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PHYSICIAN SPOTLIGHT PAGE 3
Donna R. Powell, DO
LETTER FROM THE EDITOR The Tampa Bay Medical News family is getting larger, thanks to the addition of the ManateeSarasota-Charlotte market. It will appear monthly as a regular section under the banner, ManateeSarasota-Charlotte Medical News. The expanded audience of licensed MDs and DOs and healthcare administrators provides greater opportunities for partnerships with Medical News. Medical News also provides partnership opportunities with special publications and awards programs. Articles for both markets will be available online, in print, and in our digital editions. As we roll out the expansion, please let us hear from you about ways we can deliver the highest quality industry news – clinical and business – to the local medical community. With 15 markets across the Southeast and MidWest, Medical News remains the nation’s only local B2B monthly publication for the medical community. Feel free to contact me with story ideas, suggestions, feedback, and/or Physician Spotlight candidates to Lynne@MedicalNewsInc.com.
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Unprecedented Accomplishments
Stephen Klasko leaves USF Health in stellar shape By LyNNE JETER
‘‘
The reason I was able to do so much was
TAMPA, Fla. – In less than because our supportive team didn’t back down the a decade, Stephen Klasko, MD, first time somebody didn’t like what we did. has transformed the medical component of the University of Dr. Stephen Klasko Stephen Klasko, MD, Dean, USF Morsani College of Medicine; USF Health. South Florida (USF) into two formidable institutions – USF and staff. But there’s also something Morsani College of Medicine and USF Jefferson University and the TJUH Sysmore,” said Klasko, dean of the USF Health – with unique partnerships, innotem, the first person selected to head both Morsani College of Medicine and CEO of vative collaborations, aggressive planning, institutions. USF Health. “In most places, a president and clearly outside-the-box thinking. While here, Klasko laid the groundand board really try to micromanage This month, Klasko is transitioning work for turning Tampa Bay into a true health sciences. (USF CEO) Judy Genshaft from Tampa to his hometown of Philamedical destination. delphia, Penn., where he’ll lead Thomas “We obviously have a great faculty (CONTINUED ON PAGE 4)
’’
FMA Roundup
Annual meeting nets fresh focus and local representation; survey results announced By LyNNE JETER
In his installation speech on July 27 as president of the Florida Medical Association, Jacksonville gastroenterologist Alan Harmon, MD, said he sensed a movement of physicians “separating into various interest groups as economic forces” swirl around the state’s healthcare industry. “We’ve all taken an oath to have loyalty to our patients and to our colleagues,” said Harmon, whose leadership focus is
Dr. Alan Harmon
“Strength and Progress through Unity.” “External and internal forces will try to split our organizations asunder, but we must all resist having the House of Medicine divided. I’ve started a process of contacting the executives of the various county medical societies regarding our need to work together, and I’ve been greatly encouraged by the response.” Also in July, the FMA
launched the Business of Medicine Quarterly Index Survey to identify hot-button issues concerning Florida physicians. The findings reveal a physician workforce concerned about burdensome regulations, decreasing reimbursement rates, and medical liability issues while practicing medicine in a rapidly evolving healthcare system.
Highlight:
What could be done at the state level to help doctors practice medicine? • Reducing burdensome regulations (30.34 percent); (CONTINUED ON PAGE 5)
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PhysicianSpotlight
Donna R. Powell, DO Gastroenterologist, HealthPoint Medical Group By JEFF WEBB
TAMPA - For 10-year-old Donna Powell, the event was painful, but prodigious. “My mother drank coffee every morning. She would pour it from the pot and then put it in the microwave for another minute. It was super hot,” Powell recalled. “We were in the car one day and (the coffee) was on the dashboard when a car pulled out in front of us” and she had to brake abruptly, Powell said. “The coffee poured all over my lap and I ended up with some severe burns.” Powell was treated in her native Philadelphia at a hospital that had a special burn unit. “Initially they thought they might have to do a skin graft,” she said, “and a physician named Dr. Brown was there to assure my parents I would be OK. He eventually told my parents that I was healing nicely and would not need a skin graft. I remember seeing the relief on my parents’ faces. My mom was so happy she hugged him. From that point on I said ‘I would like to make people feel that way, help them feel better,” said Powell. “That was when I decided I would be a physician.” About three years later Powell’s father, an engineer, was transferred to Florida and the family moved to New
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Port Richey, where Powell was a member of the swimming and track teams as she earned a Bright Futures Scholarship to attend the University of South Florida and study biology. As she applied to medical schools, Powell said she was focused on osteopathic medicine “because I liked the philosophy of the whole-person approach” to healing, she said. But she also was motivated by a bit of wanderlust. “I thought I wanted to live back up north,” she said, so she enrolled at Lake Erie College of Osteopathic Medicine in Erie, Pa. She completed her medical doctorate there, but also came to the realization that “Erie was too far north and tool cold. It snowed in April! I said to myself ‘Florida’s not too bad, after all.’” she laughed. “I don’t want to see snow again ever. I am totally fine living in Florida, especially Tampa, for the rest of my life.” Back in Tampa Bay, Powell completed her internal medicine internship and residency at Northside Hospital and Tampa Bay Heart Institute in St. Petersburg. Powell said she “realized I was gravitating toward patients who had abdominal pain. It was interesting because it was kind of like a mystery. Is it their gall bladder? Or do they have an ulcer? What’s causing their pain? That was intriguing.” But the variety of gastroenterology as
a specialty also held appeal, she said. “You get to do procedures at the same time you are practicing medicine. It’s kind of in-between medicine and surgery. I thought it was really cool that I could do procedures and treat issues with a direct, hands-on approach without necessarily being in the OR” most of the time, said Powell. Powell completed her gastroenterology training with a three-year fellowship
at Largo Medical Center before joining HealthPoint Medical Group in January. She sees patients at both the Habana Avenue and Van Dyke Road offices, where she works with five other gastroenterologists and a nurse practitioner. Powell said she schedules most of her procedures for the mornings and sees patients in her office during the afternoons. Most procedures are at St. Joseph’s Hospital in Tampa, and St. Joseph’s Hospital-North in Lutz. “I have nothing but positive things to say about the hospitals and staff,” Powell said. “Everyone is helpful and nice. It’s a great place to work.” Powell said she also does seminars at St. Joe’s about the importance of colonoscopy screenings because she thinks education is an important part of her responsibility to patients. But when she is not working as a physician, Powell said she immerses herself in her family. “The greatest challenge for me has been learning how to balance both family and work. I feel this is a task that I have begun to master over time in that I try to keep the two totally separate,” said Powell. “When I am at work I focus on work; when I’m at home I focus on my family.” Powell and her husband Cedric, a financial adviser, have been married 8 years and they have three children under the (CONTINUED ON PAGE 5)
