Nashville Medical News February 2015

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VHVI Offering World’s Tiniest Pacemaker, Pulmonary Hypertension Surgery

By MeLANIe KILgoRe-HILL

Micra TPSA pacemaker the size of a vitamin is changing the cardiac game at Vanderbilt Heart and

Vascular Institute. Last September, cardiologist Christopher Ellis, MD, director of clinical arrhythmia research, implanted the fi rst Medtronic Micra Transcatheter Pacing System (TPS) in a 59-year-old Johnson City patient.

The VHVI arrhythmia team has implanted 10 more since that fi rst procedure, par-ticipating in a global clinical trial to test the safety and effi cacy of the world’s smallest pace-maker. (CONTINUED ON PAGE 4)

Suzanne Brown Sacks, MD

PAGE 2

PHYSICIAN SPOTLIGHT

By CINDy SANDeRS

A large delegation of Nashville healthcare executives will de-scend on Washington, D.C. next month to meet with policymakers, political pundits and industry insiders as part of Leadership Health Care’s annual trek to the nation’s capital.

Jenni Bradley, whose role as director of Talent Development for the Nashville Health Care Council includes oversight of Leader-ship Health Care, will spearhead the group of nearly 100 delegates during two days of high-level meetings and networking opportuni-ties. From March 9-10, the group will gain insight into healthcare

policy issues, federal healthcare spending priorities and reform im-plementation while also representing Nashville’s $70 billion health-care industry in meetings with key decision-makers.

After arriving in D.C. on Monday, the delegation will dive in with briefi ngs and panel discussions with national association ex-ecutives and thought leaders, a kick-off reception, dinner, keynote speech, and evening networking event. “Our confi rmed keynote speaker is David Wasserman, the house editor of The Cook Politi-cal Report. David spoke to our group two years ago, and we had an unbelievably positive response to him,” Bradley said of the nonparti-

LHC Prepares for Annual D.C. Delegation

(CONTINUED ON PAGE 12)

The small pacemaker being tested at Vanderbilt is one-tenth the size of conventional devices.

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PhysicianSpotlight

By LARRy MCCLAIN

Very few physicians and clinicians get the itch to tackle show business. It’s a short list that includes novelist/screenwriter Michael Crichton, MD, and “Friends” star Lisa Kudrow, who was a medical researcher for nearly a decade before launching her acting career.

The newest member of this dual-passion club is Suzanne Brown Sacks, MD, assistant professor of Medicine in the Division of Cardiovascular Medicine at Vanderbilt University Medical Cen-ter, whose alter ego is an award-winning singer/songwriter named Suzie Brown.

Each month, Brown works two con-secutive weeks at Vanderbilt followed by two weeks off to pursue her musical ca-reer. “The arrangement works very well because of our department structure and resident schedules,” said Brown. “It’s ac-tually better than trying to work three days every week.”

Like her medical predecessor Mi-chael Crichton, Brown chose the Ivy League route. She attended Dartmouth College for her undergraduate degree in chemistry, then went to Harvard Medical School followed by residency at Brigham and Women’s Hospital. Brown completed a cardiology fellowship at the University of Pennsylvania, where she also earned a master’s degree in translational research (the “bench to bedside” discipline bridging the gap between basic science and clinical research). She is board certified in Internal Medicine, Cardiovascular Diseases, and Adult Comprehensive Echocardiology.

Toward the end of her fellowship,

Brown began feeling the tug of a long-deferred dream. She started writing and performing her own songs – and it didn’t take long to start gaining attention. In 2010, she won a “Best of Philly” award from Philadelphia magazine and was a semi-finalist in the International Songwrit-ing Competition.

Brown also started collaborating with songwriter Scot Sax, who had chart suc-cess with a Philadelphia band called Wan-derlust. In 2005, Sax wrote the Top 10 hit “Like We Never Loved At All” for Tim McGraw and Faith Hill. Brown and Sax soon married, and she uses his actual last name “Sacks” in her medical persona.

Brown’s first dual-career opportunity

came at Einstein Healthcare Network in Philadelphia. However, the couple wanted to be part of a more vibrant musical com-munity so they decided to move to Nash-ville – and Vanderbilt was willing and able to accommodate Brown’s part-time requirement. It’s been a busy first year, though … new home, new job, and the musical duo welcomed a baby daughter just nine months ago.

Since coming to Nashville, Brown has been able to segment her two careers and avoid the obvious puns likes “achy breaky heart,” although that aptly describes her specialty. “I’m an advanced heart failure specialist,” she said. “I see patients before and after heart transplants, and those with heart-assist devices like the one Dick Cheney once had. My work is mainly in the clinical setting, seeing patients while training residents and fellows.”

Meanwhile, her musical career is doing quite well. Following her acclaimed debut “Heartstrings,” she has now re-

leased a second album titled “Almost There” (produced by Oliver Wood of the Americana group The Wood Brothers). It’s a showcase for her rich vocals remi-niscent of Bonnie Raitt, Linda Rondstadt and even Patsy Cline. The musical collec-tion also highlights a remarkable songwrit-ing breadth … from poignant love songs to “Fallen Down” about the young victims of the Sandy Hook shootings.

Like many other projects in the fast-changing music business, Brown’s new album was entirely fan-funded. “It lets us have complete control over publishing, and we own the master,” she said. “Plus it’s a great way to deepen relationships with our fans around the country.” Like most Americana artists, Brown’s website (suziebrownsongs.com) is the engine that drives those financial and fan connections, providing the latest tour schedules, photos and much more.

Brown and Sax frequently tour to-gether, which helps when you have a new-born. “Americana is wonderful because it’s lifelong music,” said Brown. “There’s no age cutoff like in most pop music. Alison Krauss, Robert Plant and Bonnie Raitt can keep playing for the Americana audience as long as they want.”

Music also gives Brown a much-needed break from the emotional intensity of treating patients facing life-and-death conditions. “I get emotionally involved because my patients are dealing with such difficult circumstances,” said Brown. “Per-forming helps me recharge and refocus.”

Despite her Ivy League credentials, Brown doesn’t seek recognition in the medical field. “I’m not looking for honors and awards. I just want to provide the best care I possibly can for my patients.”

But winning musical awards is an-other matter. After receiving the Emerg-ing Artist award at last year’s Falcon Ridge Folk Festival, there’s still plenty of room left on Brown’s mantel.

Suzie Brown Balances Two Demanding Careers

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How it WorksThe Micra TPS is recommended in

patients requiring a pacemaker for in-termittent, or permanent pacing of the right ventricle only (VVI or VVIR), and in those with no existing transvenous de-fibrillation or pacemaker devices in place. The minimally-invasive procedure lasts approximately a half-hour with the de-vice placed through a catheter running from the femoral vein into the heart. Ellis said the Micra TPS is a welcome change from traditional wire pacemakers, which require a much bigger surgery.

“You can walk out the door same day and be sure it’s going to work,” said Ellis, lead investigator for the Micra TPS clinical trial. Traditional single wire pace-makers require surgical incision, a device pocket created above the muscle, a trans-venous lead and a lot more hardware, said Ellis. Wire pacemakers also carry greater risk of complications including device infection, air leakage around the lungs and fractured leads under the col-larbone. While traditional pacemakers are necessary for certain diagnoses, Ellis expects the wireless, miniature technol-ogy to completely revolutionize cardiac care over the next decade. Patients don’t require antibiotics following implantation, and no surgical pocket means no wound checks. A tenth the size of a traditional pacemaker, the Micra TPS can last 12 to 14 years for intermittent pacing and six to 10 years when used for full-time pacing.

The device also is MRI compatible and capable of rate responsive pacing. “The watch-like battery is a very novel design, and the MICRA is pulled into the muscle nicely by tiny hooks which keep the pacing threshold very low,” Ellis explained. “You can also steer it right to where you want it, so there’s no hunting for healthy tissue like with traditional surgeries.”

