Transition to ICD-10 Smooth . . . Thus Far Years of Training, Preparation, Computer Programs Paved the Way Nearly a quarter-century in the making, the ICD-10 coding system is barely one month into implementation in the United States, and – at least in its early stages – Memphis-area medical professionals report a fairly smooth transition to the new classification process ... 4 Congress Holds Key to Tax Credits for 2015 Lawmakers Typically Wait Until End of Year to Decide on Extensions Ask CPA Sandy Blockman what advice he has for physicians as they consider their 2015 business taxes, and he’ll tell you that the best advantages now hinge on action by Congress. In other words, they’re unpredictable at best ... 5 December 2009 >> $5 ONLINE: MEMPHIS MEDICAL NEWS.COM PRINTED ON RECYCLED PAPER November 2015 >> $5 BY JUDY OTTO Mark Luttrell responded to an early call- ing to public service, as many civic-minded citizens have done before him; but few have followed the calling to a level where their ef- forts affect the lives of so many others. His 22 years with the Federal Bureau of Prisons, two terms as Shelby County sheriff and two terms (and counting) as mayor of Shelby County have given him unique insights into the mental health prob- lems that land many in prison — as well as the challenges and responsibilities of improving the health and well-being of Shelby County citizens. Initially a schoolteacher with a BA from Union University, he pursued a master’s de- gree in public administration from the Univer- (CONTINUED ON PAGE 10) HealthcareLeader Mayor Mark Luttrell Touches Many By Making Healthcare a Public Affair Arrival of 2016 to Signal Opening of New Facilities Affordable Care Act Playing a Key Role in Planning BY BETH SIMKANIN As 2016 approaches, the scheduled openings of a number of large-scale projects – including an extensive outpatient services facility – promise to substantially increase the delivery of various forms of healthcare in the Memphis area, particularly eastern Shelby County. In fact, the current growth trend is expected to continue as hospitals look at the Affordable Care Act and how it will affect their operations and efficien- cies. According to Bret Perisho, vice president of finance and chief business development offi- cer for Regional One Health, construction on its 110,000-square-foot, outpatient services building on its east campus at 6555 Quince Road is almost complete. The five-story building has been under renovation this year to accommodate a women’s re- productive clinic, a physical rehabilitation center, a multi-specialty and primary care clinic, an outpatient pharmacy and a comprehensive imaging center. (CONTINUED ON PAGE 7) FOCUS TOPICS ENVIRONMENTAL HEALTH/MEDICINE FINANCIAL/TAX PLANNING ON ROUNDS PRST STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.318 PAGE 3 PHYSICIAN SPOTLIGHT Richard Pearson, MD Heather Pearson Chauhan, MD Keep your finger on the pulse of Memphis’ healthcare industry. Available in print or on your tablet or smartphone www.MemphisMedicalNews.com SUBSCRIBE TODAY Opening Soon Healthcare facilities due to open soon in the Memphis area include: Regional One Health – A 110,000-square-foot, outpatient services building at 6555 Quince Road. Baptist Memorial Health Care Corporation and Regional One Health – Have filed a joint venture certificate of need for a 20,000-square-foot emergency department next to the Regional One outpatient services building on Quince. Delta Medical Center, Baptist Memorial Health Care Corporation and St. Francis Hospital – A 60-bed, 61,000-square-foot psychiatric hospital in Germantown. Methodist Le Bonheur Healthcare – A 161,000-square-foot renovation to the UTMG building to accommodate West Cancer Center in Germantown. Methodist Healthcare – Expansion of its emergency department at Methodist South from 9,950 square feet to 22,750 square feet and renovation of its intensive care unit there. Also, renovations to the entrance and lobby of Methodist North. Crosstown Concourse in Midtown – Scheduled to open the first quarter, 2017.
Transcript
Transition to ICD-10 Smooth . . . Thus FarYears of Training, Preparation, Computer Programs Paved the WayNearly a quarter-century in the making, the ICD-10 coding system is barely one month into implementation in the United States, and – at least in its early stages – Memphis-area medical professionals report a fairly smooth transition to the new classifi cation process ... 4
Congress Holds Key to Tax Credits for 2015Lawmakers Typically Wait Until End of Year to Decide on ExtensionsAsk CPA Sandy Blockman what advice he has for physicians as they consider their 2015 business taxes, and he’ll tell you that the best advantages now hinge on action by Congress. In other words, they’re unpredictable at best ... 5
December 2009 >> $5
ONLINE:MEMPHISMEDICALNEWS.COM
PRINTED ON RECYCLED PAPER
November 2015 >> $5
BY JUDY OTTO
Mark Luttrell responded to an early call-ing to public service, as many civic-minded citizens have done before him; but few have followed the calling to a level where their ef-forts affect the lives of so many others.
His 22 years with the Federal Bureau of Prisons, two terms as Shelby County sheriff and two terms (and counting)
as mayor of Shelby County have given him unique insights into the mental health prob-lems that land many in prison — as well as the challenges and responsibilities of improving the health and well-being of Shelby County citizens.
Initially a schoolteacher with a BA from Union University, he pursued a master’s de-gree in public administration from the Univer-
(CONTINUED ON PAGE 10)
HealthcareLeader
Mayor Mark Luttrell Touches Many By Making Healthcare a Public Affair
Arrival of 2016 to SignalOpening of New Facilities Affordable Care Act Playing a Key Role in Planning
BY BETH SIMKANIN
As 2016 approaches, the scheduled openings of a number of large-scale projects – including an extensive outpatient services facility – promise to substantially increase the delivery of various forms of healthcare in the Memphis area, particularly eastern Shelby County.
In fact, the current growth trend is expected to continue as hospitals look at the Affordable Care Act and how it will affect their operations and effi cien-cies.
According to Bret Perisho, vice president of fi nance and chief business development offi -cer for Regional One Health, construction on its 110,000-square-foot, outpatient services building on its east campus at 6555 Quince Road is almost complete. The fi ve-story building has been under renovation this year to accommodate a women’s re-productive clinic, a physical rehabilitation center, a multi-specialty and primary care clinic, an outpatient pharmacy and a comprehensive imaging center.
Keep your fi nger on the pulse ofMemphis’ healthcare industry.
Available in print or on your tablet or
smartphone
www.MemphisMedicalNews.com SUBSCRIBE TODAY
Opening SoonHealthcare facilities due to open soon in the Memphis area include:
Regional One Health – A 110,000-square-foot, outpatient services building at 6555 Quince Road.
Baptist Memorial Health Care Corporation and Regional One Health – Have fi led a joint venture certifi cate of need for a 20,000-square-foot emergency department next to the Regional One outpatient services building on Quince.
Delta Medical Center, Baptist Memorial Health Care Corporation and St. Francis Hospital – A 60-bed, 61,000-square-foot psychiatric hospital in Germantown.
Methodist Le Bonheur Healthcare – A 161,000-square-foot renovation to the UTMG building to accommodate West Cancer Center in Germantown.
Methodist Healthcare – Expansion of its emergency department at Methodist South from 9,950 square feet to 22,750 square feet and renovation of its intensive care unit there. Also, renovations to the entrance and lobby of Methodist North.
Crosstown Concourse in Midtown – Scheduled to open the fi rst quarter, 2017.
