UCF Lake Nona Life Sciences Incubator to Open Early …bw-31b5b7b61bc03a158c3c602c6ce6489b-bwcore.s3.amazonaws.co… · In essence, all nonsurgical vaginal CO2 la - sers drill a matrix

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HEALTHCARELEADER

George J. Haidukewych, MDOrlando Health Orthopedic Institute, Academic Chairman and Chief of Joint Replacement

Andreia Moraes Acuna, MD ... 3

PHYSICIANSPOTLIGHT

“No one has access to turnkey space,” … the UCF Life Sciences Incubator is a ‘game-changer’UCF Lake Nona Life Sciences Incubator to Open Early Spring

Internationally recognized for joint replacement surgery and trauma, George J. Haidukewych, MD, serves as director of orthopedic trauma, chief of complex joint replacement, academic chairman for the Orthopedic Faculty Practice and professor at the University of Central Florida College of Medicine. He trained at the Mayo Clinic in Rochester, Minn.

Dr. Haidukewych specializes in total hip and total knee replacements as well as orthopedic trauma. He brings extensive ex-perience in the management of failed and infected total hip and total knee replace-

ments and in reconstruction of the joints after trauma.

In the Fall of 2017, Dr. Haidukewych was inducted into the International Hip Society, an exclusive association of joint surgeons from all over the globe that have demonstrated excellence in hip surgery. The society is comprised of top surgeons from various countries who specialize in hip replacement surgery. Dr. Haidukewych is the only Florida surgeon in the society.

Dr. Haidukewych is also an award-winning researcher who has published more than 100 peer reviewed publications

and book chapters and has presented hun-dreds of educational lectures on trauma and hip and knee replacement. Dr. Haid-ukewych holds over 20 patents and has developed multiple innovative implants for fracture fixation and joint replacement. Dr. Haidukewych earned his medical de-gree from Wayne State University School of Medicine in Detroit, Michigan. He was

By PL Jeter

Central Florida’s Medical City is taking another bold step in technologi-cal development with the Lake Nona Life Sciences Incubator coming online in early spring. A partnership consisting of the Uni-versity of Central Florida, Florida Hospital,

the Tavistock Group, the City of Orlando, the state of Florida and the Florida High Tech corridor has brought the first life sci-ences incubator in Central Florida to frui-tion in the GuideWell Innovation Center.

The 10,000 sq. ft. facility, operated by the UCF Business Incubation Program,

is equipped with 7 high-demand wet lab spaces, robust infrastructure, unparalleled business support and state-of-the-art shared equipment, all available to the region’s most promising life science and biotech startups.

The incubator will be a hub of entre-preneurial activity, from university spin-

outs commercializing UCF technologies to local startups filling critical needs in the local healthcare community. The incubator will create an environment of innovation, collaboration and comprehensive support programs for promising life sciences and

RADIOLOGY INSIGHTSHeart Attack and Prevention ... 22

HEALTH INNOVATORSPhysician Innovation …What If ... 9

The Case for SOGI Data ... 9

HR LADY... 6

Change in the Weather? The Top 10 Health Care Law Areas For Physicians and Providers for 2018 ... 5

CONTINUE TO PAGE 4...


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Andreia Moraes Acuna, MD, is a board-certified Gynecologist and Obstetri-cian and fellow of the American Congress of Obstetricians and Gynecologists.

Acuna obtained her medical degree at the University of Mogi das Cruzes, in Sao Paulo, Brazil. She completed her medi-cal residency at Joan C. Edwards School of Medicine-Marshall University in West Vir-ginia. During her training, she participated in medical research as well as volunteer work.

She received additional training in the Da Vinci Surgical System, MonaLisa Touch CO2 laser therapy, weight loss, hor-mone replacement therapy, sclerotherapy, Botox injections and dermal fillers.

Acuna’s special interests include mini-mal invasive surgery, menopausal manage-ment and hormonal replacement therapy, diagnostic hysteroscopy in office, Essure tubal sterilization, aesthetics and high- risk pregnancy. She is a member of the Ameri-can Association of Gynecological Lapa-roscopist, the International Society for the Study of Women’s Sexual Health, the American Medical Association, the Florida Medical Association, and the American Col-

lege of Obstetricians and Gynecologists.She’s fluent in English, Portuguese

and Spanish.In her time away from work, she en-

joys empowering women, spending time with her family, and traveling.

IN OTHER WORDS with Andreia Moraes Acuna, MD

Blessings Women’s Care & Medical Spa is a wellness-focused OB/GYN prac-tice in Central Florida, providing health and wellness support for women of all ages, from obstetric care to general gyne-cology and menopausal conditions.

I want to discuss one of the conditions we see many patients for, which is change in a woman’s optimum vaginal and sexual health and how it affects her overall well-being and quality of life.

Vaginal health can change as a woman goes through different stages of her life cycle, which can include childbirth and menopause. The drop in estrogen that comes with menopause or even during breastfeeding after delivery, causes a series of problems that have a severe impact on one’s social life and personal relationships. Among the most bothersome problems is atrophic vaginitis, which is the lack of nour-ishment and hydration of the cells of the vaginal mucosa. This condition causes a progressive thinning of the vaginal and vul-

var mucosa which then becomes more deli-cate, sensitive and more exposed to trauma.

Some of these hormone changes can contribute for what is known as pelvic re-laxation.

Other factors that directly affect vagi-nal health are certain medical conditions and treatments that affect a woman’s abil-ity to produce hormones such as some cancer treatments.

Laser vaginal revitalization is a non-surgical solution available to correct these changes and enhance the vaginal muscle tone, strength, and control. I was trained on the MonaLisa Touch, which is a mini-mally invasive procedure that uses CO2 fractional laser technology to reverse vagi-nal atrophy and laxity due to various con-ditions discussed here. The laser is inserted into the vagina and laser pulses stimulate new collagen production in the vaginal wall. The outpatient procedure lasts less than 10 minutes. It is recommended that each patient undergo 3 separate treatments spaced 6 weeks apart for maximum results.

Laser vaginal revitalization is indi-cated for urinary incontinence, vaginal laxity (especially after childbirth), dyspa-reunia (painful sex), dryness, itching, and atrophic vaginitis (vaginal atrophy).

The advantages of laser vaginal tight-ening are the lack of downtime, the rapid return to sexual activity, and lower upfront cost. The tradeoff is a less intense effect

and a temporary duration of effect ver-sus surgery with vaginoplasty. This might be an ideal choice for women who suffer from vaginal laxity, but wish to have more children, have a busy schedule or can’t af-ford surgery. Some effects of laser vaginal tightening such as increased lubrication can’t be replicated by surgery.

Many women experience at some point in their life vaginal health changes and may not know that there are safe op-tions available and that their optimum sexual health can be restored without sur-gery and with no down time.

There is also some confusion among some clinicians as to what laser resurfac-ing of the vaginal skin accomplishes. This is probably due to the fact that a company who sought FDA approval for vaginal at-rophy is only allowed to market their prod-uct for that indication while a company sought FDA approval for skin tightening is only allowed to advertise that indication. In essence, all nonsurgical vaginal CO2 la-sers drill a matrix of holes into the vaginal epithelium. That process stimulates the production of collagen as the body seeks to repair the holes. The production of new collagen tightens the skin, corrects vaginal atrophy and enhances vaginal lubrication.

Reach Dr. Andreia Moraes Acuna at Blessings Woman’s Care & Medical Spa at 407-571-9185.

PHYSICIANSPOTLIGHT

Andreia Moraes Acuna, MDClearing up confusion on laser vaginal revitalization

(CONTINUED ON PAGE 4)

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biotech startups in Central Florida.Other amenities include private offices,

conference rooms and a large fully equipped communal laboratory with shared research instrumentation and autoclave facilities.

UCF BUSINESS INCUBATION PROGRAM

The UCF Business Incubation Pro-gram is an economic development part-nership designed to help create & sustain jobs in the community and spur economic growth throughout the region. This goal is accomplished by helping new and strug-gling early-stage businesses grow to the point where they need to hire employees in order to continue operating and growing. Since 1999, the program has assisted more than 350 early-stage companies, who’ve sus-tained nearly 3,700 jobs throughout Central Florida. These companies have also had a total impact on regional economic output (GDP) in the amount of $2.48 billion.

UCF ACCESS Access to additional specialized equip-

ment and expertise is available through the UCF core facilities on a fee for use basis.

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• Biosafety Level II facility, • Secure entry to facility, private labs and offices, • High-speed Internet, • Mail & package reception, • Lake Nona ‘Medical City’ business address, • Backup power for critical equipment, • Ample parking, • Fee-based access to UCF core facilities

Orlando Medical News asked Dr. Tom O’Neal, Associate Vice President of Research & Com-mercialization at the University of Central Florida for more information on the develop-ment and operation of the incubator.

Q: What’s the genesis of the idea for the incubator?Wet-lab space is in high demand, but until now, budding life science and biotech startups had few options for access to state-of-the-art equipment and business support in one place. The 10,000-square-foot UCF Life Sciences Incubator is the first of its kind in Central Florida, and helps to fill that need.

Q: Is this the same project that was envisioned nearly 10 years ago? What brought it together now?

UCF Lake Nona Life Sciences Incubator, continued from page 1

INCUBATOR SHARED EQUIPMENT RESOURCES The incubator will allow tenants to focus on research and building the latest innovations, instead of fretting over expensive purchases or jumping through hoops for access to equipment. The shared lab workroom is fully outfitted with the best in life sciences instrumentation.

Thermo Fisher Scientific NanoDrop 8000 Spectrophotometer UV/VIS

Fisher Scientific Accuspin 8C Benchtop Centrifuge

Thermo Scientific Sorvall MTX Ultra Centrifuge

Thermo Fisher Scientific Forma Steri Cult 3310 CO2 Air Jacketed Incubator

Thermo Fisher Scientific Forma Environmental Chamber (Incubator)

Shel Labs SSI10 Large Capacity Shaking Incubator

Thermo Fisher Thermolyne Furnace

Thermo Fisher Orion Star A111 pH Meter

Labconco FlaskScrubber Glassware Washer

Primus PSS500 Steam Sterilizer

Mettler-Toledo Analytical Balance

Fisher Scientific Isotemp Dual Chamber Water Bath

Branson Ultrasonic Bath

Vacuubrand ME 1C Oil-less Vacuum Pumps

Thermo Revco Lab Refrigerator

Thermo Fisher TSX -20oC Freezer

Thermo Fisher Scientific Revco UxF -86oC Ultralow Freezer

Follett Nugget Icemaker

Thermo Scientific Barnstead Pacific TII 40 RO/DI water purification

The incubator will provide each lab with the essentials for life science product development. Each lab is plug and play, so tenants can quickly set up and begin operations

Baker SterilGARD Class II Bio Safety Cabinet

Baker Chemgard Fume Hood and Acid Storage Cabinet

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By MICHAeL r. LOWe, esq.

What do they say about the weather in Florida? If you don’t like it, wait 5 minutes and it will change. Health care and health care laws are exactly the same and will experience even more rapid and dynamic changes in 2018 from what we have been experiencing in Florida these past several years. Here are 10 of the top health care law areas that will affect physi-cians and providers in 2018:1. HIPPA/Business Associate Agreements/Privacy/Security/Data Breaches and Cybersecurity.

Ransomware, phishing, hacking and other forms of intrusion continued to be par-amount issues for physicians, group practices and providers. It is important for all covered entities to ensure that they have appropriate business associates agreements and privacy and security measures in place to prevent, detect and respond to breaches and cyber-security threats. Expect increased enforce-ment and investigation activity from HHS/OCR in 2018 and start now in developing an effective compliance program including appropriate private and security safeguards and breach prevention and response com-ponents which should include purchasing appropriate cyber liability insurance cover-age for your group practice or entity.

2. Private Equity Investment Within the Physician Health Care Provider.

2017 saw a huge uptake in private eq-uity investment in the health care arena. With hedge fund and private equity manag-ers having less options to invest in income stream producing investments and assets, they are looking more and more to health care entities as investments. These types of transactions are complex and require corpo-rate and health care regulatory expertise in order to properly structure them. We an-ticipate further activity in the private equity/health care marketplace throughout 2018.

3. The Opioid Crisis.With the opioid crisis in national

headlines on a weekly basis, physicians and providers need to be cautious about prescribing any narcotic pain medications for their patients. There are a whole host of potential legal issues from professional liability/medical malpractice claims to professional licensure and federal gov-ernment investigations to criminal action which can arise if a physician or provider is accused of misprescribing or facilitating the trafficking of opioids. Pain manage-ment, medications, contracts are an area of particular focus and concern for physi-cians treating chronic pain patients.