Once positioned, the pacemaker is se-curely attached to the heart wall and can be repositioned or retrieved if needed. The pacemaker delivers electrical impulses

that pace the heart through an electrode at the end of the device. Vanderbilt is one of only 50 hospitals worldwide to use the investigational device, and the only trial site in Middle Tennessee.

Surgical Treatment of Pulmo-nary Hypertension

VHVI also is among an elite list of re-ferral centers offering surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH). Patients with this life-threatening condition often have a history of acute pulmonary embolism, or blood clots in the lung.

“We don’t know why some patients get blood clots in the lung and don’t re-solve it,” said VHVI cardiologist Ivan Robbins, MD, professor of medicine. “While most people resolve the problem with or without coagulation, clots turn into scar tissue for some.”

For that small percentage of patients, scar tissue causes obstruction in the pul-monary arteries, putting strain on the right heart and causing potential heart failure.

“Cardiologists and pulmonologists need to keep in mind that there will al-ways be a percentage of patients who don’t resolve clots, and we suggest they get follow-up imaging and care,” Robbins said. Diagnosing the problem is difficult and is confirmed by pulmonary angiogra-phy. Initial, nondescript symptoms often include shortness of breath, on oxygen and able to walk for only short distances without having to rest.

Big Surgery, Big ResultsFor the 400-plus CTEPH patients

who undergo surgery annually, pulmo-nary thromboendarterectomy (PTE) offers a second chance at life.

Robins said the surgery is sometimes confused with embolectomy. However, PTE is a high-risk, complex operation reserved for a specific type of patient. Patients are placed on the heart-lung ma-chine, and the body temperature is cooled to 64.4 degrees Fahrenheit. The chest is opened via median sternotomy, and the surgeon removes scar tissue from the lungs, operating on each side in 20-min-ute intervals.

Robins said results are immediate and extremely gratifying, as pulmonary pressure returns immediately to a safe level. One of fewer than 10 sites nation-wide to offer PTE, Vanderbilt has per-formed 40-plus surgeries since their first operation more than five years ago, with patient outcomes equal to those of the most prominent referral centers.

While physicians often know about treatment facilities in San Diego or North Carolina, Robbins said many are still un-aware about options in Middle Tennes-see. “People are starting to realize there’s surgical treatment for this,” he said of the life-threatening diagnosis. “It’s the only form of pulmonary hypertension that can be treated surgically and markedly im-proved, and many patients go on to live normal lives.”

AHA Releases Updated Worldwide, U.S. Heart & Stroke Statistics

Last December, the American Heart Association/American Stroke Association released updated heart and stroke statistics in the United States … and, for the first time in the 50 years such information has been provided, added a global perspective with health data compiled from nearly 200 countries.

Key findings from “Heart Disease and Stroke Statistics 2015 Update” include:

• Heart disease remains the No. 1 global cause of death with 17.3 million deaths annually. The annual death toll is expected to rise to more than 23.6 million by 2030, according to the report.

• Stroke, which has fallen to the No. 4 cause of death in the United States, remains the No. 2 cause of death in the world. Although the number of deaths per 100,000 declined worldwide between 1990 and 2010, the number of people having a first or recurrent stroke increased each year, reaching 33 million in 2010.

• In the United States, nearly 787,000 people died from heart disease, stroke and other cardiovascular diseases in 2011. Nearly 2,150 Americans die daily from cardiovascular diseases … or one person every 40 seconds … accounting for approximately 1 in every 3 deaths in this country.

• Additionally, about 85.6 million Americans are living with some form of cardiovascular disease or the after-effects of stroke.

• The AHA estimates direct and indirect costs of CVD and stroke in this country to be more than $320 billion.

• Breaking heart disease out separately from stroke in America, heart disease remains the number one killer in the United States with more than 375,000 dying annually … or about one person every 90 seconds.

• Nearly half of all African-Americans have some form of cardiovascular disease and more than 39,000 died from heart disease in 2011.

• On the plus side, the death rate from heart disease fell about 39 percent between 2001 and 2011. The physical and cost burden, however, remain incredibly high. About 735,000 people in America have heart attacks each year (accounting for approximately 120,000 deaths), and cardiovascular procedures and operations increased around 28 percent between 2000 to 2010.

VHVI Offering World’s Tiniest Pacemaker, continued from page 1

Dr. Christopher Ellis (R) and Janet Byrd, RN, along with colleagues, are testing the world’s smallest pacemaker.

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By MeLANIe KILgoRe-HILL

There’s good news for patients with drug-resistant, paroxysmal atrial fibril-lation (AFib). A clinical trial underway at TriStar Centennial Medical Center is offering hope through the reMARQable clinical study, which will assess the safety and effectiveness of the nMARQ™ Pul-monary Vein Isolation System in treating the condition.

One of only two reMARQable trial sites in Tennessee (Vanderbilt University Medical Center is also enrolling) and only 50 nationwide, TriStar Centennial has received interest from patients and physi-cians across the state, said Sybil Harrelson, director of operations for Cardiovascu-lar at Sarah Cannon Research Institute, which oversees the nMARQ trial.

Understanding AFibParoxysmal AFib is an episode of un-

coordinated movement of the atria that occurs occasionally and then stops. Epi-sodes can last from minutes to days before stopping and returning to normal sinus rhythm.

“In the past, conventional treatment was anticoagulation, rhythm drugs, and sometimes a patient could be shocked out of AFib,” Harrelson explained.

A newer option, catheter-based ab-lation can sometimes target and kill the tissue causing the irregular rhythm. How-ever, the challenge of paroxysmal AFib, said Centennial Heart’s Gregory Bashian, MD, lies in the high probability of recon-nection.

“In AFib there’s an abnormal heart rhythm coming from the top chamber,” explained Bashian, who is leading the nMARQ trial along with colleague Chris Jones, MD. “For patients with paroxysmal AFib, the focus of the ablation isn’t burn-ing just one spot but burning a perimeter around each of the four pulmonary veins.”

Cardiologists burn a circle around each vein to create a build-up of scar tis-sue in hopes of preventing reconnection of the faulty electrical path. Traditional ablation utilizes a tiny, single point tool to burn multiple sites in the shape of a ring around each pulmonary vein.

“Even in the best case scenarios, the success rate for this method is far from perfect,” Bashian said. “The majority of the time a second procedure is needed because of reconnection.” He noted that’s because point-by-point burning around four separate structures creates a very real chance of the slightest missed gap, leaving room for reconnection to occur.

The nMARQ AdvantageEnter the nMARQ™ Catheter Sys-

tem from Biosense Webster. The fully in-tegrated multi-ablation platform includes a ring-shaped catheter, allowing ablation with any or all of the seven to 10 catheter electrodes with the push of a button. It

also enables full isolation of the catheter loop, allowing for easier and faster map-ping.

“The premise of the new cath-eter is that it looks at and burns the tis-sue through a more contiguous lesion, which leaves less chance of developing gaps which would require repeat ablation down the road,” Bashian said of the inves-tigational device.

The trial is open to patients without prior ablation and with a diagnosis of par-oxysmal AFib. While it’s too early in the trial to measure nMARQ’s long-term suc-cess, Bashian said he’s been very pleased with safety outcomes to date.

“My hope is that this technology will improve both the efficacy and speed of ab-lation,” said Bashian.

CardioMEMS Offers Hope for Heart Failure Patients

The first wireless monitoring system approved by the Food and Drug Admin-istration for heart failure patients is also now available at TriStar Centennial.

The CardioMEMS™ HF System, which received approval last May, has been shown to significantly reduce hos-pital admissions when used to manage heart failure. The device made its na-tional debut in Nashville in 2007 when Saint Thomas West Hospital became the first program in the nation to successfully implant two patients with the monitoring system during the clinical research study.

Centennial Heart’s Thomas John-ston, MD, explained, “Patients with con-gestive heart failure have shortness of breath and swelling because the heart isn’t meeting the body’s needs. Some patients don’t need intensive monitoring, but oth-ers have severe swelling to where it’s diffi-cult to manage volume status. This device allows us to monitor that.”