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Unprecedented Accomplishments, continued from page 1 (PhD) and our board promised when I came here in 2004 from Philly they were going to give me the keys to create the medical school and health sciences center of the future. They fulfilled that promise.” When Klasko joined USF, the university had four separate colleges. Four or five deans had passed through the doors in a decade. Klasko was immediately challenged with budget cuts. Since 2004, the medical school has lost 43 percent of its state funding; four new medical schools have opened in Florida. “The reason I was able to do so much was because our supportive team didn’t back down the first time somebody didn’t like what we did,” explained Klasko. “Judy and three board chairs in particular – Dick Beard, Rhea Law and John Ramel – have all been unbelievably supportive of our initiatives. They said, ‘make this great and we’ll look at the results.’ We’ve taken some calculated risks and done some things statewide even with local pressure.” Last year, Klasko brought in Steve Liggett, MD, a pioneer in the emerging field of personalized medicine, to direct the newly created USF Health Personalized Medicine Institute. Then Klasko helped craft an innovative, public-private strategic alliance with Florida Hospital to boost the quality of patientcentered care and improve outcomes in cardiology, breast health, neuroscience and surgical oncology. He also helped engineer a record gift – $37 million by Frank and Carol Morsani – whose name now precedes the new College of Medicine. To cap 2012, he opened the nation’s first-of-its-kind Center for Advanced Medical Learning and Simulation (CAMLS). “We cannot transform this whole healthcare system, reduce admissions, create better quality, and have less mistakes without the ability – like the airlines have taught us – to simulate those models, not just technically, but also from a teamwork prospective,” said Klasko about CAMLS. CBS “Sunday Morning’s” Charles Osgood called CAMLS’ training a “stress test simulating real life-and-death circumstances” for emerging surgeons. And the 2012 list of milestones doesn’t include perhaps Klasko’s greatest triumph: a partnership with The Villages, the nation’s first community-led, primary care-driven Accountable Care Organization (ACO). “It’s also probably the nation’s first true university-community partnership,” said Klasko, adding that 40 family doctors will partner with USF as exclusive specialists. At press time, 31 family doctors had been hired. Earlier this year, USF Health contracted with United Healthcare to manage the insurance component. “The Villages project has received national attention, and we’ve even had venture capitalists come see how we’re going to serve 90,000 people,” he 4
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‘‘
Some have complained that (healthcare) isn’t like it was before. Guess what? It wasn’t that great before! Things are better. We’ve got to stop whining. We can’t count on the government to solve our problems.
’’
– Stephen Klasko, MD, Dean, USF Morsani College of Medicine; USF Health.
said. “If we save $3 million by providing healthcare more efficiently and effectively, $1 million will go back to the insurance company, $1 million will go back to USF, and $1 million will go back to the community. It’s a reinvestment in the local healthcare community that everyone can see. It’s very, very exciting.” Also, Klasko generated $2 million from Hillsborough County for the USF Health Byrd Alzheimer’s Institute. The state has earmarked $20 million toward the USF Health Heart Institute. With the Moffitt Cancer Center, a teaching affiliate of USF, USF Health has the only on-campus, NCI-designated Comprehensive Cancer Center based in Florida. “There’s probably no place in the country that has that concentration,” he said. Remarkably, Klasko brought these initiatives to fruition during a time of economic sluggishness and incredible turmoil in the healthcare industry. “While everyone else was fighting the Affordable Care Act, we’ve taken another approach,” he said. “We’ve
asked ourselves: What can we do now? Each of those accomplishments wasn’t happenstance. For example, we think it’s ridiculous that we still accept medical students based on their science GPA, MCAT scores, and ability to memorize organic chemistry formulas. We have a program now where we’re choosing students based on emotional intelligence. We think 10 years from now, it’ll be obvious that if you have a robotic surgeon, he’ll be competent. If you have a doctor, he can communicate well. Today, that’s not the case. So we built CAMLS.” Nationwide over the next decade, Klasko predicts more partnerships will emerge – perhaps some surprising ones – between universities and communities. “It’s obvious that university (higherups) will no longer be able to sit in their ivory towers and hope that communities will send all their patients to them and charge whatever they want,” he said. “People will be rewarded with better care, not more or less care.” Changes in medical care via personalized medicine are already taking hold,
Two healthcare leaders were tapped to replace Stephen Klasko, MD, who is transitioning this month from Tampa to Philadelphia, Pa., as head of Thomas Jefferson University and the TJUH System. Harry van Loveren, MD, chair of the Morsani College of Medicine Neurosurgery Department, and Donna Petersen, ScD, dean of the College of Public Health, are interim leaders for USF Health. Van Loveren serves as interim dean of the Morsani College of Medicine; Petersen leads USF Health as interim CEO.
said Klasko. “For example, we’re already changing cardiology treatments based on genomics,” he said. “This gets back to where everything comes together. At The Villages, our goal within 18 months is that all 90,000 residents will be on a common electronic health record, along with their history, physical and genetic data. For example, Steve (Liggett) has just done a polymorphism study about people at risk for Alzheimer’s. We’ll go to The Villages and do an analysis of all 90,000 people who are normal but have that genetic combination.” Klasko attributes the institutions’ philanthropic successes, such as the $37 million gift to establish the Morsani College of Medicine, and the Morsanis’ additional contribution of $2 million to create the Klasko Institute for an Optimistic Future in Healthcare, to “an optimistic approach during a challenging time.” “Some have complained that it’s not like it was before. Guess what? It wasn’t that great before! Things are better. We’ve got to stop whining. We can’t count on the government to solve our problems,” he said. When asked if items remained on his wish list to accomplish in Tampa, Klosko named two. “One, I’d like to see the vision of MediFuture 2023 (by leaders Rick Homan, CEO of the Tampa-Hillsborough Economic Development Corporation, and Stuart Rogel, CEO of the Tampa Bay Partnership) really take hold,” he said, noting that MediFuture is a local leader initiative by visionary stakeholders to shape the transformation of healthcare in the Tampa Bay area. USF was a sponsor of the kick-off event; USF Health is a key driver of the ‘disruptive innovation initiative’ in the Tampa Bay region. “I was part of that movement, which started earlier this year,” he continued. “The whole concept of Tampa Bay’s ‘where tomorrow’s healthcare happens today,’ shows healthcare as an economic development tool, and I’d like to see Tampa become a robust healthcare hub. “Two, I’d like see local hospitals work together and with USF, such as Tampa General, Moffitt, and Florida Hospital, to really create a Tampa Baybased medical center. It doesn’t matter what it’s called. The winners are going to be those who can really consolidate around a vision and then make creative partnerships.” On one hand, Klasko said, Tampa has a strong cluster base. On the other hand, it’s comprised of individual hospitals working separately. “To really achieve what we have the potential to do is for people to identify an academic medical center in Tampa Bay,” he said. “I’m hoping that as people look at the potential … and start to talk to each other, those two things will happen.”
