On June 28 the U.S Supreme Court announced itsdecision on the challenge to the Patient Protectionand Affordable Care Act (PPACA). Its decision touphold the constitutionality of the health reform lawcame as a surprise. However, it has assured thatmillions of Americans who are presently uninsuredwill have the opportunity to gain insurance coveragein the future. To quote Glen Stream, M.D., M.B.I.,president of the American Academy of FamilyPhysicians, “there is plenty to like, and dislike aboutthe PPACA. He feels that the Patient Protection andaffordable Care Act has been a divisive issue not onlyin our country but also amongst physicians. I agreewith his statement that the legislation is far fromperfect, but now that the Supreme Court has issuedits long-awaited ruling, we can move forward withneeded health system reform.

The Court’s declaration that the mandate ofMedicaid expansion was unconstitutional truly tookeveryone by surprise as all eyes were on the“Individual Mandate. It has limited the expansion ofMedicaid by making it optional for states rather thana mandated expansion. This means that states thatwant to move forward with planned expansion (whichwould give coverage to all individuals under 133%Federal Poverty Level,(FPL) may do so, but states thatdo not want to will no longer be required to do so.Already governors in several states including Floridaand Louisiana have declared they will not participatein the expansion. Unfortunately this means that someof the poorest and neediest individuals who wouldhave benefitted most from health care reform risklosing their only means to affordable health carecoverage. The health reform law establishes subsidieson a sliding scale for individuals and familiesbetween 100% and 400% FPL. It did not establishsubsidies for those under 100% FPL because it wasassumed that they would be covered by the Medicaidexpansion.

Even with its flaws it is felt that by extendinghealthcare coverage to over 30 million more people,the law will improve the health of the nation byensuring access to basic primary care includingpreventive services and chronic disease management.Physicians will need to advocate for changes in theflawed provisions of the law and will need to refocuson things that still need to be addressed. Theseinclude the Independent Payment Advisory Board(IPAB); meaningful liability reform; finding apermanent fix for the sustainable growth rate (SGR)formula and passing The Medicare PatientEmpowerment Act (H.R. 1700/S.1042) that will giveseniors the ability to see any physician they chooseand privately contract to access their Medicarebenefit without having to pay the full out-of-pocketcost for their care.

Several provisions of the health care law arebeneficial for patients, physicians and the workforce.It eliminates annual and lifetime coverage limits andcovers preventive services. Insurers cannot denycoverage based on pre-existing conditions and youngadults are allowed to remain on their parents’insurance up to age 26.Medicaid payment for primarycare services will be boosted to Medicare levels andprimary care payment incentives will be created forMedicare. For our workforce there is provision forfunding for teaching health centers and scholarshipand loan repayment programs in the National HealthService Corps.

There are still many unknowns about theAffordable Care Act and additional legal challengesare likely. The FMA states that it will continue itsadvocacy efforts on issues not addressed by the ACAand will work to preserve its good provisions. It offersto provide guidance to members as the healthcarelaw is implemented and will be actively engaged inthe regulatory and rule-making process.

President’s Message

Landmark DecisionDr. George A.W. Smith

www.escambiacms.org

jUly/AUGUSt 2012VolUmE 42, No. 4

BULLETINUpcoming

Events

Tuesday August 14, 2012General Membership

Meeting“Veterans Mental Health:

Identifying Patients & Local Resources”

[1 AMA PRA Category 1 CreditsTM]

Heritage Hall5:30p

Sunday, September 30, 2012Women in Medicine Brunch

Fish House11:30a - 1:30p

Tuesday, October 9, 2012General Membership

Meeting[1.5 AMA PRA Category 1 CreditTM]

Speaker: Patricia Green,M.D./ Topic: “Breast MRI”Speaker: Bruce Horten,

M.D./ Topic: “Breast CancerAnalysis”

RSVP: 478-0706

Dr. George A.W. Smith

Founded in 1873

E.C.M.S. BulletinThe Bulletin is a publication for and by the members ofthe Escambia County Medical Society. The Bulletinpublishes six times a year: Jan/Feb, Mar/Apr, May/Jun,Jul/Aug, Sept/Oct, Nov/Dec. We will consider forpublication articles relating to medical science, photos,book reviews, memorials, medical/legal articles, andpractice management.