Opening of New Facilities Affordable Care Act Playing a Key Role in Planning
– A 110,000-square-foot, outpatient services building at
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m e m p h i s m e d i c a l n e w s . c o m NOVEMBER 2015 > 3
Father, Daughter Join Forces to Make Exceed SucceedUnusual Pairing of Gynecologist, Urologist Address Need for Hormone Balance
PhysicianSpotlight
BY RON COBB
This month, Heather Pearson Chauhan is celebrat-ing the first anniversary of the opening of Exceed Hormone Specialists, a two-physician practice in Germantown. She is one of the physicians; her father, Richard Pearson, is the other.
Exceed is not just unusual because it’s a daughter-father combination. It may be unique in another way.
“As far as we can tell from what we’ve researched nation-ally,” Chauhan said, “we can’t find any other practices that have a gynecologist and urolo-gist in the same office.”
And then there is the fact that Chauhan, the gynecolo-gist in the family, is married to a urologist, Ravi Chauhan.
“There are a number of married couples who are a urologist and a gyne-cologist both in Memphis and nationally,” Heather Chauhan said, “and so the big joke about that is you could put a urolo-gist and gynecologist in the same office and open it and call it All Things Pelvic.”
But it was her father, not her hus-band, with whom she went into business when she was trying to find the best way to juggle family and career.
As a young girl, Heather would spend most Saturdays with her father when he made rounds at Baptist Memorial Hospi-tal in Midtown. She’d wear a white coat that dragged along the ground, its sleeves rolled way up. Even then she knew she wanted to be a doctor someday, so why, she wondered, was she told to wait at the nurses’ station while her dad, a urologist, went into the examining rooms?
But her time would come, even though she took the somewhat unortho-dox path of majoring in history at Princ-eton University rather than science. She was looking ahead, thinking a liberal arts education would make her a better doctor down the road.
She came home to Memphis for med-ical school and residency at the University of Tennessee, and then she enjoyed what she describes as “a terrific experience” as a gynecologist for 10 years at Ruch Clinic.
But she and her husband had two young children, and she felt they deserved more of her time, so she left Ruch.
And then came the idea that spawned Exceed.
“I knew I wanted to practice medi-cine, but I couldn’t figure out what I
wanted to do,” she said. “Looking at what my skills and expertise were and where I saw a need in the marketplace, I got in-terested in doing concierge medicine and looking at hormone management.”
She also was interested in having her
father join her in the new practice. It was a fairly bold idea, inasmuch as Richard Pearson was approaching his 70th birthday and was winding down his own ca-reer. Pearson, a founder and past president of the Conrad Pearson Clinic, had recently been practic-ing in Amory, Mississippi, and reducing his workload in the kind of small-town environment he’d grown up in.
“I told him I kind of have this idea about how I’d like to structure a prac-tice,” she said. “I have the gynecology-side experi-ence, but obviously I don’t have the male side. I said, ‘Would you help me do this?’ He’s had a great deal of experience in opening
offices and running businesses, which I had none of. I figured the two of us to-gether could come up with a unique prac-tice that might serve needs that weren’t being met.”
Pearson regarded the request not
with skepticism but as something of a new lease on life for him.
“Approaching 70, I felt like Ulysses – about to be beached!” he said. “Heather’s first phone call began a collaboration that has given me a new ship, a great new crew and a new direction. My contribution is knowing how to row.”
Not only did Pearson come along, but so did Heather’s mother, Freida Pearson, who is the practice administrator. The Chauhans’ children, ages 8 and 11, help on weekends.
“When we opened this business,” Chauhan said, “I told them this is the third baby in our family, and as you know, babies require a lot of care and attention.”
Chauhan believes hormone manage-ment is an under-served area of medicine that Exceed is trying to address. She says she thought she knew a lot about the sub-ject until she began researching it, “and I realized there’s so much more to know than what I was taught in residency or what I learned in practice.”
“In residency I was essentially taught that if a woman wasn’t menopausal, then there wasn’t a lot of therapy you could offer her to alleviate symptoms or address complaints that might be occurring in her
Heather Pearson Chauhan and her father, Richard Pearson
(CONTINUED ON PAGE 6)
4 > NOVEMBER 2015 m e m p h i s m e d i c a l n e w s . c o m
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Nearly a quarter-century in the mak-
ing, the ICD-10 coding system is barely one month into implementation in the United States, and – at least in its early stages – Memphis-area medical professionals report a fairly smooth transition to the new clas-sification process.
This is in large part due to years of training to prepare medical personnel for the deluge of new codes, and to time-saving computer programs that help demystify and simplify the process.
“Our software converts the ICD-9 codes to the new ICD-10 codes, and there are prompts and pop-up questions that lead us through every facet of a patient’s diag-nosis,” said Dr. Frederick Pelz of Mem-phis Internal Medicine. “All in all it’s been pretty easy, but we’re just in the beginning stages. We’ll have to see how it goes after we’ve been using this for a while.”
Bill Griffin, vice president of corporate finance at Baptist Memorial Health Care
Corporation, agreed.“It’s been 23 years since we first heard
about the transition to ICD-10 and started getting ready for it, and we’ve had a mas-sive education program for hundreds of our doctors, coders and hospital employees,” Griffin said. “We’ve offered hundreds of hours of training and spent millions of dol-lars to prepare for this because we realized the magnitude of the process and we knew we had to get ready for it.”
And yet Griffin acknowledged that it would be premature to declare the imple-mentation of ICD-10 codes an unqualified success.
“It’s too early to offer a definitive opin-ion, but at this point it reminds me of the hys-teria surrounding Y2K, when people thought there would be a massive worldwide disrup-tion in computer services when we ushered in the year 2000,” Griffin said. “That turned out to be a non-event, and other than a few minor bumps here and there, and from what I’ve seen at this point, that sums up the initial transition to ICD-10.”
But while implementation of the new coding system has mostly been without in-cident, many local healthcare practitioners are anticipating a different scenario several months from now, when billing practices begin to reflect how accurately – or not – the tens of thousands of new codes are being utilized.
“So far, so good, but it’s early. We won’t really know for a while, will we?” said Dr. Jerome Thompson, a pediatric ENT physician at Le Bonheur Children’s Hospital and chairman of the Department of Otolaryngology – Head and Neck Sur-gery at the University of Tennessee Health Science Center. “There may be prob-lems with reimbursement from different insurance companies, with one company reimbursing for one code while another company doesn’t. When this system rolled out in Canada, initially there was a 50 per-cent reduction in reimbursements because of the ways different insurance companies interpreted the codes. We’re going to be watching very closely to see how it plays out here.”
Meg McGill, corporate director for health information management at Meth-odist Healthcare, echoed those sentiments. Methodist spent about three years provid-ing training for its physicians, medical per-sonnel and coders to prepare for the big switch, and thus far the process has gone off without a hitch.
“I’m glad to say that it’s gone well, amazingly well, since we made the tran-sition,” McGill said. “We’ve had many groups working simultaneously to prepare everyone for this because we were deter-mined to be ready for it when it finally hap-pened.”
Added Donna Hunt, corporate coding director for Methodist, “We were very me-thodical going through all the terminology, and we offered personal training, consulta-
tions and online courses. We started about three years ago, and that gave us the time necessary to address any situations and en-sure that all our personnel felt confident in using the new system.”
The ICD-10 coding system that went into effect Oct. 1 is an extensive list of more than 55,000 new codes that often pose diz-zying degrees of specificity.
For example, farm workers have an expanded list to choose from when suffer-ing from on-the-job injuries, such as code W55.29XA: Other contact with cow, subse-quent encounter. And then there’s this ani-mal kingdom reference point, W56.22XA: Struck by orca, initial encounter.