Such patients are prone to frequent

TriStar Centennial Offering Latest for AFib, Heart Failure Patients

The nMARQ Team - Standing: (L to R) Vickie Braun, Jennifer Baxter, Dr. Gregory Bashian, Jeff Demiel, Casey Kappenman; Seated (L to R): Amanda Orrand, Susie Forczek, Ashley Crane. Not Pictured: Dr. Chris Jones

Novel Aortic Valve Replacement Trial Underway at Saint Thomas Heart

By MELANIE KILGORE-HILL

In June, Saint Thomas Heart became one of 27 cardiac programs nation-wide to offer an investigational “sutureless” prosthesis for patients in need of an aortic valve replacement. Participants are still being recruited for the TRANSFORM™ trial, a cardiac surgery for aortic stenosis that is expected to decrease surgery times and improve patient outcomes by using a next generation surgical aortic valve.

“The surgery utilizes three small sutures to place the valve, which traditionally takes 15-18 sutures around the valve,” said Evelio Rodriguez, MD, principle investigator for the trial’s Saint Thomas site. A balloon is then used to dilate the valve.

The TRANSFORM Trial is the first U.S. clinical trial of a rapid deployment system for surgical aortic valve replacement (AVR) proce-dures. The EDWARDS INTUITY valve system, which consists of a bovine peri-cardial heart valve and novel balloon-expandable frame, is designed to facilitate small incision surgery and rapid valve deployment with the goal of enabling faster procedures.

“As we move through smaller incisions, we can perform an aortic valve replacement in a less invasive manner,” Rodriguez said. “It saves time, which means the heart is stopped for less time, and the patient spends less time on the bypass machine.”

The multi-center trial by Edwards Lifesciences is expected to enroll be-tween 500 and 700 participants nationwide. In addition to Saint Thomas Health in Nashville, Baptist Memorial Hospital in Memphis is currently the only other participating trial site in Tennessee. For information on patient eligibility, exclu-sion criteria and other trial specifics, call Saint Thomas Hospital at (615) 222-3083 or visit clinicaltrials.gov.

Dr. Evelio Rodriguez

hospitalization. The ability to monitor a patient’s status without hospitaliza-tion saves time and money and keeps the patient’s health in check before major emergencies arise. Wireless monitoring of pulmonary arterial pressure can reduce heart failure hospitalizations in high-risk populations by nearly 50 percent and 30-

day readmissions by 78 percent, according to a recent trial presentation.

Smaller than a paper clip, the tiny pressure monitor is inserted through the femoral vein and implanted in the pulmo-nary artery. There it measures pressure and sends electrical signals to a monitor-ing device.

“It tells us what pulmonary artery pressures are, and an elevation suggests that the patient has volume overload and needs to increase diuretics,” Johnston ex-plained.

Previously, physicians would rely on medical history and symptoms like short-ness of breath and swelling and would then order lab work. Still, the process can be a guessing game for physicians of fre-quently hospitalized patients.

Johnston, who sees patients at TriS-tar Centennial’s Advanced Heart Failure Clinic, said the majority of heart failure patients can be managed through medica-tion and monitoring.

“We’re using new biomarkers that didn’t exist 25 years ago; and if patients can get on the right meds, they can do very well for a long time,” Johnston said. “Most patients don’t require these devices, but it’s very beneficial to those who are chronically ill. Not only will it reduce hos-pitalization, but it improves the quality of life for patients.”


By CINDy SANDeRS

Perhaps it should come as no surprise that there is a major divide between what Americans should do and what is currently being done when it comes adopting healthy cardiovascular lifestyle habits.

Based on data from the Framingham Heart Study – the landmark research project founded in 1948 by the National Heart, Lung, and Blood Institute – a re-cent multi-institutional study found few in the United States hit the mark … or even come close … in terms of scoring well on the American Heart Association Cardio-vascular Health score (CVH score).

“Ideal Cardiovascular Health: Asso-ciations with Biomarkers and Subclinical Disease and Impact on Incidence of Cardiovascular Dis-ease in the Framingham Offspring Study,” which initially published online in Circulation late last fall, investigated the correla-tion between the seven lifestyle factors used to calculate the CVH score and cardiovascular disease (CVD) incidence. Multiple past epidemiological studies have shown the correlation be-tween the risk factors and cardiovascular events.

The seven factors used collectively to calculate the CVH score are: 1) non-smoking status, 2) body mass index, 3) physical activity, 4) diet, and a favorable profile of 5) serum cholesterol, 6) blood pressure, and 7) blood glucose.

“The better your score, the lower your cardiovascular risk as evidenced by

less subclinical atherosclerosis and a lower risk of future cardiovascular events,” noted Thomas J. Wang, MD, director of the Division of Cardiovascular Medicine and physician-in-chief for the Vanderbilt Heart and Vascular Institute in Nashville and a co-author of the study.

“We know a lot of the health prac-tices that are associated with better car-diovascular outcomes, but there seems to be a disconnect,” added the professor of Medicine at Vanderbilt University Medi-cal Center.

Of the main findings, Wang contin-ued, “The number of individuals who had ideal cardiovascular health scores was low meaning the number of individuals who adhered to five or more of these healthy lifestyle practices was low.”

In fact, he added, only 1 percent of the Framingham participants included in the data (mean age 58 years; 55 percent women, no overt signs of CVD) had opti-mal marks for all seven. “Fortunately, hav-ing zero healthy lifestyle practices was also uncommon at about 1 percent of people. Most people did at least one thing asso-ciated with good cardiovascular health,” Wang said.

However, more than 8 percent did fail to meet the ideal CVH score for at least six of the seven lifestyle factors. “The vast majority of people were at four and below … 18 percent fell between five and seven,” he continued of scoring well on the seven benchmarks.

“The fact that such a small number of people actually meet all of the cardio-vascular health criteria highlights that there is still a big gap with current lifestyle practices,” he stated.

The group studied originated with the Framingham Offspring cohort par-ticipants attending the sixth examination cycle (1995-1998) when a routine assess-ment of subclinical disease was performed along with assays of multiple biomarkers. From the original group of 3,532 potential participants, more than 850 were excluded for a variety of reasons ranging from prev-alent CVD to unavailable concentrations of biomarkers. While Wang said none of the final sample of 2,680 participants had overt heart disease at the beginning of the study, during the 15 years the cohort was followed after the baseline examination, a significant number of them developed car-diovascular events. He noted those who developed a CVD event tended to have lower CVH scores at baseline.

“I think people feel as if we’re mak-ing a lot of progress with cardiovascular disease, which is true … but it’s still the number one cause of death in America,” Wang stressed.

“Physicians could probably do a better job of encouraging their patients to adhere to these healthy practices and give them strategies for adherence, and patients need to do a better job of adher-ing to them. I think, as with all things in medicine, it is a joint effort,” Wang said.

While the study findings might seem intuitive to some extent, Wang pointed out, “It is important to continually remind physicians about the fundamental impor-tance of healthy lifestyle factors in lower-ing the risk of cardiovascular events.” He added, “It also serves as motivation for the scientific community to better understand the biological mechanisms linking lifestyle factors such as diet and exercise to lower cardiovascular risk.”

Wang recognized medical interac-tions occur in very tight timeframes these days, which makes it difficult for provid-ers to cover the full spectrum of useful

information with patients. However, he noted, there are a number of organiza-tions at the national level – including the American Heart Association and National Heart, Lung, and Blood Institute – that offer excellent tools and resources that can be printed or accessed online to help patients better understand the importance of healthy lifestyle strategies.

“It’s clear that a better lifestyle would not just be associated with better cardio-vascular outcomes but also with less death from cancer and other diseases, as well,” Wang concluded of the critical need to change American habits.