Vision for the Bulletin:• Appeal to the family of medicine in Escambia and SantaRosa County and to the world beyond.• Collaborate with the Alliance to bring together Escambiaand Santa Rosa County medical families. To know the needsof the community and promote the healthcare needs.• A powerful instrument to attract and induct members toorganized medicine. Views and opinions expressed in the Bulletin are those of theauthors and are not necessarily those of the directors, staff oradvertisers.

Ad placementContact Erica Laxson at 478-0706

Ad rates1/8 page: $100 • 1/4 page: $150 • 1/2 page: $300

ContentsPage 3 -New Members

Page 4 - Internal Threats Can HarmYour IT Network

Page 5, 6 & 7 - Electronic HealthRecord Risks

Page 8- Pain Management Remains aPain for Some Practitioners

Page 9 - Failed Communications inthe Medical Office Lead to an“Alleged Delay in Treatment” Page 10 & 11 - Hospital News

Editors:Christopher Burton, MD

Erica Laxson, Executive Director

Membership 3ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Edward Friedland, M.D. | HumamHumeda, M.D. | Ronnie Wiles, M.D. |Maged Nashed, M.D.Pensacola Nephrology1619 Creighton RoadPensacola, Fl 32504P: 444-4700F: 444-7497

Ismeth Abbas, M.D.1000 W. Moreno St.Pensacola, Fl 32501Phone: 850-469-7406Fax: 850-437-8283

Elias Banuelos, M.D.5992 Berryhill Rd., Ste. 300Milton, Fl 32570Phone: 850-623-9787Fax: 850-626-7512

Vishnu Behari, M.D.1921 East Nine Mile RoadPensacola, FL 32514Phone: 850-479-4791Fax: 850-494-2260

Amy Doyle, M.D.1000 W. Moreno St.Pensacola, Fl 32501Phone: 850-469-7406

Richard Sims FSU College of Medicine,3rd Year Student

Correction to the 2012 Directory:

New MembersAlecia Chen, M.D.4900 Bayou Blvd. Ste. 107Pensacola, Fl 32503P: 607-6269F: 607-6279

John Gary, M.D. | Dr. Mark Scott, M.D. Pulmonary, Critical Care & SleepDisorders Medicine, PA435 Airport Blvd.Pensacola, Fl 32503P: 435-7448 F: 471-3410

Move/relocated

Security of data and networks, an issue that companies aretaking seriously. They’re going to great lengths to protectthemselves from external threats and are, for the most part,safe from them. And yet, there are still stories about howbusinesses are being infected by malware. If they’re safe tothe external environment, where’s the threat coming from?In recent years the majority of security threats andcompromises have come from within the company. Acommon threat to companies is the logic bomb - malwarethat targets IT systems and disabled data. As a logic bomb isintroduced from within the network, the blame often lieswith a disgruntled employee with full access to internalsystems.

Insider threats giving employees full access to the networkwhen they don’t need it is a common mistake often made bycompanies. There’s little need for an employee who doesnursing to have access to accounting records. This practicecould set your company up for a considerable securityproblem in the future.

Take Precautions, Security threats can be a particularlyharsh nightmare for small practices, as many don’t have an ITdepartment or staff with the technical expertise needed tomaintain a secure network. If you’re one of theseorganizations, it’s a good idea to hire an outside consultant tohelp you with your network security. With consultants, it’simportant that you maintain close contact with them toensure any issues that crop up are dealt with expeditiously.

