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Pre-pregnancy and Prenatal Genetic Testing

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genetic testing

Tanya Mack of Women’s Telehealth

Pre-pregnancy and Prenatal Genetic Testing

We continue our twice-monthly series with Women’s Telehealth’s Tanya Mack.  She caught up with Certified Genetic Counselor, Rachel Klein, of GenPath Diagnostics.  The topic of discussion was focused on pre-pregnancy and prenatal genetic testing, when it makes sense, the difference between screening and diagnostic tests, how to deal with results, and more.

Women are routinely offered a variety of genetic tests during the first three months of pregnancy in the US.  Every woman wants to believe their baby is normal and uncomplicated. However, the CDC reports that 1:33 babies born in the US will have a birth defect. Genetic tests, both screening and diagnostic, show the likelihood that a developing baby has a genetic condition that may cause problems with growth, development and bodily functions.

Information from genetic testing plus the mother’s age, the couple’s ethnic background and a family history of a genetic disorder can help calculate the odds that the fetus might have a defect such as Cystic Fibrosis, Tay-Sach’s Disease, Sickle Cell Anemia, Down’s Syndrome or neural tube defects. Joining us for this segment of Top Docs is Rachel Klein, a Certified Genetic Counselor from one of the nation’s leading prenatal genetic testing labs, GenPath.

Special Guest:

Rachel Klein, Genetic Counseling Program Manager, GenPath Diagnostics  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  

genetic testing

 

Transforming Clinical Practice Initiative (TCPI)

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TCPI

Dr. Doug Patten

Transforming Clinical Practice Initiative (TCPI)

Dr. Doug Patten is the chief medical officer of the Georgia Hospital Association, which is the leading advocate for Georgia’s hospitals and health systems. GHA supports the efforts of its members as they strive to improve access to health services, improving the health of all Georgians. Dr. Patten was a general surgeon in southern Georgia before he became the chief medical officer of the Phoebe Health System in Albany.

He has been GHA’s chief medical officer for nearly two years. He is focused on improving quality and safety, engaging patients and their families, and physician leadership. He is a member of the Medical Association of Georgia and the American College of Surgeons.

The Transforming Clinical Practice Initiative (TCPI) is designed to help more than 150,000 U.S clinicians improve quality and reduce costs – keeping in mind that the Medicare is changing from a volume-based payment system to a quality-based payment system in the next several years. The four-year, $800 million TCPI initiative is being funded by the Center for Medicare & Medicaid Innovation.

It is aligned with the Affordable Care Act (ACA) and the Medicare Access and Reauthorization Act of 2015 (MACRA). The TCPI includes a network of 29 “practice transformation networks” (PTNs) that are designed to 1) improve health outcomes and 2) improve care coordination and 3) better engage patients and families and 4) improve patient, clinician and staff satisfaction and 5) reduce the overall cost of care.

There is no cost for clinicians or practices to join a PTN. There are four PTNs that support clinicians in Georgia, including the Compass PTN – which has been endorsed by the Medical Association of Georgia given MAG’s “multi-year collaboration with GHA on matters related to quality, safety and community health.”

The Compass PTN will serve more than 7,000 primary and specialty care clinicians in six states. The Compass PTN is led by six non-profit partners, including the Georgia Hospital Association. In Georgia, the Compass PTN hopes to serve 1,000 clinicians, including 150 specialists.

Special Guest:

Dr. Doug Patten, CMO, Georgia Hospital Association  youtube logo  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3

TCPI

Zika Virus

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Zika

Dr. Cherie Drenzek

zika

Dr. Patrick O’Neal

Zika Virus

The Zika virus has been making news over the past year as we approach the coming Olympics in Brazil, a known location heavily populated by the species of mosquito known to carry the virus.  I sat down with Dr. Patrick O’Neal of the Georgia’s Department of Public Health, and Dr. Cherie Drenzek, Epidemiologist for the State of Georgia to talk about what we need to be thinking about here in Georgia.

Dr. Cherie Drenzek grew up in Detroit and received her bachelor’s degree in Biological Sciences and her Master’s degree in Food Microbiology from Wayne State University. She attended Michigan State University College of Veterinary Medicine and received her DVM in 1995. She then entered the Epidemic Intelligence Service program at CDC and was stationed in the Rabies Section. Following EIS, Dr. Drenzek was employed as an Assistant Professor of Epidemiology at the University of Georgia College of Veterinary Medicine.