Affairs of the HeartAmericans & Cardiovascular Health

Dr. Thomas J. Wang

How We Stack Up on the Seven CVH Score FactorsAccording to recent American Heart Association statistics, there is a great

deal of work to do to improve ‘Life’s Simple 7’ … the seven key health factors and behaviors that increase risk for heart disease and stroke. Below is a sample of key findings from the latest statistical update.

SmokingWorldwide, tobacco smoking and secondhand smoke was one of the top

three leading risk factors for disease and contributed to an estimated 6.2 million deaths in 2010.

Despite improvements in smoking rates and education, 16 percent of students grades 9-12 report being current smokers. Among adults, 20 percent of men and 16 percent of women are current smokers.

Physical ActivityAlmost one-third of adults in the United States, 31 percent, report

participating in no leisure time physical activity.Among students 9-12, only about 27 percent meet the AHA recommendation

of 60 minutes of exercise every day.

Healthy DietLess than 1 percent of American adults meet the AHA’s definition of ‘ideal

healthy diet’ and essentially no children met the definition. Increasing whole grains and reducing sodium remain two of the biggest challenges.

Research between 1971 and 2004 showed American women consumed an average of 22 percent more calories and men an average of 10 percent more by the end of that time frame.

Overweight & ObesityMore than 159 million U.S. adults … 69 percent … are overweight or obese.Additionally, nearly one-third of American children … 32 percent … are

overweight or obese with about 24 million being classified as overweight and 13 million as clinically obese.

CholesterolAbout 43 percent of Americans have total cholesterol of 200 mg/dL or higher,

and about 13 percent of Americans have total cholesterol over 240 mg/dL.About 33 percent of Americans have high levels of LDL and around 20

percent have low levels of HDL.

High Blood PressureAbout 80 million U.S. adults, or 33 percent, have high blood pressure. Of

those, about 77 percent are using antihypertensive medication(s), but only about 54 percent have their condition controlled.

Hypertension is projected to increase by about 8 percent by 2030.Rates of high blood pressure in African-Americans are among the highest of

any population in the world. In the United States, 46 percent of African-American women and 45 percent of African-American men have high blood pressure.

Blood Sugar/DiabetesAbout 21 million Americans … or nearly 9 percent of the adult population …

have diagnosed diabetes. Another 35 percent of Americans have pre-diabetes.

Williamson Medical Center Opens Pulmonary Rehab Unit

Williamson Medical Center’s Cardiac Rehab program recently added pulmonary rehab as its newest rehabilitation service offered. The programs will function out of a newly renovated 5,100-square-foot space across the hall from Cardiac Rehab’s existing home on WMC’s campus.

WMC Chief Operating Officer Julie Miller said the success of WMC’s Cardiac Rehab program, which consistently has a six-week waiting list, made a new, larger space a necessity to continue to meet the needs of the community.

Adding pulmonary rehab to the mix, according to Ashley Perkins, WMC’s associate administrator for nursing, was driven by a clear need in the community.

“Currently, pulmonary rehab services are not available in Williamson County,” Perkins said. “When a patient needs this therapy, they are referred to other facilities out of the county. Offering this service will allow residents to receive treatment in their own community.”


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By CINDy SANDeRS

Coming off a banner year for merg-ers and acquisitions in the healthcare in-dustry, it’s easy to believe most deals are smoothly completed. Yet, those who have been involved in M&A activity would be quick to say even the most success-ful transactions are time consuming and disruptive. Going in, the hope is that any short-term pain will be alleviated by long-term improvements.

Cindy Reisz, member at Bass, Berry & Sims PLC, recently shared thoughts on four steps sellers can take during the due diligence phase to ensure the pro-cess works as efficiently as possible. Reisz, who serves on the American Health Lawyers Associa-tion Board of Directors, has deep transactional and operational experi-ence within the healthcare industry.

Keep Compliant“One of the things we see with clients

is those who have a true culture of compli-ance in the way they operate get through the process more easily,” Reisz observed.

She said hospital systems that rou-

tinely have lawyers and auditors look at financial arrangements and compliance with the Stark Law and Anti-Kickback Statute won’t be taken by surprise when a potential buyer delves into their history. “The method by which you are conduct-ing your business is not going to expose you to risk,” she said of that type of opera-tional mentality.

Besides, Reisz added, it’s how day-to-day business should occur anyway. “You never want to have to be concerned if the OIG comes to visit or a payer wants to do an audit,” she pointed out.

That said, such operational transpar-ency doesn’t always happen. Reisz noted in recent years buyers have increasingly made self-disclosure a condition of closing the transaction.

“They do not want any lingering li-ability coming with the closing,” she said of buyers requiring sellers to self-report any potential Stark violations to the Cen-ters for Medicare & Medicaid Services and anti-kickback issues to the Office of the Inspector General.

She added such assertions by a buyer could really put the seller in a tough posi-tion … especially when the seller disagrees that any wrongdoing has occurred. Po-tentially a seller might have to choose be-tween reporting an incident they believe

to be unwarranted or losing the deal.“If you’ve crossed all your t’s and

dotted all your i’s along the way, you shouldn’t run into any potential viola-tions that would require self-disclosure,” Reisz said of having business practices and transactions stand up to scrutiny.

Centralized DataSellers can make it much easier for

buyers to work through the myriad details that make up any healthcare business – from a physician practice or health system to a services company or consulting firm – by centralizing information. Reisz said the process is much more manageable if physician contracts, lease arrangements, valuations, equipment leases and other useful data points are kept in a central re-pository.

This is especially important for health systems that have hospitals across the country, large physician practices with multiple offices across a region or industry service providers that have a presence in a variety of locations throughout the nation.

While it’s important to have central-ized records in order to prepare for the scrutiny that comes along with selling, Reisz said really it should just be standard operating procedure. Having data from multiple sources and geographic regions

flow into one location allows a clinical or service provider to more easily analyze op-erational efficiencies and share best prac-tices across the enterprise.

Consider the Culture“I think it is important for both par-

ties … both the buyer and the seller … to look long and hard at what is the cor-porate identity of the other party,” Reisz said.

There is more than one ‘right’ way to strategically conduct business, but if two potential partners operate in very different manners, it could be difficult to marry the two philosophies.

A common example, Reisz said, might be trying to merge two hospital systems where one utilizes a highly inte-grated physician employment model and the other relies on medical director agree-ments or co-management arrangements where physicians also maintain an inde-pendent practice. “It will be hard to merge those two different models. It can be done, but it requires a lot of effort,” Reisz noted. “If you’re more integrated, it’s hard to buy into that other strategy … both work, but they are very different approaches.”

Reisz added that given the expense to unwind a failed merger, she thinks both

Four Considerations Before You SellAppropriate Due Diligence Eases M&A Transactions

Cindy Reisz

(CONTINUED ON PAGE 11)


By CINDy SANDeRS

Capella Healthcare, Inc. ended 2014 with a flurry of activity to help strategi-cally grow the company through a variety of mechanisms including new acquisitions and partnerships.

Michael A. Wiechart, who was named Capella’s president and CEO in January 2014 after serving five years as senior vice president and chief oper-ating officer of the com-pany, recently shared some of his thoughts on growing and adapting to meet the needs of a changing healthcare de-livery system. Capella, which was recognized by Modern Healthcare as one of the country’s fastest growing healthcare companies in 2012 and 2013, now owns and/or operates more than a dozen acute care and specialty hospitals in seven states — Arkansas, Missouri, South Carolina, Oklahoma, Oregon, Tennessee and Wash-ington.

The latest acquisition expanded Ca-pella’s presence in South Carolina. “We recently consummated the Carolina Pines Regional Medical Center transaction and came into 2015 very excited to have that facility as part of the Capella family,” Wiechart said.

The community hospital in Hartsville, S.C. and its related outpatient services were previously subsidiaries of Commu-

nity Health Systems, Inc. This latest move comes shortly after Capella announced a clinical collaboration with the Medical University of South Carolina (MUSC) and the formation of Midlands HealthONE Network, a regionally-based healthcare de-livery network.

