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Patient Engagement

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Fank Martin

 

Patient Engagement

This week I caught up with our friend, Frank Martin, of The Medical Consultants Group.  We talked about how his consulting firm can help a wide range of medical practices, from solo offices to multi-site large groups.  Frank talked about the variety of facets of a business that is a medical practice improve operations.

Frank talked about strategies for helping patients related to managing their out-of-pocket obligation, including deductible and co-payment.  We also discussed how the ACA has placed new emphasis on patient satisfaction and outcomes relating to how the practice (or isn’t) reimbursed.  Another requirement is to provide an electronic portal that allows remote access to patient data BY the patient, coupled with a means to transmit/receive relevant information to/from patients.

We discussed the difference between legacy EMR systems (where software was installed on hardware in the office) and cloud-based applications where data and the software exist on a remote cloud-computing-based architecture.  The decision-making capability of the cloud-based applications, coupled with security and rapid access to important data, make modern cloud-based EMR applications the wise choice for practices to convert to today.  These modern applications do not require on-site updates of the application on every device.  Now, the application is updated where it lives, meaning the user’s experience is not interrupted or inconvenienced.

Frank places great emphasis on helping his client practices become better-running businesses.  To that end he works with the group to be able to change processes, or software, business plan, and/or other key facets such as office location and office space leasing to operate more efficiently and profitably.

Special Guest

Frank Martin / Medical Consultants Group Twitter Facebook

frank

  • Past recipient, “Volunteer of the Year, Big Brothers Big Sisters”
  • Published author
  • Successful entrepreneur in the healthcare sector

The 4 R’s of Gut Health

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Ellie TDR

The 4 R’s of Gut Health

Did you know that as much as 80% of your body’s immune capacity comes from your gut?  Neither did we.  That’s why we’re glad Dr. Ellie Campbell of Campbell Family Medicine came by to blow our minds(again) with information (The 4 R’s of Gut Health) about ways we can dramatically improve our health.  She shared how she progressed from her traditional primary care practice to a Direct Pay model to get away from the pressure to see more patients, faster, in order to make a respectable physician’s income.  In her office she doesn’t work with insurance companies.  Instead, her patients simply pay a monthly membership fee to have access to her 24 hours a day, 7 days per week (sometimes even when on vacation!).  She also wanted to be able to provide care to her patients that is based on best practices and evidence rather than being simply limited to what an insurance company will or won’t pay for.

We talked about the fact that, with limited time per patient, prescribing a medication and moving on to the next patient is often the way physicians must conduct their practice.  She shared how allergic responses to foods and other environmental sources are behind many of our illnesses (or mirror many illnesses).  We also talked about how important what we eat and drink is in our overall health.  Dr. Campbell described how food and beverages have such dramatic impacts on our hormone levels and cellular health that we need to look at what we consume much like drugs one can take in a pill.

Dr. Campbell discussed The 4 R’s of Gut Health, going over foods we should eliminate (or at a minimum significantly reduce) from our diets because they cause inflammatory responses in the gut and vascular system (and elsewhere).  Things like wheat and plants from the nightshade family such as tomatoes, peppers, potatoes, and eggplant can, for many, create allergic reactions.  The challenge is, many of these allergic responses don’t manifest in immediately-recognizable ways.  It could be a general feeling of malaise, skin problems, GI problems that can emulate reflux, and more.

The 4 R’s of Gut Health (Explained in greater detail in the interview):

  • Remove offending substances from the diet.
  • Replace digestive enzymes, bile salts, immunoglobulins, DAO, and stomach acid where necessary
  • Re-inoculate the bowel with pre- and probiotics
  • Repair gastroentestinal mucosa through proper nutritional support

4Rs

Special Guests:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine  twitter_logo_small  linkedin_small1  facebook_logo_small3

Campbell Family Medicine

  • Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine
  • Family Medicine Residency, Medical College of Georgia
  • Board Certified Family Medicine

Correctional Medicine

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MAG TDR  MAG LOGO

 

Correctional Medicine

This week we continued our monthly series with Medical Association of Georgia.  I sat down with MAG CEO/Executive Director, Donald Palmisano, Jr., and Director of Correctional Medicine, Clyde Maxwell.  We talked about how MAG became involved with accreditation of numerous correctional medicine facilities in the state of Georgia.

MAG created its Correctional Medicine Committee in 1975 – following the prison riots in Attica, New York, and just before Georgia State Prison was placed under the jurisdiction of the federal courts for maintaining health care facilities that violated a constitutional prohibition on cruel and unusual punishment. The committee was charged with “studying and recommending ways to improve the delivery of health care in non-federal prisons in Georgia.”

