St Louis Medical News May 2015

PROUDLY SERVING THE GATEWAY CITY

May 2009 2015 >> $5 December

PHYSICIAN SPOTLIGHT PAGE 3

Mary McLennan, MD ON ROUNDS

Population Health Advances Physicians are buzzing about the new healthcare paradigm America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States ... 4

Same Professionals, More Convenient Location

St. Louis Children’s Hospital ready to open specialty care center in west St. Louis County

By JULIE PARKER

In June, Washington University and St. Louis Children’s Hospital will open St. Louis Children’s Specialty Care Center in west St. Louis County, a month ahead of schedule and spot on budget.

More importantly, the nearly 141,000-square-foot, tri-story facility on 15.8 acres in Town and Country, acquired from the Missouri State Highway Patrol in 2006, will provide clinical space for many Washington University School of Medicine pediatric and surgical subspecialists.

The neighborhood center will feature three operating rooms; a laboratory; occupational, physical and speech therapy; imaging and infusion capabilities; audiology and psychology services; and the unique

Pediatric Acute Wound Service (PAWS).

“The overarching aspiration we have is to provide the same level of excellent care we provide at the main campus in a more accessible, convenient environment,” said David Leonard, MD, surgical codirector of the Specialty Care Center.

Six months ago, BJC HealthCare, the area’s largest employer and provider of healthcare, tapped Julie Bruns to serve as director of the Specialty Care Center, one of its newest facilities located along Interstate 64 near Mason Road in Town and Country.

Dr. David Leonard

(CONTINUED ON PAGE 9)

Setting a High Standard HIT: Optimization Through Integration You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level.

Therefore, you might as well learn to optimize it ... 10

St. Anthony’s among five St. Louis Level 1 stroke centers named by the Department of Health and Senior Services

By JULIE PARKER

When the Missouri Department of Health and Senior Services revealed the state’s inaugural list of designated Time Critical Diagnosis Stroke Centers on March 23, five of the 10 designees representing the highest level of stroke care were in St. Louis: Barnes-Jewish Hospital, Mercy Hospital St. Louis, SSM DePaul Health Center, St. Louis University Hospital, and St. Anthony’s Medical Center.

The newest component of the state’s Time Critical Diagnosis (TCD) System bonds the 911 emergency response systems, hospitals and emergency (CONTINUED ON PAGE 8)

ONLINE: STLOUIS MEDICAL NEWS.COM PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357

stlouismedicalnews

Now Available!

Register FREE online at StLouisMedicalNews.com to receive your digital edition copy of Medical News optimized for your computer, tablet or smartphone!

PRINTED ON RECYCLED PAPER .com

MAY 2015

>

1

2

>

MAY 2015

stlouismedicalnews

.com

PhysicianSpotlight

Mary McLennan, MD

By LUCY SCHULTZE

Keeping a great program on track and nurturing already-strong relationships are among the goals of Mary McLennan, MD, as she takes the reins of the Department of Obstetrics, Gynecology and Women’s Health Services at Saint Louis University School of Medicine.

“I was willing to take on this challenge as someone who has an understanding of the people and players — where the program has been and where it needs to go,” she said. “For someone coming in from the outside, it would take time to understand those things.”

McLennan, a gynecologist with SLUCare Physician Group, has spent the past 15 years on the medical school faculty. She follows Raul Artal, MD, as chair of OB/ GYN. “I’m very lucky in that Dr. Artal left our department in great shape,” McLennan said. “The average length of time that our faculty members have been here is 11 years, so we have been with each other a long time. We like each other and work well together.”

As she steps into the role of chair, she’s broadening her attention to relationships beyond her division of urogynecology and beyond the OB/GYN department as well.

“Our maternal service line is in partnership with SSM and St. Mary’s Health Center, and we work together in strategic planning for where we want our program to go,” she said. “It’s also new for me to have more interaction with chairs of other departments and with the business aspects of SLU. But I enjoy all these kinds of interactions.”

For McLennan, accommodating those new responsibilities has come with a shift away from patient care, which she did not take lightly.

“My relationship with my patients is important to me, so it was a very hard decision to cut back on that,” she said. “But I also want to see the relationship between SLU and our private hospital partners continue to grow and bloom.

“I appreciate the intricacies of that relationship and how important it is to nurture it. It’s not unlike looking after a patient: The continuity of care is really important.”

McLennan officially became chair of the OB/GYN department on March 1 after serving as interim chair since July 2014 and vice chair for the year prior.

She has been a member of the SLU faculty since 1999 and served as director of the division of urogynecology. She has also been director of the OB/GYN residency program for eight years.

As a urogynecologist, McLennan is recognized locally and nationally as a leader in her field, treating patients who have pelvic floor disorders and incontinence.

She holds a medical degree from the University of Queensland in St. Lucia, stlouismedicalnews

.com

Australia, and completed an internship and residency in family practice before choosing to focus on OB/GYN care. She received a diploma of obstetrics from the Royal Australian College of Obstetricians and Gynaecologists.

After marrying an American, McLennan completed her OB/GYN residency training in the United States at the SLU School of Medicine, followed by a fellowship in urogynecology at the Greater Baltimore Medical Center. There, she stayed on to practice alongside her fellowship director as partner for three years, before being recruited to SLU by Artal.

“It had always been my intention to come back, because I had such a good time at SLU,” she said. “It was the best decision of my life to come back. I love this program and feel very blessed to be here.”

Among the efforts McLennan is excited about within the partnership between SLU and SSM St. Mary’s Health Center are continuing to advance not only the program’s well-known service for high-risk obstetrics, but also the gynecologic side of the program. McLennan is among four urogynecologists in the division.

“We provide a lot of services for incontinence and prolapse, and we hope to partner with St. Mary’s in providing a multidisciplinary approach to both urinary and fecal incontinence,” she said. “Providing a pelvic pain center – something for which there’s a need in this city – is also something we’re working toward.”

Likewise, she said, SLUCare’s Vulvar and Vaginal Disorders Specialty Center serves an area of need in St. Louis and receives regional referrals. And the Fetal Care Institute provides the only fetal surgery center in the region for in-utero procedures.

The department also provides OB/ GYN care for several of St. Louis County’s public health clinics, caring for patients at the South County Health Center, North Central Community Health Center and John C. Murphy Health Center. Meanwhile, its resident clinic stays busy providing care for patients who are uninsured, underinsured or on Medicaid.

