April 2015

For and about members of the Office of Johns Hopkins PhysiciansBestPractice

When she describes the benefits of tele-medicine, nurse practitioner Wendy

Batchelor recalls one factory worker who recently visited her office in the Nestlé Dreyer’s Ice Cream Products plant in Tulare, California. The woman was seeking advice about a blistery rash on her hands that had become increasingly bothersome, despite her primary care physi-cian’s attempts to treat it. She faced an eight-month wait to see a local dermatologist who would take her insurance.

Thanks to the Johns Hopkins Medicine program at her workplace, however, the woman was able to obtain a dermatologist’s diagno-sis—dyshidrotic eczema—and appropriate treatment quickly, via telemedicine.

“Instead of having the patient come to the medical center, we are in effect taking our medical center to patients across the U.S. with this model,” says Ed Bernacki, director of the Division of Occupational and Environmental Medicine and pro-fessor of medicine.

Increasing Access, Extending ReachBatchelor is program coordina-tor in Johns Hopkins’ Division of Occupational and Environmental Medicine as well as the care provider at the Nestlé Dreyer plant, which is one of 56 workplaces ranging from multinationals to small manufactur-ers scattered across 23 states where Johns Hopkins offers on-site health care through nurse practitioners. In the past six months, the services have been augmented by telederma-tology.

“Our NPs see a lot of skin prob-lems. The wait for a dermatologist in a farm community such as Tulare can be very long,” Bernacki says. “When a patient presents with a skin lesion, for instance, the NP takes photos of it, transmits those photos to a Johns Hopkins Medicine dermatologist, gets the opinion and delivers timely care.” The NP then follows the patient, consulting again with the dermatologist if necessary.

Teledermatology will soon be piloted at Johns Hopkins Aramco Healthcare in Saudi Arabia, says

John Ulatowski, vice president and executive medical director for Johns Hopkins Medicine International and interim CEO of Johns Hopkins Aramco Healthcare. International patients will get second opinions and follow-up care via telemedicine as well.

“It’s an efficient, cost-effective way of doing certain parts of the medical evaluation that are ame-nable to interview, and saves the patient the cost and time of traveling when unnecessary,” says Ulatowski. He points out that televisits can be better for patients whose mobility is impaired by neurological condi-tions, such as Parkinson’s disease. The technology allows neurologists to evaluate patients in their regular environment, typically home.

Appropriate, High-Value CarePaul Scheel, director of the Division of Nephrology, who heads up Johns Hopkins Medicine’s tele-medicine efforts, is working with Ulatowski to ensure that all divi-sions of Johns Hopkins Medicine pursue telemedicine strategically.

“Telemedicine is the future, espe-cially as it pertains to population health,” says Scheel. “When we are responsible for managing popula-tions and decreasing costs, telemedi-cine can help us deliver effective, high-value care.”

Research is underway on the best ways to use the technology. Johns Hopkins is one of several institutions enrolling patients with

Taking Johns Hopkins to the PatientTELEMEDICINE INCREASES ACCESS TO SPECIALTY CARE.

(Continued on back)

Announcing the Johns Hopkins Medicine Clinical Awards for Physicians and Care TeamsTHE AWARDS WILL HONOR PHYS ICIANS AND TEAMS WHO EMBODY THE BEST IN CLINICAL EXCELLENCE .

“Medicine begins and ends with the patient. That recognition underpins our commitment to deliver the highest-quality patient- and family-centered health care. With these awards, we want to honor the physicians and care teams who embody our commitment to the patient.”

–PAUL ROTHMAN, DEAN AND CEO

The Johns Hopkins Medicine Clinical Awards for Physicians and Care Teams will be presented in six categories:

n Physician of the Year

n Innovations in Clinical Care

n The Armstrong Award for Excellence in Quality and Safety

n Excellence in Service and Professionalism

n Clinical Collaboration and Teamwork

n Best Consulting Physician

The awards program, supported by the Office of Johns Hopkins Physicians, is open to physicians and care teams from The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Sibley Memorial Hospital, Suburban Hospital, All Children’s Hospital and Johns Hopkins Community Physicians.

Nominations are being accepted through Friday, May 15, and may be submitted to hopkinsmedicine.org/clinical-awards by anyone with a JHED ID. Supporting documentation, such as data or presentations, is encouraged. Winners will be determined by June 30 and will be recognized at the annual meeting of the Office of Johns Hopkins Physicians this fall.