4. The Amazon/JP Morgan/Birkshire Hathaway Joint Venture.

Recently announced the plans by these 3 mega-giants in the corporate and finan-cial world could change the entire face and structure of the health care delivery and pay-ment system. Although in its infancy, this joint venture should be monitored closely by all physicians, providers, facilities and

other players in the health care delivery sys-tem as contractual relationships, structure of health care networks, and the way in which providers are reimbursed for the provision of health care goods and services could all rapidly change over the next several years depending on the implementation and out-come of this joint venture.

5. Medicare Access and Chip Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Path (MIPS).

Physicians and providers need to un-derstand what financial opportunities and pitfalls would result from the application of MACRA, particularly with regards to physician compensation for employed physicians. Significantly, CMS recently announced the launch of its New Bundled Payments for Improved Advanced Model in an attempt to address Advance Alter-native Payment Model issues which have risen with the initial implementation of MACRA, while the Medicare Payment Advisors Commission (“MedPAC”) de-cided last month to ask Congress that it repeal and replace MIPS with more of a voluntary participation model. Both Part A and B providers should continue to moni-tor MACRA for the remainder of 2018.

6. Ancillary Services (i.e. diagnostic imaging, labs, physical therapy, dispensing practitioners)/Acquisition of Them by Physicians and Providers/Stark Law Reform and Considerations.

On January 17 of this year, CMS an-nounced that it would be establishing an in-ter-agency group to review the current Stark Law in particular referral by physicians for designated health services such as diagnostic imaging procedures, labs and physical ther-apy. While we do not expect any short-term changes to the Stark Law, CMS has signaled that it is going to look at long-term sweeping changes in particular changes to the exist-ing regulatory exceptions. Therefore, until newer amended legislation is officially signed into law, physicians and health care organi-zations providing designated health services should ensure any current or future transac-tions in which they are involved, fit squarely within the parameters at least within one (1) of the Stark Law exceptions. Physicians and providers should consider having existing transactions and potential future transactions reviewed by competent and experienced health care regulatory counsel in order to en-sure compliance with the Stark Law.

7. Clinically Integrated Networks and Accountable Care Organizations.

We continue to see consolidation in the health care world and continued growth of clinically integrated networks and account-able care organizations. These types of entities implicate not only corporate, tax and business, but also detailed health care regulatory law considerations involving Stark Law, the federal Anti-Kickback Stat-ute, and a number applicable Florida laws as well. Physicians and providers are well served to obtain financial, legal, and busi-

ness advice before agreeing to enter into one of these types of entities.

8. What’s the Future of 60-day Overpayment Rule.

Physicians and providers that submit claims to and receive payment from the Medi-care and/or Medicaid programs need to be familiar with the 60-day overpayment rule and how it is triggered, when the government will consider that a provider knew that they had an overpayment, and the steps to take to report and refund the overpayment in order to avoid federal false claims act investigation and/or proceeding. It is critical to understand the time frames involved in an overpayment situation and when the 60-day deadline begins to run, as well as how to respond to a correct/address an overpayment in order to avoid fed-eral False Claims Act issues.

9. Peer Review Re-Engineered/New Paradigms for Employed Physicians and Value-Based Purchasing Within the Employment of Them by Hospitals.

With the continuing emphasis on value based reimbursement in health care, many hospitals and facilities are incorpo-rating value-based principles in internal peer review analysis. This is a relatively new phenomenon, and as it progresses it will involve defining and distinguishing adverse peer review incidents from simple economical credentialing, as well as the

careful analysis of how value-based peer review situations must comply with ap-plicable Federal and Florida health care regulatory laws. The physicians and med-ical staff would be well served to work with hospitals and facilities to develop value-based peer review criteria and programs, as the current peer review landscape ad-verse incident reporting and discovery environment in Florida will present signifi-cant hurdles for the cooperative develop-ment of value-based peer review.

10. Increased Enforcement and Scrutiny by the Florida Agency for Health Care Administration of Licensed Providers and Facilities and the Florida Department of Health of Licensed Professionals.

While these are 10 of the top health care law areas that will affect physicians and providers in 2018, they are not all of the health care law areas that will affect physicians and providers and are by no means exclusive. If you are facing issues in these areas or issues in other health care law areas, please consult with an attorney.

Michael R. Lowe, Esq. is a board-cer-tified health law attorney at Forster, Boughman, Lefkowitz & Lowe. The firm regularly represents providers, physi-cians and other licensed health care professionals, and facilities in a wide variety of health care law matters.For more information regarding those health care law and such matters please visit our website www.FBL-Law.com

Change in the Weather?The Top 10 Health Care Law Areas For Physicians and Providers for 2018

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Q: I am a small business with three employees. Do I have to obtain workers compensation insurance?

Technically, Florida law only re-quires non-construction employers with four or more employees (owners included in that headcount) to obtain workers com-pensation insurance.

Even though you believe the biggest injury may be a papercut, you will be sur-prised how easy it is to trip and fall over a box of copy paper or acquire wrist or back

pain, even in an administrative function. Strains and sprains are actually the top 30 percent of worker injuries according the Insurance Journal and the top causes of injuries are material handling at 32 percent and slips, trips and falls at 16 percent. So, what does this mean for you? Even though the law does not require workers compen-sation insurance for small businesses under five employees, this does not mean you are still not responsible and face major risk of financial ruin. The good news is for admin-istrative functions, workers compensation insurance is not very expensive, and own-ers can exclude themselves. Call your local

broker for further advice.Q: I am having a really hard time retaining employees. We have a great family culture here, however, I simply cannot afford to compete with the bigger firms in regard to pay. What advice do you have?

Contrary to popular belief, pay is not the highest motivator for most employees. A Gallup survey reports that 1 in 2 em-ployees leave to get away from their man-ager. They were miserable at work which followed them home and simply made their life unsatisfying. The most impor-tant thing to understand is that employees leave managers, not companies. If you are a small company with only one manager (you), then you may be part of the prob-lem. Should you care about improving employee satisfaction? Yes! Why? Be-cause satisfied employees are productive employees and productive employees pos-itively affect the bottom line. Employees want these items in no particular order:

• Clear communication. “What are your expectations of me so that I can meet them?”• Support of employee’s strengths. “Bashing me about my weakness is not going to change them.”• Approachability. “I would like to come to you to discuss challenges at work rather than hide them from you due to fear.”One side note, as a small business you

can offer your employees benefits that may not even cost you a penny. Consider flexi-ble work hours, working from home, bring-ing pets to work, bringing children to work, voluntary benefits that employees pay for but can only get through an employer pay deduction, monthly educational “lunch and learns” provided by vendors and of course complimentary medical care for staff and family members.

Q: As the business manager of a medical practice, I cannot get the doctor to understand that his direct and abrupt personality is offensive to our team and some of our patients, too. He just says they need to get over it. How can I get through to him?

His personality style responds to facts not emotions, so show him the data and stop focusing on emotions. His behav-ior may have affected the bottom line. If you are losing staff and/or losing repeat patients, this has a major impact on rev-enue growth and of course on company profit. Gather information on how much it costs to replace an employee including costs of advertising, drug tests and back-ground screenings. Remember that time is money, therefore you will also need to estimate the number of hours each per-son spends on reviewing resumes, doing phone interviews, conducting in person interviews, completing new hire paper-work and orientation and then all the hours every person on the team has to take to train the new hire. If hourly, non-exempt staff are involved, do not forget to add overtime numbers. Also, calculate

how much of that time could have been used dealing with patients and refer to that as “lost time or lost profit.” A person only changes when they want to. If your doc-tor is bottom line motivated, this may be a great time to educate him on understand-ing personality styles and the effect on a business. When he is ready, call BlackRain Partners for coaching.

Q: All of our employees have been with us for at least 10 years each and are over 55 years of age. While most of our patients seem to really connect with our team, we are trying to hire younger individuals to bring in new skills and prepare for our current team’s retirement. Unfortunately, our new hires leave within a few weeks of starting. No matter who we hire, I feel I need to “cut the tension with a knife.” What are we doing wrong?

First, congratulations for recognizing the need for age diversity in your medical practice. For the first time in history we have five generations in the economy. In your practice, your patients may include all of these generations: Silent Genera-tion, Baby Boomers, Generation X, Mil-lennials/ Generation Y and Generation Z. While it is important for your patients to connect with your team due to their age, it is more important for your team members to understand that different gen-erations communicate differently and are motivated by different things. The issue you are experiencing with younger gen-erations leaving your practice is probably due to communication challenges amongst your team. Baby Boomers and older Gen-eration Xers tend to tell people what to do with the expectation that there will be no questions asked because that is how it used to be. Often, they may also believe that “if it is not broken, we do not need to fix it.” Younger Generation Xers and Millennials question everything as they want to know why things are done in order to understand the end goal, and even improve processes to become more efficient. This simple dif-ference in communication styles and mo-tivations may not sit well with current or incoming staff, with frustrations being no-ticeable by all and causing major tension in the workplace. Educating your staff to un-derstand all generations, particularly their communication styles and what motivates them will help your retention rate. Addi-tionally, being clear about the company vision for the next ten years is no longer op-tional. Millennials demand knowing: where are we going so I can help get you there. They also want to know how they will fit in. If you do not know where the company is headed, Millennials will struggle to stay en-gaged. Old ways will not bring new results.

Wendy Sellers, MHR, MHA, SHRM-SCP, SPHR, “The HR Lady” is the COO of BlackRain Partners, a business con-sulting company. She is a Master of Health Care Administration, a Mas-ter of Human Resources, SHRM-SCP and SPHR certifications and is also a licensed Florida 2-15 life and health agent which she uses solely to advise and educate BlackRain’s clients. Visit www.blackrainpartners.com

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The idea for a life sciences incubator in Central Florida has been discussed for several years. A combination of available funding, a location in the heart of Lake Nona’s Medical City, and increased de-mand for a fully equipped wet-lab facility made this the perfect time and place to open the UCF Life Sciences Incubator.

Q: What will be the cost to tenants for the use of the facility?Companies can expect flexible lease terms and varying cost options depending on the space and services needed in this turnkey incubator. Move-in ready, fully equipped office and lab space is $35 per square foot and $47 per square foot, respectively, and grants access to collaboration space, shared equipment and support services.

Q: Will there be a component of the research facilities at UCF to assist the companies that use the incubator? If so, how will that work?Yes, incubator clients have access to a suite of support services, plus additional special-ized equipment and expertise from UCF core facilities ranging from imaging to ad-vanced microfabrication.

Q: How will the incubator benefit the UCF/Florida Hospital partnership and the Central Florida area?Central Florida’s growing life sciences com-munity is increasingly in need of a turnkey life sciences incubator as more biotech and life sciences companies emerge and flourish. There isn’t a better location for it than Lake Nona Medical City, at the heart of prom-ising life sciences research and innovation. UCF believes in the power of partnerships and this exemplifies how they make things possible that would just not happen without them. The incubator has many partners that will benefit from the Life Sciences Incu-bator. We appreciate that Florida Hospital assisted in getting grant dollars directed to the project from the state and city of Or-lando and believe that is just the beginning.

Q: Are there plans to expand the facility in the future?We are excited to be opening the doors soon to help fill a need for wet-lab space in the area. There are no current plans for expanding the space at this time but hope-fully that will change in the future.

Q: What does this program mean for life sciences development in Central Florida?We’re looking forward to contributing to the exciting work in Lake Nona by helping our clients fill critical needs in life sciences, health care, biotechnology and more. I often hear ‘no one has access to turnkey space,’ so the UCF Life Sciences Incubator is a game-changer. We need a robust set of tools and infrastructure to build a thriving life sciences industry sector and believe this is a critical addition to this industry sector.

UCF Lake Nona Life Sciences Incubator, continued from page 4

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a resident in orthopedics at the Mayo Graduate School of Medicine in Roch-ester, Minnesota and then a fellow in or-thopedic traumatology and post traumatic reconstruction at Florida Orthopedic In-stitute in Tampa, Florida.

In this month’s In Other Words seg-ment, Dr. Haidukewych discusses The Future of Joint Replacement: Getting Pa-tients Back on Their Feet Faster.

IN OTHER WORDS by George J. Haidukewych, MD

Every time the next generation iPhone comes out, it’s practically hailed as a na-tional holiday. Hundreds of thousands of people stand in line just to be among the first to get their hands on the latest, greatest technology. And for good reason; each year, there’s typically something new and excit-ing that makes our smart phone experience even better than it was the year before.

Believe it or not, rapid technologi-cal advancements are also changing the world of orthopedic surgery – and there’s much to celebrate. Changes in major joint replacement procedures along with the in-creased use of new and improved materials are making our daily lives better than they were not so very long ago.

I performed my first joint replacement

surgery more than 20 years ago. Since then, I’ve replaced joints in thousands of patients – and I’ve seen the technology im-prove dramatically. The artificial joints we used when I first started back in the 1990’s look quite antiquated when you compare them to what we’re using today. There are various new designs, including new materi-als – even ceramics – that are truly ground-breaking, and they’re giving orthopedic patients new opportunities to live full and active lives with artificial joints that can potentially last them the rest of their lives.