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PhysicianSpotlight
Donna R. Powell, DO continued from page 3
age of 6. “It was initially difficult to draw that line (between her personal and professional lives), especially when you have children back to back to back. It takes a bit of an adjustment. But the only way I can be a really good mother at home is to separate that from work, and vice versa,” Powell said. But that doesn’t stop her children from being proud of what mommy does for a living. “My oldest daughter tells everyone she sees that mommy is a doctor,” Powell laughed. When she can find time, Powell likes to dance. Her parents live in Trinity and her mom is a Zumba instructor, so she squeezes in classes when possible. Powell also has a home gym where she stays in shape on a stationary bike and an elliptical. “But I mostly just go home and play with my kids,” she said. Powell also places a family priority on her faith. She attends Bible-Based Fellowship Church in Carrollwood. “It is an important part of my life. I am a Christian and in my daily practice I try to incorporate that. I often ask myself ‘What would Jesus want me to do in this situation?’” she said. Powell said the best advice she was ever given also is rooted in her faith: “God will never put more on you than you can handle.”
FMA Roundup, continued from page 1 • increasing payment for physician services (22.47), and; • bringing increased fairness to the medical liability system (16.85 percent). “We’re providing them with the resources they need to successfully adapt to the modern healthcare landscape and continuing to fight for policies that allow them to focus on patient care, not regulatory and administrative obstacles,” said FMA Executive Vice President Timothy Stapleton. “These results will help us further focus our advocacy so that we can do even more to help Florida physicians practice medicine.” State survey feedback mirrors national industry trends: More Florida practices and physician employers are mulling alternative payment models (40.41 percent). Many have implemented electronic medical records (EMR) technology (69.77 percent). Most respondents are practice owners, partners or associates (57.46 percent); a significant percentage of them now work for hospitals, medical groups or health systems (29.6 percent). Looking ahead, half of respondents plan to continue working as normal in the next few years. The balance said they would consider reducing work hours (10 percent), retiring (7 percent), changing to a “concierge” practice (2.5 percent), seeking hospital employment (2.25 percent), and reducing their patient load (1.25 percent). One in four doctors said EMRs have improved the quality of patient care. Another 10 percent said even though the new electronic systems hadn’t improved the quality of patient care, they felt confident it would happen.
TAMPA BAY: At the annual meeting of the 139-year-old organization, 2013-14 FMA councils and committees were announced. Local members include: • AMA Delegation: David Becker, MD (Safety Harbor); Madelyn Butler, MD (Tampa Bay); Ralph Nobo Jr. MD (Bartow)*; and Michael Wayslik, MD (Tampa). Alternate Delegates: Lee Alice Goscin, MD (Largo); Kenneth Louis, MD (Tampa); Sergio Seoane, MD (Bartow); and Michael Zimmer, MD (St. Petersburg) • Committee on Bylaws: Ralph Nobo, Jr., chair (Bartow)* and David Becker, MD (Clearwater) • Committee on Federal Legislation: David Becker, MD (Safety Harbor); Madelyn Butler, MD (Tampa); and David McKalip, MD (St. Petersburg); Ralph Nobo, Jr., (Bartow)*; and Michael Wasylik, MD (Tampa) • Committee on Finance & Appropriations: Ralph Nobo, Jr., (Bartow)* and Michael Wasylik, MD (Tampa) • Committee on Membership: Jose Jimenez, MD (Tampa) • Committee on Accreditation and CME: Bruce Shephard, MD (Tampa) • Council on Ethical & Judicial Affairs: Jack Rothman, MD (Clearwater); Nancy Silva, MD (Tampa); and Dennis Agliano, MD, AMA liason. • Council on Healthy Floridians: Jayant Rao, MD (Tampa) and FMA Alliance Nimisha Chheda (Tampa) • Council on Legislation: Stanley Dennison, MD (Tampa); Ralph Nobo Jr. (Bartow)*; Ed Homan, MD, special advisor (Tampa); and William Pearce, MD (Tampa). • Council on Medical Education: LingLing Rong, MD, RFS (Tampa) and Jason Wilson, MD (Tampa) • Council on Medical Services and Health Care Delivery Innovation: Ajoy Kumar, MD (St. Petersburg) and Michael Wasylik, MD, chair of the Managed Care Subcommittee (Tampa) • Task Force on the Future of Medicine: Madelyn Butler, MD (Tampa) and Jose Jimenez, MD (Tampa) *FMA PAC President
MANATEE-SARASOTA-CHARLOTTE: At the annual meeting of the 139-year-old organization, 2013-14 FMA councils and committees were announced. Local members include: • AMA Delegation: Robert Lastomirsky, MD (Venice) • Audit Committee: Michael Patete, MD (Sarasota) • Committee on Membership: Michael Patete, MD (Sarasota) • Council on Legislation: Aaron Sudbury, MD (Bradenton) and Ricardo Morales, PA-C, FAPA, non-voting (Sarasota) • Council on Medical Services and Health Care Delivery Innovation: Steven Shell, DO (Port Charlotte)
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New Lines of Research
NCI Data Set Opens Access to Cancer-Related Genetic Variations By CINDY SANDERS
How will this breast cancer drug react in patients that are HER2 positive? Will this new lung cancer therapy work in a patient with multiple genetic variations? Finding answers to those questions just got a bit easier with the rollout of a vast data set of cancer-specific genetic variations by scientists at the National Cancer Institute (NCI). Yves Pommier, MD, PhD, chief of the Laboratory of Molecular Pharmacology at the NCI, was one of three lead researchers on the study, published July 15 in Cancer Research, that pinpointed more than six billion connections between cell lines with mutations in specific genes and the drugs that target those genetic defects. Paul Meltzer, MD, PhD, chief of the Genetics Branch at the Center for Cancer Research and James Doroshow, MD, director of the Division of Cancer Treatment and Diagnosis, were the other principal investigators. Pommier explained the new database builds upon the NCI-60 cancer cell line collection, which is comprised of nine different tissues of origin – breast, ovary, prostate, colon, lung, kidney, brain, leukemia and melanoma. In their Cancer Research article, the authors note the NIC-60 panel is the most frequently studied human tumor cell line in cancer research and has gen-
erated the most extensive cancer pharmacology database worldwide. “Most of the cell lines are from cancer tissues that are hard to treat and are usually resistant to therapy,” he said. “The genomic database is unmatched and enables researchers to mine all the gene expression in relationship to a drug.” Pommier continued, “Each drug has a different profile in the cell line because they act on different targets.” In this most recent study, the investigators sequenced the whole exome of the full NCI-60 cell lines to define novel cancer variants and deviant patterns of gene expression in tumor cells. “The whole genome for the cell line has never been done before,” he said. “Many, many genes had never been sequenced.” The researchers cataloged the genetic coding variations, developing a list of possible cancer-specific gene aberrations. The group then used the Super Learner algorithm to predict the sensitivity of cells with variants to more than 200 anti-cancer drugs … those approved by the FDA and those still under investigation. By study-
ing the correlation between the gene variants – such as TP53, BRAF, ERBBs, and ATAD5 – and anti-cancer agents including vemurafenib, nutlin and bleomycin, the researchers were able to predict outcomes, showing one of the many ways the data could be used to validate and generate novel hypotheses for future investigation. Access to the data is freely available through multiple sources including the CellMiner and Ingenuity websites. By opening up the scalable data on the whole genome sequencing and drug connectivity, Pommier and his colleagues hope to help other researchers connect cancer-specific gene variants with drug response to move the science forward. “It’s an evolving sys-
tem,” he said, adding that profiles on drugs in clinical trials will be added to the database as information becomes available to keep the data set current. In explaining how the system works, Pommier said a researcher interested in a specific agent could plug that drug into the database. “You’ll get the profile activity of the drug, and then you can ask if there is any match to any specific gene mutations,” he said. From there, Pommier continued, the researcher could query, “Are these cells more resistant or receptive to the drug?” Getting those answers rapidly should help researchers move major lines of oncology drug development toward personalized medicine to achieve optimal outcomes in a safer, more efficient and effective manner. With the added knowledge provided by the data bank, Pommier said researchers might separate patients into groups based on their genetic profile and therefore be able to use specific drugs in a more rational manner. “Between a targeted drug and a clinical application, you need a verification in the middle,” he stated. That’s just what this new database offers.