Dr. Drenzek has been employed at the Georgia Department of Public Health since 1999 and has served in a variety of roles, including infectious disease medical epidemiologist and State Public Health Veterinarian. She served as Director of the Acute Disease Epidemiology Section and Deputy State Epidemiologist since October 2005 and was named State Epidemiologist and Director of the Epidemiology Program in 2011.

Dr. Patrick O’Neal is the Director of Health Protection for the Georgia Department of Public Health (DPH), where he has oversight responsibility for Emergency Medical Services (EMS), Trauma, Emergency Preparedness, Epidemiology, Infectious Disease, Immunizations, and Environmental Health. For 29 years prior, he practiced
emergency medicine at DeKalb Medical Center in Decatur. He received his medical education at the Tulane University School of Medicine in New Orleans.

Zika virus (pronunciation: zee-kah) is a viral disease that is primarily transmitted to people by infected Aedes species mosquitoes. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito.

However, there can be more severe clinical outcomes, and Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects.  Prior to 2015, outbreaks have occurred in Africa, Southeast Asia, and islands in the Pacific Ocean.  In May 2015, Zika virus transmission was confirmed in Brazil and outbreaks are currently occurring in many countries in the Americas and worldwide.

No local mosquito-borne Zika virus disease cases have been reported in the continental U.S., but there have been travel-associated cases, as well as cases associated with sexual transmission from travelers to affected areas. These imported cases could result in local spread of the virus in areas of the United States where the Aedes mosquito vectors are found. A list of countries where Zika virus is currently being spread can be found at the CDC website http://www.cdc.gov/zika/geo/index.html. Zika is an unprecedented public health emergency that poses significant risks to pregnant women.

This is the first time in more than 50 years that a virus has been linked to serious birth defects and poor pregnancy outcomes (and the first-ever mosquito-borne cause!).  Georgia has not documented any local transmission of Zika virus, but as of the end of April 2016, has confirmed more than a dozen travel-associated Zika infections.

For general information about Zika virus and surveillance for mosquito‐borne diseases in Georgia, call your District or County Health Department or the Georgia Department of Public Health at 404‐657‐2588. You may also visit the Georgia Department of Public Health website at dph.georgia.gov. Also go to the CDC website at cdc.gov/zika/index.html.

Special Guests:

Dr. Cherie Drenzek, Epidemiologist, Georgia Department of Public Health

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Dr. Patrick O’Neal, MD, Director of Health Protection, Georgia Department of Public Health

 

Azalea Health

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Azalea Health

Baha Zeidan

Azalea Health

This week we started our twice-monthly series with Tanya Mack, CEO of Women’s Telehealth.  Her first guest was CEO and Co-founder of Azalea Health, Baha Zeidan.  Azalea Health is an EMR company that launched in 2008 in Valdosta, GA.  Since then the company has enjoyed steady growth and has been recognized as one of Inc. 500 Nation’s fastest growing private companies, Georgia Top 40 Innovator, and 2014 Emerging Company of the Year Phoenix Award Winner.

Healthcare IT is at the forefront of revolutionizing trends that will change the way healthcare is delivered and patients’ health and wellness outcomes. Healthcare providers and patients who are resistant to technology may be left behind. Today- EMR’s, patient portals, mobile health apps and wearables, cloud computing, and interoperability are not fringe applications but active advances that allow the patients to become more a part of the healthcare team.

Technology makes that possible. Currently, the global EMR market is $11 Billion and the US remains dominant in EMR adoption. As we move to electronic medical records, EMR’s hold a lifetime of health data and can be used to predict our individual health future through modeling.

Today’s guest, Baha Zeidan, CEO of Azalea Health will be discussing his company’s
EMR and Practice management platform and how it is evolving to incorporate these new technology advances.

Special Guests:

Baha Zeidan, CEO of Azalea Health  linkedin_small1  twitter_logo_small  feed logo  facebook_logo_small3  youtube logo  

Azalea Health

Tanya Mack, President, Women’s Telehealth  youtube logo  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3

telemedicine

 