If you don’t work with an external company there are afew things you should do when you have an employee leavethe company. First, their accounts should be deletedimmediately and their access privileges should also berevoked. Second, if you have accounts with sharedpasswords, you should change them to ensure an ex-employee can’t gain access to the system.

If you’d like to learn more about internal security, andmeasures you can take to ensure you are safe, we are ready tohelp you. Please contact us.

Internal Threats Can HarmYour IT Network

Article submitted byLANformation

4 Practice ManagementESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTYPractice Management 5ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

A survey of 50,000 members of The Doctors Company inthe third quarter of 2011 (with 5,100 responses) revealed that30 percent of responding members have an electronic healthrecord (EHR) in their practice that fulfills Meaningful Usecriteria. Another 14 percent of responders plan to have anoffice EHR within the next three years. Only 17 percent haveno plans to use a practice EHR (56 percent of members inthis group are likely to retire within five years).

In the fall of 2011, the Institute of Medicine issued a reporttitled Health IT and Patient Safety: Building Better Systems for BetterCare. It concluded that the information needed for analysisand assessment of the safety of health IT (HIT) and its useisn’t available, adding that our understanding of EHRbenefits and risks is largely anecdotal. The reportrecommends creating a federal agency for systematic anduniform data collection to investigate harm and safety eventsrelated to HIT. Currently, PDR Network’s EHRevent is theonly national reporting system for EHR users to documentadverse events. This Web-based, confidential EHR SafetyEvent Reporting System is available at www.EHRevent.org.Report confidentiality is protected through its designation asa certified Patient Safety Organization.

The discussion of EHR benefits and risks that follows isbased on articles and reports appearing in peer-reviewedand non–peer-reviewed medical literature and in theEHRevent Newsletter, a publication that features an “Event ofthe Month” reported to EHRevent.org.

EHR Benefits and Associated RisksImproved medical Record Documentation andlegibility. Computer physician order entry (CPOE) reduceserrors by eliminating illegible orders and transcription errors.

Enhanced medication management. EHRs generate alertsfor improper drug dosages, adverse drug-drug interactions,and drug allergies.

However, drug-drug interaction lists may generatefrequent, annoying, or disruptive alerts. Doctors may develop“alert fatigue” and override or disable them. If the alert wouldhave prevented an adverse drug event, the physician may beliable. Optimized or expert consensus lists focused on fewerclinically meaningful interactions may be a solution.

Facilitates medication Reconciliation. EHRs ensure thatthe active medication list corresponds to what the patient isactually taking.

Better Presentation of Data for Clinical Decision-making. Examples include procedure findings, consultations,and lab and imaging results—and abnormal results can beflagged. However, be aware of the following:

Doctors may copy information from prior notes (theirs orothers) and paste it into a new note—then make edits asappropriate. This may cause irrelevant over-documentation,often aggravated by the use of templates, that results in theloss of narrative documentation.

EHRs may autopopulate fields in the history and physical(H&P) (from data fields in a prior H&P) and in procedurenotes (from personalized or packaged templates). Enteringerroneous or outdated information may increase liability.Example: An internist’s EHR was the medical record. Someof the autopopulated fields contained obviously wronginformation. At deposition the plaintiff’s attorney asked thesequestions:

“So is the information in this record accurate or not?”“Do you bother looking at your records?”“If these ‘autopopulated’ fields are incorrect, can we trust

anything in this record?”“Do you deliver the same level of patient care as the care

you take in record keeping?”Templates with drop-down menus facilitate data entry but

are often integrated with other automated features. If youselect an item above or below the one desired, amoxapinebecomes amoxicillin or “qd” becomes “qid.” Entry errors maybe perpetuated elsewhere in the EHR—and be overlooked.Erroneous information is easily disseminated.

Meaningful Use requires online patient connectivitythrough patient portals. Some EHRs have questionnairesusing algorithms to interview the patient. These may addressissues physicians are not prepared to pursue (depression,substance abuse, STDs, etc.). Failure to follow up can createliability.