MAG developed standards for evaluating health care in jails and prisons in the state as part of a national initiative; these evolved into the standards that are now used by the National Commission on Correctional Health Care.

In 1982, MAG developed legislation to establish an accreditation program for health care for correctional facilities in Georgia. The state began funding the program in 1983, and MAG subsequently started charging application fees for site accreditation visits.

The Medical College of Georgia assumed responsibility for the health services contract for state prisons in the 1990s.

MAG currently surveys eight county jails and 33 state prisons.

A number of major deficiencies have been corrected at jails and prisons in the state as a result of MAG’s site accreditation visits, including some that were related to…

  • Physician and nurse licensure
  • Physician and nurse CPR/ACLS certification
  • Expired pharmaceuticals
  • Needle and narcotics security
  • Nurse call systems
  • Inmate physicals
  • Mandatory CQI and infection control meetings

Special Guests:

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

Clyde Maxwell, Director of Correctional Medicine of Medical Association of Georgia

Clyde Maxwell Atl Skyline

  • Masters, Hospital Administration, Baylor University
  • Certified Correctional Health Professional
  • Active duty in the Medical Service Corps for more than 20 years
  • Designed the “Quick Reaction Hospital” that is used to respond to natural disasters through much of the world

Georgia Prostate Cancer Coalition

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Georgia Prostate Cancer Coalition

Statistics show that 1 in 6 men will develop prostate cancer in their lifetime.  The risk for developing the disease rises with age, being most prevalent among men over the age of 60.  However, the risk begins to rise after 40 and prevailing medical thought is men should get at a minimum a PSA test (a blood test that can detect prostate cancer) or if possible a digital rectal exam as well around the age of 40.  This will provide an early warning if there are worrisome findings on either study that will afford the patient more options for treatment that are much less traumatic and much more likely to be successful than if the cancer is found at a more advanced stage.

Ken shared his own story about how he was found to have a lump on his prostate on an insurance exam but was not actually recommended to have a biopsy until roughly a year later.  At that point it was found he did, in fact, have prostate cancer and that it was a more advanced stage.  He ended up having a radical prostatectomy, followed by a recurrence of the cancer.  To fight the recurrence of the cancer he underwent radiation therapy and more surgeries.  After all of that it was found his PSA levels were rising yet again, prompting his physicians to recommend hormone therapy to slow the progress of the cancer.

After his challenging experiences he began to work to increase awareness of the value of early detection of the disease to help his male counterparts avoid having to undergo similar difficulties.  He interfaced with the American Cancer Society to lobby for increased information for men about the risks of prostate cancer and the benefits of early detection.  He spent some time as a spokesman for the American Cancer Society.  He ultimately co-founded the Georgia Prostate Cancer Coalition, a non-profit organization aimed at creating community awareness as well as raising funds to help provide screening (including some free PSA testing) for men in the community.  The organization also collaborates with community businesses to help them provide prostate cancer screening for their male employees.

In speaking with Ken it’s clear that we men can do ourselves a big favor and go to our primary care physician or one of the screening events held by the Georgia Prostate Cancer Coalition to get a PSA test done and ideally, couple that with a digital rectal exam.  If our lot in life is to be a prostate cancer patient, we can have a large impact on what our journey is like in dealing with it if we endeavor to catch it early.

Special Guest:

Ken Stevens, Co-founder of Georgia Prostate Cancer Coalition  twitter_logo_small  facebook_logo_small3

 

Mitochondrial Diseases and Hyperbaric Medicine

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Mito TDR

Mitochondrial Diseases and Hyperbaric Medicine

This week I sat down with experts in the fields of mitochondrial diseases and hyperbaric medicine.  Each cell in our body has an “engine” where the nutrition we consume through eating is converted to the energy we need to function and survive.  These engines are known as “Mitochondria”.  These cellular components use genetic code to function and on occasion there will be problems with the genetic code or with how it is decoded.  In these cases, a variety of health problems can reveal themselves, depending on what sort of tissue is made up by these cells in question.  These can range from challenges with learning, developmental problems, or disease states such as Alzheimer’s, Parkinson’s, Muscular Dystrophy, and others.  Dr. John Shoffner, neurologist and geneticist of Medical Neurogenetics came by with Laura Stanley of the Foundation for Mitochondrial Medicine.