“In collaboration with SSM, we do a lot of public service for patients who don’t have insurance,” she said. “We touch many lives – from those who have the best insurance to those who have none. It doesn’t matter: We provide the same level of care.”

McLennan is also keen to spread the word about the personalized care provided by the department’s small gynecological oncology division.

“It’s a hidden secret and a gem,” she said.

On a national level, McLennan has served as a member of the board of directors of the American Urogynecological Society and is a board examiner at the American Board of Obstetrics and Gynecology.

She is editor of Female Pelvic Medicine and Reconstructive Surgery and has served on several editorial boards and as an ad hoc reviewer of several other journals including the International Urogynecology Journal, the Journal of Urology and the American Journal of Obstetrics and Gynecology.

Additionally, she has published over 40 peer-reviewed publications, books and book chapters and has received many awards and honors.

Outside of work, McLennan enjoys life at home with her husband, Ron Pearson, an emergency physician, and their cheerful brood of five pugs and one mixedbreed rescue dog.

Continuing Medical Education CME.WUSTL.EDU

CMEONLINE.WUSTL.EDU

May 7

Update on Gynecologic Cancers

May 9

Care of the Hospitalized Patient 2015

May 9

Update on Osteoporosis and Fracture Prevention

Jun 13

Cardiology Update

Jun 20

Highlights from the ASCO 2015 Annual Meeting

July 17

9th Annual St. Louis Therapeutic Endoscopy Course

July 17-18

Clinical Allergy for the Practicing Physician

July 18

9th Annual Sports Medicine Update

Aug 15

Update on the Management of Pituitary Tumors

Sept 12

Advances in Diagnosis & Treatment of Hematologic Malignancies

Sept 26

16th Annual St. Louis Critical Care Update

Visit cme.wustl.edu for full course listing and to register.

Responsive interface Over 125 CME Credits Available Online in Over

Newest Online Topics: • Update on Vitamin D • Type 2 Diabetes in Adolescents • Update in Current Surgical Therapies for Obesity • Pediatric Traumatic Brain Injury • Anti-thrombotic Treatment in Acute Ischemic Stroke • E. B. Approach to Medical Care of Acute Stroke

Washington University is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Campus Box 8063, 660 S. Euclid Ave. St. Louis, MO 63110

cme.wustl.edu & cmeonline.wustl.edu Email: cme@wustl.edu

Ph: 314-362-6891 or 800-325-9862 Fax: 314-362-1087

MAY 2015

>

3

Population Health Advances

Physicians are buzzing about the new healthcare paradigm

By JULIE PARKER

America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States.

The focal point: population health, a relatively new front burner issue unfamiliar to many practitioners. Congress included the model as a component of mandates in the Patient Protection and Affordable Care Act (ACA) (See box).

“We covered a lot of ground at our annual meeting to educate independent physicians about population health,” said Al Holloway, founder and president of TIPAAA. “Once we fully understand what it is, then we’ll find tools, products and services that can assist independent physicians in their daily practice.”

One question that repeatedly popped up: What’s the difference between population health and public health?

“Some view population health as a more modern version of public health, which itself – improving the health of the public – may be a goal, a measurement system, and a conceptual framework that undergirds a profession and a scientific field,” wrote Michael A. Stoto, PhD, in “Population Health in the Affordable Care Act Era,” published by Academy Health (Feb. 21, 2013).

“Population health differs from public health, at least perceptually, in at least two respects,” Stoto explained. “First, it’s less directly tied to governmental health departments. Second, it explicitly includes the healthcare delivery system, which is sometimes seen as separate from or even in opposition to governmental public health.”

David B. Nash, MD, MBA, founding dean of the Thomas Jefferson University School of Population Health, pointed out that population health “builds on public health founda- David Nash tions.”

Among the building blocks, according to Nash: • Connecting prevention, wellness and behavioral health science with healthcare delivery, quality and safety, disease prevention/management and economic issues of value and risk – all in the service of a specific population. Examples: a city, provider’s practice, employee group, hospital’s primary service area or pre-school children.

• Identifying socioeconomic and cultural factors that determine the health of populations, and developing policies that address the impact of these determinants.

• Applying epidemiology and biostatistics in new ways to model disease states, map their incidence and predict their impact.

• Using data analysis to design social and community interventions and new models of healthcare delivery that emphasize care coordination and ease of accessibility.

“When applied to healthcare delivery, population health differs from conventional healthcare by emphasizing value rather than volume of services rendered,” said Nash.

How will population health affect physicians?

Monumentally, said Kathy Jordan, president of Jordan Search Consultants.

“The primary care practice of the fu-

ture will look much different than it does today,” she said. “Instead of one-on-one encounters between the patient and their provider, the patient interaction process will include phone visits, email consultations, group visits, education programs and encounters with a variety of care team members. Out-of-office contact will become the new norm as patient health improves. Additionally, primary care physicians of the future must exhibit leadership and interpersonal skills, as well as a passion for top-tier service delivery. How well they manage the team will directly translate to how well the health of their patient population is being managed, which will directly impact future compensation models.”

Important financially: To be eligible for incentivized government funding, organizations must prove their commitment to, and implementation of, population health, said Jordan.

“They’ll be required to improve the patient care experience, the overall health of populations, and lower per capita costs of case,” she said. “As a more comprehensively integrated system focused on population health begins to dominate, the healthcare industry, healthcare experience and provider recruitment initiatives must also evolve.”

Enter population health management.

Regina Levison, vice president of client development for Jordan Search Consultants, said that “while population health is defined as the health outcomes of a group of individuals comprising a specific demographic population, population health management is a business model centered on the delivery of comprehensive care and management of total risk.”

The foundational shift in the health-

A Better You...

A Best Practice.

For registration & membership: mgmastl.org • 314-499-9344

MGMA of Greater St. Louis Join us at an upcoming meeting!

• May 13: Webinar on Interacting with Patients • June 10: Lunch Meeting on Safety: How to Handle Angry Patients & Staff • July 8: Webinar on Payer Enrollment • August 12: Lunch Meeting on Interviewing to Develop Your “A” Team

4

>

MAY 2015

care experience will morph from an industry driven by reactivity to an industry driven by proactive measures, said Levison.