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Breakthrough Procedure for Lymphedema Orlando Health Surgeons Bring VLNT to Florida for Lymphedema Patients By LYNNE JETER
ORLANDO – Six months ago marked the advent of Florida’s first Vascularized Lymph Node Transfer (VLNT) procedure, which took place at Orlando Health under the direction of Dr. Richard Klein Richard Klein, MD. Since then, Klein and his surgical team have assessed 40 patients with lymphedema, a chronic condition that leads to swelling of the arms and legs. They’ve completed a half dozen VLNT procedures, with a half dozen on the books. Because the only surgical treatment for lymphedema is so new to the United States, with few surgical teams trained to perform the complex microsurgery, many physicians aren’t yet aware of the new procedure. “We see many patients suffering from lymphedema and no one had a cure other than conservative efforts such as massaging and compressions, so we started aggressively looking for surgical outcomes,” said Klein, who oversees MD Anderson Cancer Center Orlando’s Plastic and Reconstructive Surgery Center for Orlando Health, and received special training in Paris to bring VLNT to
Florida. “This procedure has the potential to change the lives of patients affected by lymphedema who, until now, had very little options for treatment.” Lymphedema prevents lymph fluid from draining from the tissues in the body and as a result, fluid builds up and causes swelling and soreness to one of the extremities and significantly increases the risk of infection in the affected limb. In many cases, lymphedema causes chronic wounds and ulcers and breakdown of the skin. VLNT moves lymph nodes from one area of the body to another that’s affected by a blockage in the lymphatic vessels, relieving sufferers’ pain and discomfort and allowing them to resume their daily activities. Most insurers have covered the procedure. Klein learned about VLNT from Corinne Becker, MD, a Paris surgeon who’s performed more than 4,000 lymph node transfers in the treatment of both upper- and lower-extremity lymphedema over the last two decades. Two years ago, Becker gave a lecture about the new treat-
ment at a symposium in New York that Klein attended. Last November, he traveled to Paris to train with her for a week. When he returned to Orlando Health, he trained fellow surgeons Kenneth Lee, MD, and Jeffrey Feiner, MD, on the twosurgeon technique. “The operation is very demanding because the first step is to go back to the site which nodes were taken from without damaging any nerves,” explained Klein. “There’s usually a lot of scarring in that area from previous surgeries. You have to
find a small artery and vein in the location to transfer and set it into. Then, you have to harvest tissue from another part of the body without causing lymphedema in that location. Those lymph nodes must be attached to a small vein. The artery and the vein measures approximately 8.8 millimeters, so it’s a very tiny vessel. Then you’re operating under a microscope to reattach the artery and veins and sutures to put arteries together. That’s how small they are.” The first VLNT patient, local breast cancer survivor Jean Hutchinson, is doing remarkably well, said Klein, who led the surgical team to transfer lymph nodes from Hutchinson’s abdomen to her arm pit, and reconnected arteries and veins to provide the transferred lymph nodes oxygen and nutrients to survive and develop new lymphatic tissue. She had developed lymphedema in her right arm following breast surgery and radiation, and had lived with the condition for 18 months. “Jean is a perfect patient,” he said. (CONTINUED ON PAGE 12)
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PROUDLY SERVING FLORIDA’S CULTURAL COAST
Expediting EHR Implementation
Allscripts and Sarasota Memorial partner to implement federal program By LyNNE JETER
SARASOTA —Physicians affiliated with Sarasota Memorial Hospital (SMH) who don’t yet have patients on electronic health records (EHRs) have a unique opportunity to partner with the local public hospital and take advantage of a substantial startup subsidy and Meaningful Use (MU) incentive money. Physicians could also avoid accruing penalties in 2015 for not having an EHR system. On Jan. 1, 2012, SMH partnered exclusively with Allscripts, a Chicago-based healthcare information technology firm, and one of the nation’s leading vendors
certified to meet the government’s definition of MU, on an outpatient basis via a subsidized EHR community program for physicians affiliated with the hospital. (SMH and Allscripts have partnered on inpatient solutions for 15 years.) The SMH-Allscripts offering became available when the federal government relaxed the Stark laws (until Dec. 31), providing a way for hospitals to subsidize up to 85 percent of the entrance fee to EHR implementation, which includes licensing and implementation fees. Affiliated physicians need only pay the remaining 15 percent, plus the hardware and $600 (CONTINUED ON PAGE 11)
Shining a Light on Physician, Industry Relationships Physician Payments Sunshine Act Now in Effect By CINDy SANDERS
If you’ve recently enjoyed a golf outing with your friendly pharmaceutical rep or a nice dinner with a device manufacturer, that information will soon be available for all to see. The Physician Payments Sunshine Act went into effect Aug. 1 of this year and requires applicable manufacturers to report certain interactions with physicians and teaching hospitals that are deemed to have value. ‘Applicable manufacturers’ are defined as pharmaceutical, device, biologic and medical supply manufacturers whose products either require a prescription to be dispensed or for which payment under federal healthcare programs is available. “The Sunshine Act generally applies when physicians or teaching hospitals receive transfers of value from applicable manufacturers, and the applicable manufacturers receive actual or potential value in return,” explained Tom Baker, a shareholder in the Baker Donelson Health Law group. Baker, who practices in the firm’s Atlanta office, pointed out the manufacmedicalnews
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turer doesn’t actually have to receive financial benefit in exchange for the ‘value transfer,’ which can take a wide variety of forms, including donated items, payment to a physician for consulting services or expenditures for entertainment. “It’s enough that it might influence a physician,” he noted. “The Sunshine Act is about transparency in two different fundamental ways,” he continued. “First, there is the potential interference in medical judgment in clinical trials required for FDA approval of drugs or medical devices. Second, there is potential interference in medical judgment in terms of ordering an item or service for which federal reimbursement is available.” Baker said the policy is to shine a light on interactions that could be construed to unduly influence a physician or teaching hospital and to ferret out conflicts of interest. “It’s not saying that transfers of value are, per se, illegal but that the public has a right to know when medical judgment might be influenced by the value transfer,” he continued. Relationships between physicians and industry will now be on display for patients, auditors, personal in-