Clinical Decision Support (CDS) Systems. As required byMeaningful Use, CDS systems provide algorithm-basedalerts, warnings, and reminders for medication management,chronic disease management, and preventive care. It’simportant to know the source of this information because itmay conflict with your specialty’s clinical standards of careor practice guidelines—and with the information in FDA-approved drug labels and alerts.

EHRs provide extensive documentation of clinicaldecision-making and activity, including departures from CDSguidelines, that physicians may have to justify. Will CDSsystems establish new standards of care?

Facilitates E-Prescribing. It is estimated that 35 percent ofoffice practices use e-prescribing. SureScripts has medicationdata on 66 percent of patients and transmits to all chainpharmacies, 60 percent of independent pharmacies, andmost insurance formularies. E-prescribing reduces costs byflagging generic and “on-formulary” drugs and encourages

Electronic Health Record Risks

By David B. Troxel, MD,Medical Director, Board ofGovernors, The DoctorsCompany

Continued on page 6

6 Practice Management ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

patients to fill prescriptions (25 percent do not). The softwarechecks for drug-drug interactions, dosage errors, medicationallergies, and patient-specific medication factors (renal failure,liver failure, etc.). However, be aware that EHR e-prescribingcreates exposure to community medication histories (drugsprescribed by others). Drug-drug interactions can be time-consuming to trace, as in the following example:

Dr. A renews a medication. His e-prescribing programsends an alert advising him that it could interact with anotherdrug the patient is taking. He did not prescribe that drug, sohis office will have to contact the patient to identify who did.

Dr. A will then have to contact Dr. X to discuss which drugwill be discontinued or changed. If failure to do so results inpatient injury from a drug interaction, Dr. A may be liable.

EHR RisksDoctors are responsible for e-health information they canaccess from outside the practice, from their practice EHR orWeb site, or through a health information exchange (hospitalcharts, consultant reports, lab and imaging reports, etc.). Itwill be a challenge to examine the patient and his or herelectronic dossier in a 15-minute visit.

The computer may become a barrier between doctor andpatient. Filling in a computer template may divert attentionfrom the patient, limiting interactive conversation andrestricting creative thinking—further weakening the doctor-patient relationship.

Vendor contracts may attempt to shift liability resultingfrom faulty software design or clinical decision support ontothe user. Malpractice policies may exclude coverage forproduct liability and for indemnification of third parties. Readall EHR contracts carefully.

As part of the discovery process, lawyers may request notonly printed copies of the EHR but also the raw e-data formetadata analysis. This includes logon and logoff times, whatwas reviewed and for how long, what changes or additionswere made, and when the changes were made. Smartphoneand e-mail records are also discoverable. Remember: allphysician interactions with the EHR are time-tracked anddiscoverable.

Computer-assisted documentation, including point-and-click lists, drop-down menus, autofill, templates, and cannedtext, bypasses natural language and produces structuredprogress notes. These often contain redundant, formulaicinformation. It is easy to overlook significant clinicalinformation lost in a sea of normal or irrelevant findings(primarily documented for coding and billing purposes). As aresult, communication with on-call and consulting physicians(and with patients) may be compromised.

In a misguided attempt to protect records from alteration,some EHRs won’t allow editing or correction of entry errorsmade in progress notes. You can make another note callingattention to the error, but the error may persist elsewhere inthe EHR.

Electronic Health Record Risks continued from page 5

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTYPractice Management 7ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

The transition from paper to EHRs can be risky. Whenscanning or entering paper records into an EHR, you mustcomply with federal and state record retention laws beforedestroying old records. Failure to do so can result in anallegation of spoliation of evidence.

The Medical eRisk Considerations for Online Communication wereoriginally created by the eRisk Working Group; developmenthas been transferred to the iHealth Alliance. The eRiskConsiderations are available in the EHR and TelemedicineResource Center at www.thedoctors.com/erisk. These are afew highlights:

Clinician-patient relationships should be preexisting andnot be initiated online.