“The goal of population health is to keep a patient population as healthy as possible and minimize the need for costly interventions, procedures, emergency room visits, and hospitalizations,” she said.

As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will be reconstructed, said Jordan.

“Within this transformation, we’ll see an altered patient and physician experience,” she said. “With an emphasis on proactive preventative care, evidencebased protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen.

“Although the results of these initiatives won’t manifest for a decade or more, population health management will almost certainly improve the quality of lives for millions of individuals throughout the country.”

If your marketing plans include impacting the medical doctors of St. Louis, you should consider an advertising program in the

5

The largest audience of medical doctors in the St. Louis area will read your advertising messages.

CONTACT ME TODAY FOR INFORMATION ABOUT REACHING OUR PHYSICIAN READERS FOR PENNIES PER MONTH:

LARRY HENRY

St. Louis Medical News 314-917-6107 lhenry@medicalnewsinc.com

stlouismedicalnews

.com

Mastering Population Health Thomas Jefferson University offers nation’s first MS-PopH program

By JULIE PARKER

The hottest new advanced degree in healthcare, beyond medical school, focuses on a game changer for the nation’s healthcare delivery system: population health.

Thomas Jefferson University (TJU), home of the nation’s only School of Population Health, received approval March 5 to become the only institution of higher learning in the United States to offer a new graduate-level degree program: Master of Science in Population Health (MS-PopH).

The program is accepting applications for this fall.

“Population health is catching fire. It’s a raging inferno at the moment,” said David B. Nash, MD, MBA, founding dean of the Jefferson School of Population Health and the Dr. Raymond C. and Doris N. Grandon professor of health policy at Thomas Jefferson University.

Nash, a board-certified internist, became involved in promoting quality improvement and lobbying for healthcare policy change in the 1980s. He joined the university in 1990 as a faculty member; the former university president asked him to build the School of Population Health for the campus, which opened in 2008 as the first U.S. academic institution focused on population health. Already, 25 students have completed the graduate certificate online program, which takes 12 to 20 months to complete. Its focus: to help current and emerging healthcare leaders understand the new population health paradigm. More than 100 students have completed the onsite Population Health Academy, a 40-hour continuing education program, providing an overview of basic concepts in population health.

“Healthcare inside a medical facility is only 15 percent of the story; 85 percent of healthcare happens outside the hospital,” noted Nash. “We have to reach outside the four walls of our hospitals to coordinate with community pharmacies, nursing homes, extended care facilities and the like, and link all of these care providers – from the hospital’s board of trustees to the folks delivering home infusion medication. It’s a big operational challenge. We’re going to have to become a well-oiled, organized, valuegenerating team.”

For additional information on the Jefferson School of Population Health degrees – program content, admissions requirements, deadlines, and tuition and fees – visit http://www.jefferson.edu/ university/population-health/ degrees-programs/populationhealth/about.html.

stlouismedicalnews

.com

Kathy Jordan, president of Jordan Search Consultants, said the new degree program is well-timed.

“The healthcare landscape is shifting more dramatically right now than it has since its inception,” she said. “As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will transform.

With an emphasis on proactive preventative care, evidence-based protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen. In some cases, this may require new types of training.”

The comprehensive MS-PopH online graduate degree program will help students develop competencies in five key public health areas – behavioral and social sciences, biostatistics, environmental health sciences,

epidemiology and health policy. Students will also develop proficiency in the application of population health skills and principles, culminating in a Capstone project applying theory and lesson in realworld situations.

Already in place at Thomas Jefferson University: a doctoral degree program – PhD in Population Health Sciences –that started four years ago and has 14 students.

The first two graduates will receive their degrees this month.

The doctoral degree is studied onsite, with the goal of preparing leaders with global vision to analyze the determinants of health. Doctoral candidates specialize in one of four areas: health policy, healthcare quality and safety, applied health economics/outcomes research and behavioral/health sciences.

“The PhD in Population Health Sciences isn’t intended for those new to the discipline,” noted Nash. “Preference is given to applicants who’ve completed a master’s degree or master’s level coursework in appropriate fields of study, such as public health, social work, health policy and behavioral sciences.”

The addition of the MS-PopH program came soon after Stephen K. Klasko, MD, MBA, relocated from the University of South Florida (USF) Morsani College of Medicine and USF Health, where his transformative ideas took the Tampa medical

school to unprecedented heights.

Klasko is in his first year as president of Thomas Jefferson University and president/ CEO of the Thomas Jefferson University Hospital System, now the largest healthcare system in Philadelphia, Pa., the nation’s sixth largest city.

“We’re moving healthcare from a Blockbuster mentality to a Netflix mentality,” said Klasko, pointing out the university began offering population health “before Dr. Stephen anybody put population Klasko health in the same sentence.”

“At Thomas Jefferson University, we created a whole new mission and vision, where health is all we do,” he explained.

“Our vision is to reimagine healthcare education discovery to create unparalleled value. Jobs will be needed in healthcare in 10 years that aren’t even yet imagined, and a good many will be in population health.”

Nash, who also serves as a government and private-sector consultant, chairs the Technical Advisory Group of the Pennsylvania Health Care Cost Containment Council and is a board member of various healthcare organizations, including Humana.

“The great thing about Dr. Nash’s school, it’s not a Johnny-come-lately. He’s devoted his life to population health,” said Klasko. “In most universities, population health is part of another school and lacks the panache … that puts us at the forefront.”

POWER PLUS DOCTOR LOAN Only At First Integrity Mortgage

POWER PLUS DETAILS • Down Payments As Low As 5% • No Private Mortgage Insurance • Jumbo-Sized Loans Without Jumbo-Sized Requirements • Purchase Or Refinance Transactions • Also Available For Resident Doctors

For More Info Contact: Michael Burge NMS 293833

314-406-4444 77 West Port Plaza, Ste.200, St. Louis, MO 63146 NMLS # 276593

MAY 2015

>

5

Help Wanted: Population Health Physician Leaders Filling positions may be a tall order; job-getters will enjoy top-of-license roles

By JULIE PARKER

Finding presentable candidates for population health physician leaders is a tall order, especially since many doctors remain unfamiliar with the new paradigm in post-healthcare reform.

Personnel represents one of three key ingredients to implementing population health management. It’s the glue to connecting data and the changing nature of the overall healthcare experience. The hard shift in practice management has healthcare organizations scrambling to secure top-notch population health physician leaders, a move that keeps physician recruiters like those at Jordan Search Consultants quite busy.