Value-based Payments

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Value-based Payments

Dr. Kimberly Rask

Value-based Payments

Kimberly J. Rask, M.D., PhD is the chief data officer at Alliant Health Solutions, which is a nonprofit companythat supports quality improvement in public sector health care programs under Medicare, Medicaid and End-Stage Renal Disease (ESRD) Networks across the Southeastern U.S. Dr. Rask is a primary care physician andhealth economist.
She also holds joint appointments in health policy and management and medicine at EmoryUniversity. Dr. Rask has published book chapters and peer-reviewed articles on primary care practice, quality improvement, and outcomes measurement.  With more than 20 years of experience in quality research and practice, she also serves on national expert panels on value-based purchasing programs and quality measurement.
The Value-based Payment Modifier (VM) is a relatively new pay-for- performance program that is being used by CMS to pay physicians in part based on how their quality and cost compare to other physicians. It is similar to other pay-for- performance initiatives for hospitals, nursing homes, and home health agencies – and it is part of a larger effort by public and private payers to control health care costs.
Although the VM started as part of the Affordable Care Act (ACA), more recent federal legislation has expanded its reach.  Medicare uses the VM program to adjust physician pay based on quality and cost measures, which vary by specialty. The reimbursement rates for 2016 are based on 2014 Physician Quality Reporting System (PQRS) data.
There are more than 250 quality metrics. Eligible providers are required to select a number of metrics –typically nine – to report. Failure to report PQRS measures can result in a penalty that is applied to all Medicare payments for the entire year. The program is revenue-neutral, so physicians who score well receive higher payments while physicians who have relatively lower scores receive lower payments.
In 2016, only medical groups with 10 or more eligible professionals will be subject to the program. In 2016, all eligible groups could receive a bonus – but only groups with 100 or more eligible professionals face a penalty in 2016. By 2017, the program is scheduled to apply to all Medicare physicians.  Of the nearly 14,000 physician groups that will subject to the VM program in 2016, less than one percent – only 128 groups that include about 4,300 physicians – will receive Medicare bonuses of either 16 or 32 percent; the higher increase will go to the practices with the most high-risk patients.
Meanwhile, more than 5,400 groups that include more than 130,000 physicians will see a two percent pay cut for failing to submit their data. And nearly 60 groups that include more than 10,000 physicians will see a pay cut of one percent or two percent because their quality measures were too low.  Under the MACRA legislation that passed in 2015 that permanently replaced the Medicare sustainable growth rate (SGR) formula, the VM will become one component of a new consolidated performance score.  There will be two payment options for physicians.
Physicians who participate in Alternative Payment Models (e.g., some types of ACOs) will be eligible for an automatic five percent incentive payment every year. Physicians who are not participating in an APM will receive incentives or be subjected to penalties of up to nine percent based on how they perform relative to other physicians on PQRS measures, their use of EHR, quality improvement efforts, and the cost of care for their patients. Since this “new” payment program is similar to the existing VM program, preparing physician practices for success with today’s VM will position practices for success in the future.
There are several programs that available to assist physician practices with accurate quality reporting and quality improvement, which includes Alliant Quality (www.alliantquality.org) in Georgia.
Special Guest:
Dr. Kimberly Rask, MD, Alliant Health Solutions 

Adopting Innovation

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innovation

Judy Mod

Adopting Innovation

I sat down with Judy Mod and Trent McEwan of RevenueSphere.  We are in the midst of a significant business transformation – as organizations are redefining their own path to adoption – from recognition of pain through problem resolution. What’s broken?

The fundamental shift in the way buyers are now adopting technology is increasing the complexity surrounding the decisions being made about what strategic business problems to adopt – what operational approaches to adopt to fix the problem – and ultimately technically what to buy.

innovation

Trent McEwan

The rule of thumb is the more complex the organization, the more disruptive your innovation, the more difficult your market development; the bigger drag this adoption problem is likely having on your business growth. The more disruptive the innovation = The more complex the adoption.

One critical effect – 80% of sales today are being lost – not to the competition – but to “non-decision”; RevenueSphere, LLC, the problem we solve is the process of adoption across the entire life cycle (problem, operational, technical, and financial), bridging the widening gap between buyers and sellers.

Special Guests:

Judy Mod, CEO, Chief Adoption Officer, RevenueSphere

 

Trent McEwan, COO/CTO, RevenueSphere

Georgia’s Philadelphia College of Osteopathic Medicine

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Philadelphia College of Osteopathic Medicine

Dr. Bill Craver

Georgia’s Philadelphia College of Osteopathic Medicine

I hosted Dr. Bill Craver to talk about the Georgia campus of Philadelphia College of Osteopathic Medicine.  Dr. Craver is the dean and chief academic officer of the osteopathic medical program at the Georgia Campus of the Philadelphia College of Osteopathic Medicine, which is also known as GA-PCOM, in Suwanee.

Dr. Craver is a professor of surgery, is board certified by the American Osteopathic Board of Surgery, and is a fellow of the American College of Osteopathic Surgeons. Dr. Craver earned a degree in physical therapy from the University of Delaware. He worked in the areas of physical therapy and sports medicine at the Hershey Medical Center before enrolling at Philadelphia College of Osteopathic Medicine, where he earned a doctor of osteopathic medicine degree with honors.