Comparing today’s artificial joints to the ones in the past is like comparing a new iPhone to an old rotary dial phone.

And the advancements go well-beyond just the technology. Replacement surgery is becoming more and more customized for each patient. During an initial consultation with a potential patient, they usually ask an important question about lifestyle: “Will I be able to do many of the things I’ve done in the past?” As an orthopedic doctor, I’m genuinely excited to be able to tell them “yes” –and to say it with enthusiasm.

As technologies, materials and surgi-cal techniques have improved, we have also seen a trend in recent years toward younger orthopedic patients. These pa-tients not only want to return to their pre-surgery activities, but they want to do so quickly. Because of improved surgi-cal practices and less-invasive procedures,

we’ve been able to cut the average hospital stay after a joint replacement surgery to one to two days. In fact, some patients are even able to have replacement surgery as an outpatient procedure – something un-heard of just a few years ago.

Meanwhile, the need for hip and knee replacements is growing because Ameri-cans are literally growing too. Sadly, about one-third of our nation’s population is clin-ically obese, and that is causing issues in the world of orthopedics – with increased wear and tear on overburdened joints. Before undertaking any replacement procedure with an obese patient, we always discuss overall health improvements, including weight loss, which can help shorten the re-covery process, improve surgical outcomes and minimize complications. Sometimes, a patient may need to work with a weight loss specialist for several months before we even schedule a joint replacement surgery.

Joint replacement is a fast-growing and active field, which requires surgeons like myself to keep up on the latest trends, materials and state-of-the art techniques being used by orthopedic specialists around the world. I was recently invited to join both the North American and In-ternational branches of the International Hip Society. Each branch is an invitation-only group, made up of fewer than 100 of the best joint replacement surgeons from around the world.

My involvement in the society allows me to tap into the collective knowledge of orthopedic surgeons worldwide and bring it back to Central Florida where we can use it on behalf of local patients. This means we can have the best possible joint replace-ment patient care and outcomes right here at home. During a recent gathering of the Hip Society members, I was fascinated to learn how certain international surgical teams are treating infections differently than we do here in the United States, with demonstrable positive results. I also heard from my European colleagues about the implant registries they maintain in Europe as a way to track which implants work best. Having access to this kind of information and cutting-edge techniques makes me better as a surgeon and that’s obviously good for my patients.

As a young medical student, I became enthralled with joint replacement surgery because of the ability of orthopedics to positively impact people’s lives. Happily, I remain just as excited about working in orthopedics today. Whether I’m address-ing a congenital knee issue, malformed hips, arthritis, or the impacts from a severe joint injury – it is extremely gratifying as a doctor to be able to help relieve people’s pain and to get a patient literally and figu-ratively – back on their feet.

George J. Haidukewych, MD, continued from page 1HEALTHCARELEADER

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HEALTH INNOVATORS

Physician Innovation…What IfBy, KeLLI MUrrAy, MeDsPeAKs

What if…“we could develop a (method) that was faster, and provide the type of clinical expertise that a clinical neurolo-gist would ask, to the fingertips of laymen,” asked Anitha Rao, MD, MA. I recently met Dr. Rao, who is one of just 1,000 physicians globally with training in geriatric neurology and dementia, to learn about why and how she is answering this question.

Unbeknownst to her at the time, the path to entrepreneurship began with clinical experience in helping patients and their caregivers diagnose and navigate the various stages of memory loss. Dr. Rao identified common threads across symp-toms, questions, and frustrations expressed by caregivers. These commonalities led her and a social worker to wonder if de-mentia care plans and education could be accurately generated using technology. Through experimentation, they found that it can - even in difficult cases.

Using evidence-based research and clinical guidelines, the Neurocern plat-form guides family members and caregiv-ers through a series of questions about the

patient’s symptoms and concerns. The answers are analyzed using a proprietary algorithm and a series of predictive and prescriptive analytics to create a care plan from the personalized brain profile of the patient. Additionally, it provides a library of suggestions on managing and mitigat-ing certain behaviors and situations. For instance, educating on how mirrors may cause a patient to have a traumatic re-sponse and/or an aversion to bathing out of fear that their own reflection is a stranger or intruder in the room.

The case for this type of caregiver resource is significant - particularly for geographic areas identified as “demen-tia deserts.” Desert designations have been assigned to 20 states in Neurocern’s ANDI study (Alzheimer’s Disease and Re-lated Disorders Neurology Desert Index) as having the lowest projected ratio of neurologists per 10,000 dementia patients based upon population health data from the Centers for Medicare and Medicaid Services. The list includes states such as Wyoming, North Dakota, South Carolina, South Dakota and Oklahoma.

According to Beth Kallmyer, MSW, Vice President of Constituent Services at the Alzheimer’s Association, “This intriguing study highlights several issues, including the clear inequality that exists across the United States in distribution of health resources and specialist knowledge to diagnose and treat brain diseases, such as Alzheimer’s.”

Clinical extension solutions like Neu-rocern have a fit in helping providers and payers reach and leverage an untapped valuable resource - the family and caregiv-ers within the patient’s home. The industry is at an infantile stage when it comes to this

type of engagement but the progression of its use is inevitable. For more information go to www.neurocern.com.

Look for additional physician driven innovations in future articles. If you’d like to nominate a company, invention, or process to be considered, please email [email protected].

UPCOMING EVENTS

MedSpeaksTM showcases the most exciting experts, events and innovations in Central Florida by bringing together the state’s largest community network of Health Innovators. We have converged over 1,400 healthcare professionals including clinicians, entrepreneurs, and technologists to discuss and promote the problems facing healthcare today and the innovations reshaping the future. www.medspeaks.com

Lake Nona IMPACTForumFEBRUARY 28, 2018 | ORLANDO, FLlakenonaimpactforum.org/

HIMSS 2018MARCH 5-9, 2018 | LAS VEGAS, NVhimssconference.org/

SynapseFLMARCH 28-29, 2018 | TAMPA, FLsynapsefl.com

HealthCon APRIL 8-11, 2018 | ORLANDO, FLhealthcon.com

MeGa Health JamAPRIL 12-16, 2018 | ORLANDO, FL megahealthjam.com

TechStars Startup Week FEBRUARY 12-16, 2018 | TAMPA, FLtampabay.startupweek.co

FEATURED INNOVATORS:

Disclosure: Readers, please take note that the companies featured in the Health Innovators section have not paid for or bartered for these acknowledgements. All companies are selected based on merit, intrigue, and their potential to move healthcare forward towards the Quadruple Aim. In a noisy and biased market, we believe this to be a valuable distinction.

TSOLIFE (The Story of Life) is creating in-novative ways to preserve legacy and pass down life stories. The software solution en-ables assisted living communities, memory care communities, hospices, and funeral homes the ability to easily capture the life sto-ries of their residents, while its family-facing online platform organizes and preserves these stories. For more www.tsolife.com

NEUROCERN – Founded by Anitha Rao, MD, MA, Neurocern is a caregiver plat-form aimed at the early identification and management of dementia and Alzheimer’s patients living at home. The tool utilizes algorithms and family reported data to pro-vide families with personalized care plans and access to the same types of tools used by neurology and geriatric care professionals. For more www.neurocern.com

By NINA tALLey

Early last year, sexual orientation and gender identity (SOGI) questions were quietly removed from two federal surveys, the National Survey of Older Americans Act Participants and the Annual Program Performance Report for Centers for Inde-pendent Living. This move was a huge loss for both the LGBTQ+ and research com-munities.

“It’s a big deal to make this change,” Michael Adams, CEO of Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders, or SAGE, said. “What this is about is stripping out an en-tire population.”

Having only been in circulation since 2014, the collection of SOGI data was described as “a pilot test” with an “in-sufficient” sample size by Kelly Mack, a spokeswoman for the Administration for Community Living, of the Health & Human Services (HHS) division, which oversees the surveys. LGBTQ+ advocates are incredulous of this claim.

The National Health Interview Survey (NHIS), which the HHS relies on to monitor trends in illness and disability and to track progress toward achieving national health objectives, has collected ethnicity data of its respondents for almost 20 years. This has resulted in a wealth of minority health data. For example, we know that older African Americans and Native Americans have the highest disability rates in America, followed by older Hispanic/Latinos. What we don’t know is what percentage of those disabled

populations identify as LGBTQ+. This is particularly notable as the tracking of these disability trends, which often project future disability rates, are especially important for the shaping of public policy.

The implications of the erasure on the LGBTQ+ patient population are stunning. As of 2000, there were more than 2 million older adults that identified as gay, lesbian, or bi-sexual. This number is on track to more than double, with a likely population of over 6 million LGBTQ+ seniors by 2030. Can you imagine? 6 million minority Americans becoming more reliant on physician care, with little to no data to support their aging transition, or to support the doctors who will care for them. But what can be done about this?

“The collection of SOGI data is im-portant for understanding potential dis-parities and for building mutual trust and respect among healthcare providers, re-searchers, and our LGBTQ community,” says Dr. Jason Flatt, an Assistant Professor at UCSF’s Institute for Health & Aging.

The unique stressors facing the LGBTQ+ population are sure to create health trends unique to the population. The first step to identifying, and eventually treat-ing those trends, is including SOGI-based questions, not just in federal surveys, but in all medical forms. We must modernize what we consider to be standard patient data to be inclusive, and to reflect our expanded under-standing of the human condition.

Standard Sexual Orientation and Gender Identity Questions as identified by the The Williams Institute are:

What is your current gender identity? (Check all that apply.) Man Woman Trans male/Trans man Trans female/Trans woman Genderqueer/Gender non-conforming

ANOTHER IDENTITY:

What sex were you assigned at birth, on your original birth certificate? Male Female

How would you describe your current sexual orientation? (Check all that apply.) Asexual Bisexual Gay Lesbian Queer Questioning Straight/Heterosexual Not listed above (please write in):

This is a highly emotional issue, with passionate arguments coming from both sides. But we must think of and understand our patient populations, all of them, in order to best serve them. In this case, a small but inclusive change could have a massive impact for generations of LGBTQ+ Americans.

Special thanks to Dr. Jason Flatt of the Institute for Health & Aging at University of California San Francisco for providing his unique insight on this matter.

The Case for SOGI Data

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https://williamsinstitute.law.ucla.edu/wp-content/uploads/geniuss-report-sep-2014.pdf


By rON FreCHette, tHe CyBer GUy

This is the time when we are super motivated to crush the goals we set out to achieve in the new year. It is also the time when many of us schedule our annual phys-icals or what are known today as Preventive Healthcare exams. A routine examination typically includes our doctors asking a series of questions related to our lifestyle activities, an inspection of our physical bodies and some internal testing such as blood pres-sure, heart rate and lab tests.

Preventive healthcare exams allow our healthcare providers to find potential problems BEFORE we get sick. They also share their expertise to help us ward off potentially fatal infections and prevent long term negative healthcare conse-quences. There are simple things we can do to increase our health and vitality like, eat nutritious meals, exercise, and get the appropriate amount of rest.

As we embark further into the new Digital Age, we must adopt a similar prac-tice of performing Preventative Cyber Health Exams to protect our digital pres-ence from being infected in cyberspace. The average American spends more than 10 hours a day in front of a digital screen, 5 hours of which are on a mobile device. Most mobile devices have little to no se-curity controls in place. Combine that with 500,000 new malware viruses being launched into cyberspace daily. The risk of infection is eminent unless we begin to take proactive cyber health measures.

The following checklist will help de-

termine your cyber health status. If you answered “No” to most of these

questions, it is likely you have poor cyber-security hygiene and your risk of contract-ing viruses and becoming a victim of a cyber-attack is extremely high. Don’t be discouraged. Rather use this as a wakeup call to take the appropriate actions towards becoming more cyber health conscious in 2018. If you happened to answer “yes” to most of these questions… congratulations! You are most likely in good health on line.

Like improving our overall physi-cal health, the practice of improving and

maintaining good cyber health is a journey not a destination. For detailed instructions on how to implement the above checklist cyber health practices, I highly recommend reading Jill Duffy’s online article in PC Magazine titled, “10 Simple Things You Can Do to Be More Secure Online” The url is also listed in the sources below.

Add increasing cyber health to your to do list and I guarantee 2018 will be a year that will truly bring peace of mind and much less worry about having your per-sonal information compromised and used for malicious purposes in the years to come.

QUESTIONS? Send me a tweet @GoldskyRon.

Sources:https://www.pcmag.com/article2/0,2817,2478462,00.asphttp://www.cnn.com/2016/06/30/health/americans-screen-time-nielsen/index.html

Ron Frechette, Co-Founder & Manag-ing Partner of GoldSky Security is a cybersecurity and healthcare entrepre-neur who over the last several years dedicated his career to helping enter-prise companies reduce the risks of cyber-attacks. Ron left the enterprise security world in 2015 and co-founded GoldSky Security, LLC. Ron’s vision is to build cybersecurity firms across the US that exist to help small-midsize busi-nesses implement affordable cyberse-curity solutions. Ron can be reached at [email protected]

Here’s to Good Cyber Health CYBER HEALTH EXAM CHECKLIST____ Do you Use Unique Passwords for EACH of your on-line accounts?

