Non-Surgical Heart Valve Replacement Available at HealthPark

Inside
this issue.
2012 CMS Quality
Core Measures 3
New Physicians 4
System Updates 5
Board of Med Memo 6
Current CMEs 7
Recognitions Back
Visit us at
www.leememorial.org/
physicianpub
2
Non-Surgical Heart Valve
Replacement Available at
HealthPark
The Edwards SAPIEN Transcatheter Aortic Heart Valve
Replacement (TAVR) has become a recent alternative to open
heart surgery, and is the first transcatheter aortic heart valve
replacement approved by the FDA.
HealthPark Medical Center is the first hospital in Lee County to offer this
option as an alternative for inoperable patients with severe symptomatic
native aortic valve stenosis. The next closest TAVR approved facility is in
Miami.
Treatment with TAVR is expected to increase a patient’s survival rate by
30-­‐40% over a five year period, and post-­‐op recovery takes only half the
time of traditional valve replacement methods. In addition, HealthPark
Medical Center uses a newly built hybrid operating room which makes
new procedures like TAVR possible by integrating multiple technologies
such as cardiac catheterization and 3-­‐D radiologic imaging technologies
with real-­‐time patient monitoring.
LMHS Offers Latest Technology
with High-Field Open MRI Imaging
As an alternative to traditional MRI, a high-­‐field open MRI is
now being offered at Outpatient Radiology at Riverwalk.
The unit creates high-­‐quality images and
offers a greater degree of comfort to
patients. It can accommodate patients as
large as 660 pounds, and also lowers to
wheelchair height—making it accessible
to a wide range of patients.

2012 Core Measure Updates
CMS Specification Manual for
Quality Core Measure Updates
Quality measures are used to gauge how well an
entity provides care to its patients. Measures are
based on scientific evidence and can reflect
guidelines, standards of care, or practice
parameters. A quality measure converts medical
information from patient records into a rate or
percentage that allows facilities to assess their
performance. Quality measures are used in several
activities under the Hospital Quality Initiative (HQI),
most notably for the Hospital Compare website. In
FY 2013, CMS will make value-based incentive
payments to acute care hospitals, based either on
how well the hospitals perform on certain quality
measures or how much the hospital’s performance
improves on certain quality measures from their
performance during a baseline period.
For more information, please go to
https://www.cms.gov/HospitalQualityInits/
KEY
Lighter Blue = Value Based – Paid for Performance
Yellow = Updates effective January 2012
www.leememorial.org/physicianpub
PRESENT INDICATORS 2012 CHANGES
SURGICAL CARE IMPROVEMENT PROJECT (SCIP)
INF-1 Antibiotic within 60
minutes of incision
No Change YES
INF-2 Antibiotic Selection No Change YES
INF-3 Prophylactic Antibiotic
discontinued within 24 hours
after Anesthesia End Time
(AET)
No Change YES
INF-4 Cardiac Surgery Patients
with Controlled 6 AM Blood
Glucose
No Change YES
INF-6 Surgery Patients with
appropriate hair removal
No Change NO
INF-9 Urinary catheter
removed on Post-Op Day 1 or
Post-Op Day 2 with day of
surgery being Day 0
No Change NO
CAR-2 Surgery Patients on a
Beta Blocker prior to arrival
receive a Beta Blocker during
the perioperative period
VTE-1 Surgery Patients with the
recommended VTE Prophylaxis
ordered
VTE-2 Surgery Patients with the
recommended VTE Prophylaxis
administered within 24 hours
prior to incision to 24 hours
after anesthesia end time
Perioperative period changed: YES
Now identified as 24 hours prior to
incision through post operative
Day 2 with surgery day as Day 0
Oral Factor Xa Inhibitor has been YES
added for elective total knee and
total hip surgeries
No Change YES
GLOBAL INITIATIVE: EMERGENCY DEPARTMENT
None ED-1a Median time from ED arrival
to ED departure for admitted ED
patients overall rate
None ED-1c Median time from ED arrival
to ED departure for observation
ED patients overall rate
None ED-2a Admit Decision time to ED
Departure time for Admitted
Patients
GLOBAL INITIATIVE: IMMUNIZATION INITIATIVE
None IMM-1a Pneumococcal (PPV-23)
Immunization Rate Overall
NO
Presently for IP Pneumonia IMM-1b Pneumococcal (PPV-23) NO
Patients
Immunization age 65 or older
None IMM-1c Pneumococcal
Immunization (PPV-23) high risk
patients age 6 years through 64
years
NO
Presently for IP Pneumonia
Patients
IMM-2 Influenza Immunization NO
VALUE
BASED?
NO
NO
NO
2