Dr. Craver completed a residency in general surgery at the Osteopathic Medical Center of Philadelphia. He cared for patients in Jasper, Georgia and Hardinsburg, Kentucky before coming to GA-PCOM.  GA-PCOM is a private, not-for-profit branch of the fully accredited Philadelphia College of Osteopathic Medicine, which has a 117-year tradition of excellence. Located in Suwanee, GA-PCOM was established in 2005.

It offers a Doctor of Osteopathic Medicine degree, a Doctor of Pharmacy degree, a Master of Science degree in Biomedical Sciences, and a Master of Science degree in Physician Assistant Studies.   The campus also includes the Georgia Osteopathic Care Center, which is an osteopathic manipulative medicine clinic that is open to the public by appointment.

What is osteopathic medicine and what does it mean to be a D.O.? Andrew T. Still, M.D., was dissatisfied with the effectiveness of 19th century medicine. He was one of the pioneers of osteopathic medicine – and he was one of the first of his time to study the attributes of good health to better understand disease. Dr. Still’s philosophy is based on the unity of all body parts and views the musculoskeletal system as a key element of health.

Dr. Still introduced the idea of returning the body to health through manipulation based on a thorough understanding of the body’s systems.  Along with M.D.s, today’s D.O.s are licensed to prescribe medication and perform surgery in all 50 states.  Osteopathic physicians practice a “whole person” approach to medicine, treating the entire person rather than just the symptoms.

With a focus on preventive health care, D.O.s help patients develop attitudes and lifestyles that don’t just fight illness but help prevent it as well. D.O.s are trained to be doctors first and specialists second. The majority of D.O.s are family-oriented primary care physicians. Many D.O.s practice in small towns and rural areas,
where they often care for entire families and communities.

Special Guest:

Dr. Bill Craver, Dean and Professor of Surgery, Georgia campus, Philadelphia College of Medicine  issuu  instagram-logo-transparent-png-i11 (16x16)  twitter_logo_small  youtube logo  facebook_logo_small3  linkedin_small1

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Surviving With Incurable Breast Cancer

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breast cancer

Dr. Amelia Zelnak

Surviving With Incurable Breast Cancer

This week I sat down with breast cancer specialist, Dr. Amelia Zelnak, of Atlanta Cancer Care.  We talked about patients dealing with incurable breast cancer or they have a malignant recurrence.  Pfizer, maker of several medications used to treat various cancers, have launched an initiative, “Breast Cancer: A Story Half Told”. 

This effort aims to expand the breast cancer conversation on multiple fronts.  As the website states, “Earlier this year, Pfizer unveiled the results of two complementary studies that uncovered gaps in the breast cancer conversation within society at large and between patients and physicians in the doctor’s office, and along with leaders in the breast cancer community issued a public call-to-action to expand the breast cancer dialogue to include metastatic disease. Breast Cancer: A Story Half Told – Supporting Workplace Conversations aims to identify gaps in the current conversation about breast cancer and the workplace, and encourage healthcare professionals and employers to join together with women with breast cancer to better address their unique workplace needs.”

We talk about this and more.  Check back soon for more info!

Telemedicine

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Telemedicine

Today’s technology, particularly internet, communications, and mobile platforms, is empowering disruption in the traditional healthcare delivery model. Telemedicine is an emerging trend that shows no sign of slowing and my guests on this episode focus on this platform for delivering high quality care.

In some ways, mobile technology is bringing us full circle.  The “House Call” is back and being seen by a physician and/or other health professional in our home or other location outside of a doctor’s office, urgent care, or ER will likely be as common as it was decades ago, if not even more so.

Telemedicine is taking advantage of these technology capabilities to put patients together with healthcare professionals virtually and in some cases, through a combination of someone sitting with the patient facilitating an exam while another provider is connected to the interaction via video/telephony.

TeleHealth Solutions is a consultancy that works with healthcare organizations and practices seeking to add telemedicine to their delivery model.  The company is able to evaluate the client’s goals and determine (hopefully prior to any expenditures on equipment/platforms) the best platform for achieving those objectives.

In some cases they may even advise the client to hold off on adding such a platform, depending on what they were expecting it to do, avoiding large costs for something that will ultimately not be used.  Turner Smith explained how there are often unseen pitfalls around launching such a delivery model, so working with experts such as himself and his team can insure desired patient outcomes are achieved while making financial investments in the right technology/service.