“Healthcare providers are building clinically integrated networks and forging other partnerships because to be competi-tive in the future, providers will need to demonstrate that they can delivery qual-ity outcomes and cost-effective care while staying attuned to the needs of local com-munities,” Wiechart said when the MUSC partnership was announced in late Novem-ber.

He told Nashville Medical News creating value for local communities and physicians is central to Capella’s mission. By providing governance, support and resources to appro-priately grow a local health system’s medical staff and service lines, Wiechart said Capella can help communities keep a robust delivery system in an era of dramatic change.

“Our focus as an organization has al-ways been based on two things – patient care excellence and a decentralized leader-ship model, which we believe provides the best platform for promoting growth organi-cally,” he explained. He added the value proposition is to deliver high quality patient care while effectively beating the competi-tion.

In addition to growth strategies such as acquisitions and integrated care partner-ships, Capella also has a collaborative rela-tionship with Saint Thomas Health. “The difference is the Capella-MUSC relation-ship is a clinical integration model whereas Capella-Saint Thomas is a true equity partnership,” he explained. Wiechart con-tinued, “Each market is going to have nu-ances about it so that I don’t think you can take a cookie cutter approach.”

However, he added, he does see a shift towards complex clinical partnerships that move away from a siloed approach to care delivery and are based on regional relation-ships. He also said he thinks the trend of physician employment by a health system is a market reality that will continue to ac-celerate.

With hospitals in various regions of the country, Wiechart has a first-hand view of geographic differences in both health sta-tus and in standards of care. “It’s why we don’t think national solutions are the best option but more of a regional approach,” he explained.

He also said shifting population needs have resulted in a much heavier empha-sis on care in the outpatient setting. “The movement from inpatient to outpatient is good for the industry as a whole from the perspective of quality of care and cost … and is something we support,” Wiechart said. While that might seem odd coming from a company that owns and operates hospitals, Wiechart noted the company’s focus is shifting to meet the new reality.

“We are a multisite provider and not just necessarily inpatient providers,” he ex-plained. “Within Capella, three out of every four dollars that we are investing in patient care are in the outpatient enterprise. Ten years ago, that was just the opposite.”

Wiechart added this new reality also in-creases the need for smaller, non-urban hos-pitals to find a strategic partner like Capella to help them continue to do what they’ve always done … care for communities.

Strategic Growth:The Health System Perspective

Capella President & CEO Mike Wiechart (far R) looks on as the new Midlands HealthONE Network logo is unveiled during an event welcoming Carolina Pines Regional Medical Center to the Capella family.

Recent Middle Tennessee School of Anesthesia graduate Mindy Mullins, DNAP, CRNA, received the inaugural President’s Medal for her innovative cap-stone project that focused on improving the accuracy of blood pressure measure-ment for obese patients.

Mullins, who works as a CRNA at Baptist Memorial Hospital – North Mis-sissippi in Oxford, said the idea stemmed from her experience working in her hos-pital’s Bariatric Center of Excellence. “We care for a high percentage of indi-viduals who are obese. The simple task of blood pressure measurement is difficult at times,” she said.

Due to the extra weight impact-ing the upper arm’s shape and size that causes poor blood pressure cuff fitting, Mullins said it is common to place the cuff on the forearm. “Either the cuff doesn’t wrap properly around the upper arm, or it extends below the antecubital fossa,” she noted. “Because CRNAs rely on the blood pressure measurement to assess a patient’s hemodynamic status and anesthetic depth perioperatively, I became curious. Is the blood pressure measurement from the al-

ternate approach valid?”For her capstone project, Mullins re-

viewed 42 studies and honed in on an ad-ditional 15 studies dating from 1956-2013 focused on upper arm vs. forearm nonin-

vasive blood pressure measurement and found concerns about accurate readings are warranted. Her research uncovered:

The findings of extant evidence and manufacturers of oscillometric monitoring devices discourage a forearm approach in obtaining blood pressure measurements.

The quality of evidence strongly war-rants further investigation of the approach in obtaining valid measurements with uni-fied measurement methods, data collec-tion procedures, and validated tools.

In the presence of numerous co-morbidities or complex positioning with improper noninvasive blood pressure measurement technique, invasive moni-toring should be considered in patients who are obese to avoid perioperative com-plications.

Mullins is now conducting a study to compare the accuracy of GE Critikon radial cuffs – a cuff validated for forearm blood pressure measurement – with the correct-sized upper arm cuff in obese indi-viduals. Her study could potentially be the first to use a validated tool on the forearm versus a validated tool on the upper arm and impact best practices going forward.

During the recent graduation ceremony, MTSA President Dr. Kenneth Schwab (L) congratulates Mindy Mullins, who proudly wears the President’s Medal she was awarded for her capstone project.

MTSA Capstone Project Highlights Blood Pressure Accuracy in Obese Patients

M&A Conference Scheduled for NashvilleApril 27-28Omni Nashville Hotel

More than 30 speakers will converge in Nashville for the Investment and M&A Opportunities in Healthcare event slated for late April at the Omni Hotel. The eighth annual conference and networking event hosted by the International Institute for Business Information & Growth (iiBIG) brings together healthcare executives, investors and dealmakers. For more information or registration details, go online to iibig.com/HealthcareMA/Nashville.

Michael A. Wiechart


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By CINDy SANDeRS

After a record-setting year of mergers and acquisitions in the healthcare sector for 2014, a recent survey by U.S. audit, tax and advisory firm KPMG LLP indicates 2015 will offer more of the same.

A number of considerations ranging from cash-rich balance sheets to changing business models driven by the Affordable Care Act to easier access to capital are ex-pected to fuel the continued feeding frenzy for those looking to enlarge their corporate footprint. Conversely, for those facing in-creasingly tight margins and regulatory oversight, the timing could be right to take the money and run.

“We are seeing a convergence of fac-tors facing providers, health plans, and drug and device makers that are forcing them to make tough decisions about strat-egy,” noted Bill Baker, the national partner in charge of transaction services for KP-MG’s Healthcare & Life Sciences Practice. He added those hard decisions sometimes include selling their business or practice.

Texas-based Baker, continued, “Technology, regulation, consumerism and pushback from employers and gov-ernment payers are reshaping all facets of healthcare, forcing companies to review all of their options. The capital markets – low

Experts Predict Another Year of Robust Healthcare M&A

Health Care Council’s Annual Wall Street Analysts Provide 2015 PredictionsIn late January, top investment analysts gathered to discuss 2015 industry predictions as part of the Nashville Health Care

Council’s annual Wall Street panel.More than 500 healthcare executives gathered for the discussion moderated by Wayne T. Smith, chairman and CEO of

Community Health Systems. Panelists included Darren Lehrich, managing director, Deutsche Bank; Josh Raskin, managing director, Barclays; A.J. Rice, managing director, UBS; and Paula Torch, senior research analyst, Avondale Partners.

The analysts identified acute care, behavioral health, physician services and ambulatory surgery centers as top sectors for growth in 2015.

“Healthcare facilities have recently excelled in the marketplace, and as the ACA is implemented, growth could continue as more people gain coverage and the amount of bad debt for hospitals declines,” said Lehrich.

Rice added, “As long as hospitals are able to control costs and better manage readmissions, they can expect positive growth under the new reimbursement models that are emerging as a result of the Affordable Care Act.”

Continued consolidation across the industry also was an ongoing theme. Raskin said passage of the ACA in March 2010 arguable created the biggest change in the healthcare landscape since 1965 and has led to what would have previously been considered ‘strange bedfellows.’ He noted the industry has recently seen surgery centers come together with staffing companies, acute care providers buy home health agencies, and dialysis companies acquire delegated provider groups, among other interesting M&A activity. “I think that will continue as providers expand their reach across the entire continuum of health delivery,” Raskin predicted.

Torch noted she also expects to see consolidation continue in 2015. “An area of continued potential is the behavioral space, and much of that momentum is occurring right here in Nashville, home to interesting players in that niche,” said Torch.