 

We talked about the research Dr. Shoffner is doing in an effort to find medical therapies that could help patients who are dealing with the variety of disorders caused by mitochondrial dysfunction.  We talked about how challenging it can be to identify a health problem(s) that are caused by mitochondrial disease unless a patient’s family is fortunate enough to be seen by a physician familiar with the genetic tests that can be utilized to diagnose them.

As described by the Foundation for Mitochondrial Medicine, “Every aspect of our beings – seeing, breathing, thinking, moving – requires energy. Mitochondria, often called the cells’ “powerhouses,” supply that energy by turning raw materials found in the food we eat and in the air we breathe into a substance called ATP (adenosine triphosphate), which our cells can use as fuel. ATP is, quite simply, vital to life.  Without enough ATP, children cannot appropriately develop, grow, learn, move, or even sleep. Adults without enough ATP are unable to sustain brain, muscle, and other vital organ function. A deficit of ATP can also cause invisible damage in some disease states, leading to early failure or dysfunction of organs, or just a chronic state of inefficiency leading to pain, fatigue, changes or limitations in thinking and learning, and increased susceptibility to acquired diseases.”

Laura and Dr. Shoffner shared how they are working to improve awareness of mitochondrial diseases and through research, uncover treatments to halt or at  least slow the effects of these diseases.  The ultimate goal is to find a way to prevent or reverse these problems.
Dr. Helen Gelly joined us to talk about a recent article she co-authored with Dr. Caroline Fife in Today’s Wound Clinic, called, “Hyperbaric Oxygen Therapy in Wound Care: A Service Under True Pressure“.  In the article, Dr. Gelly and Dr. Fife talked about how numerous Medicare Administrative Contractors and Commercial insurers are making changes to indications they are willing to reimburse hyperbaric oxygen therapy for.  That means that patients with wounds that place them at risk for amputation or for degraded quality of life due to previous radiation therapy may not be able to receive this evidence-based, effective treatment.  We talked about how in some cases where the providers in a given MAC were asked for clinical documentation of their HBO treatments provided, as many as 30% failed to respond.  Dr. Gelly shared how this lack of response leads to suspicions of fraud.

It was clear from the Today’s Wound Clinic article and from our conversation that hyperbaric medicine specialists must begin to activate and collaborate to protect this evidence-proven treatment modality.  HBO providers need to not only be responsive to requests for data but ACTIVE as it relates to advocating on behalf of educated decisions being made as it relates to the availability of the modality for tomorrow’s patients in need.

Special Guests:

Dr. John Shoffer, MD, CEO of  Medical Neurogenics 

Shoffner

  • Former Associate professor of neurology and molecular medicine at Emory University
  • Former Director of the molecular diagnostics program at Children’s Healthcare of Atlanta
  • Discovered some of the first gene mutations causing mitochondrial diseases and one of the first genes causing epilepsy
  • Finalist, 2012 Atlanta Business Chronicle’s Health-Care Heroes Awards

Laura Stanley, of Foundation for Mitochondrial Medicine  feed logo  facebook_logo_small3  twitter_logo_small  youtube logo

Laura

  • IMBA, University of South Carolina Darla Moore School of Business
  • Former Senior Associate, Korn Ferry
  • Former Vice President, EzGov
  • Parent of a child with mitochondrial disease

Dr. Helen Gelly, MD of HyperbaRXs  twitter_logo_small  google-plus-logo-red-265px  facebook_logo_small3  linkedin_small1

helen

  • Doctor of Medicine, Emory University School of Medicine
  • Internship/Residency: Pediatrics/Emergency Medicine at Emory University Affiliated Hospitals
  • Board Certified in Emergency Medicine
  • Fellow of the American College of Emergency Physicians
  • Fellow of the American College of Certified Wound Specialists
  • Subspecialty Certified Undersea and Hyperbaric Medicine

Sleep Disorders

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North Atlanta Pulmonary and Sleep Specialists

Sleep Disorders

It is estimated that as many as 35-40% of Americans experience poor quality of sleep secondary to a variety of sleep disorders.  We continued our series with Northside Hospital this week as I sat down with Sleep Medicine specialist, Dr. Robert Albin.  We talked about the statistics around sleep disorders and Dr. Albin discussed the serious accidents that have occurred that are thought to be related to sleep deprivation.  Some of those include:  Three Mile Island, the Exxon Valdez oil spill, Chernobyl, a recent ferry accident in NYC, and more.