2012 Core Measure Updates
2012 Core Measure Updates
.
This update includes Surgical Care
Improvement Project (SCIP),
Global Initiatives for the
Emergency Department,
Immunization Initiative, Tobacco
Treatment, and Substance Abuse.
It also includes Acute MI, Heart
Failure, and Pneumonia.
Please direct questions to
Medical Staff Quality
at 343-2690.
KEY
Blue = Value Based – Paid for Performance
www.leememorial.org/physicianpub
PRESENT INDICATORS 2012 CHANGES
GLOBAL INITIATIVE: TOBACCO TREATMENT
Presently for PN, HF and AMI
and only cigarettes within the
last 12 months
Presently for PN, HF and AMI
and only cigarettes within the
last 12 months
TOB-1 Tobacco Use Screening for
smokeless, cigar, pipe and
cigarettes within the last 30 days
TOB-2 Tobacco Use Treatment
provided or offered
None TOB-3 Tobacco Use Treatment
provided offered at discharge
None TOB-4 Assessing status after
discharge
GLOBAL INITIATIVE: SUBSTANCE ABUSE
VALUE
BASED?
NO
(TJC only)
NO
(TJC only)
NO
(TJC only)
NO
(TJC only)
None SUB-1 Alcohol Use Screening NO
(TJC only)
None SUB-2 Alcohol Use Brief
NO
intervention provided or offered (TJC only)
None SUB-3 Alcohol and other Drug Use NO
disorder treatment provided or
offered at discharge
(TJC only)
None SUB-4 Alcohol and Drug Use NO
Assessing Status after discharge (TJC only)
ACUTE MYOCARDIAL INFARCTION (AMI)
AMI-1 Aspirin on Arrival No Change NO
AMI-2 Aspirin prescribed at
Discharge
No Change NO
AMI-3 ACE/ARB for LVSD No Change NO
AMI-5 Beta Blocker at
Discharge
No Change NO
AMI-8 Median Time to PCI No Change YES
AMI-10 Statin Prescribed at
Discharge
No Change NO
HEART FAILURE (HF)
HF-1 Discharge Instructions No Change YES
HF-2 Evaluation of LVF No Change NO
HF-3 ACEI or ARB for LVSD
PNEUMONIA (PN)
No Change NO
Pn-3A Blood Cultures
performed within 24 hours
prior to or 24 hours after
hospital arrival for patients
who were transferred to or
admitted to the ICU within 24
hours of hospital arrival
No Change NO
PN-3b Blood Cultures
performed in the Emergency
Department prior to initial
antibiotic received in the
hospital
No Change YES
PN-6a, b Initial antibiotic
selection for
immunocompetent ICU and
Non-ICU CAP Patient
No Change YES
3

Medical Staff Additions & Updates.
Salman Ahmed, M.D.
Internal Medicine
Cogent Healthcare
Richard M. Liu, M.D.
Otolaryngology
ENT Associates
Francisco Marasigan, M.D.
Internal Medicine
LPG - Pine Island Rd
Ashwini Sahni, M.D.
Cardiology
Associates in Cardiac Care
www.leememorial.org/physicianpub
Michael J. Wilsey, M.D.
Pediatric Gastroenterology
Pediatric Gastroenterology,
Hematology & Nutrition
PRACTICE UPDATES
Arin J. Sheingold, D.P.M.
Podiatry
Foot & Ankle Center
Michael A. La Corte, M.D.
Pediatric Cardiology Associates
3501 Health Center Blvd #2440
Bonita Springs, FL 34135
239-390-0723 Phone
239-390-0734 Fax
Peter M. Denk, M.D.
Florida Incisionless
4857 Palm Beach Blvd., #3
Fort Myers, FL 33905
239-204-4976 Fax
Archana R. Mandala, M.D.
Vijay D. Ganatra, M.D.
13770 Plantation Road, #4
Fort Myers, FL 33912
239-561-6263 Phone
236-561-6264 Fax
Robert DiFronzo, M.D.
Solo Internal Medicine
NEW MAILING ADDRESS:
709 SW 51st Terrace
Cape Coral, FL 33914
Justin Fitz, PA
ICU Practitioners
9981 S. HealthPark Dr ED502
Fort Myers, FL 33908
239-343-5533 Phone
239-343-6143 Fax
4