In addition to discussing the Affordable Care Act’s impact on the market, speakers offered insights on the upcoming Supreme Court Case of King v. Burwell. The case is challenging the use of tax subsidies on the federal exchange. “The industry as a whole, as well as consumers, could be hit with higher costs if tax incentives are taken away as a result of King v. Burwell so investors are keeping a close eye on the case,” said Torch.

Pictured (L-R) Wayne Smith, Darren Lehrich, Paula Torch, Josh Raskin, and A.J. Rice.

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interest rates and strong valuations – are creating favorable conditions for those con-sidering selling or divesting assets.”

The Year That WasThe Associated Press recently reported

2014 was one of the most active years for healthcare M&A activity in the last decade. KPMG noted that through the first three quarters of 2014, deal value across all in-dustry sectors reached nearly $1 trillion, re-turning the United States to pre-recession levels.

Irving Levin Associates, a leading healthcare market intelligence firm based in Connecticut, seconded the sentiment with data showing similar transaction in-creases specific to the healthcare industry. In nine of 13 healthcare industry sectors, there were an increased number of deals for 2014 in comparison to 2013. Through Dec. 19, 2014, Levin’s The Health Care M&A Information Source had captured 1,208 deals across healthcare, which was an increase of 17 percent over 2013. Spending also was up significantly for deals in 2014 v. 2013 at $386 billion compared to $163 billion.

Leading the way in transactions was eHealth (up 65 percent in 2014) and bio-technology (up 50 percent). Long-term care, managed care, pharmaceuticals,

rehabilitation and other services also had double digit increases in deal activity for 2014 over 2013.

Behavioral health and medical devices had more modest gains at 6 percent and 4 percent, respectively. However, transactions are anticipated to be strong in the coming year. Nashville-based Acadia Healthcare led the way in the behavioral health mar-ket with a fourth quarter announcement the company would purchase CRC Health Group out of Cupertino, Calif., which has more than 140 programs treating 44,000 patients daily. The transaction, estimated to be valued at nearly $1.2 billion, is expected to close in the first quarter of 2015.

2015 M&A Outlook SurveyLooking ahead, KPMG, in collabora-

tion with SourceMedia’s Research Practice Group (publisher of Mergers & Acquisi-tions), surveyed 738 M&A professionals in the United States last fall about anticipated activity across a broad spectrum of indus-

tries. Survey participants work in senior management at companies advising an array of industries including healthcare, en-ergy, financial services, technology, manu-facturing, and consumer products.

Of those surveyed, a full 82 percent said they were planning at least one ac-quisition in 2015 and 10 percent said they expected to do 11 or more deals this com-ing year. Perhaps not surprisingly, deals touching the healthcare industry, which is in the midst of transformative change, were predicted to lead the way with 84 percent of the experts saying they expected heavy healthcare activity.

Almost half of respondents (47 percent) expect technology companies, including those tied to the healthcare industry, to be the most active individual industry sector for mergers and acquisitions. Coming in second, nearly one-third of the profession-als anticipate pharmaceuticals and biotech-nology to be the most active M&A sector in 2015. Expiring patents for a number of leading drugs plus the need to hone product portfolios to build ‘franchises in key treat-ment categories’ are two factors behind the anticipated jump in activity for the pharma/biotech industry.

Additionally, 27 percent of the experts think healthcare providers are ripe for con-solidation and cited forces tied to the ACA as being the primary driver of such moves. However, regulatory factors are expected to play an increasingly prominent role in de-cision-making on the front end considering the Federal Trade Commission’s scrutiny of several large deals last year.

Among those being surveyed, some due diligence issues were seen as a bigger factor within the healthcare industry than in other sectors. In addition to how a merger or acquisition might impact the competitive landscape, healthcare providers also are perceived as being more concerned about cultural shifts when joining forces. The ex-perts cited the cultural assessment as being a larger factor for healthcare companies in comparison to all industries (32 percent v. 28 percent).

“Mergers and acquisitions are never easy for everyone involved,” Baker pointed out. He added that negotiating a favorable and mutually acceptable transaction is just the first step. “Managing the various stake-holders of ownership, employees, customers and vendors during an integration process can be daunting … and, if not executed properly, can destroy the very benefits the transaction was modeled on generating,” Baker said.

Another due diligence issue expected to factor prominently in healthcare transac-tions is volatility of future revenue streams, which was cited as a key issue among re-spondents for healthcare companies at a rate of 58 percent as opposed to ‘all indus-tries’ at 51 percent. Interestingly, ‘quality of earnings,’ while still a key due diligence factor for the healthcare sector, trailed in-dustry averages at 29 percent for healthcare companies compared to an average of 42 percent for all industries.


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By CINDy SANDeRS

Middle Tennessee’s largest, indepen-dent, multi-specialty practice is getting a little bigger with the announcement that Heritage Medical Associates is acquiring Summit Medical Associates.

The deal, which was announced in mid-December, creates a combined entity with 14 locations in six cities across three counties with 136 providers serving an ac-tive population of 150,000 patients. With the acquisition, Heritage Medical Associ-ates will have physicians and advanced practice providers in 15 specialties includ-ing four primary care specialties – family practice, internal medicine, pediatrics, and combined internal medicine and peds.

Chetan Mukundan, MD, FAAP, president of Heritage, noted the deal was almost a decade in the making. Recently approached by Summit’s physician leader William Baucom, MD, the gen-esis of the merger started many years earlier. “There is a history where Heritage and Summit had previous discussions about nine years ago, but the consensus was the timing wasn’t right then.”

What the two groups did realize dur-ing those early meetings was how closely

aligned their practice philosophies were. “It’s like looking in a mirror,” Mukundan said. That belief has been reinforced over time as the two worked together as part of the Synergy HealthCare accountable care initiative.

“We have followed the success of Summit for many years. The practice’s holistic approach to patient care, coupled with their primary care emphasis and dedicated, professional team, directly align with our business model,” Mukun-dan said.

He noted, “We realized that their cul-ture is very similar to our culture. What made this stand out is they practice very similarly to us. The goal is quality care de-livered at a lower cost.”

Despite the good fit however, Mukun-dan said the decision to join forces wasn’t made lightly on either side. “The due dili-gence was unbelievable,” he said. “We in-vestigated this incredibly thoroughly; but the more we looked at it, the more it made sense”

The similarities extended beyond the philosophical to the practical. “The two organizations are using the same elec-tronic health system, which will make the transition seamless,” Mukundan said, add-ing both practices have in-house IT pro-fessionals who are working together on the data migration. Mukundan said the resulting larger practice also benefits both

groups by combining some administra-tive functions and by lowering overhead through increased volume. “There are resources we have that will benefit them, and resources they have that will benefit us,” he added. “As we grow together, we will leverage our insights and expertise to benefit the patients and communities we serve.”

For Heritage, those benefits include adding the specialty of hospital medicine to the practice and extending their geo-graphic reach into the Hermitage and Mt. Juliet areas of Middle Tennessee. “It was a part of town where we weren’t engaged at all,” Mukundan explained.

While this merger made sense, Mukun-dan said he didn’t foresee Heritage routinely absorbing other practices. “I don’t think our goal is to take over Nashville healthcare,” he said with a laugh, adding it would have to be the right practice at the right time to consider another acquisition. But, he added, “We’re always willing to listen.”

Whether or not Heritage partners with other groups in the near future, Mu-kundan said the practice would continue to seek methodical, intentional opportuni-ties to grow. The shareholders, he noted, regularly evaluate the need to add special-ties or expand those already being offered.

“We try, as an organization, to allow

individual departments to have the say on those sorts of growth issues,” he said of in-creasing clinical staff and services. “If the individual departments are spearheading those decisions, it’s always more effective.”