jury lawyers and others to see when the Centers for Medicare and Medicaid Services (CMS) begins publishing the reported data next fall. (CONTINUED ON PAGE 10)
12 KEY EXEMPTIONS TO THE REPORTING RULE • Certified and accredited CME. • Buffet meals, snacks, coffee breaks that are provided by a manufacturer at a large-scale conference or event when the items are generally available to all attendees. • Product samples that are not intended for sale and are for patient use. • Educational materials that directly benefit patients or are intended for patient use. • The loan of a medical device for evaluation during a short-term trial period (not to exceed 90 days). • Items or services provided under a contractual warranty in the purchase or lease agreement for a device. • The transfer of any item of value to a physician when that physician is a patient and not acting in his or her professional capacity. • Discounts including rebates. • In kind items for use in providing charity care. • A dividend or other profit distribution from, or ownership or investment in, a publicly traded stock or mutual fund. • Transfer of value to a physician if the transfer is payment solely for the services of the physician with respect to a civil or criminal action or an administrative proceeding. • A transfer of anything with a value of less than $10 unless the aggregate amount transferred to, requested by, or designated on behalf of the physician exceeds $100 in the calendar year.
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Shining a Light, continued from page 9 The Back Story
Act. A couple of missed rulemaking deadlines by CMS pushed the law’s effective date to Aug. 1, 2013 for the balance of this calendar year and requires annual reporting going forward.
Championed by Sen. Chuck Grassley (R-Iowa) and Sen. Herb Kohl (D-Wis.), the impetus behind the Sunshine Act came from mounting concern over potential conflicts of interest within the industry. These conflicts were highlighted by several egregious incidents involving clinical trials and devices up for FDA approval where physicians received large payments from the manufacturers of the drugs or devices being studied. Grassley publicly described a number of academic physicians taking money from the National Institutes of Health when those physician-scientists had direct financial interests in their own research. Among the worst offenders, the former chairman of the Psychiatry Department at Stanford University received an NIH grant to study a drug when he owned $6 million in stock in the company seeking FDA approval. Similarly, the former chair of the Psychiatry Department at Emory failed to report hundreds of thousands of dollars from GlaxoSmithKline while researching the company’s drugs. Harvard also had to discipline three researchers who received almost $1 million each in outside income while heading up several NIH grants. Outside of these flagrant examples, the concern persists that much smaller gifts might also influence medical decisions. Earlier this year, Pew Charitable Trust published Persuading the Prescribers: Pharmaceutical Industry Marketing and its Influence on Physicians and Patients, which stated the drug industry spent nearly $29 billion marketing their products in 2011 (Source: Cegedim Strategic Data). Of that amount, $25 billion was spent directly marketing to physicians. After unsuccessfully introducing the legislation in 2007, the Sunshine Act was incorporated into the Affordable Care
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With 12 major exceptions (see box), any direct payment or transfer of value of $10 or more (or an aggregate of $100 or more in a calendar year) to a physician or teaching hospital must be reported. Additionally, indirect transfers through an intermediary or third party are also subject to reporting. There are 14 main reporting categories. These include consulting fees, compensation for services other than consulting, gifts, entertainment, food, travel, charitable contributions, education, grants, research, royalty or licensing fees, current or prospective ownership or investment interest, direct compensation for serving as faculty or a speaker for a medical education program, honoraria. Under the new rules, Baker said a physician could accept a ballpoint pen or pad of sticky notes from a manufacturer without it being included in the annual report, but most meals, tickets, or gifts probably will fall under one of the reporting categories considering the $10 threshold. “The days of the pharmaceutical company taking a group of physicians to the Super Bowl are over … or at least it will be disclosed and expose you to the risk of Anti-Kickback statute prosecution,” Baker said. “It’s the entertainment part of it that physicians would probably like to have exposed the least,” he added. The law also requires applicable manufacturers and GPOs (group purchasing organizations) to report ownership interests by physicians or their immediate family members. It should be noted, however,
Disputing a Report
So what happens if your name appears on a report, and you disagree with the data? Baker said CMS is going to notify physicians of all their reported relationships. Once access is granted to the online portal housing the consolidated report, a physician should have at least 45 days to challenge the data and try to resolve the dispute with the reporting entity. Those who cannot agree will be given an additional 15 days to come to a resolution before the information is made public. If no agreement can be reached, the data will be published but flagged as disputed. Physicians cumulatively have up to two years to dispute reports even after the data is published. “While physicians aren’t required to track transfers of value, they are encouraged to do so,” said Baker. “How in the world are you going to be able to refute a report if you don’t have evidence to the contrary.” Baker pointed out you might not think you received an influential ‘gift’ from a device manufacturer by grabbing a bite of lunch, but even a sandwich, tea, tip and
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that purchased industry stocks and mutual funds that are generally available to the public are not reportable. If Dr. Smith buys 50 shares of ABC Pharmaceutical stock, which is publicly traded, it doesn’t have to be reported. If a representative of ABC Pharmaceutical gives Dr. Smith stock, then it does. Ultimately, a patient whose doctor recommends a specific device or drug will be able to search the CMS database to see if there is a connection between the physician and the manufacturer. “You’re going to know when your physician has a personal financial interest in your healthcare beyond the physician’s professional services,” Baker pointed out.
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tax is often over the $10 threshold. Short of asking to see the bill, it would be difficult to gauge the cost per person at the table; and without a copy of the receipt, it would be difficult to dispute the reported item. “As a practical rule, doctors probably aren’t going to be good at refuting the evidence,” Baker said. However, he added, CMS has created a smartphone app with a version for industry and another for physicians to make it easier to keep track of reportable transfers. “Open Payments Mobile” is available at no charge through the Apple Store and Google Play Store.