System Updates.
EPIC Update: CCH GO LIVE
850 providers are using Epic at GCMC, CCH, and their offices.
Epic allows patient information to be accessed seamlessly
from hospital setting to hospital setting and includes
information from the acute care setting, all four EDs, LPG and
LCC offices. Remember, Epic can be accessed from home or
office and from any device at all LMHS facilities.
Suggestions for improvement continue to be offered,
investigated, brought to the Physician Advisory Committee
(PAC) and implemented. Please watch for notification of
changes, from the myEpic for Physicians on the intranet page
and an Epic Update board.
The list below contains some of the requests received during
the CCH December 1 st go live:
Surgeon ability to see own group scheduled surgeries:
Available
Events Report showing patients current & past locations:
Available as “ADT Events” in Patient Summary reports.
Anesthesia to have access to the L&D manager: Available
TCBili display on H&P: Available
Display newborn feeding status: Available in Newborn
Overview under Recent Communication
24-­‐hour results report (lab, radiology & dictated reports in
last 24 hours): PAC review in January.
Improved Micro results display to include at least 1 year of
data: In design phase, may not be available until next
version of Epic.
Add a View Only Notes activity in the Activity List: PAC
review in January.
Add specialty to consult notes/transcriptions: In review
Ability to print Med Rec forms from the Medication
Activity: In review
Improve Case Management Notes: PAC review in January
Add outpatients to the recently discharged list: PAC review
in January
Friedman’s Curve availability: Will explore, is available in
next Epic version.
GBS Status: in development
Display hours since rupture of membranes: explored but
not possible
Ideas/suggestions?
Contact myepic@leememorial.org
Jan Villwok at jan.villwok@leememorial.org, or
Michele Hildebrand at Michele.hildebrand@leememorial.org
www.leememorial.org/physicianpub
Update for 2012:
Pharmacist will complete the dosing
calculations and the Heparin Order Set
A change in practice has been approved by Pharmacy
Leadership with support from Nursing. The pharmacist will
take over the calculation and completion of the Heparin
Drip Protocols. The primary purpose for the change is to
assure timely processing and dispensing of Heparin drips.
A pharmacist will calculate and complete order
sets for all inpatient heparin drips.
In the Emergency Department it is preferred that
the pharmacist provides calculations and
completes the order set but there may be STAT
situations in which nursing will do calculations
and obtain drip from their ED pyxis.
If patient is admitted from the ED and continued
on a heparin drip, the pharmacist will verify the
calculation or re-­‐calculate if needed (especially
if there is a difference in weight) and complete
the heparin pre printed order set if needed.
To assure timely administration of Heparin drips
to your patients, please make sure the specific
heparin drip protocol (Heparin low dose or heparin
standard) is specified on all heparin drip orders.
Suzanne Turner, Pharm.D.
Pharmacy Clinical Specialist-­‐
Education and Residency Coordinator
suzanne.turner@leememorial.org
Phone: 239-­‐343-­‐2232
5

Florida Board of Medicine: Facts Every Physician Should Know
.
Purpose of the Florida Board of Medicine: To protect
the public through health care licensure, enforcement
and information.
An enormous number of rules, statutes
and regulations exist to assist the Board
fulfill its purpose. Practitioners may have
“difficulty” as they attempt to understand
and comply with this perceived “maze” of
information as they try to fulfill their purpose, namely
caring for Floridians.
This article is the first of a series intended to inform
and assist practitioners understand specific facts that
they should know.
Practitioner’s Profile
Since 1997, Florida law has required physicians to
create and maintain a Practitioner Profile [s.
456.041 – 046, Florida Statutes].
When a physician becomes licensed in Florida,
he/she is given their practitioner profile to
review for accuracy. The profile goes live on the
web site 30 days later. Thereafter, practitioners
are required to update their profile within 15
days of any change. Failure to do so places you at
risk for disciplinary actions.
You might be asking yourself, when your profile
was last updated. I would urge each of you to
take a moment and access and update you
Practitioner Profile on the Internet.
Go to www.doh.state.fl.us/mqa
Click Practitioner Profile
Click Update/Confirm Profile Online
James W. Orr, Jr. M.D. F.A.C.O.G., F.A.C.S.
Member, Florida Board of Medicine
Crystal A. Sanford, CPM
Program Operations Administrator
Florida Board of Medicine
Most of the updating can be accomplished
online; however some items require the
information to be sent to the Board Office.
Additionally, profiling staff are available to assist
you and can be reached at (850) 488-­‐0595.
Take a moment to review your Practitioner Profile
now and please remember to promptly update
if/when changes occur!
The categories on the profile include:
Mandatory Reporting Categories
-­‐ Education and Training
-­‐ Professional and post-­‐graduate training
-­‐ Specialty certification
-­‐ Year began practicing
-­‐ Other state licensure
-­‐ Primary and secondary locations
-­‐ Academic appointments
-­‐ Financial responsibility
-­‐ Liability claims exceeding $100,000
-­‐ Liability claims exceeding $5,000
-­‐ Bankruptcies
-­‐ Staff privileges
-­‐ Criminal offenses
-­‐ Final disciplinary actions
-­‐ Final disciplinary actions taken by a licensing agency
-­‐ Final disciplinary actions taken by a specialty board
-­‐ Final disciplinary actions taken by an HMO, pre-­‐paid
health clinic, nursing home, out-­‐of-­‐state ambulatory
surgical center
-­‐ Resigned from or had any medical staff privileges
restricted or revoked by an HMO, pre-­‐paid health clinic,
nursing home, out-­‐of-­‐state ambulatory surgical center
Optional Reporting Categories
-­‐ Medicaid participation
-­‐ Other health related degrees
-­‐ Email address
-­‐ Committees/memberships
-­‐ Professional or community service awards
-­‐ Publications
-­‐ Professional web page
-­‐ Languages spoken other than English
-­‐ Other affiliations
www.leememorial.org/physicianpub
6