“Our clients know the organizations able to most effectively aggregate and distribute data—to collaborators, team members, and even patients themselves—will succeed,” said Kathy Jordan, president of Jordan Search Consultants.

“Healthcare systems are now implementing robust software systems and population health management programs that help automate data integration, analysis, reporting, and communications so that real-time evaluations—and adjustments in patient care plans—can be made instantaneously. Having the right IT systems – and IT personnel – in place is critical to advance clinical outcomes, improve care, and lower costs. Organizations with the ability to master data control and predictive analytics to generate decision-driving insights will succeed in population health management.”

Unfortunately, the shortage of primary care physicians (PCPs) – the leaders of population health management – con-

tinues to escalate. As population health management becomes the dominant healthcare model, the demand for their roles will be unprecedented.

“As physicians continue to leave the private practice model in favor of employed physician models, cultural fit within an organization will become a key recruitment parameter,” said Regina Levison, vice president of client development for Jordan Search Consultants. “In addition, PCPs will be recruited based on their ability to build consensus, manage teams, and lead a diverse care team to better patient health. Organizations must understand what physicians are looking for clinically, financially, and administratively to ensure a fit with the organization. Physicians who embrace the care team model, understand how to utilize advanced practice providers, and enjoy leadership opportunities will be in high demand. In addition, recruits must understand new incentive and reimbursement structures. Physicians will be rewarded for meeting care management needs of patients; reimbursement will be tied to quality as opposed to quantity.”

Characteristics of a potential population health physician leader, according to Jordan Search Consultants, include: • A minimum of five to 10 years of practice experience.

• Board certification.

• A good understanding of the way Electronic Medical Records (EMRs) work.

• A plan to help move the population health management team to the next level.

• Mentoring ability.

• Advanced education.

“We’ve changed how we evaluate physician candidates and physician leaders so we can provide a better slate of candidates to our clients,” said Jordan. “We want to assess their ability to embrace population health, their understanding of population health, and their attitude and ability to treat patients under a population health model. We have to dig more deeply. The physician leader of the population health management team will be working at the highest end of their license.

We evaluate their ability to give direction and make assignments to the team and to educate their colleagues. They’ll need to assess where the team is strong, and where it needs additional education, training and support. It’ll be dictated not only by geography, but also by the socioeconomic element of the population being served.”

Clients are thrilled, said Jordan, when the consulting firm finds a candidate who already knows the EMR system they’ve implemented.

“That’s one less bridge to cross,” she said.

One of the most pleasant surprises Jordan Search Consultants’ recruiters have discovered in physician leader candidate pools is the growing number of physician candidates who have, or are pursuing, advanced business degrees, such as an MBA, perhaps with a concentration in healthcare management, MHA (masters of healthcare administration), MPH (masters of public health), MHI (masters of healthcare informatics), MMM (masters of medical management), or MS-PopH (masters of population health).

“The MMM is a relatively new degree,” Jordan said, adding the MS-PopH degree program is a brand new offering

PROFESSIONAL CARE FOR

CARING PROFESSIONALS You deserve the same level of professional attention you are so accustomed to giving others—and Hawthorn delivers: • Pursuing every claim relentlessly, no matter how small • Retaining accounts longer and working them harder • Sharing business insights for continuous improvement Convert your services to cash with our hassle-free approach to revenue cycle management.

at Thomas Jefferson University, the nation’s only school to offer that particular advanced degree. “They’re educating themselves to lead the charge.”

On the flip side, PCPs who otherwise might be excellent candidates for those positions simply lack time to pursue higher education.

“The rank-and-file practicing physician in a community doesn’t need a degree in population health to see his patients,” said Al Holloway, founder and president of TIPAAA (The Independent Physicians Association of America). “No, that doesn’t make sense. Having an understanding of population health will impact his practice, but he doesn’t need a degree in it.”

The need for these type of leaders is unprecedented, said Jordan.

“As the demand increases, and we continue to have a very limited supply of physician professionals for these leadership positions, automatically the compensation goes up,” she said. “That’s something I hope potential candidates will strongly consider.”

Subscribe to

Digital

Medical News Free!

Get the current digital edition of St. Louis Medical News delivered to your desktop.

FREE!

Addressing Complexity with Certainty

EMAIL NOTIFICATIONS

Hawthorn Physician Services Corporation 10820 Sunset Office Drive | St. Louis, MO 63127 | 800 899 5757 www.hawthorngrp.com

stlouismedical news.com

Additional offices in Chicago, Indianapolis and Atlanta

6

>

MAY 2015

stlouismedicalnews

.com

Avoiding Pitfalls of Planning with Joint Ownership

By JULIE PARKER

Just in case, is it a good idea to put an account in a joint name with another trusted person, such as a child, grandchild or other caretaker?

When asked that question, estate planner Steven M. Laiderman usually asks about the concern meant by “just in case.”

Usually, it’s a concern from a client about becoming incapacitated or otherwise unavailable for some reason, to have someone to pay bills, and (heaven forbid!) pay for funeral or burial expenses.

“Given these particular concerns there’s generally no reason to add anyone other than a spouse as a joint owner of any account,” said Laiderman, principal of The Laiderman Law Firm PC, an estate planning, probate and business law firm based in St. Louis. “Except for spouses, I recommend against such a practice, as there are other preferred ways to deal with these concerns.”

Laiderman explained: “If someone needs help with finances, they can get help without adding a joint owner to their accounts.”

A simple option: to add a trusted individual as agent under the provisions of a power of attorney.

“Even if the individual doesn’t have a power of attorney in place, most financial companies and banks have their own form of power of attorney that can be used for their accounts,” he said. “Further, when the owner dies, the assets will pass to the intended heirs.”

Another option: ask the trusted individual to complete the checks or other documents, leaving only the task of signing to the disabled individual. If only a temporary absence is expected, the trusted individual can pay the bills and be reimbursed later.

If someone dies, the trusted individual can be repaid from the estate or trust, Laiderman said.

“It’s important to make a distinction between types of joint ownership,” he noted. “There are joint tenants with rights of survivorship, tenants by the entireties, and tenants in common. Joint tenants with rights of survivorship means that when one joint owner dies, the property passes automatically (by operation of law) to the surviving joint owners. Generally, either joint tenant has access to bank and financial accounts. However, some assets would still require both joint owners consent to access or sell the assets, such as car titles, stock certificates and real estate.”