The detail in the new codes provides greater flexibility in diagnosing conditions, medical professionals say, and offer better methods for tracking recovery and treat-ment options.
“There are now nearly 20 codes that may apply to a patient who has eaten a toxic mushroom,” Griffin said. “And if you’ve eaten a bad mushroom, you need to know what kind and what to do about it. It’s all about specificity.”
But while the specificity of the new coding system may help to more narrowly define diagnoses, the codes aren’t as useful in clinical research.
Dr. Dan Martin, a gynecologist and reproductive surgeon with UT Regional One Physicians, said a very real problem with the new codes is that they aren’t, well, new.
“The main inadequacy with ICD-10 is that the codes are 23 years old,” he said. “That’s how long they’ve been around, and as far as being useful as a clinical research tool, the codes just don’t do that job very well. They may be useful in other practice areas, but by nature of what I do, by the time these codes come out they’re already outdated. Imagine all of a sudden imple-menting technology that’s two decades old and using it as a tool for your research. It’s just not that useful for research purposes.”
But with more than 70,000 diagnos-tic codes and more than 72,000 procedure codes now just a mouse click away, physi-cians have an extraordinary range of condi-tions from which to choose.
“One of my favorites is code R46.1, which refers to ‘Bizarre Personal Appear-ance.’ I think there are probably a lot of applications for that one, depending on where you practice and the patients you treat,” Griffin said. “Another favorite is V95.41XA, which refers to ‘Spacecraft crash injuring occupant, initial encounter.’ It’s all about specificity, and that code il-lustrates that point pretty well.”
Of course, doctors allow that while the ICD-10 system offers thousands of mi-nutely detailed codes to consider, occasion-ally there are those that probably aren’t specific enough, such as code Z63.1: Prob-lems with the in-laws.
Or this code, which perhaps serves as the antithesis of specificity: T63 – Unspeci-fied event, undetermined intent.
Transition to ICD-10 Smooth . . . Thus FarYears of Training, Preparation, Computer Programs Paved the Way
m e m p h i s m e d i c a l n e w s . c o m NOVEMBER 2015 > 5
vice he has for physicians as they consider their 2015 business taxes, and he’ll tell you that the best advantages now hinge on ac-tion by Congress. In other words, they’re unpredictable at best.
“It’s a guessing game at this point,” said Blockman, a partner at Watkins Uiberall who’s been practicing for 35 years and estimates that medical providers com-prise about 20 percent of his client base.
“At the end of every year, it seems that tax-payers wait anxiously for Congress to enact extensions of popular business tax breaks that are set to expire,” Blockman said. “And what happens is that every year Congress waits to act until what seems to be the last possible moment.”
Last year, lawmakers approved the extensions in December. “They extended probably a few dozen provisions retroac-tively,” Blockman said, “and the year be-fore that, at the end of 2013, they didn’t act until January (2014) to extend the pro-visions that were going to expire at the end of 2013.”
The Wall Street Journal reported in Au-gust that a survey of 912 chief financial of-ficers and comptrollers by the auditing firm Grant Thornton found that more than half of companies that use tax credits were as-suming for budget purposes that Congress wouldn’t extend the provisions. At the time, only 9 percent of the CFOs said they felt confident the tax breaks would pass.
“So we’re dealing with a very dysfunc-tional Washington,” Blockman said. “As we stand right now, the currently expired business tax breaks include what every-one loved, which was the bonus first-year depreciation,” as well as the provision called Section 179, which allows taxpay-ers to claim some property as business expenses that would otherwise have to be considered capital expenditures.
The deductions for new equipment in the year of purchase make it unnecessary to depreciate them over time.
“Doctors who are buying new diag-nostic equipment or other medical equip-ment, even furniture for the office, those again now have to be depreciated over typi-cally five or seven years, where previously it could have been written off very rapidly, or bonus depreciation would have allowed them to write off a very large percentage in one fell swoop,” Blockman said.
With expiration of the bonus depre-
ciation and Section 179 deduction limits, companies can claim only $25,000 in first-year depreciation on equipment that costs up to $200,000. Blockman said the deduc-tion had been as high as $500,000 on pur-chases up to $2 million.
Many of the most liberal business tax provisions were a response to the financial downturn of 2007 and 2008.
“They just kind of opened the flood-gates and said we want people to start spending money. Let’s give them the abil-ity to do so by giving some tremendous tax advantages,” Blockman said. “Everybody’s gotten addicted to this largesse, and so Congress keeps reinstating it.”
However, he said, the unpredictable and retroactive extensions by Congress don’t encourage business spending in the way the tax provisions were intended.
“If I buy $100,000 worth of equip-ment, and I’m going to save potentially 40 percent of that, or $40,000, in income tax, my after-tax cost is only $60,000,” Block-man said. “If I know that when I’m buying it, that might encourage me to buy it. But if I’m buying the equipment in January, and I don’t know that, then restoring it to me and letting me write it off at the end of the year – I love it, but that didn’t really encourage me back in January to buy it or not to buy it.”
Another popular provision that has expired, and may or may not be extended, is the research and development tax credit.
“There are a number of physicians in the Memphis area and across the country who are involved in research and com-mercial applications of that research, who have taken advantage of this,” he said. “Any particular physician specialty, be it orthopedics, gastroenterology or cardiol-ogy, if they are coming up with new surgi-cal procedures or new devices to be used in surgical applications, the monies that are being spent to develop those technologies and those products have qualified for the R&D credit in the past. . . . Whether it will become available retroactively, your guess is as good as mine.”
Blockman says a useful strategy to re-duce taxes in 2015 is to delay income to 2016. “The very simple technique is just to delay receipt of money, so don’t invoice patients at the end of the year. That’s not a very common ploy any longer (for phy-sicians’ offices) because most patients are coming in with insurance, and you can’t really control when those monies come in.”
In addition, businesses on the cash method of accounting should pay as many bills as possible before the end of the year.
“Identify money that can be spent on
Congress Holds Key to Tax Credits for 2015Lawmakers Typically Wait Until End of Year to Decide on Extensions
Sandy Blockman
(CONTINUED ON PAGE 6)
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NOW OPEN Editor’s note: This is the first in a series sharing music in the operating room.
It’s hard to argue with John Lochemes when he says he has the perfect tune to play in the operating room.
“It has to be Smooth Opera-tor – what’s better than that?” said Lochemes, an orthopedic surgeon with Memphis Orthopaedic Group. Of course, the song made popular by the English group Sade in 1984 has nothing to do with a physician performing surgery (it’s about a cool dude who’s popular with the women) but who’s going to argue? The title is perfect and it’s often what is playing when Lochemes is operating.
However, Lochemes is not sure about music in the OR.
“My opinion is that it’s not al-ways a good idea,” he said. “People will argue that we’re not in a club – we’re in an OR and the music is a distraction. Others argue that it helps the work environment and keeps the team alert. I personally survey the staff to see how they feel. I want efficiency of the staff. I feed into their needs.”
So for Lochemes, music in the OR is a sometimes thing. And while he prefers Smooth Operator, he is open to requests.
Lochemes, who grew up in Wisconsin, has only one rule: “No country music.”
WHAT’S PLAYING IN THE OR?
late 30s to mid-40s,” she said. “Over the last few years I’ve learned there is in fact a lot that can be done.
“When we think back 100 years, women didn’t live to be 85. So now that women live to be 85, they’re spending a third of their life after menopause. So we have to figure out what the key pieces are to help them live that third of their life as well as they can.”
