A recent survey by the Community Oncology Alliance found orlandomedicalnews

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that 72 percent of the community oncology practices across the country would change the way they deal with Medicare patients if the cuts continue.

Central Floridians can rest assure though, because Central Florida Cancer Care Center will continue to accept and treat new Medicare cancer patients. According to Steven Lester, MD, FACRO, Radiation Oncologist with Central Florida Cancer Care Center, they are still able to care for Medicare patients and hope to continue to do so.

He said they want all their patients not to be anxious that their physician will be unavailable.Central Florida Cancer Care Center offers radiation therapy services which include: IMRT, IGRT, MammoSite, External Radiation Therapy, Internal Radiation Therapy (Seed Implants), and High Dose Rate Therapy (HDR).

We are an independent insurance agency with a statewide team of specialists dedicated solely to insurance placement for Florida’s doctors. Independent means you have options. We shop widely for the best coverage and price to fit the unique needs of your practice.

Call Dan Reale today at 888.496.0059 to see what we can do for you.

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info@dannagracey.com • www.dannagracey.com 888.496.0059 • dan@dannagracey.com • www.dannagracey.com

Migraine Headaches?

Does Your Child Suffer From

Does Your Child Suffer From

Does Your Child Suffer From

Migraine Headaches?

Migraine Headaches?

Alma Van Der Velde Joins Sand Lake Imaging Radiology Centers

If your child is 12-17 years of age, and experiences 2 or more migraines a month, they may be eligible to If your child is 12-17 years of age, and experiences 2 or participate in a clinical research study for adolescents who more migraines a month, they be eligible to suffermay from migraines.

Sand Lake Imaging is pleased to announce the addition of one of Orlando’s longtime marketing and public relations community networker’s to their team as Marketing Account Specialist.

In her new role, Van Der Velde’s addition brings her unparalleled interpersonal relationship building skills, dynamic personality, innate communicative skills and her passion for driving results as the primary liaison between community physicians and practices highlighting state-of-the-art radiology services available to the community in order to generate patient referral growth and revenues to both facilities.

participate in a clinical research study for adolescents who Eligible participants will receive all study related suffer from migraines. medication, exams, and lab work at no cost.

Compensation for time and travel may be provided.

Eligible participants will receive all study related medication, exams, and lab Call work at no cost. us for more information.

Compensation for time and travel may be provided.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section.

Content and accuracy of the releases is the sole responsibility of the issuer.

Call us for more information.

MAY 2013

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