Dr. Albin shared how poor quality and low quantities of sleep can lead to heart disease, high blood pressure, poor mental function, depression, and others.  We talked about the process sleep specialists go through to determine the source of a person’s sleep disorder.  In many cases, the issue is borne out of mental or emotional stress rather than a physical/neurological  issue.  In those cases the sleep specialist will collaborate with a psychology/psychiatry specialist to help work through those causative issues.

For patients who have a sleep disorder related to brain chemistry/function or an obstructive process such as obstructive sleep apnea, the specialists have specialized tests they can conduct to determine the quality of sleep and determine the cause of the problem.  The sleep specialty team at Northside offers a variety of diagnostic studies/treatments and it was the first sleep center of its kind in the city.  For our listeners who are themselves or their loved ones are experiencing difficulty sleeping please take a listen to this week’s show and share it!  You might help someone you care about.

Special Guest:

Dr. Robert Albin, MD, of North Atlanta Pulmonary and Sleep Specialists

North Atlanta Pulmonary and Sleep Specialists

  • Board Certified, Pulmonology, Internal Medicine, and Sleep Medicine
  • Doctorate of Medicine, Cum Laude, Emory School of Medicine
  • Associate Medical Director of NAPS Center for Sleep disorders
  • Medical Director for Peachtree Road Race and Atlanta Marathon
  • Past President and current Board member of the Medical Association of Atlanta

Medical Association of Georgia’s 2015 Legislative Priorities

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Medical Association of Georgia

Medical Association of Georgia’s 2015 Legislative Priorities

This week I sat down with Dr. Michael Green and Marcus downs of MAG to discuss Medical Association of Georgia’s 2015 legislative priorities.  We talked about several issues that have a serious impact on both patient outcomes as well as Georgia physicians’ ability to provide care.  Some key areas of focus this year include Physician Autonomy/Scope of Practice relating to physician-extending providers such as optometrists, nurse practitioners, and physician assistants, Third Party Payers, Tort Reform, and Patient Access to Care/Physician Shortage.

Dr. Greene and Marcus shared important information about how the year’s priorities are decided upon from how they’re raised as issues, to how they are elevated through committee to final discussion/determination.  They also talked about how valuable it is to have active participation in the process by the members of MAG.  We discussed the ways that MAG members are able to contribute input on the process and identification of issues for the association to consider.

Marcus and Dr. Greene also talked about some important legislative issues MAG has been able to provide input on that helped shape or revise laws affecting how physicians provide care within the state of Georgia.

Special Guests:

Dr. Michael Greene, Chairman, Council on Legislation, MAG   twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • Doctorate of Medicine, Mercer University School of Medicine
  • Former President of MAG, 2003-’04
  • Board Member, Secure Health Plan of Georgia
  • Practicing Family Practice Physician, Macon, GA

 

Marcus Downs, Director of Government Relations, MAG  linkedin_small1  

Medical Association of Georgia

  • Recipient, 2012, Outstanding Advocate Award, National Association of School Psychologists
  • National Institutes of Health Research Fellow, 2000
  • Former Director, Government Relations/External Coalitions/Research, Georgia Association of Educators

Complex Patients

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Infectious Disease Consultants

Complex Patients

This week I sat down with our colleague, Dr. Andrew Pugliese, Infectious Disease specialist of Infectious Disease Consultants in Johns Creek.  He stopped by to talk about complex patients.  He shared how medical studies focus on single illnesses, disqualifying certain age groups and patients with multiple disease states.  Dr. Pugliese talked about the fact that in the real world medical office, rare is it that a patient walks in to be treated for a problem who is only dealing with that single disease.  More commonly, patients present with obesity, and/or diabetes, heart disease, or any number of other health problems that can affect the way the body responds to a given disease state and treatments for them.  Dr. Pugliese shared how these “multi-morbid” (having more than one health issue) patients are very complex and often do not respond to therapies as studies suggest they will.  He offered advice for providers to help them be better able to manage patients when they need care for a given problem when other health issues are present.  Check out Dr. Pugliese’s blog at http://sinusitisblog.com/.

Special Guest:

Andrew Pugliese, MD, Infectious Disease Consultants twitter_logo_small  linkedin_small1  facebook_logo_small3  Blogger 2  

Infectious Disease Consultants

  • Doctorate in Medicine, St. George University School of Medicine
  • Fellowship, Infectious Disease, Winthrop University Hospital
  • Triple Board Certified in Internal Medicine and Infectious Disease
  • Pioneer in non-surgical treatment of acute and chronic sinusitis
  • President of Sinus Solutions

Swift School

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Swift School

Swift School

This week I sat down with two learning specialists and three students from The Swift School in Roswell, GA.  This private school is one that focuses on the learning needs of high-potential students that are challenged with dyslexia, dyscalculia (problems with math), working memory issues, and others.  Their learning environment is designed to help these children achieve their academic potential through smaller class sizes, teaching styles (such as Orton-Gillingham method) that take these various brain types and learning process needs into consideration.