Also key, Chauhan said, is the per-sonal relationships that she and her father build with patients and the time they de-vote to them. Initial visits with patients last 45 minutes to an hour. She differentiates Exceed from, for instance, some of the men’s clinics that are popping up.
“The clinics out there where you come in and get your shot and you’re out the door in 15 minutes, that’s not us,” she said. “That is not what we want to be, and that is not what we are now.”
Working with her father, she said, has exceeded her expectations.
“In going through residency training, I never dreamed that I would practice with him,” she said. “When this unique opportunity developed a few years ago, it was kind of a dream to think, wow, that we could find a way to practice together.
“Plus, I’ve got the best COO that I could possibly have who’s got my back. You couldn’t ask for a better person than your mom to look out for you.”
Father, Daughter Join Forces, continued from page 3
deductible expenses. Say you have to repair some equipment, do it now. Don’t wait until January 2016. If you’re paying bo-nuses, pay them before the end of the year. There’s nothing exotic about that strategy, but it still works,” Blockman said.
He said medical groups also should determine whether they qualify for the tax credit to help small employers pay for em-ployees’ health insurance premiums. An employer with 25 or fewer full-time equiv-alents, and a salary average of less than $50,000, can qualify.
“The sweet spot is essentially less than $25,000 in average wages, and less than 10 people working for you,” Blockman said. “That’s a 50 percent credit of the amount of insurance premiums, but there is a steep phase-out, so you’ll start losing the advantage of the credit once your av-
erage wages increase between $25,000 and $50,000 and you have more than 10 full-time equivalent employees.”
Because of the unstable political cli-mate, “We’re working with clients now with the law as it is, not as we would like it to be,” Blockman said.
“Back in July, the Senate finance committee came up with a bill of the usual extenders. The House of Representatives wants to make some of these provisions permanent, and they didn’t act on it. So something’s likely going to happen. Can they get something done before the end of the year? History shows that they have. But they say in the investment business, past performance is not an indication of what the future is gonna bring, and I guess you could say the same thing about Con-gress.”
Congress Holds Key, continued from page 5
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“Our goal for the east campus facility is comprehensive integrated care,” Per-isho said. “We want individuals to have an efficient patient experience. This campus will provide a full range of specialists who will take care of a variety of specialties. For instance, we will have a cardiologist, endocrinologist, urologist and an internist on staff. Some of these physicians will ro-tate between our downtown and east cam-pus locations.”
Currently, the women’s reproductive clinic, which includes urogynecological services, the outpatient rehab center and multi-specialty clinic are open for patient care. Accord-ing to Perisho, the front entrance and canopy is scheduled to open this month. The imag-ing center is expected to open in January once the first floor renovation is complete, which is the last phase of the project.
Once complete, Regional One will have operations on the first, second and fifth floors. The building has been reno-vated to accommodate 50,000 square feet for medical space and 60,000 square feet for office space.
Perisho estimates that the total proj-ect’s renovation cost will be $10 million to $12 million upon completion.
In addition, a certificate of need has been filed for a 20,000-square-foot, one-story emergency department next door
to the Regional One outpatient services building. A hearing is scheduled this month, and if approved by the state, Bap-tist Memorial Health Care Corporation and Regional One Health will undergo a joint venture to construct and operate a co-branded, free-standing emergency department on four acres of the property.
“We feel that there is a need for this type of service in the southeast portion of the county,” Perisho said. “It will be easily accessible from the freeway, and patients can drive to the location from any-where in the county in about 20 minutes. Patients will be able to walk over to the east campus to continue outpatient treatment.”
Perisho said the site is ready for con-struction, and if the certificate of need is approved this month, construction could begin quickly.
Construction is expected to be com-plete in April 2016 on Crestwyn Behav-ioral Health, a 60-bed, 61,000-square-foot psychiatric hospital in Germantown.
The one-story hospital is a joint ven-ture between Nashville-based Acadia Healthcare, which owns and operates Delta Medical Center; Baptist Memorial Health Care Corporation and St. Francis Hospital. Crestwyn will offer inpatient mental health services, including adolescent, adult, addic-tion and geropsych programs. Acadia will manage the day-to-day operations.
“There are not any behavioral ser-vices like this offered in this part of the county, “ said Bill Patterson, interim chief executive officer of Delta Medical Center and project coordinator for Crestwyn Be-havioral Health. “Lakeside, Delta Medi-cal Center and St. Francis are operating at capacity, and we felt there was a need for a free-standing location that offers ad-ditional behavioral services.”
Methodist Le Bonheur Health-care has many expansion projects in the pipeline throughout the Mid-South. A 161,000-square-foot renovation to the UTMG building, which will accommo-date West Cancer Center in Germantown, is almost complete, according to Dave
Rosenbaum, vice president of facilities management for Methodist Le Bonheur Healthcare. Most operations are housed inside the building now with additional services from The West Clinic moving in November. The building is expected to be fully operational at the end of the month.
In addition, renovations to the en-trance and lobby of Methodist North Hos-pital will be completed by the end of the month. Construction is underway to ex-pand the emergency department at Meth-odist South Hospital from 9,950 square feet to 22,750 square feet. Construction is expected to be complete by the end of next year. According to Rosenbaum, con-struction will begin in the first quarter of 2016 to renovate the intensive care unit at Methodist South Hospital.
“These hospitals haven’t been reno-vated in certain areas since they were built 30 years ago,” Rosenbaum said. “We are bringing them up to current standards so it is a better environment for patients, staff and families.”
Also, Methodist plans to move various administrative functions into Crosstown Concourse in Midtown, which is sched-uled to open the first quarter of 2017.
“We are working with our designer now and are selecting contractors to work on the space,” Rosenbaum said. “We have employees located in third-party lease properties throughout various parts of the city, and they will move to Crosstown when it’s complete.”
Methodist will occupy 115,000 square feet inside Crosstown. Also, other medical and wellness-related tenants will occupy over 620,000 square feet, including the Church Health Center, which will con-solidate its current 14 buildings under one roof and will occupy 150,000 square feet of space, according to Todd Richardson, co-leader of Crosstown Concourse.“The primary goal for us now is finishing the shell and core where tenants can start building their internal space in January,” Richardson said. “So far, we are on sched-ule to do that.”
Richardson mentioned that tenants will have the entire year to wrap up in-ternal renovations and should be able to move on schedule in the first quarter of 2017. Out of 1.1 million square feet, only 60,000 square feet is vacant. Richardson’s goal is to lease the remaining space next year.
As 2016 approaches, several Mid-South hospi-tals and medical-related entities are looking at what’s next on the horizon for building development. According to Kelly Truitt, executive vice president of CB Richard Ellis Memphis, a local commercial real estate agency, the Affordable Care Act will be a factor in how hospitals look at expansion.
“I think there was some delay in stra-tegic planning for future development to see if the Affordable Care Act (ACA) would stay or if any changes would be made,” Truitt said. “Now that we know the law is here to stay, I think we will see some plan-ning focused on efficiencies. Also, hospitals are going to want to be more accessible to patients and how they deliver services. We are already seeing that with all of the medical expansion out east. I think we will see quieter growth in 2016 than we saw in 2014 or 2015 as hospitals get their strategic planning together.”
Truitt’s prediction aligns with Meth-odist’s development strategy on future expansion. According to Rosenbaum, the ACA is being considered in the hospital system’s strategic plan for future develop-ment.