Timeline
Data accumulation for 2013 has already begun. Below is a timeline of upcoming key dates in the process. Jan. 1, 2014: Anticipated launch date for CMS physician portal where doctors can register to receive notice when their individual consolidated report is ready for review. This portal also provides a means for physicians to contact manufacturers and GPOs about disputes in accuracy. March 31, 2014: Partial year data (August-December 2013) must be turned into CMS. June 2014: Anticipated access to individual consolidated reports from 2013. Physicians have a minimum of 45 days by law to seek corrections or modifications to the information by contacting manufacturers/GPOs through the portal. September 2014: Searchable reports are published and open to the public.
Be Prepared
“The act itself is vexing,” said Baker. Adding to the frustrations, he continued, is that CMS is interpreting the Sunshine Act very broadly. “The applicable manufacturers are not going to take any chances,” Baker continued. He noted, those who accidentally fail to disclose required data will face penalties of not less than $1,000 and not greater than $10,000 per incident up to a cap of $150,000 annually. Those who knowingly withhold reportable information face penalties between $10,000 and $100,000 for each value transfer with an annual cap of $1 million. “Physicians need to know other people are going to be talking about them,” concluded Baker. “One would hope everything reported is within the legal boundaries … but if you are testing those boundaries, you better stop.”
MORE INFORMATION FOR PHYSICIANS The American Medical Association has put together the “Physician Sunshine Act Tool Kit” with additional information on the new requirements, a webinar and links to the free mobile app. To access the kit, go online to www. ama-assn.org/go/sunshine.
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Expediting EHR, continued from page 9 monthly maintenance fees on a 3-year, $21,600 contract.
Speed Bump
Even though all of the hospital’s 800plus affiliated physicians have access to the hospital’s EHR system, less than 3 percent have signed up with Allscripts to implement EHR in their own practices. Globally, much of the reluctance of physicians to fully implement an EHR solution involves training staff, adopting a new workflow system, and paying maintenance fees. Stark laws prohibit hospitals from subsidizing maintenance costs. SMH provides the training, support and service issues at no cost to affiliated physicians. Cindy Perry, PMP, MS, director of physician IT services for SMH, said the hospital is available to demonstrate the EHR and optional Practice Management systems, and answer questions about how Allscripts software could enhance their practice. “Physicians can evaluate the information and decide if it’s something they’d like to pursue,” said Perry.
Financial Incentives
Early adopters that met MU requirements received the best incentive package: $18,000 in 2011, $12,000 in 2012, $8,000 in 2013, $4,000 in 2014, and $2,000 in 2015, for a total of $44,000. To qualify, the EHR system must be up and running for at least 90 days in the preceding calendar year. Qualifying physicians must also achieve the core measures of MU to receive the incentive payments. For example, 40 percent of prescriptions must be done electronically. With the time needed to implement each system, physicians signing up this late in 2013 will not qualify for 2014 incentive money. However, even though the available incentives for late adopters of EHR systems is substantially lower, it’s enough to offset maintenance contract fees.
Barriers to Change
Initial barriers to EHR implementation include physicians facing a significant change in work flow and adopting a different way to provide patient care.
“It’s challenging to transition from paper to electronic records, but once achieved, providers and patients benefit from the readily available clinical information,” said Perry. Another challenge: the initial population of the patient record. For example, going electronic means patients’ problems, medications, and allergies must be entered into the computer system. The SMH solution helps with getting the information in the computer by allowing the copying of SMH patient demographic data to the physician office database, and interfacing directly with entities, such as SMH, LabCorp, and Quest for automated transmission of laboratory results. SMH support staff provides physician offices with information on best practices to accomplish the initial load, and stays in the physicians’ offices during the initial “go-live” transition to ensure ready assistance. A minor barrier: Some physicians who are close to or considering retirement aren’t as enthusiastic about investing the time and money into a new health records system, notes Zach Schooler, associate client executive with Allscripts, who relocated to Sarasota to assist SMH affiliated physicians with the implementation process. Physicians already using this system have enjoyed benefits such as access to the patient’s record immediately – soon, it’ll be available via mobile device – and builtin drug formularies, e-prescribing on the go, and immediate access to lab results. They’re also coordinating care with other physicians via shared records. With the MU incentives, the federal government accomplishes another mission: making patients more accountable for their health. Patients of physicians with EHRs receive a clinical summary of information, including a list of current medications and details of the visit. For more information on the Allscripts EHR system, contact Zach Schooler, associate client executive, at (352)8741440 or Zach.Schooler@Allscripts.com.
On Saturday, Sept. 7, the community will see the new $186 million Courtyard Tower in full regalia during the grand opening celebration on the campus of Sarasota Memorial Hospital (SMH). The nine-story patient tower replaces the oldest wings of the hospital with 220 beds, adds more private rooms, a landscaped courtyard, and advanced equipment, technology and patient amenities. Improved clinical features include laptop stations built into every room, medical equipment and monitors suspended from the ceiling, and newborn beds equipped with special tools to resuscitate babies in emergency situations. From 9 a.m. to 2 p.m., tours of floors 4 through 9 will showcase new Labor & Delivery and Mother-Baby Suites, an expanded Neonatal Intensive Care Unit (NICU), as well as cardiac and orthopedics units. A brief program will begin at 10:30 a.m., highlighting the Sarasota Military Academy color guard and a time capsule ceremony. Skanska is sponsoring a snow globe photo booth in the courtyard and children’s activities will be ongoing in EPIC Park. The project represents SMH’s largest in half a century.