Tenants by the entireties are a special joint ownership between spouses that provides asset protection in many states, such as Missouri. Generally, the asset held in tenancy by the entireties cannot be reached by one spouse’s creditors, Laiderman pointed out.

“Tenants in common mean that each joint owner owns a divisible share of the property,” he explained. “For example, if non-spouses own a parcel of real estate, without any further designation that they stlouismedicalnews

.com

hold it with rights of survivorship, then each one is deemed to own one-half. If one dies, his or her interest passes to his or her heirs, and not to the other joint owner. If this were a bank or financial account, it would pass to the joint owner. So, depending on the type of asset, the results of a death of one joint owner may vary. If joint ownership is used as a substitute for a well thought-out estate plan, and the title on the account isn’t carefully considered, the property may pass to unintended heirs.”

Aside from the obvious risk of a nonspouse having access to financial accounts, one of the greatest risks of putting accounts in a joint name is that the account passes automatically to the surviving joint owner or owners, emphasized Laiderman.

“If the joint owners are spouses, generally it’s intended that the surviving spouse own the assets,” he said. “That might not be the case for non-spouse joint owners.

Many individuals expect the surviving joint owner to share the assets with others or use the account to pay expenses associated with their death. However, there’s nothing to prevent the surviving joint owner from deciding to keep the assets.”

Many joint owners take the position that if the deceased individual didn’t intend for the surviving joint owner to have the account, the deceased individual could have planned otherwise, said Laiderman.

“In one situation, not only did the child keep the account, but because of how the estate plan was drafted, the other heirs paid the estate tax on the money the joint owner kept! Even if between spouses, the surviving joint owner would have no asset protection that other methods of planning might provide,” he said.

If the estate plan includes a revocable trust, then accounts in joint tenancy may obviate the provisions of the trust.

“With a trust, generally the object is to have all the assets pass through the trust to be sure the accounts pass to the intended heirs, and perhaps to provide heirs with asset protection,” said Laiderman. “If the trustmaker is disabled, or dies, the trust will generally have provisions for a successor trustee to be appointed and succeed to management of the assets, including paying bills and expenses. The process to do this is generally not complicated, and can be handled promptly so that bills can be paid timely. If the trustmaker still wants another individual to have access to accounts, the trusted individual can be added as a cotrustee and given the independent power to access accounts, and upon the death of the trustmaker, the assets will still pass to the intended heirs.”

Even if after this discussion an individual insists on having joint accounts with a non-spouse, Laiderman recommends “doing what makes them feel comfortable, as long as they understand the possible consequences.”

“If they choose to have joint accounts, because of the consequences outlined above, we recommend that it only be on accounts with small balances,” he said.

FREE ONLINE FREE ONLINE SUBSCRIPTION OFSUBSCRIP

INTEGRATED HEALTHCARE INTEGRATED HEALTHCARE DELIVERY

ihdelivery.com/subs ihdelivery.com/subscribe Sign up online for a subscription and learn how to thrive in the new integrated healthcare paradigm.

On a business tri Out of the countr Integrated Healthca Delivery is everywhe you are. Online 24/

On a business trip?

Out of the country?

Integrated Healthcare Delivery is everywhere you are. Online 24/7.

The way we deliver healthcare outside of the hospital is rapidly changing. Forward thinking practitioners are collaborating with other providers to improve the patient experience while decreasing costs. If you are an executive or medical director who seeks to thrive in the new integrated healthcare paradigm, then join the conversation by subscribing to Integrated Healthcare Delivery, and find Transforming the way we deliver care out how your peers are already improving outcomes with greater efficiency.

Transforming the way we deliver care

ihdelivery.com/subscribe

The way we deliver healt rapidly changing. Forwa collaborating with other experience while decrea or medical director who integrated healthcare pa by subscribing to Integrat out how your peers are al greater efficiency.

ihdelivery.com/subscribe

Larson Financial.com 314- 569-2400

You’re a Person First and a Physician Second

We’re Here for You Larson Financial is a driven team of professionals that focuses on helping clients understand each step of the comprehensive planning process. We recognize that it often takes a team to tackle challenges that stand in your way.

Call us to schedule a complimentary consultation where we can discuss our in-depth approach to financial planning for doctors.

275 N. Lindbergh Blvd., Suite 10

Retirement Planning Asset Protection Tax Planning Estate Planning Employee Benefits Mortgage Planning Investments Practice Management Risk Management/Insurance

St. Louis, MO 63141

Advisory services offered through Larson Financial Group, LLC, a Registered Investment Advisor.

Securities offered through Larson Financial Securities, LLC, member FINRA/SIPC. Larson Financial Group, LLC, Larson Financial Securities, LLC and their representatives do not provide legal or tax advice or services. Please consult the appropriate professional regarding your legal or tax planning needs.