“We are currently doing our strategic planning for the next five years and are keeping the Affordable Care Act in mind,” Rosenbaum said. “Our goal through 2020 is to provide accessible facilities in neigh-borhoods so better healthcare can be pro-vided. We want to have the right facility to give the patient what they need. We want to bring the healthcare to them.”
Arrival of 2016 to Signal Opening of New Facilities, continued from page 1
Bret Perisho
Todd Richardson
8 > NOVEMBER 2015 m e m p h i s m e d i c a l n e w s . c o m
On Oct. 12, the Tennessee Health Care Hall of Fame inducted its inaugu-ral class at a gala luncheon celebration at Belmont University’s Curb Event Center. Hosted by Susan Dentzer, senior policy adviser for the Robert Wood Johnson Foundation, the event paid homage to eight pioneers who have shaped the health and healthcare industry of Tennessee and the nation.
The Tennessee Health Care Hall of Fame was created by Belmont University and Belmont’s McWhorter Society with the support of the Nashville Health Care Council, a founding partner. Grand spon-sors for the 2015 event were Community Health Systems and Hospital Corporation of America. Other sponsors included Aca-dia Healthcare, BlueCross BlueShield of Tennessee, FirstBank, JourneyPure, Med-Care Investment Funds, Meharry Medical College, AmSurg, Foundations Recovery Network, LifePoint Health, Medical News, NashvillePost, and PYA.
For more information, go online to tnhealthcarehall.com.
Thomas F. Frist Sr., MDCommitted Physician, Savvy Businessman
A native of Me-ridian, Miss., Thomas Frist, Sr. attended the University of Mis-sissippi, where he started a transporta-tion company that eventually employed 17 other students, the first evidence of his entrepreneurial spirit. But Frist’s passion lay in caring for people, shaped from his early experiences working as an orderly at Meridian’s local hospital. Frist studied medicine at Vanderbilt University School of Medicine and completed his residency at the University of Iowa.
In 1935, he opened a medical prac-tice in Nashville. During World War II, Frist served in the U.S. Army Medical Corps as the chief of medical services for a 1,000-bed hospital. Discharged as a major at the war’s end, he returned to his Nashville medical practice. In 1957, he was appointed to the American Medi-cal Association Committee on Aging and subsequently established the Tennessee Commission on Aging.
During this time, Frist envisioned cre-ating a hospital where patients came first and where funding was not dependent upon government sources. This dream led him to set up Park View Hospital with several other medical professionals and businessmen. The success of Park View served as the seed of inspiration for Frist, his son Thomas Frist Jr., MD, and friend Jack C. Massey to form Hospital Corp. of America in 1968. Frist served as chief medical officer and chairman of the board for HCA.
One of his most important contribu-tions to HCA was its patient-first culture. Frist, who is the namesake for the HCA Frist Humanitarian Award, believed that if the company focused on giving qual-
ity care, the bottom line would take care of itself. That emphasis on patient care permeated every decision he made while leading HCA and remains a centerpiece of the company’s culture today.
Thomas F. Frist Jr., MDPhysician, Philanthropist, Entrepreneur
A Nashvi l le nat ive, Thomas “Tommy” Frist, Jr., MD is a graduate of Nashville’s Mont-gomery Bell Academy and Vanderbilt University. An entrepreneur at heart, Frist created a collegiate advertising com-pany and earned his pilot license while at Vanderbilt University. In 1965, he gradu-ated from the Washington University School of Medicine in St. Louis and then returned to Vanderbilt University for his surgical residency.
His residency was interrupted by a two-year term as a flight surgeon at Rob-ins Air Force Base in Georgia during the Vietnam War. While in the military, Frist had an idea for a company that would bring hospitals together to share re-sources. In 1968, Frist, along with his fa-ther and Jack C. Massey, formed Hospital Corp. of America. As one of the nation’s first investor-owned hospital companies, HCA modernized the way healthcare was delivered in the United States.
Frist served HCA in various leader-ship roles including as president, CEO and chairman. He remained on the board of directors of HCA until 2009 and cur-rently serves as chairman emeritus.
Philanthropy has always been central to Frist’s life. His board activities have included The Frist Center, Harvard Busi-ness School Board of Dean’s Advisors,
Montgomery Bell Academy, the Nashville Health Care Council, Vanderbilt Uni-versity and both the national and local United Way. Frist also has been the re-cipient of a number of awards, including the United Way’s “Lifetime Achievement Award” and the Nashville Business Jour-nal’s “Best in Business Lifetime Achieve-ment Award.”
He is quick to credit his success to his wife, Patricia (Trish), for her support and encouragement throughout the years. Frist credits his wife with keeping him grounded on their first priority — their three children — while building HCA into the company it is today.
Ernest Goodpasture, MDPathologist, Passionate Educator, Public Servant
Born in 1886 near Clarksville, Er-nest Goodpasture was a 1907 graduate of Vanderbilt University. After obtaining his undergraduate degree, Goodpasture attended Johns Hopkins Medical School and served as a faculty member at Johns Hopkins and Harvard Medical Schools.
In 1924, he was invited to join the new Vanderbilt School of Medicine as the Department of Pathology’s first chairman. Returning to his home state, he spent the majority of his career in Tennessee at Vanderbilt before taking the position of scientific director of the Armed Forces In-stitute of Pathology in 1955.
While at Vanderbilt, Goodpasture served as associate dean and dean of the medical school, but his passions were re-search and teaching. His scientific accom-plishments led to his recognition as one
Tennessee Health Care Hall of Fame Inducts Inaugural Members
(CONTINUED ON PAGE 7)
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of the world’s foremost pathologists. His interest in infectious agents and viruses led to the development of the chick em-bryo technique used for the cultivation and study of a number of viruses. This work provided the foundation for the suc-cessful development and improvement of vaccines against yellow fever, typhus and influenza, saving thousands of lives.
In recognition of his scientific work, Goodpasture received honorary degrees from Yale University, the University of Chicago and Washington University. He was elected as a member of the National Academy of Sciences and the American Philosophical Society, among others. Goodpasture was awarded the Association of American Physicians’ Kober Award, the American Public Health Association’s Sedgwick Medal, the Association of Pa-thologists’ Gold Headed Cane, and was nominated for the Nobel Prize in Physiol-ogy and Medicine.
Jack C. MasseyPharmacist, Philanthropist, Investor
Georgia native and University of Florida alumnus, Jack Massey began his ca-reer as a pharmacist and small business owner. Relocating to Tennessee, he built a long career steeped in healthcare, business and investment.
After selling his chain of six drug stores, the entrepreneur founded Massey Surgical Supply Co. in the 1930s and sup-plied area hospitals and doctors with med-ical equipment. In the 1940s, Nashville’s Protestant Hospital was experiencing sig-nificant financial challenges that would likely lead to the facility’s closure. Under-standing the importance of the hospital to the area, Massey and the Rev. James Sul-livan presented a plan to save the hospital to the Tennessee Baptist Convention. In 1948, the hospital was renamed Mid-State Baptist Hospital, and Massey served as a trustee for two decades, 12 as chair.
During his successful career, Massey also entered the food industry as owner of Kentucky Fried Chicken and later at the helm of Winner’s Corporation, one of the largest franchisees of Wendy’s restaurants. In 1968, Massey and the Frists co-founded HCA, an organization that would become the country’s largest for-profit owner and operator of hospitals.
Passionate about his work and con-tributions to society, Massey’s career was built on the belief that operations, con-venience and service can always be im-proved. Throughout his career, he was quick to comment on the joy he found from learning and accomplishing those improve-ments. “Lots of people have more than I do, but not many have as much fun. The fun is in the accomplishing,” he stated.