Online diagnosis and treatment of new conditions mayincrease liability; consultation should be limited to knownpreexisting conditions.

Licensing jurisdiction: Online interactions are subject tostate licensure requirements. Physicians should be licensed inthe state in which the patient resides.

Avoid emergency subject matter. Send patients to the ERfor chest pain, shortness of breath, high fever, trauma,bleeding in pregnancy, etc.

Web site advertising and promotional material may raisepatient expectations, imply a warranty or an implicitguarantee, or violate consumer protection laws (and damagecaps don’t apply). Cosmetic medicine and surgery, off-labeldrug use, and non–FDA-approved drugs and medical devices

are at high risk.Avoid discussing sensitive subject matter, including

substance abuse, mental health, HIV status, and sexuallytransmitted diseases.

tips to reduce social media risks:• Social networking is too informal for physician-patientcommunication.• Don’t discuss individual patients or give medical advice.• Social media sites are not HIPAA-compliant, securenetworks.• Assume that anything you say or post is in the publicdomain.• Don’t text message hospital orders (Joint Commissionrequirement).

This article originally appeared in The Doctor’s Advocate, secondquarter 2012 (www.thedoctors.com/advocate).

The guidelines suggested here are not rules, do notconstitute legal advice, and do not ensure a successfuloutcome. The ultimate decision regarding the appropriatenessof any treatment must be made by each health care providerin light of all circumstances prevailing in the individualsituation and in accordance with the laws of the jurisdictionin which the care is rendered.

Electronic Health Record Risks continued from page 6

8 Medical/LegalESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Pain Management Remains aPain for Some Practitioners

Factoid: the number of pain management clinics in Floridahas dropped from over 900 to 444.

And changes are afoot again for physicians treating patientswith chronic nonmalignant pain! House Bill 787, which becamelaw on July 1, 2012, affects many aspects of the health careindustry, including controlled substance prescribing and painmanagement clinics. The bill is 69 pages. A summary of thosechanges is as follows:Prescribing

Only physicians prescribing controlled substances listed onschedule II through IV for the treatment of chronicnonmalignant pain must designate themselves as a controlledsubstance prescribing practitioner on the Board of Medicinepractitioner profile

Patients with chronic nonmalignant pain who also have ahistory of substance abuse or have a co-morbid psychiatricdisorder now require a consultation with an addiction medicinespecialist or psychiatrist, rather than an addictionologist orphysiatrist.

Additional exemptions from pain management registrationand standards of practice have been extended to board certifiedrheumatologist and certain board eligible practitioners.

Certification by the American Board of Pain Medicine hasbeen added to the list of valid certifications.

“Board eligible” is defined as successful completion of ananesthesiology, physical medicine and rehabilitation,rheumatology, or neurology program approved by ACGME orthe American Osteopathic Association for 6 years fromsuccessful completion of the program.

Physicians who prescribe medically necessary controlledsubstances for a patient during a hospital inpatient stay no longermust register as a controlled substance prescriber.

The definition of “addiction medical specialist” now includesnow includes a board certified psychiatrist, but it excludesphysiatrists.

Rheumatoid arthritis no longer is considered chronicnonmalignant pain for the purposes of registration and standardsof practice for physicians.

“Board certified pain management physicians” now includephysicians certified by the ABMS.

Pain Management ClinicsThe following now are exempt from registration as pain

management clinics:• Clinics wholly owned and operated by one or more boardcertified rheumatologists.• Clinics wholly oned and operated by one or more board-eligible anesthesiologists, physiatrists, rheumatologists, orneurologists. • Clinics wholly owned and operated by board eligible or board-certified medical specialists in a multi-specialty practice in whichone or more of the specialists has completed a fellowship in painmedicine, recognized by certain accrediting organizations andperforms interventional pain procedures.• Clinics appproved or certified by the American Association ofPhysician Specialists, the American Boasrd of Pain Medicine orthe American Osteopathic Association are now exempt fromregistration.