____ Do you routinely scan your devices to insure they are free from viruses?

____ Do you have passcodes set up on all your devices?

____ Do you VERIFY all links and attachments are legitimate before clicking?

____ Do you have a VPN (Virtual Private Network) service in place?

____ Do you clear your cache in all your devices on a routine basis?

____ Do you have the “auto save password” in your browser turned off?

____ Do you use Two-Factor Authentication where sensitive data is stored?

____ Do you know how to use the security features on your devices?

https://www.pcmag.com/article2/0,2817,2478462,00.asp



http://www.cnn.com/2016/06/30/health/americans-screen-time-nielsen/index.html

http://www.cnn.com/2016/06/30/health/americans-screen-time-nielsen/index.html

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By JAy sHOrr, BA, MBM-C, CAC I-XII AND MArA sHOrr, Bs, CAC II-XII

Selecting the proper employee can make or break your medical practice, re-gardless of your specialty. At some point in your career, present or past, you’ve worked with that staff: the one filled with drama, disrespect toward leadership and constant turnover. Ultimately, you want to do everything possible to keep from finding yourself in that position again.

Whether you’re looking to hire an aesthetician, medical assistant, nurse, receptionist or even another provider, all members of your practice are incred-ibly important. They represent you, your brand and the manner in which you are perceived by your patients and the pub-lic as a whole. A rude receptionist sets the tone for the entire visit, should a patient choose to book that appointment after a less-than-lovely phone interaction at all. From poor bedside manner, to employee theft and clerical errors in your practice management software, curb the issues be-fore they arise with a few of these simple selection tips:

STEP #1: RECRUITMENT• Refine the job description so that it’s

one you’re happy with. Examine what the true and current needs for your practice are. If you had employees leave recently, examine the skill set of your current team and look for gaps. Be honest about what you’re looking for, and if recent graduates don’t fit your search terms… say so in the description.

• Establish what you’re willing to pay the position ahead of time. Are you looking for a full or part-time employee? Hourly or salary? What benefits are you willing to provide, if any? Is this person an employee or a contractor? Will they receive a bonus or commission based on certain guidelines? Establish this prior to starting the interview component.

• Once you post the position, carefully scrutinize the resumes as they begin to arrive. Eliminate typos, illegible formats and other initial turnoffs. Review the length of time the candidate spent with his/her previous employers. Warning signs appear when you see a series of five-month employers. You don’t want to add your name to that list of short-term employers if you’re looking for someone who will help you grow in the long term.

STEP #2: INTERVIEWING• It goes without saying you’ll want to

conduct an interview in person… not just over the phone. However, feel free to hold a brief phone interview first to ask any initial questions that may serve as deal breakers down the

line. For example, are they looking for full or part-time work, and does this match what you’re looking for?

• When you schedule the in-person interview, be sure to not only conduct these with the doctor, but with additional staff members down the line as well. Other team members will pick up on things that you may not, and this allows you the opportunity to sit back and see how the candidate interacts with your other team members as well.

• Ask pointed questions about the candidate’s knowledge about both your practice and your industry. For example, find out what they know about your practice, your reputation in the community, and the treatments you offer. Ask them why they would want to work in YOUR office? What do they consider they greatest accomplishments, and what would they like to achieve in the next five years? How do they handle stress or drama in the workplace? Ask why they’re leaving their last job as well; you’ll be surprised at the answers that some people give!

• Be sure to review scheduling conflicts. If the possible new employee is unavailable during your peak hours, for instance, wish them well on their search, and explain you’re not the office for them. You want to make sure that this is addressed right off the bat.

• Consider, when your state allows, a working interview. Use this time to see how your potential new staff member interacts not only with other employees, but with your patients as well. How do they react to the stress load in your office when the phone

rings all day, when there’s down time… or no moment to breathe?

• Check references for at least three previous employers and verify your prospect’s industry-related experience. We’ve seen people claim they’ve held jobs that they haven’t and, even scarier, claim they’ve held certifications and degrees that they never earned. Double check as many of these as possible.

• Perform a background check, and consider the results as they relate to the position. A new bookkeeper, for example, should not be hired if s/he has a history of fraud, embezzlement, or bankruptcy. Is a current valid driver’s license valid for the position, or does the candidate live within walking distance? Make sure that s/he has a reliable form of transportation to work each day, as well as a valid form of identification.

STEP #3: ORIENTATION AND ONGOING TRAINING

• Let your new staff member know right off the bat about your code of conduct. This should include, but is

not limited to, your policies on staff uniforms, body piercings, tattoos, hair color, tardiness and cell phone usage on the job. This should all be included in an easy-to-locate Employee Handbook. (We always recommend having ALL employees, both new and existing, sign off on these policies.) This should include a staff social media policy as well.

• Training should occur not only when a new employee starts with your practice, but throughout his or her time with you. Ongoing, clear, concise and consistent training, both in your workplace and taking place as teambuilding outside of the office do wonders for both employee development and morale. When looking at ongoing training opportunities, don’t be afraid to recruit outside vendors, as state and local laws apply.

• Meet with your staff members on a regular basis to go over their performance. Recognize opportunities for improvement as well as outstanding behavior you wish to see duplicated in the future. Be sure to work with your staff members in a way that offers incentives for them. For example, some people do better being praised publicly, while others prefer to be praised in private. Pay attention to your individual team member’s motivators.

STEP #4: INCENTIVES TO MOTIVATE STAFF

• From healthcare benefits to cash bonuses, not all incentives have to come in the form of dollars from your

Top Tips to Consider When Hiring a Strong Staff


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By COrNeLL L. NeWBILL

When was the last time you as a doc-tor, physician and /or a clinician had a checkup – that is a check up on your busi-ness, your practice?

Fact – Year 2016, one third of practices closed their doors. With the ever-changing world we live in and the laws governing our lives, how great would it be to have a sys-tem would assist us in achieving our goals whether personal or professional.

In the beginning of the year, we all take some kind of inventory to see where we are, where we have fallen short, and with that assessment we can make a cog-nitive determination as to what we would like to achieve in the future. A medical practice should operate on the same logic.

Don’t wait until it is too late Allow a revenue management com-

pany to assess your practice for you. Some will charge you and there are a few who will not. How great would it be to have an expert who is certified in revenue medical management to provide a free assessment, and what if the revenue management company after the assessment, would pro-vide you with a free demo that would give insight on how to stop the bleeding (loss of revenue and profits) in your practice?

The medical profession is struggling. Remember the previous statement one third of doctors in 2016 closed their doors. You must ask the question why? Answer:

• The “National Rejections Rate is 34 percent

• Slow Payment by carriers as long as 120 days

• National Average of $22 per claim• Providers facing mandatory audits

by CMS• 70 percent of Covered Entities are

NOT compliant• HIPAA Fines/Penalties are increasing

from $50,000 up to $ 1.5 million

Revenue Cycle Management – (RCM) is the process that manages claims processing, payment and revenue genera-tion. It entails using technology to keep track of the claims process at every point of its life, so the healthcare provider or medi-cal billing company doing the medical billing can follow the process and address any issues, allowing for a steady stream of revenue. The process includes keeping track of claims in the system, making sure payments are collected and addressing denied claims. RCM encompasses every-thing from determining patient insurance eligibility and collecting co-pays to prop-erly coding claims using CPT and ICD-9, should be ICD-10 codes. Time manage-ment and efficiency play large elements in RCM, and a physician’s or hospital’s choice of an EMR can be largely center around how their RCM is implemented.

Doctors, physicians, clinicians and any/all medical practices, why not take care of your practice, so you can continue taking care of your patients.

Cornell L. Newbill is the owner of Newbill’s Revenue Net-work in Winter Springs. Visit www.newrevnet.com

Doctors, Physicians, and Clinicians Need a Check – Up

Direct Support For Patients & Families

• Lynx Single Ride Option Bus Passes and gas cards to make

reaching our health centers easier

• Publix, W almart or Target Gift Cards

• Videos and DVD’s, Coloring books & crayons, and games for

children who wait to see the provider

• Financial contributions to support patient visits and medical services

Direct Support of Our Health Center Managers

• Kleenex and Multi-Fold Paper Towels

• Hand Sanitizer

• Disinfectant Wipes

• AA and AAA Batteries

• Tall Kitchen Garbage Bags

• Non-Latex Medical Gloves

• Forever Mailing Stamps

• White Copy Paper

• Plain White Mailing Envelopes (Size #10, 9” x 12” and 10” x 13”)

• Automatic Blood Pressure Cuffs

• Wall-Mount Flat Screen Television for Volunteer Trainings

t For Patients & Families

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bank account. We suggest flexible schedules, when available, or an extra day of vacation.

• Looking for FREE ideas? A certificate to your Employee of the Month costs you only the ink from your printer, as does posting a duplicate version of the certificate in your reception area for patients and clients to see. In addition, include an Employee of the Month section in your office’s monthly e-newsletter, and ask your clients to show their gratitude when they see your staff member in the office on their next visit.

• Looking to make an investment in your staff ’s education, and the education of your practice? Consider taking them to an industry conference.

We can almost guarantee they’ll come back motivated and servicing your patients better than ever!

Ultimately, hiring and training a strong staff will help grow your practice by leaps and bounds… and it all starts with the right hire.

Mara Shorr, B.S., CAC II-XII, serves as the vice president of marketing and business development for Shorr Solutions. She is level II-XII certified aesthetic consultant, utilizing her knowledge and experience to help clients achieve their po-tential. She is also a national speaker and writer. Jay A. Shorr, B.A., MBM-C, CAC I-XII, is the founder and managing partner of Shorr Solutions, assisting medical practices with the operational, financial, and administrative health of their business. He is also a professional motiva-tional speaker, an advisor to the Certified Aesthetic Con-sultant Program, and a certified medical business manager from Florida Atlantic University.

Top Tips, continued from page 11

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By MArK LANtON, CMrM

Expenses for an individual to receive healthcare in America steadily increases, although the general health of our country continues to fall behind other countries. A transformation began to take place within the U.S government, as the use of the elec-tronic health record (EHR) technology hit the scene. The EHR was meant to convert all patient medical records from paper to a digital format.

A move was initiated in 2009 to cre-ate a movement for physician practices to convert to electronic medical records systems. This was an idea of the 111th Congress on February 17, 2009, where President Barack Obama signed into law the American Recovery and Reinvest-ment Act. This Act was to furnish funding to strengthen the health information tech-nology infrastructure through the Health Information Technology for Economic and Clinical Health (HITECH) provision.

At the June 15, 2009 American Medi-cal Association (AMA) Conference, Presi-dent Obama emboldened the healthcare industry to depart from the paper medi-cal records and adopt EHR’s. There is a multitude of advantages in converting to an electronic health record system. The EHR is an important way doctors commu-

nicate with each other in that treatments, diagnosis’/prognosis, therapies are clearly documented for review. One of the great features of an EHR is that a patient’s medi-cal information is all in one place. The in-formation is quick to access in real-time from doctor to doctor, and easy to read (we all know the handwriting of a physician).

Electronic medical record systems have a myriad of benefits that will help a doctor. EHR records are safe in that they cannot be destroyed. They are stored in a cloud-based system that automatically and regularly backs itself up. EHR records can be accessed from anywhere you have an internet connection. You are not limited to the confines of your practice to view re-cords. For paper charts, if there is a fire that destroys all of the paper medical records, they are forever gone. EHR’s have a feature where a doctor has real-time access to com-plete a patient record at the time of care, which improves the quality of care and en-ables doctor’s to better communicate with each other. EHR’s will reduce and prevent medical errors by sending clinical alerts and reminders. It gives a coordination of care and they can interface with labs. The pa-tient portal enables the patient to directly communicate with their doctor. EHR’s also increase the doctor’s cash flow with the improved billing and coding features. The

insurance claim denial rate will dramatically decrease with a good EHR. And to top it off, the records are legible.

The usage of an EHR can have some challenges, so paying attention to detail and being meticulous is paramount. Being watchful can save your prac-tice loads of agony. One of the challenges is security and privacy. Although document-ing patient care will greatly improve, the security to prevent unauthorized persons to access a patient’s health information (PHI) should be in place. A practice should have security features set up to prevent illegiti-mate usage and access to patient informa-tion. An EHR can improve the quality of healthcare given. A doctor has quick ac-cess to patient records from inpatient and remote locations for more coordinated, efficient care. There are enhanced deci-sion support, clinical alerts, reminders, and medical information. They can also inter-face with labs, registries and other EHR’s. Also, reliable prescribing of narcotics is an-other great feature of an EHR.