MAY 2015

>

7

Setting a High Standard, continued from page 1 responders to proMalik: Endovascular vide a more efficient treatment, along with continuum of care for tPA for acute stroke. For trauma, stroke and several years, there have heart attack victims. been inconclusive studOf the Level 1 ies about whether enStroke Centers desigdovascular treatment is nated statewide, the beneficial to the patient. five Missouri hospitals This year, four indepenoutside St. Louis are dent studies have been Boone Hospital Cenpublished, showing this ter and the University treatment is definitely Marsha Enchelmaier Dr. Maheen Malik Dr. B. Kirk Bieneman of Missouri Hospital beneficial to patients. and Clinics in ColumWith the new emphasis, bia, Research Medical Center and Saint hospitals with an endovascular unit and geons, board-certified emergency physiLuke’s Hospital in Kansas City, and Cox treatment available would come front and cians and emergency department staff, Health in Springfield. center. St. Anthony’s is very fortunate to including specially-trained stroke team/ The new stroke certification program, have a strong endovascular team. rapid response nurses who are in house several years in the making, is the result 24/7. of a state law that gave the state health What’s the percentage of tPA Our stroke team is activated before department authority to create desigadministered to incoming stroke the patient arrives, when emergency crews nated stroke centers that meet standards patients? notify the emergency department about to provide definitive and timely treatment Enchelmaier: About 10 percent. an incoming stroke patient and provide for stroke patients. Designations, valid for photos and video from the field. Patients four years, were made after a thorough reWhat’s the greatest barrier to who meet certain criteria will skip the view by a team that consisted of a stroke administering tPA? emergency room and go directly to receive coordinator or stroke program manager, Malik: The timeline, patients not reca CT scan. an emergency medicine physician, a neuognizing the symptoms of stroke and getBieneman: From the basics to the most rologist/neuro-interventionalist or two ting here as quickly as possible. sophisticated interventions to treat stroke, – all with significant experience in stroke we provide the highest level of care for – and a Department of Health representaWhat steps are you taking to stroke patients, comparable to the care tive. educate consumers about recogprovided by the best medical centers in St. Louis Medical News spoke with leadnizing the symptoms of stroke? the country. We look at every patient iners of the stroke team at St. Anthony’s, Enchelmaier: We provide a great deal dividually to determine the best course of one the metro area’s largest, most comof public education, from mall events to action. We have all the latest, most effiprehensive healthcare systems with 767 capture all ages, such as the one we held cient devices for clot retrieval. beds, and the southernmost area hospital in March, to elementary school talks for to receive the certification, about how the children who are typically at home when What sets apart St. Anthony’s new stroke center designation impacts the their parents or grandparents start to have stroke program from other local medical community. The roundtable strokes. Obviously, there’s a big push for designated stroke centers? discussion included Marsha Enchelmaier, consumer education and a need for more Enchelmaier: We very much pride ourMSN, RN, stroke program manager; Mapublic education. It’s unfortunate that we selves on having a very cohesive stroke heen Malik, MD, medical director of the have stroke patients who remain at home, team in-house that responds instantastroke program; and interventional radiwaiting for their symptoms to improve, neously to patients in the emergency ologist B. Kirke Bieneman, MD. when we could’ve been treating them department or on the floor with stroke sooner. symptoms. Also, we’re a communityWhat does state’s Level 1 cerMalik: We have a very good relationbased, faith-based, independent hospital tification represent for St. Anthoship with EMS crews. We provide eduthat provides the same services as the ny’s? cation for them at the firehouses. That’s larger academic centers in a family-oriMalik: It highlights that St. Anthony’s important because stroke victims who ented, community environment. Rather has an in-house stroke team available 24 receive fast treatment are more likely to than forging downtown when ‘time is hours a day to immediately assess patients recover without permanent disabilities. brain,’ and risk traffic jams and directional and start treatment. The team includes challenges, St. Anthony’s is closer to home four neurologists who cover the stroke What type of post-stroke care for many people. program 24/7, two interventional radidoes St. Anthony’s provide? ologists on call 24/7 for patients needing Enchelmaier: At St. Anthony’s Medical What’s the newest emphasis in endovascular lab services, three neurosurCenter, we have a very robust in-house stroke treatment? acute rehabilitation program. For example, the neurologist on duty may continue to follow patients on the spot. Having an in-house program of this caliber is unique.

Blue loafers? yeah, we’ve

got those loafers.com 8

>

MAY 2015

Share with us some of St. Anthony’s stand-out accomplishments regarding stroke and heart care.

Enchelmaier: Just this month (April), St. Anthony’s became the first and only facility in Missouri to use the Apollo System, which is a minimally invasive neurosurgery tool used to treat ventricular subdural hematomas. Dr. Fangxiang Chen performed that surgery.

We were the world’s first hospital to implant an iliac branch stent graft to treat aortic and iliac aneurysm. Dr. Brian

Peterson did the implant. We were the first in Missouri to use the Thermacool Smarttouch catheter to treat AFib. Dr. Gregory Botteron performed that procedure, which uses direct contact force technology for the treatment of AFib. We were also the state’s first to use the Topera Mapping System to improve the diagnosis of patients with cardiac arrhythmias, also done by Dr. Botteron.

We were the first in the St. Louis area to use Medtronic’s drug-coated balloon to treat peripheral artery disease in the upper leg, used by Dr. Christopher Allen. And we were one of two in the metro area to implant a new miniature cardiac monitor just a week after it received FDA approval.

Dr. Michael Shapiro implanted it. Also, St. Anthony’s has cardiologists available around the clock to our patients.

Our team is more than just the specialists in invasive cardiology, noninvasive cardiology, and clinical cardiac electrophysiology and cardiothoracic surgery; it also includes vascular surgery and interventional radiology.

Missouri Time Critical Diagnosis System The Missouri Time Critical Diagnosis System for trauma, stroke, and STEMI recently implemented four levels of hospital designation across the state. The center designation and the level is a voluntary designation for which a hospital can apply. These center designations reflect a range of hospital-based functions within the emergency medical care system; each plays a vital part in the system.

In general, Level I centers function as resource center within a region.

Level II centers generally provide definitive care to high volumes of trauma, stroke and STEMI patients within a region.

Level III centers play an important role in providing access into the system and important patient care in non-metropolitan areas, and generally refer to a higher level center for definitive care.

Level IV centers, a key entry point into the system, provide access into the system in rural areas and stabilize and prepare patients for rapid transfer to a higher level of care.

SOURCE: Missouri Department of Health and Senior Services.

stlouismedicalnews

.com

Same Professionals, continued from page 1 “When I came into the role in December, the priorities were meeting a tight timeline and working through challenges and modifications that come up with any new facility,” said Bruns, who has been involved with BJC HealthCare since 1991.

Most recently, she served Julie Bruns as director of the BJC call center and market research. “We’ve been on a very good trajectory with a very good team.”

In addition to Bruns and Leonard, other members of the Specialty Care Center team include surgical co-director Daniel Nieva, MD, pediatrics department medical director Robert Rothbaum, MD, and director of clinical operations Kelley Mullen.

“In addition, we’re working to enhance the culture of service that exists at One Children’s Place at the Specialty Care Center,” said Rick Majzun, vice president of operations at SLCH and vice president of Women & Infants at Barnes-Jewish Hospital/ SLCH. “Important elements supporting that culture will be an interior layout featuring logical Rick Majzun service adjacencies, signage and wayfinding designed to make getting around the building intuitive for visitors. We also want to continue the spirit we’ve created at the main campus by making the new facility inviting for children of all ages. Our goal is to ensure referring physicians, patients and their families have convenient, one-stop access to Washington University School of Medicine specialists and St. Louis Children’s Hospital outpatient services.”