Changes in pain management regulation start at page 44 ofHB 787. To see the full text visitwww.flsenate.gov/Sessions/Bill/2012/0787

By Linda Keen, P.A., The LawOffice Of Linda A. KeenTallahassee, Fl

Medical/Legal 9ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Failed Communications in the Medical OfficeLead to an “Alleged Delay in Treatment”

Case: A young woman with a long history of migraineheadaches, sickle-cell trait, and several first trimester miscarriages,finally had a normal delivery of a full term healthy infant. Herpregnancy was complicated by pregnancy induced hypertension(PIH), and possibly pre-eclampsia. She remained under the care ofher obstetrician, and continued to have high blood pressurereadings. No blood pressure medications were prescribed. At fiveweeks post-partum she went to her primary care physician (PCP)with complaints of chest pain, cough, shortness of breath anddizziness. She was diagnosed with bronchitis and prescribedantibiotics, prednisone and inhalers. A month later, she returned toher PCP with complaints of bilateral feet swelling; she had 2+peripheral edema. Two months later, she returned with similarcomplaints and also complained of congestion, wheezing and flu-like symptoms. She had no fever or chills. On physical exam, shehad no heart murmur or gallop; her chest x-ray showed leftventricular cardiac enlargement, but was otherwise unremarkable.Ten days later her PCP noted new findings: she had gained tenpounds, had swelling in her lower extremities (3+ edema) andabdomen and a S3 heart gallop. The PCP diagnosed congestiveheart failure (CHF), and contacted a cardiologist.

In his deposition, the PCP testified that he spoke to the on-callcardiologist, and discussed the patient’s history and findings indetail. Also he said that he had instructed the patient to see the

cardiologist in the morning (Friday) for an echocardiogram(ECHO). The primary aspect of his testimony that implicated thecardiologist was that the PCP asked her to call the patient thefollowing day to arrange for the ECHO. In fact, he documented inthe medical record that the cardiologist was given the patient’sname and number, agreed the patient needed the ECHO, and thatshe (cardiologist) would have her staff call the patient the followingday. This information was also written on a referral sheet, but thereferral sheet never reached the cardiologist’s office.

As instructed, the patient called the cardiology office, and wastold that there were no appointment openings, and that the officedid not perform ECHOs on Fridays. The cardiology schedulingsecretary further advised the patient that there was no urgency andthat she could be seen on Tuesday the following week. The patientcalled her PCP’s office for assistance. An employee in that officetold her to come back and see the PCP in two days if she did notfeel better.

On Sunday, the patient presented to the hospital emergencydepartment (ED) with an inability to speak and a right-sidedhemiplegia. A CT showed a large evolving left-sided cardio-embolicstroke. She was also diagnosed with post partum cardiomyopathy.The patient was eventually discharged to a rehabilitation center. Atdischarge from the rehabilitation center, she continued to havelimitations, and was unable to care for her baby.

Disposition: The claim settled for a moderate dollar amount.Allegation/s: The patient should have been sent to the ED and

admitted to the hospital for urgent treatment of her congestiveheart failure, which would have averted her postpartum stroke.

Clinical/Risk Management Commentary: The experts gavegood causation arguments that, even if the patient had seen ourinsured cardiologist and/or had been admitted to the hospital, it isunlikely that her outcome would have been different. After thepatient suffered the stroke, an ECHO was performed in thehospital setting and indicated no thrombus was present in the leftventricle. The cardiologist also performed a transesophagealechocardiogram (TEE). It revealed a left ventricle thrombus. Itwas unlikely that anti-coagulation would have helped her, given thetiming of the event.