Stability is another important con-sideration. “We’re always looking to the future. We know we have doctors in the twilight of their careers so we have to have a game plan to make sure patients stay covered,” he said of succession planning. Another growth consideration is strategi-cally expanding the practice’s geographic catchment area to reach new patients.

While many practices and physicians have opted to become hospital employees, Mukundan said the merger of Heritage and Summit is an example of how multi-specialty practices can not only survive but thrive. With a robust infrastructure in place and a good relationship with hospi-tals across Middle Tennessee, the physi-cians enjoy the flexibility that comes with being independent. “We can see our pa-tients where they need to be seen and send them where they need to go,” he said, not-ing he routinely sees patients at three dif-ferent area hospitals.

“I think the physicians all cherish the fact that we’re independent,” Mukundan concluded. “We can’t fathom relinquish-ing that because it’s part of who we are.”

Strategic Growth:The Practice Perspective

Dr. Chetan Mukundan

Bonus EditorialGo online to www.NashvilleMedicalNews.com to read

additional articles about Cardiology and Mergers & Acquisitions.

parties are increasingly paying attention to the issue of culture on the front end.

Careful Communication & Competition

Reisz noted the Affordable Care Act encourages integration, but she said some providers are struggling to find the sweet spot where they have enough critical mass to drive quality and take advantage of operational efficiencies that lower costs without being so large that they quash all competition. Size alone isn’t the tipping point, Reisz said; instead, it really comes back to perceived competitive advantage.

“When you have a community that had some competing entities, and one dominant provider begins to acquire many of them, those acquisitions would probably get you on the radar,” she said of attracting the attention of the Department of Justice or Federal Trade Commission.

Reisz continued, saying it is critical to “make sure when you are considering a merger that may give you market power that you are very careful not to use that market

power in an anti-competitive manner.” Casual emails discussing pricing or

competitive advantages have derailed more than one deal and landed involved parties in hot water. Reisz said potential partners “should be very careful in how they describe their transaction and the goals. Raising prices,” she stressed, “can-not be one of your main goals.” Not sur-prisingly, payers are particularly sensitive to any hint of collusion when it comes to negotiated contract rates or of price fix-ing.

While it’s clearly necessary the poten-tial buyer be provided a general financial picture when evaluating whether to pro-ceed with a transaction, Reisz said fee schedules and specific contracts should not be shared. Instead, information should be provided in aggregate or given to a third party ‘clean team’ to de-identify, analyze and summarize the sensitive data.

It’s important to realize that not every deal gets done. “Think of yourselves as competitors until the transaction closes,” Reisz advised.

Four Considerations, continued from page 7


By KeLLy PRICe

What if … your child needs his shot records so he can play in his team’s first game of the season … which is scheduled for this afternoon … and today is Satur-day?

What if … your 87 year old mother is whisked off to the hospital in an ambu-lance, and you don’t know where she keeps her living will?

What if … you trip over a fallen rock in Ephesus and break your ankle? How will the Turkish hospital know about your pain medicine allergies?

Before it is desperately needed, most would agree we all should take control of our health records and manage our per-sonal and family medical information so that we would be able to access it any place, any time. The good news is there’s now an app for that.

Healthspek, a local company based in Brentwood, has created a nationally rec-ognized tool that allows anyone to manage their own personal healthcare information and legal documents, such as living wills and powers of attorney, in a secure format that can be accessed anytime, day or night, wherever they are.

The tool streamlines all of the infor-mation anyone might need in a medical emergency into a personal profile. Man-aged with an iPad app and mobile web-site, an individual’s data is duplicated and stored on Healthspek’s secure cloud server and can be accessed from a desktop or smart device from anywhere in the world.

Healthspek was founded by industry veterans Bruce LeFew, company COO, and Randy Farr, who serves as president and CEO, to fill a need to be able to track, collect, and manage patients’ healthcare

information, especially in response to a growing national demand for the mean-ingful use of electronic health records.

Through thousands of “speks,” or bits of information, consumers can manage and access everything from their vital stats, prescription reminders and lab records to a knowledge library on medical conditions, family medical history, and appointment reminders. The app also has allergy and drug interaction information on a plat-form designed to suit individual needs. In addition, users can store insurance infor-mation, emergency contacts and can even include a personal photograph and signa-ture. Users can upload existing electronic documents or simply upload a picture of the document to be stored.

Since its introduction in 2013, Health-spek has received numerous accolades including being listed under the Apple App Store’s permanent list of best “Per-sonal Care Apps” in the medical category. Healthspek has also been named a “Top-Five Best Medical and Health Care” app

by TabTimes and won MediaPost’s Apply Award in the medical category. LeFew and Farr also were selected to pitch their prod-uct to thousands of consumers and prospec-tive investors at AARP’s national expo in May 2014, becoming one of 10 finalists out of nearly 200 companies to win a coveted spot at the health innovation event.

The developers said they believe Healthspek will become the “go-to-place” for consumers and patients to seek and use healthcare information. The free app is equipped with an easy-to-understand dash-board that not only allows users to consoli-date all their important medical information in one place but also to utilize that info in a meaningful way to manage conditions and improve health. They added that because of this access to information, patients will be able to “ride the wave and understand the system” in a way that is not possible now but will be demanded by users as healthcare consumerism continues to grow.

“Today’s healthcare environment is putting the power back in the hands of the people, and we see that as very positive,” Farr said.

The patient controls his record and has the ability to give information when he or she chooses to family members, caregiv-ers, and providers. With permission from the user, physicians can access medical records through Healthspek’s chartnow.com. Other commercial partners might make suggestions for appropriate product pop-ups based on a consumer’s personal health record, data, locations or insurance.

Additionally, LeFew and Farr said Healthspek could add value to a medical practice by helping meet Meaningful Use requirements for patient access, as well as by sending appointment reminders, on-line appointment scheduling, and health reminders to increase patient compliance.

“These documents – such as a liv-ing will – can be linked and displayed on Healthspek’s ChartNow webpage, allow-ing doctors or other eligible individuals to view important documents,” Farr said.

He continued, “If you are the head of a household, this can give you the peace of mind that your loved ones can quickly access important legal documents should they need to; and if you are a caregiver, you can keep track of your patient’s daily medications, power of attorney, living will, doctor’s appointments, therapy visits and more … all of this in one place.”

Chris Moore, MD, former chief medi-cal officer of Hutchison Medical Center in North Georgia and a founder of the recre-ational organization Outdoor Chattanooga, said the legal document repository is a po-tentially lifesaving feature and a ground-breaking tool for both doctors and patients.

“From the perspective of a trauma physician, I can readily imagine a situation in which access to Healthspek’s records could affect a life-or-death decision for the patient and his or her family,”

Moore said. “It is as simple as up-loading and storing this information, and it guarantees that the patient’s wishes are recorded and respected.”

Healthspek Helps Consumers Take Control of Their Health Records

HealthcareEnterprise

Bruce LaFew Randy Farr

san political analyst. “We’re adding a new post-keynote reception for networking and peer-to-peer interaction,” she continued.

Other confirmed speakers and panel-ists include:

• Former U.S. Senate Majority Leader Tom Daschle, founder and chairman of The Daschle Group, a public policy advisory of Baker Do-nelson;

• Anne Filipic, president of Enroll America, a non-government entity charged with educating the public on health insurance options;

• Sarah Thomas, research director for Deloitte Center for Health So-lutions;

• U.S. Senators Lamar Alexander and Bob Corker (R-TN) and U.S. Representative Jim Cooper (D-TN);

• Yvette Fontenot, partner at Av-enue Solutions, an all-female, all-Democratic firm specializing in representing pro-business interests on Capitol Hill with specific exper-tise in healthcare, energy, financial

services, education and telecommu-nications;

• Mary Grealy, president of the Healthcare Leadership Council, a coalition of chief executives from all disciplines within healthcare who jointly develop policies, plans and programs for a 21st century health-care system; and

• Cheryl Jaegar, principal with lobby-ing powerhouse Williams & Jensen.