As many as 1 in 5 children deal with some sort of learning challenge such as dyslexia, according to the learning specialists, Lisa Armorer and Carol Madden.  We now know that these aren’t so much learning “disabilities” as “Brain Types”.  As Carol explained, most kids dealing with dyslexia and some of these other challenges are “Right Brain” dominant.  This affects the style of learning that is most effective for them and can have an impact on their behavior patterns to some extent as well.  Many children are misdiagnosed as having behavioral “problems” when in fact they are actually exhibiting responses to frustration and/or anxiety because they are having trouble learning and they don’t understand why.

Lisa explained how Swift School’s learning approach differs from many “traditional” learning settings and how the strategies they employ take the child’s brain type and associated learning techniques into consideration.  This empowers them to achieve academically at a high level and advocate for themselves as students as they return to middle schools and high schools in traditional class environments/teaching approaches.

I got to talk to two 5th graders, Mackenzie Day and Olivia Hall, and 8th grader, Grant Meyer.  They shared their poignant stories about how it felt to be “different” from their peers as young students, watching them excel when certain (or all) concepts seemed so difficult for them.  They talked about their experiences going to visit Swift School and what it was like to become “veteran” students once they’d been there for a while.  Olivia, Mackenzie, and Grant also shared advice for peers in the community who might be considering Swift School as an option when a traditional setting is not helping them reach their academic potential.

Lisa Armorer shared this information with me:

Is your child bright but still struggling in school?  It might not be laziness.  It might be dyslexia.

Dyslexia affects 1 in 5 students today.  Dyslexia is not just seeing words backwards.  Dyslexia is a language-based learning difference and causes difficulty with reading, writing and spelling.

COMMON CHARACTERISTICS OF DYSLEXIA:

  • Delayed spoken language
  • Left/Right Confusion
  • Difficulty rhyming words and sounds
  • Poor sequencing of numbers and letters
  • Difficulty sounding out, identifying, and spelling words
  • Slow to memorize alphabet and math facts
  • Avoids reading aloud.
  • Difficulty with reading and comprehension.

For more information:

The International Dyslexia Association – www.interdys.org

Academy of Orton-Gillingham Practitioners and Educators – www.ortonacademy.org

 

Special Guests:

Lisa Armorer, Learning Specialist, Swift School  facebook_logo_small3  youtube logo

Armorer headshot 2

Carol Madden, Middle Division Director, Swift School

Armorer Madden

Grant Meyer, 8th Grade Swift Student, President, Student Counsil

Grant

Mackenzie Day, 5th Grade Swift Student

Mackenzie

Olivia Hall, 5th Grade Swift Student

Olivia Grant

 

AirWatch

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IMG_0267

AirWatch by vmware

This week on TopDocsRADIO we sat down with Paul McRae of AirWatch by vmware. Healthcare is evolving. As information technology advances and our health laws change, greater importance is being placed on electronic health records.  Today, digital data is flowing between departments in a hospital, to physician offices, to practitioners in the patients’ homes.  The result is greater efficiency in coordination of care, easier collaboration across multi-specialty teams, and an increased risk of compromise of sensitive HIPAA-protected information.

AirWatch by vmware provides technology that allows healthcare organizations to protect sensitive data across their enterprise, including mobile devices and laptops that may be in use outside the confines of the building or campus of the health company.  With their solution, the enterprise can determine whether certain data elements can be accessed by a given device (including BYOD), attachments can be included in outbound emails, and more.

If your organization is working to take advantage of the benefits of digital platforms and mobile devices then get to know AirWatch by vmware.  You’ll give your company the strengths that come with digitized information coupled with the confidence your information will meet compliance requirements and stay safe in the hands of those its meant to be seen by.

Special Guests:

Paul McRae, Director of Business Development – Healthcare Solutions, AirWatch by vmware  twitter_logo_small  youtube logo  google-plus-logo-red-265px  linkedin_small1  facebook_logo_small3

AirWatch by vmware

  • BA Economics, Cornell University
  • Board Member, Warrick Dunn
  • Presenter, Georgia Healthcare Trade Faire & Regional Conference 2013
  • Former SCVP of Healthcare Emerging Technology, AT&T