This newsletter is published bimonthly for the Office of Johns Hopkins Physicians by Johns Hopkins Medicine Marketing and Communications. Send items to the editor at 901 S. Bond St., Suite 550, Baltimore, MD 21231. Phone: 410-502-8902

For and about members of the Office of Johns Hopkins Physicians

OFFICE OF JOHNS HOPKINS PHYSICIANSPresident: William Baumgartner, M.D. MARKETING AND COMMUNICATIONSSenior Vice President: Dalal Haldeman, Ph.D., M.B.A.Director of Communications and Design: Michael KeatingEditor: Christina DuVernayWriters: Marian Callaway, Christina DuVernayDesign: David Dilworth

To read the newsletter online, please go to http://www.hopkinsmedicine.org/news/publications/_ docs/best_practice/best_practice_april_2015.pdf

© 2015 The Johns Hopkins University and The Johns Hopkins Health System Corporation

Second Year of Physician Payments Sunshine Act BeginsPHYSICIANS ARE URGED TO REVIEW DATA BEFORE MAY 20.

The Physician Payments Sunshine Act, also known as Open Payments, went into effect last year. Part of the Affordable Care Act, the law aims to increase transparency between health care manufacturers

and consumers. It requires all manufacturers of drugs, medical devices and biologics to submit reports of payments made to physicians and teaching hospitals.

The second year of the program has begun, covering transactions in 2014. Physicians have a 45-day period, starting April 6, to review the report-ed data and dispute any incorrect information before the data are made public on June 30 in a searchable database on the Centers for Medicare and Medicaid Services (CMS) website. The dispute period will end on or about May 20.

Companies are required to identify up to five principal investigators on research projects they sponsored, even though payments are not made to individual physicians. CMS uses its own criteria to define principal investi-gators, so co-investigators may also be identified.

Johns Hopkins physicians are urged to review their data promptly so there is sufficient time to dispute inaccuracies. Physicians can register to view their payment data on the CMS Open Payments website (https://por-tal.cms.gov/wps/portal/unauthportal/home/). Data reported by companies for the second year of implementation will cover all 12 months of 2014, whereas the first year of implementation covered only five months. This may result in an increase in the amount of data that needs to be reviewed. Updates are published on the Office of Policy Coordination’s website, at http://www.hopkinsmedicine.org/Research/OPC/Policies_Regulations/sun-shine_act.html.

Physicians may be required to create a new password. Solutions to pass-word reset issues are available in the Open Payments Quick Reference Guide (http://www.hopkinsmedicine.org/Research/OPC/Policies_Regulations/pdfs/EnterpriseIdentityManagementSystemRegistrationQuickReferenceGuide.pdf). Information about the review and dispute process is available on the CMS website (http://www.cms.gov/OpenPayments/Program-Participants/Physicians-and-Teaching-Hospitals/Review-and-Dispute.html). Additional information is also available on the Office of Policy Coordination’s website (http://www.hopkinsmedicine.org/Research/OPC/Policies_Regulations/ sunshine_act.html).

Physicians with questions are encouraged to contact the Office of Policy Coordination at sunshine@jhmi.edu or 410-516-5560.

—Marian Callaway

BestPractice

BPR150423 Best Practice Apr 2015

Parkinson’s disease in a clinical trial about the effectiveness of treating their condi-tion via telemedicine. Jointly sponsored by the Patient-Centered Outcomes Research Institute and the Parkinson’s Disease Foundation, the study randomizes patients into two groups. Those in the con-trol group continue with their usual care, supplemented by educational materi-als about the disease. The patients in the experimental group continue with their usual care, supplemented with educational materials and virtual care from a Parkinson’s disease specialist. The four virtual care vis-its happen via Web-based video conferencing directly into the patient’s home.

Zoltan Mari, director of the Johns Hopkins Parkinson’s and Movement Disorder Center, is enrolling patients for the trial. One is a pastor on the Eastern Shore who, like many patients with her condition, has trouble moving around and traveling. She also had encountered difficulty getting on his schedule. For those reasons, says Mari, she was pleased that she could enroll in the telemedicine trial.

“Via videoconferencing, I evaluated her, confirmed her disease status did not require an in-person visit and adjusted her medica-tions. I also advised her on modifying her daily activities.”

—Christina DuVernay

Taking Johns Hopkins to the Patient(Continued from front)

“ [Telemedicine is] an efficient, cost-effective way of doing certain parts of the medical evaluation that are amenable to interview, and saves the patient the cost and time of traveling when unnecessary.”

– JOHN ULATOWSKI, VICE PRESIDENT AND EXECUTIVE MEDICAL DIRECTOR FOR JOHNS HOPKINS MEDICINE INTERNATIONAL