There are some precautions to employ when switching from paper to electronic health records. Paper records are more permanent, and it is easy to discern if they have been altered in any way. It may be

difficult to determine if edits were made in the EHR. A solution to this may be that whoever documents or edits a chart, to indi-cate the date/time of the

edit entry. I hope this writing helps

physicians recognize the im-portance of transitioning from paper

medical records to a quality electronics health records system. The Centers for Medicare & Medicaid Services (CMS) pro-vides healthcare for millions of Americans and is the single largest payer for healthcare in the United States. The best way to keep the CMS away from your practice and your wallet is to utilize a quality EHR and use the proper codes. The U.S government passed laws that assist eligible providers through financial incentives, to switch from paper health records to EHR’s. Visit https://www.cms.gov/Regulations-and-Guid-ance/Legislation/EHRIncentivePro-grams/index.html to learn the Medicaid and Medicare EHR incentive programs.

Mark A. Lanton, CMRM, is founder/CEO of Lanton Consult-ing, LLC., specializing in increasing physician practice effi-ciency, compliance and cashflow via Practice Management, Revenue Cycle Optimization and Private Practice Business Support. Visit www.LantonConsulting.com or email [email protected]

The Advantages to Having a Credible Electronic Health Records System

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By JIM PeAKe

The Health Insurance Portability and Accountability Act (HIPAA) requires all health care professionals to safeguard patient protected health information. The United States Department of Health and Human Services Office for Civil Rights is responsible for enforcing HIPAA standards and investi-gating claims of HIPAA violations.

For some treatment facilities, market-ing and compliance can become an issue. To generate leads and find clients, addic-tion centers need to partner with a firm like us, Addiction-Rep, for rehab lead gen-eration that is HIPAA compliant. Run-of-the-mill marketing firms don’t tend to understand the delicate nature of secure data, putting you at risk for common rehab HIPAA violations. We can help your treatment facility stay full, without violating HIPAA regulations.

While many health care professionals have lost their jobs and faced substantial lawsuits for knowingly compromising pa-tient data, it’s important for health care employees to realize that even uninten-tional HIPAA violations can have the same result. We know how to promote your center and keep data secure.

COMMON HIPAA VIOLATIONSA HIPAA violation can lead to fines

up to $1.5 million, sanctions, and poten-tially loss of license. Most health care or-

ganizations take HIPAA compliance very seriously and encourage compliance at all levels of their organizations.

CONSIDER THESE COMMON HIPAA VIOLATIONS:

• Marketing and Social MediaWhile there have been notable inten-

tional breaches of patient information in recent years, most HIPAA violations arise from carelessness, complacency or simple ignorance of the law. One culprit is tech-nology. Sharing photos of work on social media, making comments about patients on social media profiles, and even private messaging with patients’ friends and loved ones can lead to HIPAA violations.

• Data SecurityLost devices are another concern.

Many health care professionals can access patient information and other HIPAA-protected data using various devices. Technology allows modern health care professionals to connect with and serve pa-tients in various ways across multiple de-vices. However, losing a device can lead to a serious HIPAA violation if whoever finds the device can access patient information.

Health care professionals should use good judgment when it comes to internet safety and passwords. Anyone working in health care should never share a pass-word with someone else, even another employee. Additionally, devices meant

for work should only be used for work. Installing personal software or accessing potentially dangerous websites can lead to a data breach. Health care organizations are one of the ripest targets for hackers since patient information is so valuable.

• Illegal DisclosureIn some instances, texting may seem

like a great way to quickly relay patient in-formation, but again can lead to common rehab HIPAA violations. While it may seem harmless and a quick way to get oth-ers up to speed on a patient’s condition, personal mobile devices are largely unse-cured. This puts patient data at risk. Ad-ditionally, health care employees should never attempt to access patient informa-tion from a home or personal computer.

Some patients may need to see mul-tiple doctors and specialists to receive treatment. In these situations, it’s vital for the primary care provider to obtain the patient’s consent to share his or her information with other health care profes-sionals. The HIPAA Privacy Rule dictates that patients must willingly provide writ-ten consent for their health information to be shared with others.

PREVENTING HIPAA VIOLATIONSOne of the best ways to prevent com-

mon rehab HIPAA violations in your work-place is to make HIPAA compliance a part of your company culture. Ensure employ-

ees understand the importance of informa-tion security and complying with HIPAA standards. Be clear about erring on the side of caution: If you are unsure whether an action would be a HIPAA violation, ask for clarification before continuing.

Network and device concerns vary from organization to organization, but a few best practices can help providers stay in compli-ance. Employ device monitoring so units can be quickly found or remotely disabled if lost or stolen. Additionally, encourage employ-ees to use complex passwords and change them regularly. Finally, offer regular train-ing to employees about HIPAA compliance.

STAYING EDUCATED ON HIPAA REGULATIONS

Even a seemingly harmless misstep can lead to loss of license, hefty lawsuit dam-ages, or worse. At Addiction-Rep, we under-stand compliance because we are focused on lead generation specifically for treatment centers. We understand the price of costly common rehab HIPAA violations, and we take that into consideration in our marketing so treatment centers can continue providing patients with the best care possible.

Traditional firms don’t understand the unique considerations of treatment facilities, but we do. We’ve dedicated our resources to helping treatment facilities and clients find each other.

Jim Peake is president of Addiction-Rep. Visit www.addiction-rep.com.

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GrandRounds

Dr. Kevin Sherin, Health Officer of the Florida Department of Health in Orange County (DOH-Orange) has named Nasseam McPherson James the department’s new Assistant Health Director. Her first day on the job iwas February 8, 2018.

Dr. Sherin said, “We are excited to announce Nasseam McPherson James as our new Assistant Health Director. She brings superb credentials and ex-perience to help lead DOH-Orange into the future with successful public health programs and operations.

Ms. James comes to DOH-Or-ange from the Children’s Medical Services, a division of the Florida De-partment of Health, where she held the position of Regional Program Administrator of the Central Region that consisted of Brevard, Orange, Osceola and Seminole counties. At the Children’s Medical Services (CMS), she served the region’s 109 employees faithfully and collabo-rated with community partners and leaders in the public, private, and faith based community to promote CMS’s mission of ensuring that chil-dren with special healthcare needs have access to resources that encour-ages healthy outcomes.

Her prior work experience in-cluded serving as an Operations and Management Consultant Manager/Healthy Start Manager for the Florida Department of Health in Seminole County, and as a Social Services Man-

ager/Healthy Start and WIC Director at the Florida Department of Health in Highlands County. Before joining the public sector, Ms. James served as the Compliance and Quality As-surance Director for the Early Learn-ing Coalition of Marion County.

“I’m honored to have the op-portunity,” said Ms. James. “While I’ll miss the wonderful staff at Children’s Medical Services, I’m extremely ex-cited to once again work within the county health structure.”

A graduate of the University of South Florida, Ms. James earned her bachelor’s degree in Social Work. In addition, Ms. James holds a Masters of Social Work – Social Policy and Admin-istration from Florida State University in Tallahassee. She anticipates complet-ing the Executive Masters of Business Administration program at the Univer-sity of Central Florida in 2019.

Ms. James has served on the Seminole County Children’s Cabinet, as a board member on the Highlands County Children’s Services Council, and the Highlands County Healthy Families Advisory Council. She is a cur-rent board member for Central Florida Health Care, Inc., the Federally Quali-fied Health Center for Polk, Highlands, and Hardee counties. She is a past re-cipient of the Jane Mansfield Award for Outstanding Dedication to Leader-ship and Community Services and was named an Ocala and Marion County Top Forty Under 40 Leader.

Nasseam McPherson James Named Assistant Health Director At The Florida Department Of Health In Orange County

Florida Cancer Specialists & Re-search Institute (FCS), the largest inde-pendent hematology/medical oncol-ogy practice in the United States, has partnered with UnitedHealthcare to im-plement a cancer care model focused on quality patient care, best treatment practices and health outcomes.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that em-phasizes volume of care delivered. Similar payment models have shown to enhance care coordination and im-prove health outcomes for patients, while reducing overall costs.

Sarah Cevallos, FCS’ Chief Revenue Cycle Officer, said, “Our collabora-tion with UnitedHealthcare to expand enhanced oncology services provides the growing population of Florida’s on-cology patients access to additional ser-vices to support their health care needs.”

In a study published in the Unit-edHealthcare’s episode of cancer care payment initiative (EOC) reduced overall cancer expenses by more than a third while improving quality outcomes. The program rewards par-ticipating medical oncologists if they demonstrate superior clinical results and reduce the total cost of care.

FCS President and Founder Dr. William Harwin said: “Identifying best practices in the treatment of this

very complex disease, coupled with a streamlined payment process, will re-sult in reduced health care costs for patients and their families. The EOC payment program from UnitedHealth-care is consistent with our priority of putting patients’ interests at the fore-front of cancer treatment.”

“We welcome the opportunity to work with UnitedHealthcare through this initiative, which is designed to im-prove the effectiveness and efficiency of oncology care,” said Florida Cancer Specialists CEO Brad Prechtl. “At FCS, we have developed various programs, such as Care Management and our Survivorship initiative that focus on ac-countability, while ensuring clinically excellent, compassionate and cost-effective care in a community setting.”

UnitedHealthcare piloted its epi-sode payment program between Octo-ber 2009 and December 2012 with over 500 oncologists nationwide. The results showed a significant reduction in hospi-talizations for patients and a 34 percent reduction in total costs while improving quality. Since then, the program has been expanded to an additional six sites. Florida Cancer Specialists joins other prominent oncology practices in a growing national movement to ex-plore care and payment models that deliver quality, cost-effective care.

Florida Cancer Specialists Partners with UnitedHealthcare Implementing Innovative Cancer Care Model

The American Medical Association (AMA) today announced the launch of a new podcast series for physicians, residents and medical students. “AMA Doc Talk” is a lively, informative, con-versation between physicians, ethi-cists, patients and academics, focused on relevant topics in medicine and packaged for quick consumption.

Season One, a six-episode run, fo-cuses on the difficult discussions with patients that many physicians face as part of daily practice. The new pod-cast series features physicians’ eye-opening encounters with patients and their real-world solutions and insights. Listeners will hear from peers who have struggled to comfort the sick or dying and agonized over word choice, and they can leave the podcast bet-ter equipped to handle even the most challenging conversation.

“In TV and in movies, doctors al-ways seem to strike just the right tone in the most trying situation. But in real life, when it comes to telling a patient she is dying or that he has dangerous

misconceptions about vaccines or an-tibiotics, delivering news delicately is not as simple as reading a script,” said AMA President David O. Barbe, M.D. “The AMA understands that these conversations are one of the many unique challenges facing physicians, and we are hopeful that this podcast series will help them feel better pre-pared when the moment comes.”

The first season of “AMA Doc Talk” is hosted by Rajesh S. Man-grulkar, M.D., associate dean for medical student education at the Uni-versity of Michigan Medical School. At Michigan, Dr. Mangrulkar leads the curriculum, student affairs and admis-sions units for the medical school.

The first two episodes of “AMA Doc Talk” were released today, and a new episode will be released each Tuesday for each of the next four weeks. Episodes are available on iTunes, Stitcher, and wherever you listen to podcasts. For more informa-tion, visit https://www.ama-assn.org/ama-doc-talk-podcast-series.

AMA Launches New Podcast Series to Tackle the Most Salient Issues in Medicine

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GrandRounds

We have welcomed our newest intern, Ena Strbac, to AID. A senior in health services administration at the University of Central Florida, Ena will work with AID through the spring. In addition to working with us while go-ing to school, Ena also works for AID member Dr. Konrad Filutowski as an ophthalmic technician.

Born in Bosnia, Ena also lived in Croatia and Germany before com-ing to the United States at the age of eight. She came to her interview with a clear knowledge of issues in-dependent doctors face and an ex-cited appreciation for AID's cause.

"I've seen my own family get knocked around by the health sys-

tem and wanted to be part of a cause that gives doctors and pa-tients a voice," she said. Over the next several months, Ena will be helping create AID's "Independent Doctor Tool Kit," to help those doc-tors looking to break free from hos-pital employment and open their own practice. She will also work on outreach to medical schools to make sure students understand that independence is an option they should consider. Please join us in welcoming Ena to the association.

Announcing New Intern at Association of Independent Doctors

Corporate Law Boutique, Adds Specialty Healthcare Law Provider, Michael R. Lowe, P.A. To Form Forster Boughman Lefkowitz & Lowe

Central Florida law firm continues expansion of boutique service in 2018 with the addition of Michael R. Lowe, P.A. “Michael allows us to expand our corporate, tax and asset protec-tion practice with a full-service health law division. We can now handle any corporate, planning or litigation mat-ter implicating the web of healthcare regulations,” said Managing Partner Gary Forster.

This brings together two extraor-dinary firms with practice strengths that are highly complementary. Mi-chael R. Lowe said, “This enables us to provide a new and broader set of services. We will be able to handle a wider variety of legal matters for our clients.”