However, the standard of care argument remained a challenge.Experts opined that once the referral was made to the cardiologist,it was the cardiologist’s responsibility to assess the patient andmake the determination on what course of treatment should bepursued, and the timing of it. Given this position, the expertsopined that although the guidelines don’t necessarily requireimmediate hospitalization for CHF, once the cardiologist wasinformed that the patient was postpartum with suspected CHF,she should have immediately admitted her to the hospital as for an“urgent” ECHO and further evaluation. To do otherwise was abreach of the standard of care by the cardiologist.

From a risk management perspective, had there been bettercommunication systems in place in both the PCP and Cardiologyoffices, the office staffs would have been better able to ensure thatif the original plan of care agreed upon by both physicians was notpractical according to scheduling constraints, an immediate, butappropriate alternate plan could have been devised.

10 In The CommunityESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

West Florida Hospital Receives Important DistinctionsACR Accreditation in Breast Magnetic Resonance Imaging

West Florida Hospital has been awarded a three-year term ofaccreditation in breast magnetic resonance imaging (MRI) as the resultof a recent review by the American College of Radiology (ACR). MRI ofthe breast offers valuable information about many breast conditions thatmay not be obtained by other imaging modalities, such as mammographyor ultrasound.

The ACR gold seal of accreditation represents the highest level ofimage quality and patient safety. It is awarded only to facilities meetingACR Practice Guidelines and Technical Standards after a peer-reviewevaluation by board-certified physicians and medical physicists who areexperts in the field. Image quality, personnel qualifications, adequacy offacility equipment, quality control procedures, and quality assuranceprograms are assessed. The findings are reported to the ACR Committeeon Accreditation, which subsequently provides the practice with acomprehensive report they can use for continuous practiceimprovement.

The ACR is a national professional organization serving more than34,000 diagnostic/interventional radiologists, radiation oncologists,nuclear medicine physicians, and medical physicists with programsfocusing on the practice of medical imaging and radiation oncology andthe delivery of comprehensive health care services.

UnitedHealth Premium® Specialty CenterDesignations for Cardiac and Surgical SpineServices

West Florida Hospital is proud to receive UnitedHealth Premiumspecialty center designations in recognition of quality care in two areas: Cardiac Services and Surgical Spine Services.

UnitedHealthcare® developed the UnitedHealth Premium specialtycenter program to give its members information andaccess to hospitals meeting rigorous quality criteria.The designation is based on detailed informationabout specialized training, practice capabilities andoutcomes and is designed to help members makeinformed decisions should they need cardiac and/orsurgical spine care.

To receive these designations, West FloridaHospital met extensive quality and outcomes criteriabased on nationally recognized medical standards andexpert advice. The criteria incorporatemeasurements of breadth and depth of care, staffexperience, emergency care, quality and outcomesreporting.

Sacred HeartPrepares for Launch of EMR Systems

This fall, Sacred Heart Hospital in Pensacola will go live witheOrders, our Computerized Practitioner Order Entry (CPOE) system.Multi-disciplinary teams are preparing for the October implementation,including creating, evaluating and prioritizing the order sets that will beavailable at Go Live. Our goal is to have four to eight order sets finalizedper service or section, prioritized by the frequency or complexity of theiruse. Order sets are generally used for admission or immediate post-operative management, rather than daily rounds.

For a brief introduction to the new CPOE system, which will be usedat both Sacred Heart and Baptist Hospitals, Dr. Michael Brown, SacredHeart CMIO, recommends the six-minute demo video by Dr. MarkPratt, accessible via YouTube at www.bit.ly/CPOEdemo.

Hospital work teams also are gearing up for our much-anticipatedeBarCode MedAdmin implementation this summer, which will use thebarcodes on patients’ hospital wristbands to enhance patient safety atone of the most critical points of care. When administering patientmedications using eBarCode MedAdmin, clinical staff members willdigitally identify the patient by scanning the barcode on the patient’swristband, and then scan the barcode on the ordered medication beforeit is given. The system will alert the caregiver of any potential error inmedication administration.