His desire to share his ideals and per-spective with future generations led to his deep commitment to Belmont University, which included helping to build a na-tionally recognized business school, now known as the Jack C. Massey College of Business.
R. Clayton McWhorterClinician, Businessman, Mentor
Creating a career as both a healthcare clinician and busi-nessman, Clayton McWhorter began making an impact on the healthcare industry as a pharmacist after graduating from Samford University.
Recognizing he could expand services to patients by moving into the business side of healthcare, McWhorter became a hospital administrator, honing his lead-ership and management skills. Working his way through the ranks at HCA, Mc-Whorter became president and chief oper-ating officer of the hospital giant. He then participated in the formation of Health-Trust Inc., where he served as chairman, president and CEO until the company merged with Columbia/HCA in 1995. McWhorter served on the Columbia/HCA board until May 2000, including a stint as chairman.
In 1996, McWhorter founded Clay-ton Associates, a firm created to invest in and advise entrepreneurs within the healthcare industry. In 2008, he founded PharmMD, served as chairman, and cur-rently serves on its board. He also is a member the Harpeth Capital Advisory Board.
Committed to philanthropy and his community, McWhorter and his fam-ily have greatly contributed to educa-tion in Nashville and beyond through the creation of the McWhorter School of Pharmacy at Samford and Belmont’s McWhorter Hall and McWhorter Soci-ety. Throughout his career, McWhorter has also been involved with a number of community organizations including, the American Cancer Society, the YWCA, and the Middle Tennessee Council of the Boy Scouts of America, among oth-ers. McWhorter is the recipient of many awards in recognition of his community service, including the United Way’s Toc-queville Award and the Joe Kraft Hu-manitarian Award.
McWhorter has mentored countless leaders throughout his career and contin-ues to offer his four guiding principles to all mentees: “Be prepared. Find a mentor and be a mentor. Act like an owner. Give back.”
David Satcher, MD, PhDAdvocate, Public Servant, Lifelong Educator
Known as a dedi-cated physician-sci-entist, David Satcher, MD, PhD, has devoted his career to advocat-ing for the health and safety of all Ameri-cans by tackling issues not previously addressed nationally – including obesity, health disparities among minority popula-tions, and mental illness.
Satcher earned both his medical degree and doctorate from Case West-
ern Reserve University. In 1982, he was named president and CEO for Meharry Medical College, where he oversaw the merger of Hubbard Hospital and Metro Nashville Hospital, changing the provi-sion of healthcare for Nashville’s under-served populations. During his tenure at Meharry, he also led the plan for aca-demic renewal, which included a national fundraising campaign and the rebuilding of faculty.
Satcher would then go on to serve at a national level. He has held the posi-tions of director of the Centers for Disease Control and Prevention, the 16th Sur-geon General of the United States, and the 10th Assistant Secretary for Health in the Department of Health and Human Services. He currently serves as director of the Satcher Health Leadership Institute at Morehouse School of Medicine.
Throughout, Satcher has received a number of top awards, including the Ronald Davis Special Recognition Award from the American College of Preventa-tive Medicine, the Jimmy and Rosalynn Carter Award for Humanitarian Contri-butions to the Health of Humankind from the National Foundation of Infectious Diseases, and the designations of Nashvil-lian and Tennessean of the Year. Satcher has also received more than 50 honorary degrees from universities and colleges and has written a clinical guide on multicul-tural medicine.
Committed to making public health work for all people, Satcher believes in the power of strong leadership. He noted, “Ethical leaders are needed who will take on the problems of poverty, racism and lack of access to healthcare.”
Mildred Stahlman, MDPioneer, Scholar, Educator
The mother of modern neonatology, Mildred Stahlman, MD, is a native Ten-nessean and longtime Vanderbilt student, educator, researcher and physician.
Graduating from Ward-Belmont College for Women, she matriculated to Vanderbilt University in 1943 and gradu-ated with honors from the Vanderbilt School of Medicine in 1946 as one of only four women in a class of 50. She com-pleted internships in Cleveland and Bos-ton, a residency year in Chicago, and a research fellowship in Sweden.
Returning home to Tennessee, Stahl-man then embarked on a 60-plus year ca-reer at Vanderbilt. Throughout her work as an instructor, professor and practitioner of pediatrics and neonatology, Stahlman had more than 150 peer-reviewed pub-lications and assisted in the training of more than 80 post-doctoral fellows from approximately 20 countries. More than just a mentor, Stahlman welcomed the fellows to her log cabin and farm for holi-days where they rode horses, swam in the creek and became part of her extended family.
During her career, Stahlman revo-
lutionized the care of high-risk newborns by creating the world’s first modern neo-natal intensive care unit in 1961. She also promoted what was at the time a novel concept of regionalized neonatal critical care and helped establish the first Angel Transport Mobile Intensive Care Unit.
Her tireless work on behalf of chil-dren and the profession was recognized in 1987 by the American Academy of Pedi-atrics with the Virginia Apgar Award and in 1996 by the American Pediatric Soci-ety’s John Howland Award. She was also named the Vanderbilt Medical Alumni Association’s Distinguished Alumna in 2002 and the University’s Distinguished Alumna in 2004. A newsletter from the in-stitution quoted Stahlman saying, “Medi-cine is more than a profession — it is my calling.”
Danny ThomasEntertainer, Humanitarian, Child Advocate
A radio, film and television entertainer and producer, Danny Thomas was born in Michigan in 1912 to Lebanese immigrants.
Before he became a star, Thomas was a struggling actor who needed money to pay for the delivery of his newborn daugh-ter, Marlo. Placing his last $7 in the col-lection box at church, he quickly realized what he’d done and prayed for a way to pay the looming hospital bills. The next day, he won a small part that paid 10 times what he had just donated.
While still trying to take his career to the next level, Thomas again found himself at church praying for guidance. He made a vow to St. Jude, the patron saint of hopeless causes, saying, “Give me a sign that I am going in the right direc-tion, and someday I’ll build a shrine in your name.”
As Thomas’ career took off, he re-membered his promise. He began raising money for his vision and joined with local business leaders in Memphis to create a groundbreaking research and treatment hospital devoted to curing catastrophic diseases in children. Opening in 1962, St. Jude has treated children from all 50 states and all over the world and continues to lead the charge in finding ways to defeat childhood cancer and other life-threaten-ing diseases.
To this day, the hospital stands by Thomas’ founding promises that no family pays St. Jude for treatment, travel, hous-ing or food and that St. Jude freely shares its discoveries to impact the lives of chil-dren across the world.
Throughout his life, Thomas was recognized with many awards, including receiving a Knight Commander of the Order of the Holy Sepulchre by Pope Paul VI, the Congressional Gold Medal, induc-tion in the Television Hall of Fame and a posthumous receipt of the Bob Hope Hu-manitarian Award.
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sity of Memphis after a stint in the military. During graduate school, he began work-ing at the Shelby County Penal Farm and began considering a career in corrections.
“I’ve always thought that the crimi-nal mind was a fascinating study,” he said. “This gave me an opportunity to deal with the issues of crime and try to understand its nature and its causal effects — and, in the process, start developing what I thought would be creative approaches to dealing with the problems of crime.”
How much of criminal behavior is rooted in mental illness — for example, the increasingly common mass shootings?
“Some of it certainly has to be at-tributed to mental health,” he said, “but I think we’ve got some people in our society that are just extremely anti-social — and whether that classifies as a mental health condition or a socialization condition, the more frequently it happens, you start to see the copycat effect.