Eric Boughman, co-founder and head of the firm’s technology coun-sel and litigation division, noted the

synergies presented by the firm's ex-perience. “We are well positioned to assist healthcare and medical profes-sionals by providing sophisticated le-gal solutions efficiently and with the personal attention that our clients have come to expect. Michael’s ex-perience with HIPAA, privacy regula-tions, and cyber security adds to the firm’s ability to service clients in the rapidly changing privacy arena.”

The mission of Forster Bough-man Lefkowitz & Lowe, is to serve as a resource for complex domestic and international business transactions, tax, asset protection, technology and healthcare counsel, and related litiga-tion. The firm is an approachable and economic alternative to large national and international law firms. For more information, visit www.FBL-Law.com

Health Care Leaders Collaborate to Streamline Prior Authorization and Improve Timely Access to Treatment

Physicians, pharmacists, medical groups, hospitals, and health insur-ance providers are working together to improve prior authorization pro-cesses for patients’ medical treat-ments, also known as pre-approval. This will help patients have access to safe, timely, and affordable care, while reducing administrative burdens for both health care professionals, hospi-tals and health insurance providers.

If a treatment or prescription re-quires prior authorization, it must be approved by a health insurance pro-vider beforehand. This is one way health insurance providers help en-sure a treatment is safe and supported by scientific evidence. When applied appropriately, these processes help to maximize the value of every dollar spent on coverage and care.

Prior authorization approvals can be burdensome for health care pro-fessionals, hospitals, health insurance providers, and patients because the processes vary and can be repetitive. Streamlining approval processes will enhance patient access to timely, ap-propriate care and minimize potential disruptions. Enhanced transparency and communication also play critical

roles in improving prior authorization processes, which underscores the im-portance of this new effort.

As the first step in this collabora-tion, the American Hospital Associa-tion (AHA), America’s Health Insurance Plans (AHIP), American Medical As-sociation (AMA), American Pharma-cists Association (APhA), Blue Cross Blue Shield Association (BCBSA) and Medical Group Management Asso-ciation (MGMA) have announced a Consensus Statement outlining their shared commitment to industry-wide improvements to prior authorization processes and patient-centered care.

According to the Consensus Statement, these health care leaders will work together to:

Reduce the number of health care professionals subject to prior autho-rization requirements based on their performance, adherence to evidence-based medical practices, or participa-tion in a value-based agreement with the health insurance provider.

Regularly review the services and medications that require prior authori-zation and eliminate requirements for therapies that no longer warrant them.

Improve channels of communica-tions between health insurance pro-viders, health care professionals, and patients to minimize care delays and ensure clarity on prior authorization requirements, rationale, and changes.

Protect continuity of care for pa-tients who are on an ongoing, active treatment or a stable treatment regi-men when there are changes in cov-

erage, health insurance providers or prior authorization requirements.

Accelerate industry adoption of national electronic standards for prior authorization and improve transparen-cy of formulary information and cover-age restrictions at the point-of-care.

This group of health care leaders is committed to ongoing collabora-tion to improve the prior authorization process for health care professionals, health insurance providers, and, most importantly, patients. As experience is gained, these processes will be fur-ther refined to maximize efficiency and minimize care disruption for patients.

Bavarian Nordic Announces Initiation of Clinical Trial with Novel Cancer Immunotherapy Targeting Brachyury in Cancer Metastasis

Bavarian Nordic A/S (OMX: BAVA, OTC: BVNRY) has announced the initia-tion of a clinical trial of BN-Brachyury, a novel cancer immunotherapy candi-date designed to target brachyury, a key driver of cancer metastasis in sev-eral tumor types. The open-label Phase 1 trial will evaluate the safety and toler-ability of the MVA-BN® Brachyury vac-cine, followed by a Brachyury encoded fowlpox (FPV) booster in patients.

The trial will enroll up to 10 pa-tients with metastatic or unresectable, locally advanced malignant solid tu-mors. Patients will receive two prime doses of MVA-BN Brachyury, followed by multiple booster doses with FPV-Brachyury. The primary endpoint of the study is safety and tolerability, and secondary endpoints include immu-nologic responses as measured by an increase in brachyury-specific T-cells and other tumor-associated antigens, as well as evidence of clinical ben-efit such as progression-free survival (PFS) and objective response (OR). The priming vaccine alone, MVA-BN Brachyury, was previously investigated in a Phase 1 study in 38 patients with chordoma or metastatic solid cancers, and was shown to be well-tolerated and to induce brachyury-specific T-cell immune responses in the vast majority of patients.

"The brachyury target represents an exciting new approach to attacking multiple cancers and deadly metasta-sis," commented Paul Chaplin, Presi-dent and Chief Executive Officer of Ba-varian Nordic. "Based on clinical results to date, we believe that BN-Brachyury may be a viable treatment option for patients with various forms of cancer. We look forward to further expanding the program with a Phase 2 study later this year in patients with chordoma - a rare tumor of the spine known to over-express brachyury, for which there are currently no systemic treatments of proven efficacy available."


GrandRounds

Florida Hospital Altamonte is providing an important new service in Seminole County that will allow its tiniest and most vulnerable pa-tients to get care closer to home.

The hospital debuted its new 6,208-square-foot Level II Neonatal Intensive Care Unit (NICU), which features 10 private rooms, and meets a growing need for critical care in Central Florida.

The rooms are equipped with Draeger’s Babyleo TN500 IncuWarm-er, which uses groundbreaking tech-nology to regulate body heat, maxi-mize efficiency for clinical staff and integrate families in their babies’ care. The Babyleo also features low sound and light levels to create a womblike atmosphere, and has advanced safe-guards against infection. Its “kanga-roo mode” allows parents to more closely interact with their baby.

“We’re pleased to add neonatal intensive care services to our net-work of care for these tiny patients and their families,” said Dr. Rajan Wadhawan, chief medical officer and medical director of neonatol-ogy at Florida Hospital for Children. “Having a child in the NICU can be a stressful time for families, and it’s important they have access to these services close to home.”

The new NICU is part of Florida Hospital’s neonatal network of care that includes 150 beds throughout Central Florida. The NICU network allows patients to receive the highest level of care, and includes a team of specialists who provide comprehen-sive diagnostic and therapeutic ser-vices, from minimally invasive surgery to highly complex cases, and innova-tive care and procedures.

Florida Hospital opens first Neonatal Intensive Care Unit in Seminole County

UCF College of Medicine-Hos-pital Corporation of America North Florida Division Consortium has es-tablished a new General Surgery residency program that will begin at Osceola Regional Medical Center and the Orlando VA Medical Center this July and is seeking immediate applicants.

The Accreditation Council for Graduate Medical Education (AC-GME) recently approved the new five-year program for a total of 15 residents. The new program is the consortium’s 19th in Central and North Central Florida.

“A new program allows us the rare opportunity to fuse the essen-tials of classical surgical education with the modern principles of surgi-cal training to create something spe-cial,” said Dr. Philip Kondylis, residen-cy program director. “Our program is devoted to excellence in surgical training and we are fully committed to graduating surgeons prepared to advance surgical care locally, and to lead the next generation of surgical thought nationally.”

The UCF-HCA North Florida Di-vision partnership is designed to in-crease Florida’s number of residen-cy programs – a key to solving the state’s physician shortage. Today the consortium has 250 residents and fel-lows training in HCA hospitals in Kis-simmee, Ocala and Gainesville and the two parties expect to increase that number to 600 + by 2020.

Osceola Regional Medical Cen-ter has undergone major expansion of its services and facilities, doubling in size to about 400 beds over the past few years. The hospital is a Level 2 trauma center and includes a Comprehensive Stroke Center, Acute Physical Medicine Rehabilitation and programs for high-risk obstet-

rics and behavioral health. Osceola Regional has received accreditation with commendation from the Ameri-can College of Surgeons Committee on Cancer and is Joint Commission disease-specific certified in breast, colorectal, lung cancer and sepsis. “Residents training at our hospital are helping us serve one of Florida’s fastest growing, most diverse com-munities,” said Davide Carbone, CEO at Osceola Regional.

The Orlando VA Medical Center in Lake Nona is one of the nation’s largest healthcare facilities for veter-ans and includes a comprehensive outpatient multispecialty clinic and an extensive variety of surgical servic-es. It houses the VA’s national simula-tion training facility.

Residents will also rotate at Nemours Children’s Hospital in Lake Nona to gain additional experience in more advanced/pediatric conditions.

All three training sites are de-voted to minimally invasive surgical procedures (hand and stick laparos-copy, robotic assisted surgery and trans-orifice surgery). The new resi-dency program has a vigorous aca-demic schedule intended to foster self-review, continuous learning and to expedite evaluation and potential application of new innovative treat-ments. The program will also empha-size research, encouraging residents to publish and review the results of their scholarly activity on an ongoing basis.

Applications are now open for the 2018-2019 academic year and should be submitted through ERAS. Qualified applicants will be selected for interviews. Contacts for the sur-gery program are Ana Acevedo, pro-gram coordinator, [email protected].

UCF College of Medicine/HCA North Florida Division Consortium Announces New General Surgery Residency Program

In response to the growing health-care needs of Osceola and Polk coun-ties, Poinciana Medical Center will break ground on a $10.1 million expan-sion to its emergency room in 2018.

Expected to be complete by 2019, the 14,000 square-foot project will in-crease the capacity of the hospital’s ER from 22 beds to 31. The project will also include the renovation of the

hospital’s lab, emergency department waiting room and entrance.

This will be the facility’s third ex-pansion since its opening in 2013.

“At Poinciana Medical Center, we are dedicated to finding new ways to meet the needs of our community,” said CEO Chris Cosby. “The expan-sion of our emergency room will con-tinue to drive down average ER wait

times and allow us to continue pro-viding our patients with the quality care they deserve. Additionally, this project will further enhance the func-tionality of our lab.”

In January 2015, the hospital ex-panded its emergency room to 22 beds and 14,500 square feet, and in November 2015, completed a vertical expansion that more than doubled its

number of private patient beds.Poinciana Medical Center employs

more than 300 full-time staff members. Additionally, the hospital has more than 280 credentialed physicians and ad-vanced practice professionals as part of its medical staff.

Poinciana Medical Center Announces Plans To Expand Emergency Room


GrandRounds

Community Health Centers, Inc. celebrates 45-year anniversary with team members, special guests and founders. On Friday, January 26, nearly 500 team members gathered for a celebration breakfast event at SeaWorld’s Ports of Call to honor their history and accomplishments.

Community Health Centers de-buted a history video highlighting the journey of four catholic nuns working with community members to bring healthcare to farmworkers in south Apopka. In attendance for the event were Sister Ann Kendrick, Sister Therese Gillespie, Sister Gail Grimes and founding Board Mem-ber Louis Kellom.

Community Health Centers, currently, has 12 centers through-out Central Florida and is the medi-cal and dental home to more than 66,000 patients. Community Health Centers accepts Medicaid, Medi-care, Private Insurances and offers a Sliding Discount Program, based on family size and income, that assists patients with or without insurance.

During the event, Community Health Centers recognized 49 team members who have been with the organization 15 years or more. Delia Sanchez a dental assistant from the South Lake center in Groveland is celebrating her 39th year in the or-ganization.

Community Health Centers Celebrates 45 Years

(L-R) – former Board Member Pascale Vincent; current President/CEO Margaret Brennan; Tim McKinney

(L-R) – Founders: Louis Kellom; Sister Ann Kendrick; Sister Teresa Gillespie; Sister Gail Grimes; Community Health Centers, current Board Chair Tim McKinney

Ormond Beach Physician, busi-nessman, and philanthropist Dr. Ste-phen A. Sevigny MD announced his entrance to the District 6 Congressional Race. Dr. Sevigny, from Ormond Beach, has been a resident of the area for 18 years and is currently a partner of Radi-ology Associates Imaging where he has cared for patients from Deltona to St. Augustine. Dr. Sevigny has also been the medical director of Twin Lakes Im-aging Center since 2005 and has privi-leges at Halifax Hospital in Daytona Beach. His wife, Dr. Gina Sevigny, is the owner of Ormond Beach Dermatology. They have 3 children who attend/at-tended Volusia county's public schools and played local sports.

“As a physician, I have seen poli-ticians try to manage health care with few positive results. Physicians do more paper work now than ever before, at the expense of what really matters – spending quality time with patients. As a practicing mammographer, I see the importance of continuous care and be-lieve that in the richest country in the world, we all deserve access to afford-able high quality health care.”