Glenn Pearson spent nearly 20 years leading the Georgia Hospital Association.  As such, he’s well-versed in the in’s and out’s of how hospitals do business, make decisions regarding technologies they will deploy (or NOT deploy), and factors that can make what seems to be a great idea for a solution that will ultimately fail to be adopted.

He’s leveraging that experience at Pearson Health Tech Insights, providing consulting services for  tech companies who are developing (or plan to develop) technology solutions that will serve the hospital/health system space.  He and his team can help the tech developer potentially pivot their solution if needed, or in some cases do some redesign before going to market.  In this way, just as Turner’s firm helps tech buyers purchase wisely, Glenn’s company helps the developer have greater probability of success in getting their technology adopted.

I met Tanya Mack a couple of years ago on her show Doctors Roundtable here on Business Radio X.  She is now leading a company called, Women’s Telehealth, a virtual physician practice comprised of maternal-fetal specialists and high-risk pregnancy OB’s.

These healthcare experts are able to link up with a hospital or group’s existing telehealth technology to provide the medical expertise needed by moms in high-risk pregnancies.  With value to both urban and rural areas, Women’s Telehealth is allowing organizations that do not have high-risk OB specialists on staff, to be able to handle many of these patient needs, allowing the organization to simultaneously meet a patient need, while keeping them in their delivery system rather than losing them to a competing hospital.

Special Guests:

Tanya Mack, President, Women’s Telehealth  youtube logo  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3

telemedicine

Turner Smith, VP of Business Development, TeleHealth Solutions  linkedin_small1

telemedicine

Glenn Pearson, Principal, Pearson Health Tech Insights  linkedin_small1

telemedicine

 

 

WellCare of Georgia and Diabetes

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diabetes

Dr. John Johnson of WellCare of Georgia talks diabetes

WellCare of Georgia and Diabetes

Dr. John Johnson is the Senior Medical Director at WellCare Health Plans, Inc. – which is one of the Medicaid CMOs in Georgia. His areas of responsibility include utilization review, care management, quality improvement and clinical outcomes.  Dr. Johnson graduated from the University of Medicine and Dentistry of New Jersey in Rutgers. He completed his residency at Emory University Hospital. Dr. Johnson is Board Certified in internal medicine.

He also has an MBA from Emory University’s Goizueta School of Business. Dr. Johnson owned and operated a practice in Douglasville that cares for patients with acute and chronic medical conditions for more than 13 years. Before joining WellCare in 2014, Dr. Johnson was the medical director for Blue Cross Blue Shield of Georgia. While there, he oversaw utilization review and case management for more than 600,000 State Health Benefit Plan patients.  Dr. Johnson is a member of MAG, the AMA, and the American College of Physicians.  He is a also colonel in the U.S. Army Reserves Medical Corps.

Diabetes is becoming more common in the United States. It afflicts more than 29 million Americans, including more than one million Georgians. One quarter of the people who are affected by it aren’t aware that they have the disease. An additional 86 million people have pre-diabetes, which means that their blood glucose (sugar) is higher than normal but not high enough to be classified as diabetic. Estimates project that as many as one in three American adults will have diabetes by 2050.

In addition to its detrimental health effects, the American Diabetes Association reports that the U.S. spends $174 billion a year to treat the disease.  The primary risk factors for diabetes include being overweight; sedentary; over the age of 45; and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, and Pacific Islanders are at an increased risk for developing the disease.

Diabetes is the nation’s seventh-leading cause of death. It is also a leading cause of kidney failure, non-traumatic lower-limb amputations, new cases of blindness, heart disease, and stroke. A significant number of Georgians who are struggling with diabetes, particularly those in low-income and medically underserved populations, do not fully understand how to manage diabetes on a day-to-day basis.

WellCare is working to address the needs the diabetic population by collaborating with patients, providers, family members, and the community using a variety of mechanisms, including value-based care, telemedicine, field-based case management, the patient-centered medical home, and advocacy.

Special Guests:

Dr. John Johnson, MD, Senior Medical Director, WellCare of Georgia  

diabetes

  • Doctor of Medicine, University of Medicine and Dentistry of New Jersey
  • Board Certified, Internal Medicine
  • MBA, Goizueta Business School, Emory University
  • Colonel, US Army

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia  twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • JD Law, Loyola School of Law
  • Board of Directors, Physician Advocacy Institute
  • Medical Payment Subcommitte Member, State Board of Workers’ Compensation
  • Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
  • Former Director, Government Relations/General Counsel/Director, GAMPAC