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Medical Identity Theft, Too Easy to Commit By DANIEL ANDREWS
Medical identity theft can have devastating consequences. Just ask Anndorie Sachs, a Salt Lake City mother of four who got a call from the Utah Division of Child and Family Services in April of 2007, informing her that agents were on their way to remove her four young children from her home as the result of a stolen driver’s license. It usually takes a jolt like that opening sentence to get most people to take identity theft seriously. In the medical profession, where the HIPAA rules have long been in effect and are applied rigorously by most practices and practitioners, the significance of identity theft can be even slower to sink in. It would be helpful, at this point, to make a clear distinction between lost data and identity theft. Every commercial entity (business, non-profit, educational institution, or other) that has, holds, or collects personal data has a moral and legal obligation to protect that data. Once Personally Identifying Information (PII) has been obtained by someone with ill intent, identity fraud of various types can be perpetrated upon the victim. One type of fraud is medical identity theft, which can have far-reaching and serious consequences that most victims don’t anticipate. Medical professionals have long protected the medical details of patients’ treatments and conditions; however, preventing imposters from getting treatment, prescriptions, or medical devices requires a significant shift in awareness and
methods. This is complicated somelated. As frustrating as that obviously what by the fact that now practically is, those in the medical profession will ALL data is considered private and recognize that an inaccurate medical ... in a study directly detailing the protected – something as simple as history file can actually be deadly. effects of medical identity theft, a name, address, and phone number Is the answer simply to check found that roughly 5.8 percent all as part of one record need to be for a photo ID when a potential pasecured, whether or not medical intient checks in? The scope of the soof American adults had been vicformation is attached. The point, in lutions and approaches that need to tims. Almost half of those (48 short, is that medical identity theft is be considered, practice by practice, not a HIPAA issue, and to the degree is too large and two “personalized” percent) lost their medical covthat HIPAA compliance is in place to be treated as a “one-size-fits-all” erage as a result of the fraud. The has really no bearing on the issues issue. But, it should be noted, that direct economic impact, on aversurrounding medical identity theft. with $20 and two or three weeks The Poneman Institute, in a of patience, any one at all can purage, was in excess of $20,000 ... study directly detailing the effects chase a “novelty ID” that looks of medical identity theft, found that exactly like a state-issued driver’s roughly 5.8 percent of American license, with whatever picture and adults had been victims. Almost half of identifying details the buyer cares to supdifferent hospitals using the stolen ID; she those (48 percent) lost their medical coverply. Take into consideration the fact that gave birth to a pre-mature baby at Univerage as a result of the fraud. The direct ecoa patient’s medical insurance policy numsity Hospital in Salt Lake City. Knowing nomic impact, on average, was in excess of ber is linked to his/her SSN, and that an that giving birth to a chemically-dependent $20,000; that’s money paid by the victims SSN is linked to a driver’s license, and it baby constitutes child abuse in every state for treatments and devices that they never becomes easy to see that medical identity in the U.S., Ms. Moran walked out of the received, attorney’s fees to fight the errors, theft is a relatively easy crime to commit. front door of the hospital and left the infant and more. The indirect impact is imposWhen the victims come looking for somebehind. Naturally, an investigation ensued, sible to measure; since many employers one to blame, will it be YOUR practice and using the information on the driver’s now want details of credit histories (which named in the lawsuit? license that had been supplied at the regcan be impacted by unpaid medical bills) istration desk, Utah DCFS mistakenly conDaniel Andrews is president of Solutions and medical histories, how many people cluded that Ms. Sachs was a criminal, and on the Spot, consulting and insurance. are NOT getting hired simply because a danger to her other children. Although He is a Certified Identity Theft Risk Management Specialist and has been they are the victims of fraud? that element of the crime was eventually reeducating employers and employees Let’s return to the case of Anndosolved, Ms. Sachs is left with a particularly about identity-theft issues since 1988. He is qualified to offer guidance and rie Sachs. Her driver’s license was used disturbing residual effect: since it has been advice across a wide range of industries, (without alteration, it should be noted) by determined that the treatment received by and is a sought-after speaker on various aspects of identity theft in a variety a pregnant woman with a methamphetthe criminal is now a part of Anndorie’s of settings. He can be reached at amine habit, Dorothy Bell Moran. Ms. medical file, she cannot see her own records SolutionsOnTheSpot@gmail.com Moran was checked into not one, but two lest the privacy rights of Ms. Moran be vio-
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Breakthrough Procedure, continued from page 7
“She was very enthusiastic and motivated to have this procedure done. And, she was prepared for the pre-op and post-op therapy to make it successful. Today, she’s so appreciative of how the procedure improved her life.” Prior to the VLNT procedure, Hutchinson underwent lymphatic therapy to prepare her body for the 3-4 hour surgery. Post-surgery, she continues to undergo additional therapy to gain mobility in her arm. With new vessels and active function of the transferred lymph nodes, she saw improvement within a month or two following the surgery. “Having the lymphedema therapy team working in tandem with the surgical team is critical. Having the entire team involved is an absolute necessity, because the operation is only one key component for VLNT to be successful,” said Klein. “Prior to the operation, the affected limb must be decongested and massaged without overwhelming the lymph nodes. It takes a trained lymphedema therapist to do this effectively pre-op and post-op. To monitor our patients’ progress, we use volume measurements to track the reduction in swelling. We also provide questionnaires involving daily living and quality of life issues to find out how we’re improving a pa-
tient’s quality of life.” Orlando Health tapped into social media channels to broadcast the first VLNT procedure in Florida on March 11 on Twitter, Instagram and Facebook. The live feed resulted in consumer interest and an uptick in self-referrals, both locally and from out-of-state. Even though the majority of lymphedema patients are adult females, the youngest person Becker treated with VLNT was six months old. “You can imagine how technically difficult it is,” said Klein, whose interest in VLNT stems from family members who have had breast cancer, though fortunately none with lymphedema, and an interest in advances in reconstruction techniques. Klein noted a tremendous need for the new procedure in third-world and developing countries for patients who develop lymphedema from parasitic disease. “Viral lymphedema of an infectious nature is rare in this country,” he said. “We haven’t scheduled any mission trips so far, but it’s something our practice wants to incorporate down the road.”
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GrandRounds FCS Lab Awarded CAP Accreditation The Pathology Laboratory at Florida Cancer Specialists & Research Institute is a state-of-the-art facility that is comprised of two specialties: Histology and Flow Cytometry. Both departments have just been accredited by the College of American Pathologists (CAP), an internationallyrenowned program that recognizes laboratories that go well beyond regulatory compliance in achieving the highest standards of excellence to positively impact patient care and safety. The pathology laboratory is located in Fort Myers and serves the more than 70 clinical locations in the FCS network throughout the state. According to the College of American Pathologists, The CAP Laboratory Accreditation program is based on rigorous accreditation standards that are translated into detailed and focused checklist requirements. The checklists, which provide a quality practice blueprint for laboratories to follow, are used by the inspection teams as a guide to assess the overall management and operation of the laboratory. FCS is one of a select few community-based practices in Florida that has achieved CAP accreditation. Dr. Ryan Olson, FCS hematopathologist, said that following a rigorous initial inspection, the laboratory was not only fully accredited, but passed with a nearly perfect record. FCS pathologists are in frequent contact with all of the clinicians in the practice, allowing immediate reporting of clinically important information. Because of its commitment to the highest quality standards, the FCS lab is able to provide both the technical analysis and the professional evaluation of all aspects of a comprehensive hematopathology and surgical pathology report.