Steve brings hands on, significant experience from the financial sector as well. Steve served on the Board of Directors of Reunion Bank of Florida, and now serves as a Director at The National Bank of Commerce headquar-tered in Birmingham, AL. “As a director of a Community Bank, and now on the Board of a $3.1 Billion-dollar institution, I have seen governmental regulations in action, both effective and at times too restrictive. Community banks are the lifeblood of the economy and small business lending. Small businesses are the main job producers in this econo-

my. I have been very fortunate to serve alongside some excellent business-people and job creators. I hope to use this real-world experience to ‘right size’ regulations to allow small businesses to thrive while not allowing Wall Street executives to make risky bets with our money. “

Steve has been an active part of the east-central Florida community for many years. He is currently the Medi-cal Director of Easter Seals of Northeast Central Florida. He is on the boards of Halifax Insurance Plan Inc., Daytona Chamber of Commerce, University of Florida Parent & Family Leadership Council, and is the current President of the Volusia County Medical Society. He is also active in the Phelan- Mcdermid Syndrome Foundation. His 18-year-old daughter is affected with this rare ge-netic syndrome which has made her physically and mentally disabled.

Steve was brought up with the im-portance of family values and working hard, following your passion and mak-ing a difference in people’s lives. He and his wife Gina now share those pas-sions and values as they bring up their family of five.

“I have been a Radiologist in Dis-trict 6 for 18 years. Gina and I raised our family here and love this area. I have been given the privilege of meeting and caring for thousands of patients throughout my career.

I promise if elected, I will work just as hard as your congressman as I have as a physician. I will work every day try-ing to make District 6 a better place to live for everyone.” For inquiries or to join our team, please visit www.se-vignyforcongress.com or email [email protected]

Ormond Beach Physician, Stephen A. Sevigny Announces Run for Congress

Interventional Radiologist Named Physician of the Quarter

Florida Hospital Memorial Medi-cal Center selected interventional radiologist Dr. Thomas Seale, from Radiology Specialists of Florida at Florida Hospital, as the physician of quarter.

“Dr. Seale embodies the qualities that make a really great physician,” said one colleague in his nomina-tion. “He demonstrates compassion, competency and prudent judgement. He explains everything to his patients and their families. He treats his co-workers with respect and is a great team player. He also has a wicked sense of humor!”

Another colleague noted Seale’s work with Florida Hospital Memorial Medical Center’s Cancer Institute.

“Every one of our physicians are exceptional, but Dr. Seale embod-ies the true spirit of our mission and it shows,” the colleague wrote in a nomination. “When asked to go that extra mile, he is always willing to do what it takes to help get the answers we need… Our patients, staff and community are truly blessed by his dedication.”


GrandRounds

Tabitha Ponte, AIA, ACHA Can-didate, Lead Architect at PONTE HEALTH becomes new Chair at American Institute of Architects, Or-lando Chapter - Academy of Architec-ture for Health.

The mission of AAH ORL is to improve the quality of healthcare through design by developing, docu-menting, and disseminating knowl-edge; educating healthcare architects and other related constituencies; ad-vancing the practice of healthcare architecture; improving the design of health care environments; affiliating and advocating with others that share our vision and promoting research.

In January, PONTE HEALTH host-ed with the support of AAH ORL the first Building Health Forum, #Build-Health18, were professionals in Archi-tecture, Engineering, Construction, and Healthcare gathered and discussed the current state and future of Healthcare Building Delivery. The event show-cased a Panel of Experts including Jen-nifer Foley from Orlando Health, Eduar-do Egea, AIA, Principal and Healthcare Architect at Stantec, and Justin Thomp-son, PhD, of 2Xalt; the event took place at the GuideWell Innovation Theater in Lake Nona, had a great turnout, and is-sued Continuing Education Credits to licensed professionals.

Lead Architect at PONTE HEALTH Becomes New Chair at American Institute of Architects, Orlando Chapter - Academy of Architecture for Health

Shepherd’s Hope Adds Six New Board Members, Elects New Board Chair for 2018

Orlando attorney Chirag Kabrawala, who hails from a family of more than fifteen physicians, has been elected the 2018 board chair for Shepherd’s Hope. In addition, six new members have joined the board for a three year term. They include:

• Carlos F. Escobar, vice president and chief information officer, Florida Hospital Central Florida Division – South Region

• Jean Florell, Community Volunteer

• William R. McClusky, CPA and senior manager, WithumSmith+Brown, PC

• Christina McGuirk, MSHA, BSN, NEA-BC, CENP; chief nursing of-ficer; Health Central Hospital

• Dr. Adalberto Torres, Jr.; chief of critical care; Nemours Children’s Hospital

• Brian L. Wagner, attorney and partner, Mateer Harbert

“These new board members con-tinue the two decade tradition of culti-vating outstanding community leaders that are committed to furthering our mission and being the voice of the un-insured” said Marni Stahlman, presi-dent and CEO of Shepherd’s Hope. “The caliber of our board has never been stronger as we embark on a ma-jor gifts campaign to fund our new healthcare facility in Winter Garden. Our goal upon completion is to have

increased our ability to meet the unre-lenting need for access to high quality, compassionate medical care for the region’s uninsured and underinsured.”

Shepherd’s Hope provides free primary and secondary medical servic-es to the one in four Central Floridians who are uninsured or underinsured, 11% of whom are children, at five health center locations in Central Flor-ida. An estimated 850,000 Floridians remain in a gray area ─ the coverage “gap” in regards to insurance avail-ability. They earn too much to qualify for some programs, but not enough to afford products offered on the Health-care.gov exchange – even with federal subsidies, because of out-of-reach de-ductibles and co-payments.

Orlando Health Implements Nation-reunification Program for International Patients

Orlando Health is releasing a white paper that outlines a new pro-gram designed to reunify interna-tional patients with their countries of origin. The need for the nation reuni-fication program was identified in the aftermath of the Pulse tragedy when multiple consulates contacted the healthcare organization in an effort to determine if any of their nationals were impacted in the shooting. More than 80 foreign missions are based in the state of Florida, with many more being based outside the State which still have responsibility for the region.

“Providing the information the consulates requested was a challenge. We realized then that we needed a better system to help reunify inter-national patients with representatives from their home countries, especially during mass casualty or mass fatality incidents,” said Eric Alberts, manager of emergency preparedness for Or-lando Health. “During an extensive after-action review of our response to the Pulse tragedy, this issue rose to the top as one that needed our im-mediate attention.”

The emergency preparedness de-partment and Orlando Health’s patient access department worked together to develop the program, which may be the only one of its kind in the United States. The program is active in Orlan-do Health hospitals located in Orange, Osceola and Seminole counties. Upon admission, international patients are provided with the contact information for their embassy or consulate-general. If the patient wishes to contact their em-bassy or consulate-general, but is un-able to do so, Orlando Health will make the connection for them. And with the patient’s consent, their nationality will be included in their medical record. Be-tween September 2017 and early Janu-ary 2018, the organization conducted a four-month long pilot of the program that reinforced the need for it.

During the pilot, more than 5,300 international patients were made aware of the nation-reunification program. More than 4,400 opted in to it while slightly over 950 patients declined. One hundred ten nations were represented by the patients who opted in to the program, ten of

which had 100 or more citizens who were patients in an Orlando Health hospital. In descending order, those nations were:

1 Haiti 827

2 Brazil 719

3 Venezuela 386

4 Mexico 339

5 Columbia 224

6 United Kingdom 162

7 Dominican Republic 144

8 Cuba 145

9 Honduras 116

10 Jamaica 110

“As one of the top tourism desti-nations in the world, Central Florida hosts millions of international visi-tors each year,” said David Strong, president and CEO, Orlando Health, “Should they become ill or injured during their stay, Orlando Health not only wants to provide them with the best medical care, we also want to help connect them to representatives of their home countries. We have seen, first-hand, the care and support consulates provide to their nationals overseas at a time when they need it most. We want to ensure all our patients, especially those who may be unfamiliar with U.S. processes, re-ceive as much support as possible.”

The nation-reunification white paper is available for download by visiting www.OrlandoHealth.com/In-ternationalPatients.


The American Medical Associa-tion (AMA) today released a new se-ries of trend reports in its Policy Re-search Perspective series illustrating the price Americans pay for the na-tion’s broken medical liability system.

“Information in this new research paints a bleak picture of physicians’ ex-periences with medical liability claims and the associated cost burdens on the health system,” said AMA Presi-dent David O. Barbe, M.D., M.H.A. “The reports validate the fact that pre-serving quality and access in medicine, while reducing cost, requires fairness in the civil justice system. Every dollar spent on the broken medical liability system is a dollar that cannot be used to improve patient care.”

The first report analyzes medical liability claims frequency among pa-tient care physicians in the U.S. and finds that getting sued is virtually a matter of when, not if, for physicians. Highlights in the report include:

• Getting sued is not an uncom-mon event for physicians. More than a third of physicians (34 percent) have had a claim filed against them at some point in their careers.• Because older physicians have been in practice for a longer time and thus have had more expo-sure, the probability of getting sued increases with age. Nearly half (49.2 percent) of physicians age 55 and over have been sued, compared to 8.2 percent of phy-sicians under age 40.• There is wide variation in the frequency of liability claims be-tween specialties. General sur-geons and obstetricians/gyne-cologists have the highest risk of being sued, more than 3½ to 4 times greater than pediatricians and psychiatrists, who have the lowest risk.• Before they reach the age of 55, more than 50 percent of gen-eral surgeons and obstetricians/gynecologists have already been sued.“Even though the vast majority

of claims are dropped, dismissed or withdrawn, the heavy cost associated with a litigious climate takes a signifi-cant financial toll on our health care system when the nation is working to reduce unnecessary health care costs,” Dr. Barbe said.

The second report analyzes in-demnity payments, expenses, and claim disposition based on a sample of medical liability claims that closed between 2006 and 2015 aggregated

by PIAA, the association representing the medical and health care profes-sional liability insurance community. The report’s key findings include:

• The average expense incurred on medical liability claims that closed in 2015 was $54,165 – a substantial increase of 64.5 per-cent since 2006.• In 2015, 68.2 percent of all closed claims were dropped, dis-missed, or withdrawn; however, they are not cost-free. Each of these claims costs an average of $30,475 to defend, accounting for more than one-third (38.4 per-cent) of total expenses incurred.• Only 7 percent of claims are de-cided by a trial verdict, and the vast majority (87.5 percent) were won by the defendants.• In about 25 percent of claims, an indemnity payment was paid to the claimant. The average in-demnity payment was $365,503 for claims that closed in 2015 – a notable increase of 11.5 percent from two years prior.• The third report analyzes annu-al changes in medical liability in-surance premiums for 2008-2017 from the Annual Rate Survey Issues of the Medical Liability Monitor. Highlights in the report include:• Despite increasing stability in liability premiums, the prospects for the near future are less than certain. Since 2015, more premi-ums increased than decreased, reversing the trend of the earlier part of the study period. In 2017, 13.4 percent of premiums were higher than those for 2016. Since 2010, 12 to 17 percent of premi-ums have increased from the pre-vious year.• The share of premiums that decreased from one year to the next has been falling since 2008, particularly in the last three years. Only 12.4 percent of premiums decreased in 2017. This is sub-stantially down from its peak in 2008, when almost 43 percent of premiums fell below their 2007 levels.• Physicians continue to face high costs of insuring themselves against medical liability claims. There is wide geographic varia-tion in premiums. In some areas of New York, premiums for ob-stetricians/gynecologists reached $214,999 in 2017– while premi-ums for obstetricians/gynecolo-gists in some areas of California

were $49,804.Together with state and specialty

medical associations and other stake-holders, the AMA is pursuing both traditional and innovative medical li-ability reforms to strike a reasonable balance between the needs of pa-tients who have been harmed and the needs of millions of Americans who need affordable, accessible medical care. More information on AMA solu-tions to reshape the current medical

liability system to better serve both physicians and patients, please read Medical Liability Reform– Now!

The new reports are the latest ad-ditions to the AMA's Policy Research Perspective series that support AMA federal, state and private sector ad-vocacy agendas. For additional infor-mation from the new reports, go to the AMA website.

GrandRounds

Florida Hospital is launching a major expansion of services on the east side of Orlando, with standalone emergency departments planned for Waterford Lakes and Oviedo.

The Waterford Lakes emergency department will be located at Co-lonial Drive and Lake Pickett Road. Florida Hospital yesterday closed on the purchase of the 5-acre parcel where the emergency department will stand.

“We want to be where you live, with a complete network that’s easy to access. This will lead to steady growth in the coming years,” said Daryl Tol, president and CEO of Flor-ida Hospital and the Central Florida Division of Adventist Health System. “Our new centers in Oviedo and Wa-terford Lakes are just the next step in our aggressive multi-year plan.”

Both emergency departments are expected to include 24 beds, including observation beds allowing patients to stay close to home should they need advanced care not requir-ing admission to a hospital. Services offered will include: Diagnostic imag-ing (CT, MRI, X-ray), full-service labo-ratory and pharmacy services. The comprehensive clinical team at the

new EDs will include board-certified emergency physicians and emergen-cy nurses trained in both adult and pediatric emergency medicine.

In Oviedo, the emergency de-partment is slated to be built on Red Bug Lake Road near Oviedo Mall Boulevard, on a parcel already owned by Florida Hospital. The par-cel also houses a Centra Care urgent-care office, which will remain on the site.