FSU COM OB/GYNResidency Program Accredited for 5 Years

Congratulations to the Florida State University Obstetrics andGynecology Residency Program at Sacred Heart Hospital for achievingthe prestigious five-year accreditation cycle from the Residency ReviewCommittee. The committee also approved an additional residencyposition at each year level, which will increase our quota of OB/GYNresidents from 12 to 16.

Hospital News

In The Community 11ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Baptist Health CareBaptist Wins National Award for Clinical Excellence & PatientSatisfactionVHA Inc., a national health care network, recently awarded BaptistHospital the Leadership Award for Clinical Excellence for top performanceon core measures and patient satisfaction (HCAPHS) scores. Only 27other hospitals in the nation received the award. Learn more ateBaptistHealthCare.org.

Baptist Medical Group Grows in Leaps and BoundsSince launching in 2009, Baptist Medical Group, Baptist’s network ofemployed physicians, has strategically grown to more than 110 physicians.Over the next three months, the growth will continue, as Baptist welcomes20 additional providers to the network. The bulk of the growth will occurin primary care with additional specialty support in key services linesincluding orthopaedics, cardiology, oncology and neurosurgery. Learn moreat BaptistMedicalGroup.org.

Baptist Hospital Invests $2 million in Emergency DepartmentEnhancementsBaptist Hospital recently completed a $2 million ED renovation project toensure seamless care for patients. The enhancements will help ensurepersonal attention while ensuring high quality care. Features of the projectinclude: centrally located physician work stations, six new behavioralmedicine patient beds, and improvements in safety and security. Learnmore at eBaptistHealthCare.org.

Cardiac Cath Lab Now Open at Gulf Breeze HospitalA new, state-of-the-art cardiac catheterization lab now open at Gulf BreezeHospital offers patients and physicians convenient access to diagnosticimaging and treatments for heart disease, heart valve disease, blockages ofthe arteries in the legs and some interventional radiology procedures. Learnmore at GulfBreezeHospital.org.

3D Mammography Now Available at Three Baptist Locations In 2011, Baptist Hospital was the first hospital in Florida to gain FDAapproval to perform digital breast tomosynthesis, 3-D digitalmammography. Beginning in August, 3D mammography will also be offeredat Gulf Breeze Hospital and Baptist Medical Park – Nine Mile. Learn moreat ebaptisthealthcare.org/DigitalMammography.

Baptist Welcomes New Oncologists, Builds Robust Cancer ProgramBaptist is pleased to welcome two new fellowship-trained medicaloncologists –Sherif Ibrahim, M.D., and Nutan DeJoubner, M.D. – to itsgrowing cancer program. Beginning in August, Drs. Ibrahim and DeJoubnerwill work alongside medical oncologists Dr. Carletta Collins, Dr. GermanHerrera, Dr. David Mann, radiation oncologist Dr. James Adams,gynecologic oncologist Dr. Tom Patton, and physician assistant GaryBelanger. With a robust, multidisciplinary cancer team, The Baptist CancerInstitute offers a comprehensive array of cancer services. Learn more atBaptistMedicalGroup.org.

Rehab Services Expand at Baptist Medical Park - Navarre Baptist Medical Park - Navarre recently completed an expansion that nearlydoubled the space of its Andrews Institute Rehabilitation department. Theprogram serves patients recovering from a wide variety of conditions –including orthopaedic post-operative recovery, neurological disorders, generaldeconditioning and weakness, and gait/walking disorders. One of the newservices offered is vestibular rehab, a form of physical therapy to help peoplewith inner ear disorders improve overall balance, mobility and coordination.Learn more at TheAndrewsInstitute.com/Rehabilitation.

Hospital News Continued

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mECoP Reminder

Infectious Diseases and TravelMedicine ConferenceFriday, September 28, 2012Sacred Heart Hospital’s GreenhutAuditorium - 7 am until 4 pmvisit www.mecop.org for full list oftopics and agendaContact mECoP at 850.477.4956(option 1) to register