Robotic Surgery and Prostate Cancer
Omar Benitez, M.D., F.A.C.S.
Southwest Florida Urologic Associates
Wednesday, February 1, 2012
6:30 -­‐ 7:30 PM
HPMC Room HP1B
RSVP for CME & Dinner by January 30th -­‐ 424-­‐2680
Documentation, Reimbursement & Billing
John F. Bishop, PA, CPC, CGSC, CPRC
President John Bishop and Associates, LLC
Physician Coding, Compliance & Reimbursement Consulting,
Tampa, Florida
Thursday, February 9, 2012
6:30 -­‐ 7:30 PM
HPMC Room HP1B
RSVP for CME & Dinner by February 7th -­‐ 424-­‐2680
Ortho Pitfalls for the Practicing Pediatrician
Pediatric Grand Rounds
Matthew R. Wagner, M.D.
Pediatric Orthopedics of SW Florida
Wednesday, February 15, 2012
6:30 -­‐ 7:30 PM
HPMC Room HP1B
RSVP for CME & Dinner by February 13th -­‐ 424-­‐2680
Federal and State Laws Relating to the
Prescribing of Controlled Substances
Walter B. Flesner, III, D.O.
Island Coast Pain & Rehabilitation Associates
Monday, February 20, 2012
6:00 -­‐ 7:00 PM
GCMC Community Room
RSVP for CME & Dinner by February 17th -­‐ 424-­‐2680
Autism
Guillermo Philipps, M.D.
Pediatric Neurologist
Neuroscience Center, Lee Memorial Health System
Wednesday, February 22, 2012
7:30 -­‐ 8:30 PM
HPMC Room HP1B
Following the Department of Pediatrics Meeting
RSVP for CME & Dinner by February 20th -­‐ 424-­‐2680
www.leememorial.org/physicianpub
Continuing Medical Education
Practical Clinical Neurology 2012:
Updates & Management Strategies
March 10 & 11, 2012
Hyatt Regency Coconut Point Resort & Spa
Bonita Springs, FL
Faculty: J. Eric Ahlskog, Ph.D., M.D., Kevin Barrett, M.D.,
M.Sc., Robert Brown, M.D.,M.P.H., Cory Duffek, M.D., P.
James B. Dyck, M.D., Neill Graff-­‐Radford, MBBCh, FRCP, ,
Brain Hoh, M.D., Daniel Kantor, M.D., Nima Mowzoon, M.D.,
Harvey Singer, M.D., William Tatum,D.O., Ryan Uitti, M.D. &
Eelco Wijdicks, M.D., Ph.D.
Topics include epilepsy, MS, neuromuscular disorders,
behavioral neurology and movement disorders and
cerebrovascular disease. Earn up to 15 CME credits.
To request a brochure Call 424-­‐2397 or email
joanne.gorgone@leememorial.org
7

Patient First ▪ Every Time
Medical Staff Matters is a publication of the Lee
Memorial Health System. Please direct all
inquiries to Yvonne Luckett at
yvonne.luckett@leememorial.org
www.leememorial.org/physicianpub
Well done, Brian Taschner, M.D.!
Congratulations to
December’s
Physician of
the Month
Brian Taschner, M.D.
Cardiologist
Coastal Cardiology
Medical Staff Member
since 1995 Thank you for bridging quality, attitude, professionalism, and
compassion, and going above and beyond expectations.
FT. MYERS, FL
PERMIT NO. 131