“There’s a cry for help there,” he said, and, for some, a frustration with how life has treated them. “It’s a sad state of affairs when a teenager sees that the only thing in their future is death.”
An April 2014 survey showed there were 10 times more people with serious mental health illnesses in prisons than in state hospitals.
Luttrell confirms that many prison inmates have mental health issues that should be dealt with in better places. “The paradox is that some of the larger mental health facilities I have found are in jails and prisons,” he said. “It’s a sad commen-tary on society, that we’re dealing with the mentally ill by putting them in jail — and then expecting that we’re going to pro-foundly improve their mental health.”
Consequently he has focused on the need to assess the mental and physical con-dition of people coming into the criminal justice system, and he recently established a mental health court in Shelby County for that purpose. Perpetrators must still be held accountable for criminal behav-ior, but Luttrell feels the impact of mental health issues on that behavior should be dealt with first.
The court relies on partnerships with mental health professionals, who help de-velop solutions for proper care and reha-bilitation for those offenders who are, in a sense, victimized by their own condition.
“We’re seeing more and more move-ment across the United States toward spe-cialty courts,” Luttrell said. “The earliest were the drug courts, because of the huge number of people in our jails and prisons that are there for drug violations or of-
fenses. “Whether it’s mental illness, drug or
alcohol addiction, we have got to do a bet-ter job of identifying that so that our pris-ons can be truly a holding place for those people who are just downright mean.”
Luttrell is passionate about the issues of mental health and better management of prison populations through aggressive programs that deal with mental health.
“That’s going to have such a pro-found impact, both on an individual scale and from a cost perspective,” he said. “It’s terribly expensive to run a prison – and if you can separate out people who can be dealt with more effectively and at a lower cost, then you’re winning in two or three ways.”
In 2013, there were 343 adult mental health courts operating in 43 states; studies consistently showed them to be effective in reducing recidivism and improving clini-cal and quality of life outcomes. The most common feature of mental illnesses seen in the courts was co-occurring substance abuse disorder.
Annually, more than 2,700 drug courts nationwide serve over 136,000 people with effective results, according to the National Association of Drug Court Professionals. Independent researchers conclude that drug courts reduce crime and return financial benefits at several times the initial investment — some cut-ting crime rates in half and returning $27 to their communities for every $1 invested.
The mayor also spearheaded the Healthy Shelby program several years ago to focus on better health, better care and lower costs as strategies for economic vital-ity for the community. The first of its kind in Tennessee, the program streamlines a more effective connection between a con-sortium of the area’s top medical resources and people who need their services.
“We need to jointly develop strate-gic approaches to move the needle on is-sues like childhood obesity, hypertension, youth illnesses, teenage pregnancy, obesity and diabetes,” he said.
He emphasizes public awareness and education as keys to motivating people to take responsibility for healthy lifestyle changes. “Growing our way out of this problem starts with a good, viable educa-tion program,” he said.
He’s proud of the strides he has made in addressing both mental and physical health problems in the community, and urges healthcare providers to encourage further progress by also examining each patient’s emotional well-being.
“It’s that emotional side that’s going to drive the individual to change their life-style and behavior to make it more health-conscious,” he said. “I’d love to see doctors help a little bit more in the socialization of our population — to promote healthcare.”
Luttrell is married, with three chil-dren and six grandchildren; a hiker and biker, he continues to improve a habitually healthy lifestyle by doing something every day that pushes him physically -- “I’m looking forward to the future and want to make sure that I’m healthy enough to enjoy it.”
Mayor Mark Luttrell, continued from page 1
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BY LYNNE JETER
ST. LOUIS, MO — Last month, Mercy unveiled the world’s first Virtual Care Center in the heartland of America. Bishop Edward Rice of the St. Louis Arch-diocese officially blessed the nonprofit Cath-olic health system’s newest facility Oct. 6 in Chesterfield, Mo., a suburb located 15 miles west of St. Louis.
The new $54 million building on a 38-acre campus houses the nation’s larg-est single-hub electronic intensive care unit (ICU/Mercy SafeWatch), and also provides a center for telemedicine innovation and a testing ground for new healthcare products and services. More than 300 physicians, nurses, specialists, researchers and support staff at the four-story, 125,000-square-foot center are tapping into technology to de-liver care to patients around the clock via audio, video and data connections to loca-tions across Mercy and around the country through partnerships with other health care providers and large employers.
“This is a huge and impactful step for-ward for telehealth and I appreciate that Mercy leadership had the vision and de-termination to demonstrate to their com-munity and the world how telehealth is
one powerful and effective solution to the issue of diminished access to healthcare that many citizens in America and across the globe are experiencing,” said Rena Brewer, CEO of Global Partnership for Telehealth Inc., and director of the Southeastern Tele-health Resource Center.
Randall Moore, MD, MBA, Mercy Virtual president, spoke with Medical News exclusively about establishing the Virtual Care Center and the positive impact it’s al-ready making on practices, clinics and hos-pitals across the United States.
How did the idea of Mercy creating a Virtual Care Center originate?
It was an evolutionary process. We launched our first virtual program – Mercy SafeWatch, our electronic ICU– in 2006, and we’ve experienced great success. As the team continued to build programs and saw the importance of virtual care becoming a transformational pathway for our health system, a light bulb went on. It made sense to create a Virtual Care Center that worked like a hospital to bring together teams, re-
sources and infrastructure to care for pa-tients in a much more coordinated manner and to offer a care continuum that extends 24/7/365. We needed a facility for this conduit of care, just as we’d need one for a particular service like cancer care.
How did the concept evolve into the world’s first-of-its-kind telehealth center?
The Virtual Care Center evolves from the culture and charism of Mercy. The
(CONTINUED ON PAGE 12)
Mercy Launches World’s First Virtual Care Center City Again Serving as Gateway to a New Era
More than 300 physicians, nurses, specialists, researchers and support staff at the Virtual Care Center are tapping into technology to deliver care to patients around the clock via audio, video and data connections to locations across Mercy and around the country.
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Sisters of Mercy who founded our health system were famously known as ‘the walk-ing sisters.’ That goes back 187 years, when nuns were mostly cloistered and did good deeds from their convent for people in need. The walking sisters, who were quite inde-pendent, didn’t want to wait for people to find them. Instead, they searched for people in need and addressed those needs on the spot. They were an anomaly for their time.
When you think about hospitals in gen-eral, we wait for people to come to us, and we give them exceptional care. The idea permeating our culture was to seek those needing medical care by taking virtual
care teams from our clinics and hospitals and proactively identifying their healthcare needs, intervening with them earlier and more completely. It translates to a lower cost, high impact option to keep a person from deteriorating.
At the board level and leadership level, (Mercy president and CEO) Lynn Britton and (Mercy CFO) Shannon Sock were the primary drivers of this project, understand-ing the Virtual Care Center is 100 percent consistent with our organizational mission – and also a model for us to progressively replace our hospital-based care with care when and where people need it. If we do
this well, we’ll be able to realign our con-tracts to be rewarded for keeping people well.
How have you made the Virtual Care Center a sustainable business model while also dealing with the complexities of regulations, interstate commerce, and the like?
First, it’s important to know we didn’t go into the Virtual Care Center think-ing that a fee-for-service equivalent would make it a sustainable business model. We weren’t expecting, though we’d have wel-
comed it, very much direct reimbursement as has panned out. In Missouri, our parity laws have helped.