Final design decisions will be made after input from city govern-ment and residents.

“Many Oviedo residents are es-tablished patients in the Florida Hos-pital network and seek it out when they need emergency care, so having this option available closer to home will be a real benefit,” said Oviedo Councilwoman Megan Sladek. “We look forward to working with Florida Hospital to create a facility that’s a great fit for Oviedo.”

Groundbreaking for the Water-ford Lakes location is expected in June of this year, with the ED open-ing in the second quarter of 2019. Groundbreaking in Oviedo is set for this October, with the opening planned for the third quarter of 2019.

New AMA Studies Show Continued Cost Burden Of The Medical Liability System

Florida Hospital Plans Emergency Departments in Waterford Lakes, Oviedo


Dr. Hugo V. HartDr. Hugo V. Hart is a board certified general surgeon with over 29 years of experience. He has been practicing in the Central Florida area

for over 23 years and is currently on staff at Orlando Regional Medical Center and Florida Hospital. Dr. Hart is an active member of the American College of Phlebology, the society for vein professionals. Dr. Hart is an active member of the Hispaniola Medical Charity, the

medical mission organization that has been established to provide medical care to the impoverished people in the Dominican Republic.

Presented in Partnership by Orlando Medical News and Vascular Vein Centers

Venous disease is estimated to affect 25 million people in the United States. Venous ulcers, the most significant complication, affect approximately 500 thousand people. More than 2 million working days are lost each year and approximately 3 billion dollars is spent treating venous disease. In addition, venous disease is estimated to account for 1 to 3 percent of the total healthcare budget. Although venous disease cannot be avoided, greater awareness in the general population and especially among physicians can diminish the impact.

Risk factors include heredity, age, gender (females > males), hormonal (estrogen and progesterone), pregnancy, obesity, jobs with prolonged standing, trauma, and previous superficial or deep vein thrombosis. Graduated compression stockings are the first line of therapy for spider telangiectasias, ankle edema and skin changes, pregnant women, or those who have jobs that entail standing for prolonged periods of time. Patients sometimes complain they are hot or hard to get on, but we must be firm and tell them about the problems that can follow. Insurance companies often insist on 3 to 6 months of conservative therapy with compression stockings prior to approving any treatment.

The majority of patients with advanced skin changes have superficial venous valvular insufficiency. Many will also have perforator or deep vein involvement. Patients with peripheral arterial disease and/or significant type 1 diabetes must be treated cautiously. If pulses can’t be detected, or the patient has ankle/arm index less than 0.5, compression is contraindicated. In patients with chronic swelling or pain in an extremity, obvious varicosities, or florid patterns of telangiectasia (spider vein), the vascular lab is the first step in the treatment algorithm. But, a word of warning, when a venous evaluation is ordered, most hospitals and diagnostic labs perform a test for venous thrombosis. One must specifically ask for an evaluation for venous insufficiency, and even then, most exams are inadequate. A study should be performed with the patient standing using valsalva and compression maneuvers to check for valvular reflux. The deep, superficial and perforator systems should be studied and reflux times should be noted along with the vein diameters. This exam reveals whether a patient has evidence of old deep vein thrombosis with scarring or obstruction. Therapy for superficial veins should not be undertaken if there is a significant obstructive component in the deep system. I see a large number of patients who have had a venous evaluation at an outside lab and 99% of these exams are inadequate for evaluation of venous insufficiency. Patients with severe type 1 diabetes or known arterial disease should have an arterial evaluation

to rule out significant disease, which might contraindicate compression or venous therapy.

Early skin changes consist of pink to red discoloration which may be blotchy and dry (stasis dermatitis). The underlying tissue may be firm. These areas should be lubricated and massaged at least two times a day. With time, a darker brown discoloration develops and the tissue becomes firmer. This is referred to as a lipodermatosclerosis. The cause is inflammation, secondary to metalloproteinases, lymphocytes, macrophages, and red cells that traverse the capillary membrane because of the hydrostatic pressure of gravity. The

brown discoloration is the result of red cell destruction with deposition of feratin. This tissue is very vulnerable to ulceration. Some patients will go on to develop lymphedema with swelling of the foot because the lymphatics in the lower legs are fibrosed by the inflammation. Flare ups of this tissue frequently occur with long periods of standing, and the tissue can become erythematous and even exude fluid. Sometimes this fluid has a scaly appearance or can even appear as a white exudare. It is important to recognize this as an exacerbation of stasis dermatitis, an inflammation, not cellulitis, an infection. In these times of concern about nosocomial and opportunistic infections, we must avoid using antibiotics for this condition. The erythema will often persist for weeks, and if left on antibiotics for that period of time, patients are vulnerable to fungal infections, MRSA, and clostridia difficil colitis. The best treatment is to focus on the underlying veins, but this takes time. Use of hydrocortisone cream, elastic compression, and elevation are bridge maneuvers. Biopsy of the skin should never be an option. The only place for a biopsy is at a site of long standing ulceration, or an ulcer, which is refractory to optimal therapy to rule out cancer.

We must be aware of patient’s complaints of aching, heaviness in the leg, and swelling as the day progresses. Varicose veins can lead to significant problems and should not treated as merely a cosmetic concern. Early attention can avoid later problems.

Corona Phlebetatica Lipodermatosclerosis

Venous Ulcer

Venous Disease/Pearls and Pitfalls in Recognition and Treatment

EVIDENCE-BASED STANDARDS OF CARE

BEST PRACTICES


PUBLISHERJohn Kelly

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CONTRIBUTING WRITERS

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Wendy Sellers and Michael R. Lowe

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WE PROVIDE• 24/7 Reads and accessibility• Continuity of care• State of the art technology• High Image quality• Lowest Levels of Radiation• Trusted Florida Hospital Radiology

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Heart Attack and PreventionRADIOLOGY INSIGHTS sponsored by

By LeeNA KAMAt, MD February is American Heart Month!

So we will focus this month’s article on heart disease and heart attack prevention.

Heart disease is the leading cause of death for men and women in the United States. It generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina), or stroke. Other heart conditions, which may affect the heart muscle, valves or rhythm, are considered other forms of heart disease.

A heart attack can occur at any age. Heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. Your heart muscle needs oxygen to sur-vive. This happens because coronary ar-teries that supply the heart muscle with blood flow can slowly become narrowed from a buildup of fat, cholesterol and other substances that together are called plaque. This slow process is known as ath-erosclerosis. When a plaque in a heart ar-tery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle. When the heart muscle is starved for oxygen and nu-trients, it is called ischemia. When damage or death of part of the heart muscle occurs because of ischemia, it is called a heart at-tack or myocardial infarction (MI). About every 40 seconds, someone in the United States has a heart attack!

The good news is that heart disease can often be prevented when we make health-ier choices and manage existing health condi-tions. The major risk factors that can be controlled include tobacco use, high blood cho-lesterol, high blood pressure, physical inac-tivity, obesity, diabetes, and alcohol abuse.

A healthy diet is one of the best weap-ons to fight cardiovascular disease. The food we eat can affect other controllable risk factors: cholesterol, blood pressure, diabetes and overweight. It is important to emphasize intake of vegetables, fruits, and whole grains and limiting intake of sweets, sugar-sweetened beverages, and red meats. In addition, to maintain a healthy weight, coordinate a healthy diet with physical activity. The American Heart As-sociation recommends at least 150 minutes per week of moderate exervice or 75 min-utes per week of vigorous exercise to im-prove overall cardiovascular health.

The radiologists from Radiology Specialists of Florida at Florida Hospital are very well trained and experienced. We have radiologists specifically trained in cardiovascular imaging who use imag-

ing techniques such as x-rays, ultrasound, computed to-

mography (CT) scans, positron emission

tomography (PET) scans, nuclear medi-cine scans, magnetic resonance angiogra-phy, and magnetic resonance imaging

(MRI) to diagnose heart and blood vessel

(vascular) disease. Using these diagnostic tests, we

can screen for heart disease, determine what is causing patients’

symptoms, and monitor the effects of treatment. We keep up to date on the lat-est technology and information so that we can offer patients the best care.

The Florida Hospital Care Network delivers seamlessly connected healthcare services for all ages. Quality Imaging and Diagnostic starts today.

For more information visit Some-daystartstoday.com

Leena Kamat, MD, is a board certified diagnostic radiologist, sub-specialized in breast imaging for Radiology Special-ists of Florida at Florida Hospital. She earned her medical degree at the Uni-versity of Florida, College of Medicine and following graduation completed her residency at the University of South Florida and a fellowship in breast imag-ing at the Moffitt Cancer Center. In her spare time, Dr. Kamat enjoys spending time with her family and friends, travel, fitness, and cooking.

http://floridahospitalradiology.com

http://www.somedaystartstoday.com

http://www.somedaystartstoday.com

Robotic-arm assisted hip and knee replacement has the ability to offer those suffering from osteoarthritis in their knees and hips almost immediate relief.

It is estimated that 15 million Americans suffer from osteoarthritis (OA) in their knees. The U.S. Census Bu-reau estimates that the 55 and older age group, who are peak knee replacement candidates, will reach 96 million by 2020. That age group is also the most susceptible to suffer from Degenerative Joint Disease (DJD) of the hip as well.

Abhijit Manaswi, MD, a specialist in joint replace-ment surgery, knows his robotic-arm assisted hip and knee replacement offers a solution to OA and DJD sufferers.

Heart of Florida Regional Medical Center, where Dr. Manaswi is the director of the Joint Replacement Center, is the only hospital in Polk County where the robotic arm joint replacement surgery is performed.

Dr. Manaswi uses a robotic arm interactive orthope-dic system to map the area that will be operated on. Using a computer guided robotic arm, Dr. Manaswi can easily and quickly remove the osteoarthritis from the healthy bone and replace the knee or hip joint with the new joint.

“There is a smaller, less invasive incision than tradi-tional surgery, and only the arthritic portion of the joint is removed, preserving the healthy bone and tissue,’’ Dr. Manaswi said. “There is less scarring, minimal hospital-ization time and a more rapid recovery time.’’

When patients start having symptoms of DJD in the hip, for example, they notice they start limping to avoid putting weight on the affected hip, and that pain radi-ates down to the lower back, or thigh to knee. They also notice that pain medication is also no longer helping.

That is when the robotic arm joint replacement sur-gery provides the most relief.

“By using the robotic arm system to remove the damaged bone, I can reduce the risk of leg length dis-crepancy and improve the post-operative range of mo-tion. There is also a rapid relief of pain and a quicker return to daily activities,’’ Dr. Manaswi said.

How It WorksIt all starts with a personalized plan. After a CT scan

of the joint is taken a 3-D virtual model of area is gener-ated. That model is loaded into the robotic arm system software and a personalized pre-operative plan is created.

During surgery, Dr. Manaswi uses that plan to

prepare the bone for the implant and the system guides him within the pre-defined arthritic area and keeps the machine from moving outside of the defined area for treatment. This helps provide a more accurate place-ment and alignment of the implant.

After surgery, the goal is to get the patient back up and moving around as soon as possible. At the Joint Re-placement Center at Heart of Florida, the patients will be up and doing physical therapy within a few hours of the surgery. They also participate in group therapy with others who have had the surgery as well.

Patients also return home sooner than after tradi-tional knee and hip replacement surgery.

Potential Benefits• Improved surgical outcomes• Optimal implant positioning • Smaller incision, less invasive• Minimal hospitalization• Less scarring• More rapid recovery• Ligaments remain intact for a more natural

feeling knee and hip• Ability to return to an active lifestyle quicklyDr. Manaswi offers several procedures including:

robotic arm assisted total hip replacement, computer as-sisted total knee replacement, robotic arm assisted partial knee replacement, revision knee replacement, and revi-

sion hip replacement.To find out more about the robotic arm joint re-

placement surgery, call Dr. Manaswi’s office today to make an appointment and come see how the robot-ic-arm assisted joint surgery can help your patients get their active lives back. For patients who would like to learn more about the surgery, please call Dr. Manaswi’s office at 863-419-8922.Disclaimer: Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks and benefits of each treat-ment can help you make the best decision for your individual situation.

Member of the medical staff at Heart of Florida Re-gional Medical Center. Heart of Florida Regional Medi-cal Center is owned in part by physicians.

Surgeon Specializes in Robotic-Arm Assisted Joint Surgery

Original knee.Robotic-arm joint replacement. Hip presentation Robotic-Arm Hip Replacement

BEST PRACTICES

3-D map of knee for robotic-arm joint replacement surgery.

3-D map of hip for robotic-arm hip replacement surgery.

Abhijit Manaswi, MD, MS, FCPS, DNB, MNAMS, FRCS

Board Certified | Fellowship Trained Total joint Surgeon Director, Joint Replacement Center

https://www.heartoffloridaphysiciangroup.com/doctors-providers/manaswi-abhijit-md--2682

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