Rather than the standard institutional look of most healthcare facilities, the Specialty Care Center will be surrounded by gardens.

“The welcoming atmosphere will begin as soon as visitors exit their cars,” said Majzun.

That environment will continue inside the building, noted Bruns.

“We’ve added a lot of artistic elements that’ll make the building a playful place to visit, yet it’ll still be a place where families know good and important work is being done,” she said. “It’ll be comfortable in terms of look, feel and design. All those architectural and artistic elements don’t mean

SAVE-THE-DATE Referring Physician Events at St. Louis Children’s Specialty Care Center: Sneak Preview: Thursday, May 21, beginning at 6 pm, in the lobby.

Formal Event: Tuesday, June 9, beginning at 6 pm, in the lobby.

Both events will include walking tours of the new facility, refreshments, and Q&A sessions with facility leaders, clinic staff and Washington University specialists.

stlouismedicalnews

St. Louis Children’s Specialty Care Center Pediatric Specialties • • • • • • • • • • • • • • • • •

Adolescent Medicine Allergy/Immunology/Pulmonary Cardiology Cochlear Implants Endocrinology/Metabolism Hematology/Oncology Gastroenterology Genetics Nephrology Neurology Orthopedics and Sports Medicine Ophthalmology Otolaryngology General Surgery Urologic Surgery Plastic Surgery Rheumatology

anything if you don’t have good people. And we do.”

Almost all St. Louis Children’s Hospital specialties will be represented at the new center; more than 80 percent of the outpatient clinic space is already subscribed, noted Bruns.

“The schedule will be full,” she said.

“Already, we’re adding some days or physicians to make access better and better as we go along.”

The Specialty Care Center will also have a pediatric phlebotomist, a service in which “referring physicians have shown a great deal of interest,” said Bruns. “They feel good about having a place like ours to send their patients for blood drives. They’ve also indicated an interest in our radiology services – sedated and unsedated MRIs, plain film x-rays, fluoroscopy, ultrasound – to make it more convenient for their patients and families who live in that part of town.”

Leonard pointed out the new center will provide six surgical services – general, ophthalmology, orthopedic, otolaryngology, urology and plastics.

“Each will provide daily surgical services on site,” he said, noting that specifics will vary from department to department.

“GI will do endoscopies. PAWS will provide excellent services for dressing changes and wound care. PAWS is among the more developed services of its kind among places I’ve worked, taking an often difficult process for pediatrics and making it easier. All these services will hopefully be important to referring physicians in west (St. Louis) County.”

Leonard said he doesn’t want the Specialty Care Center to be perceived as “Children’s Lite.”

“We’re going to have the same faculty as St. Louis Children’s Hospital, with many of the same facilities,” he said. “It’s just taking it out of Children’s into a more convenient location. The only limitation we’ll have is not being able to provide the acuity of care we provide on the main campus.

Otherwise, it’s the same procedures by the same people.”

Bruns said a priority focus of the Specialty Care Center will be “making sure we build from the very beginning a strong service culture that not only replicates what we have on the main campus, but even kick it up a notch to really set a new standard of

.com

NEED A GIFT SHE WILL

LO V E ?

HERSOUTH.COM Navigating Genetic Disease Steering Personalized Medicine

INTRODUCING Improved genomic tests for

validated next-generation sequencing

Results provide physicians with useful information for cancer diagnosis, prognosis and treatment selection Tests are available for solid tumors & hematopoietic disorders

Order a test through gps.wustl.edu

Tel: Toll Free: Fax: Email: Website:

(314) 747-7337 (866) 450-7697 (314) 747-7336 gps@wustl.edu gps.wustl.edu

MAY 2015

service for our families.”

>

9

HIT: Optimization Through Integration

By CINDY SANDERS

You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level.

Therefore, you might as well learn to optimize it.

That was a key part of the message Chris Miller, principal with Nashvillebased Cumberland Consulting Group, and Deb Dulac, director of PRISM and business systems for the University of Vermont Medical Center, shared with audiences at the recent HIMSS15 Annual Conference & Exhibition. More than 38,000 professionals flocked to Chicago last month to attend the premier health information technology conference, which included more than 300 peer-reviewed education sessions, vendor exhibits touting the latest technology options, updates on government regulations impacting the industry and keynote speakers ranging from Bruce Broussard, president and CEO of Humana, to George W. Bush, 43rd president of the United States of America.

“Over the past five years, there has been a huge shift towards technology largely because of the HITECH Act of 2009 and government programs like Meaningful Use that have helped drive the technology in healthcare,” Miller said.

Although slower to adopt technology into daily operations – particularly in a clinical setting – than many other industries, healthcare has increasingly been pressed to take an ‘all in’ stance.

Miller noted that over the last few years, technology has fundamentally changed the way providers … both large and small … operate. He added the challenge is balancing the adoption of technology with everything that brings.

“Today anything a healthcare organization wants to change in a business or clinical process requires a change in their technology, and likewise, any change in their technology has an impact on the care they provide or their revenue,” he said.

“I think healthcare entities were used to thinking of technology as a separate entity, but now it’s so intertwined,” added the Atlanta-based HIT expert.

In their HIMSS presentation, Miller said he and Dulac focused on how to manage and optimize technology now that it has become so pervasive, while at the same time accounting for all the other changes happening in healthcare including a switchover to ICD-10, meeting ongoing and new Meaningful Use requirements, actively engaging patients, supporting accountable care models, and the myriad other programs that require attention.

The bottom line is that thinking of each of these mandates or initiatives as individual tasks to conquer leads to madness … or at least extreme frustration. Instead, Miller said the question should be, “How can organizations effectively manage all of those together with a higher degree of efficiency and lower overall cost?”

He continued, “When I think implementation, somewhere between 25-30 percent of the time spent on these changes is spent on testing so if you can group – effectively overlap testing on these programs – you can significantly save time.”

More than just testing, though, Miller said very deliberately grouping initiatives under a single governance project structure helps with a range of other issues from interoperability to simplification for end users. “Being able to group things together almost makes it irrelevant as to what changes were made,” he said of the finished product in the minds of those ac-

tually using the technology.