Florida Cancer Specialists & Research Institute Offers New Treatment for Advanced Prostate Cancer Florida Cancer Specialists and Research Institute (FCS) is one of the first oncology practices in Florida to offer a new breakthrough treatment for advanced prostate cancer to its patients. The new drug, Xofigo, (radium-223 dichloride) was approved by the FDA in May, three months ahead of schedule. This occurred under an FDA fast-track priority program in which drugs that appear to provide safe and effective treatment when no other satisfactory treatment exists, or those that offer a significant improvement over existing treatments, can receive faster approval. Xofigo is used to treat prostate cancer resistant to medical or surgical treatments that lower testosterone and has spread to bones, but not to other parts of the body. This condition is known as metastatic castration-resistant prostate cancer (mCRPC). Xofigo treatment consists of a monthly injection of an iso-
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tope of radium that targets cancer cells that have spread to bones. The radium binds with minerals in the patient’s bones, where it delivers radiation that destroys cancer cells without inflicting as much damage to surrounding tissues as some older radiation therapies. A study published July 18, 2013 in the New England Journal of Medicine demonstrates that Xofigo extends median survival time to almost 15 months, which is a substantial 30% improvement. Currently seven locations within the FCS network (Sarasota, Largo, Tampa, New Port Richey, Brooksville, Fort Myers and West Palm Beach) offer Xofigo to patients. More clinical sites will be added in the coming weeks. To learn more, visit FLCancer.com.
Space Coast Cancer Center Joins the Moffitt Oncology Network Space Coast Cancer Center is partnering with Moffitt Cancer Center to enhance cancer care by joining the newly launched Moffitt Oncology Network. The move aligns Space Coast’s accomplished cancer program, the largest and longest established hematology and oncology practice in Brevard County, with the network’s vision. Space Coast is recognized by the Centers for Medicare & Medicaid Services as a pioneer group practice focused on developing a new model of cancer care delivery. Space Coast is the only member of the network in Brevard County. The Moffitt Oncology Network extends Moffitt’s knowledge and expertise to physicians and providers with the goal of offering the best personalized cancer care. Moffitt is the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida. Physicians from Space Coast and Moffitt will collaborate on patient care and novel clinical research. The relationship will include the use of Moffitt Clinical Pathways, quality management strategies and access to specialty case conferences. Space Coast will utilize the experts and best practices at Moffitt, including its multidisciplinary cancer care, peer review and quality assurance standards. In 2001, Space Coast announced an affiliation with Moffitt to bring the most advanced cancer care to Brevard County. Collaborations in multiple cancer programs have continued. This new relationship in Moffitt’s network reinforces the goal of continually improving patient outcomes and research.
SMH Geriatrician Recognized for Long Term Care Expertise Sarasota Memorial Health Care System is proud to announce that Heather Cappello, MD, board certified geriatrician and family physician with First Physicians Group and Sarasota Memorial’s Memory Disorder Clinic, has been granted the specialized title of Certified Medical Director in Long Term Care by the American
Medical Directors Certification Program (AMDP). Dr. Cappello works with patients, families and caregivers at Sarasota Memorial’s Memory DisDr. Heather order Clinic and also Cappello serves as Associate Medical Director at the Pines of Sarasota. The Certified Medical Director program recognizes the dual clinical and managerial roles of the medical director. To become certified, applicants must demonstrate core skills and knowledge in both clinical medicine and medical management in long term care. Among other qualifications, applicants must complete a number of education requirements, including fellowship programs, board certification, continuing medical education, CMD-approved and AMDA-sponsored courses in medical direction, and other continuing education programs. Once awarded, certification is valid for six years. A 2009 study commissioned by the AMDCP -- an independent not-for-profit organization -- found that the quality of nursing home care improved by 15% with certified medical directors. Dr. Cappello, who joined Sarasota Memorial’s First Physicians Group in October 2010 – is one of approximately 3,000 physicians nationwide and 128 physicians in Florida who have received the designation since the program’s inception in 1991.
Fawcett Memorial Hospital Adds Cardiothoracic Surgeon John McKinney, MD Fawcett Memorial Hospital is proud to announce the addition of leading cardiothoracic surgeon, Dr. John McKinney to its cardiac team. McKinney joins a staff Dr. John of three other cardioMcKinney thoracic surgeons, Dr. Allesandro Golino, Dr. Richard Peterson and Dr. Ronald Smith with Riverview Cardiac Surgery, who are ranked in the top 5 percent in the nation for clinical excellence in heart surgery. Dr. John McKinney is a board certified cardiothoracic surgeon specializing in surgical techniques of the heart and lungs, and has developed a high interest in cutting-edge minimally invasive procedures. After attending Miami University in Ohio, Dr. McKinney completed his medical training at Ohio State University. He completed his general surgery training in Cincinnati, and his cardiothoracic surgical residency at the University of Louisville. Accolades from training include the John W. Price Award for undergraduate instruction while at the University of Louisville and the Resident Research Award for his work at Good Samaritan Hospital. 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.
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15
World Class Medicine. Hometown Care.
Recognized nationally. tRusted locally. Caring for patients in 16 Greater Tampa Bay Area communities Tampa Bay Area Physicians Patrick Acevedo, MD
Sunil Gandhi, MD, FACP
Magda Melchert, MD
Jose Alemar, MD
Larry Gandle, MD
Jeffrey L. Paonessa, MD
Rand W. Altemose, MD
Christopher B. George, MD
Janelle Park, MD
Jorge Ayub, MD
Vivian Griffin, MD
Y. K. Peter Park, MD
Jennifer L. Ball, DO
Andrew E. Hano, DO
Hitesh Patel, MD
Gregoire Bergier, MD
Vu Tran Ho, MD
J. Andrew Peterson, MD
Sawsan G. Bishay, MD
Nuruddin Jooma, MD, MPH
Raju V. Rao, MD
Rafael W. Blanco, MD
Craig S. Kitchens, MD
V. Upender Rao, MD, FACP
Kerry E. Chamberlain, DO
Richard A. Knipe, MD
Mark S. Robbins, MD
Hafeez T. Chatoor, MD
Gajanan A. Kulkarni, MD
Joseph Sennabaum, MD
Marion T. Chirayath, MD
K. S. Kumar, MD, FACP
Ramesh K. Shah, MD, PA
Mamta T. Choksi, MD
Julio Lautersztain, MD
Shalin R. Shah, DO
Julia Cogburn, MD
Mary M. Li, MD, PhD
Gerald H. Sokol, MD, MSc, FCP
Jennifer L. Cultrera, MD
Don D. Luong, MD
Thomas H. Tang, MD
Michael Diaz, MD
Joseph R. Mace, MD
R. Waide Weaver, MD
Robert L. Drapkin, MD
Vikas Malhotra, MD
David Wenk, MD
Ramana Dutt, MD
Idelfia A. Marte, MD
David D. Wright, MD
Matthew A. Fink, MD
Arthur J. Matzkowitz, MD
Gail Wright, MD, FACP, FCCP
Gustavo Fonseca, MD
Edgar G. Miranda, MD
Lane D. Ziegler, DO
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