We’re broadening it to enable us to move our teams and our patient centric-ity from our facilities, which are somewhat limiting, to virtual care anytime, anywhere. If we did that with something like perfor-mance-based, population health contracts, we could intervene earlier and more effec-tively, and then it would pay for itself.
For example, here’s how it works in today’s environment in the hospital ICU vs. the floor. In the hospital ICU, the hos-pital is paid a lump sum for a patient with a given condition and it’s a fixed amount of money. The ICU is more expensive, and the patient usually doesn’t have as good an outcome. One result of our Mercy Safe-Watch program shows the actual v. pre-dicted mortality for the last few quarters in our Joplin (Mo.) hospital has been running around 50 to 55 percent. In other words, 45 to 50 percent of the patients who ‘should’ve’ died didn’t. That statistic doesn’t help much with finances, right? It should help us with market differentiation; by having Mercy SafeWatch in place, we can do a better job taking care of people. But here’s another example: Looking at the risk-predicted length of stay, both in the hospital and the ICU, our length of stay is running 20 to 30 percent less than predicted in the ICU, and 30 to 35 percent less than predicted on the whole hospitalization. If we can get a sick person well faster, that’s less time for the pa-tient in the ICU. Looking at it financially, the direct variable ICU costs us about of $900 a day. If it costs us $650 a day to use Mercy SafeWatch, then we’re getting 100 percent return on our investment of virtual care without being paid directly for it.
But the most important aspect is that a third of the ICU patients predicted to die aren’t dying. That’s just the tip of the ice-berg, and it implies that patients accessing the Virtual Care Center are doing better. We expect to deliver more efficient, effec-tive, and higher impact care as we integrate virtual into bedside and clinic care.
What’s Mercy’s longer-term goal for the Virtual Care Center?
One of our key growth areas for our mission is to create the Virtual Care Center as a conduit of care anyone, anywhere can access. We’ve been on a 10-year, several hundred million dollar journey to get where we are. We’ve learned many positive things, and we continue to learn from missteps.
We’re proposing that instead of selling our services, or having an entity trying to replicate the same services without us being able to provide much support, we’d like to build a national consortium of interdepen-dent partners. We’d continue packaging our offerings and building our infrastruc-ture with our partners’ support. They could buy into our entity, we could capitalize it together and replicate what we’ve learned with a fraction of time and money, and also do it in an interdependent way so we could then go to GM, Boeing, CMS, United Healthcare to offer it to people they’re cov-ering throughout the 50 states.
Mercy Launches World’s First Virtual Care Center, continued from page 11
m e m p h i s m e d i c a l n e w s . c o m NOVEMBER 2015 > 13
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GrandRoundsSemmes Murphey Clinic Installs Digital Radiography System
Semmes Murphey Clinic has in-stalled the Samsung GC80, an innovative digital radiography (DR) system which will improve patient safety and the reliability of the diagnosis by acquiring high resolu-tion images with a very small amount of radiation.
The Semmes Murphey Radiology De-partment where the staff, sonographers and physicians have benefitted from the ability of the GC80 to simplify their work-flow and reduce exam time, providing more time to focus on patient care.
The GC80 offers fast, easy and ac-curate diagnosis with minimized patient exposure across diverse applications.
Methodist Healthcare Introduces Mobile Digital Mammography Screenings to Memphis Area
Methodist Healthcare has made it more convenient for women to have their screening mammograms by offering its mobile mammography unit. The unit parks on-site at businesses to perform the procedure for eligible women who have not had their annual mammogram in the past 12 months.
The Methodist Mobile Mammog-raphy unit features the latest 3D breast screening technology. The benefits of 3D screening technology are:
• Creates a 3D image of your breast for a complete picture
• Provides incredibly sharp images that can reveal the smallest abnormalities
• Reduces the need for additional imaging
UTHSC Assistant Professor Receives Grant for Mapping Alzheimer’s Memory Failure
Catherine Kaczorowski, PhD, an as-sistant professor in the Department of Anatomy and Neurobiology at the Uni-versity of Tennessee Health Science Cen-ter (UTHSC), has received a $418,000 grant to further her research of Alzheimer’s disease and memory fail-ure.
The grant was award-ed by the National Insti-tute on Aging, one of the National Institutes of Health, and will be funded over the next two years.
The grant, titled, “Mapping AD Memory Failure: Molecules to Connectiv-ity of Brain Network,” will allow Dr. Kac-zorowski and her team to employ a novel approach to identify new molecules that underlie unusual changes in the function-al connectivity of neurons across multiple brain regions (i.e., network coherence) and monitor how these changes con-tribute to memory deficits in Alzheimer’s disease. Overall, this project also aims to discover biomarkers that could be used to detect potential onset of Alzheimer’s disease in advance, so treatment could begin earlier with better success rates.
Dr. Catherine Kaczorowski
m e m p h i s m e d i c a l n e w s . c o m NOVEMBER 2015 > 15
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GrandRoundsUTHSC Pharmacology Chair Awarded Grant to Study Effects of Consuming Caffeinated Drinks with Alcohol
The growing popularity of consum-ing caffeinated drinks with alcohol has prompted Alex Dopico, MD, PhD, of the University of Tennessee Health Science Center to expand the research he has pursued for more than 20 years into the effects of alcohol on the brain. Dopico, Distinguished Professor and Chair of the Department of Pharmacology, has re-ceived a grant totaling $100,000 over two years from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to study the effect on arteries in the brain of alcohol and caffeine when they are consumed together. The award comes in response to a competitive funding op-portunity issued by the Offi ce of Dietary Supplements of the National Institutes of Health.
Energy drinks typically contain caf-feine as a primary active ingredient. An in-creasingly popular practice among young people involves consumption of energy drinks with alcoholic beverages.
In 2010, the Food and Drug Admin-istration issued letters objecting to man-ufacturers’ claims on premixed caffein-ated alcohol products that the addition of caffeine to the alcoholic beverages is generally safe. As a result, manufactur-ers removed premixed caffeinated alco-hol products from the market. However, the practice of consuming energy drinks along with alcoholic beverages is on the rise.
Dopico’s new grant supplements a $3.6 million, 10-year research award he received in 2009 from the NIAAA for his alcohol studies.
Medical-Legal Partnership Formed to Focus on Issues That Impact Patient Health
A collaborative effort among the University of Memphis School of Law, Memphis Area Legal Services (MALS) and Le Bonheur Children’s Hospital has pro-duced a medical-legal partnership.
Called Memphis CHiLD (Children’s Health Law Directive), the partnership will focus on identifying the legal and so-cial issues that impact patient health and providing means to address these issues though direct legal services, education and advocacy for children and their fami-lies.
In addition to a variety of training programs and educational, bi-directional partnerships, Memphis CHiLD also con-sists of an on-site Legal Clinic located at Le Bonheur Children’s Hospital, where Memphis Law students enrolled in the clinic have devoted space to work on cases and referrals, meet with patients/clients, and conduct training sessions. Medical professionals and Le Bonheur residents will have access to the clinic as well, and will have direct involvement in the Memphis CHiLD Legal Clinic training sessions and learning opportunities avail-
able through the program.The initial focus of the partnership will
be helping children with severe asthma who are enrolled in Le Bonheur’s CHAMP Program (Changing High-Risk Asthma in Memphis through Partnership). CHAMP aims to reduce emergency department visits and reduce asthma episodes. Mem-phis CHiLD will help families with legal, social and health barriers like mold in rental housing.
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