The ‘ripping off the bandage’ approach means one educational update for those end users as opposed to having to create an educational module for each individual initiative. Not only does a rolling schedule of changes often feel more overwhelming, but also the time away from desks learning the new processes would typically be less under a grouping structure than to have 10 separate trainings for 10 separate initiatives.

Miller was quick to admit that creating overarching technology structures could be difficult without staff or contracted expertise, which makes it more problematic for small practices.

“Whether you see it as a good or bad thing, there’s certainly a lot of consolidation in the market. Small private practices are becoming more and more rare,’ he said. “I think one of the reasons is it’s becoming increasingly difficult for groups like that to manage all these changes.”

Miller added larger practices or health systems enjoy the economies of scale that make it easier to incorporate the rapid number of changes taking place.

However, he added that in addition to HIT consultants, software vendors typically also offer at least some assistance in helping clients assimilate new processes into their workflow.

“Managing technology is only getting more complex,” he concluded. “Organizations need to be intentional and strategic in how they do that … whether that’s implementing analytics platforms, system upgrades, system optimization, Meaningful Use programs, or ICD-10. They need to be looking at ways they can consolidate those initiatives to be more effective with their resources and increase the return on their technology investment.”

PUBLISHED BY: SouthComm, Inc. ASSOCIATE PUBLISHER Larry Henry lhenry@medicalnewsinc.com Ad Sales: 314.917.6107 NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com LOCAL EDITOR Julie Parker jparker@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley, Amy Gomoljak James Osborne, Christie Passarello

CONTRIBUTING WRITERS Cindy Sanders, Lucy Schultze, Julie Parker CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: editor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. • Suite 100 Nashville, TN 37203 615.244.7989 • (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 • Two years $78

SOUTHCOMM Chief Executive Officer Paul Bonaiuto President Chris Ferrell Chief Financial Officer Ed Tearman Executive Vice President Of Digital And Support Services Blair Johnson Director Of Financial Planning And Analysis Carla Simon Vice President Of Human Resources Ed Wood Vice President of Content Patrick Rains Vice President Of Production Operations Curt Pordes Group Publisher Eric Norwood Chief Revenue Officer Dave Carter Director Of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce

St. Louis Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2015 Medical News Communications.All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials.

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

stlouismedicalnews.com 10

>

MAY 2015

stlouismedicalnews

.com

GrandRounds Lovshin Joins Des Peres Hospital as COO Des Peres Hospital recently welcomed Alexander J. Lovshin as its new chief operating officer. In this position, Lovshin is responsible for the day-to-day operations of the hospital and related services as well as strategic planning for the facility’s long-term operational success. He reports Alexander J. Lovshin to John A. Grah, chief executive officer.

Lovshin brings more than ten years of experience in healthcare to his new position, including three in business development and performance improvement at Saint Louis University Hospital, where he was director of special projects. Prior positions at Saint Louis University Hospital include Accountant and Administrative Fellow.

In 2012, Lovshin joined Cardinal Glennon Children’s Medical Center as Executive Director for Ambulatory Care.

Most recently, he was a consultant in the area of medical practice operations and planning.

Lovshin received his bachelors of science in healthcare administration from Washington University and his masters of health administration from Washington University Medical School. He completed an administrative fellowship with Saint Louis University Hospital.

Dr. Scott Westfall, Mercy Clinic vascular surgeon and principal investigator for CREST-2 at Mercy said the study is significant to determine the best approach to care for patients with carotid stenosis and no stroke symptoms.

CREST-2 will compare include intensive medical management or intensive medical management combined with carotid endarterectomy (en-dar-ter-EKta-mee) or carotid stenting. Carotid endarterectomy is an operation in which surgeons clean out and repair a main artery supplying blood to the brain. Carotid

stenting is a procedure where a metal device called a stent is placed in a narrowed part of the carotid artery to cover the plaque and hold the vessel open. During the stent procedure, a small umbrella-like instrument called an embolic protection device is placed above the stent to catch any particles that might break away.

The carotid surgery and carotid stenting procedures in CREST-2 will only be performed by doctors who have demonstrated safety and expertise in the procedures. Of the study participants assigned to carotid revascularization, about

half will receive carotid endarterectomy and about half will receive a carotid stent.

All participants will receive intensive medical management.

Dr. Westfall heads the team at the Mercy. Mercy Clinic vascular surgeons Drs. Vito Mantese and Richard Pennell are also approved surgeons for the trial.

Other doctors involved on the medical management team include Mercy Clinic Drs. William Logan, neurologist; Timothy Schloss, internventional cardiologist; David Rempe, neurologist; and neurology nurse practitioner Marnie Donohoo.

Mercy One of First in US to Offer New Trial to Prevent Strokes Physicians at Mercy Hospital St. Louis are offering patients a clinical trial designed to compare three different methods of stroke prevention to find the safest and most effective treatment for patients with carotid artery narrowing. The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Study (CREST-2), is supported by the National Institute of Neurological Disorders and Stroke of the National Institute of Health.

Since the trial is just launching, Mercy Hospital St. Louis is one of the first 11 centers (with a goal of 120) participating in the study that is seeking 2,480 participants across the United States and Canada over the next five years. To qualify, participants must be at least 35 years old, have a significant narrowing of one carotid artery with at least 70 percent blockage, and have no history of stroke or transient ischemic attack (TIA) within the last six months.

Buildup of atherosclerosis or plaque, commonly known as hardening of the arteries, occurs at the point where the carotid artery divides into the internal and external arteries. Patients with carotid artery disease may be at risk for stroke if clots or debris from the plaque are dislodged from the carotid artery wall. As this material travels through blood vessels it can interrupt blood flow to the brain resulting in stroke. stlouismedicalnews

.com

EVERY PATIENT IS UNIQUE. Saint Louis University Physicians know this. That’s why we have teams of specialists to listen to, treat, and care for patients. And why our physicians began combining traditional medical imaging with 3D printing. The result puts a custom-made, true-to-life model in our surgeons’ hands before any incisions are made. It’s a part of Informed Medicine – our philosophy that reconnects the science of medicine, with the soul of it.

See how informed medicine makes a difference at SLUCare.edu

MAY 2015

>

11

Built on integrity.

Medical Malpractice Liability Insurance Cyber Liability Insurance Extended Reporting Coverage George R. Schoedinger III, M.D. President and CEO

231 South Bemiston, Suite 1000, St. Louis, Missouri

Learn more today at galeninsurance.com