“The second day is really geared to-ward speakers with a legislative focus,” Bradley noted. “We typically will meet with legislators from the Ten-nessee delegation.” The group also interacts with panelists comprised of key congressional staff members and emissaries from the Obama Admin-istration including repre-sentatives from the Centers for Medicare and Medicaid Services and the Depart-ment of Health and Human Services.

“We will be in the offices at 101 Con-

stitution on the second day … a new loca-tion … with incredible views of the Capitol and parts of the mall,” Bradley noted.

Although the group will include a number of first-time participants, Bradley credited the strength of schedule and in-teractive nature of the trip with enticing local industry leaders to make this an an-nual pilgrimage.

“I think what keeps them coming back is the content and agenda,” she said, adding the staff at the Nashville Health Care Council is mindful of keeping the programming fresh, timely and relevant. “The second is the peer-to-peer interac-tion,” she continued. “We really see it as our duty as an organization to create an environment that speaks to both of those delegate priorities.”

Although the registration deadline was set for February 4, Bradley was quick to add anyone interested should call (615) 743-3140 even after that date to see if space might still be available. For more information on the trip, go online to healthcarecouncil.com, click on Leader-ship Health Care.

LHC Prepares for Annual D.C. Delegation, continued from page 1

Jenni Bradley

Tennessee is TopsTennessee ranked in the top

five for states prepared for out-breaks of infectious disease. In a new report from the Trust for America’s Health and Robert Wood Johnson Foundation, most states were found to be unprepared to handle outbreaks threatening pub-lic health like Ebola or tuberculosis. The report gave pass/fail grades on 10 measures of preparedness like public health funding, flu vac-cination rates, and the speed of lab tests. About half the nation’s states failed five or more measures, but the top five states (Maryland, Mas-sachusetts, Tennessee, Vermont and Virginia), passed eight of the 10.


Joseph Webb named Nashville General Hospital CEO

At the end of last year, the Met-ropolitan Nashville Hospital Authority (MNHA) Board of Trustees announced the appoint-ment of Joseph Webb as chief executive officer of Nashville General Hospital (NGH) effective January 5.

Webb, a veteran healthcare executive with more than 25 years of ex-perience, formerly served as chief opera-tions officer for Common Table Health Alliance in Memphis. Prior to this role, he was COO at Northwest Mississippi Regional Medical Center in Clarksdale, Miss. Webb also held several executive leadership positions at Methodist LeBon-heur Healthcare, including CEO of Meth-odist South Hospital in Memphis and vice president of operations at Methodist Uni-versity Hospital, also in Memphis. Earlier in his career, he also served as CEO at HSA Coastal Carolina Hospital in Myrtle Beach, SC.

Webb completed both his under-graduate and master’s degree at Tennes-see State University and earned both a doctorate of science and a master of sci-ence in Hospital and Health Services Edu-cation from the University of Alabama at Birmingham. He is a Fellow in the Ameri-can College of Healthcare Executives (ACHE) and a member of the National As-sociation of Health Services Executives.

Can this be resized to 1/3S InCharge size and the ap-plication deadline info be deleted?

Can this be resized to 1/3S InCharge size and the ap-Can this be resized to 1/3S InCharge size and the ap-plication deadline info be deleted?plication deadline info be

SHAPE THE FUTURE OF HEALTH CARE.

Earn a CERTIFICATE IN HEALTH POLICY from the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College.

1005 Dr. D. B. Todd. Jr. Blvd. • Nashvi l le, TN 37208 • 615.327.6202 • [email protected]

Execut ive Roundtab les • Hea l th Po l icy A ssoc ia tes • Hea l th Po l icy Fe l lows • Hea l th Po l icy Scho lars • Nat iona l Scho lars ’ Current I ssues In Hea l th Po l icy • Lecture Ser ies • P i lo t Pro ject M in i -Grant Program • Profess iona l Deve lopment Program • Summer Externsh ip Program • Summer Ins t i tu te On Hea l th Po l icy

By CINDy SANDeRS

With primary campus locations in Memphis, Chattanooga and Knoxville, the University of Tennessee Health Science Center offers a broad spectrum of medical and graduate healthcare degree options on both ends of the state.

One area of Tennessee, however, has been noticeably missing when it comes to a major health education presence by the state’s flagship public university. The recent announcement of an expanded partner-ship between UTHSC and Saint Thomas Health is set to change that with additions to the Nashville campus that will dramati-cally increase UT’s educational and train-ing offerings in Middle Tennessee.

UTHSC, headquartered in Memphis, has more than 100 clinical and educational sites across the state, including a number of clinical rotation and residency sites in Mid-dle Tennessee. However, the bulk of the educational programs have been housed in Memphis, Knoxville, and Chattanooga.

Current Campus SitesMemphis: In 1911, the University

of Tennessee launched its Memphis cam-pus, dedicating it solely to health science education and research. Today, the main campus houses each of the UTHSC’s six colleges – Dentistry, Graduate Health Sci-ences, Health Professions, Medicine, Nurs-ing, and Pharmacy. Almost 2,700 students are now enrolled at UTHSC, and there are more than 45,000 alumni who have re-ceived medical and advanced degrees from the six colleges. More than 75 percent of dentists and 40 percent of dentists practic-ing in Tennessee are UTHSC graduates.

Chattanooga: The University of Tennessee College of Medicine in Chatta-nooga is one of three statewide campuses providing medical student and postgradu-ate physician education. UTCOM Chat-tanooga has 10 residency programs and nine fellowships with 172 active residents in training. Additionally, nearly 100 medical students complete a portion of their third and fourth year clinical training in Chat-tanooga annually. In addition, UTC offers multiple health science graduate programs through the College of Health, Education and Professional Studies.

Knoxville: The largest undergraduate campus, UTK also houses multiple gradu-ate programs in research and the health sciences. In 2007, a second UT College of Pharmacy building opened on the Knoxville campus and now enrolls 40-50 students an-nually. Knoxville is also home to the Health Science Center’s Graduate School of Medi-cine. The College of Health Professions has maintained its Department of Audiology and Speech Pathology in Knoxville for more than six decades, and UTK also features graduate nursing programs including MSN,

DNP and PhD programming to prepare nurses for advanced practice roles.

Nashville: UTHSC has entered into a core teaching hospital partnership with Saint Thomas Health. Although still in early stages, the expectation is that there will be a role for all six of UTHSC’s col-leges on the new Nashville Saint Thomas clinical campus when the program reaches maturity. Residency programs are already in place but will greatly expand. In 2014, the College of Pharmacy converted its ex-isting Nashville Clinical Education Center into a major academic site allowing up to 40 student pharmacists from each of the second-, third-, and fourth-year classes to complete their curriculum in Nashville.

Middle Tennessee ExpansionIn an announcement made last month,

UTHSC plans as much as a $40 million in-vestment in Middle Tennessee in partner-ship with Saint Thomas Health. Current speculation calls for the Nashville campus to be built adjacent to Saint Thomas West on approximately six acres of land.

Jessica Wells, vice president of Medi-cal Education for Saint Thomas Health, noted, “The university is a statewide insti-tution but has been noticeably missing in the Middle Tennessee area.” However, she added, that has been changing as the UTHSC/Saint Thomas Health partner-ship has grown. Wells stated, “Saint Thomas and the university are committed to providing that presence here and doing whatever we need to collaboratively work through the process.”

Currently, Middle Tennessee has five resi-dency programs at Saint Thomas Health hospitals in general surgery, family medi-cine, emergency medicine, internal medi-cine and obstetrics/gynecology. The first four programs have received accreditation, and Wells said the expectation is that the OB/GYN program will be accredited by the end of this month.

“Right now there are about 22 resi-dencies,” Wells said. “That will grow to about 115 at full complement.” She added that while medical residencies have been Saint Thomas Health’s first priority, at-tention is now expanding to the full con-tinuum of healthcare providers trained by UTHSC.

Wells said Saint Thomas launched a physician assistant residency program at the beginning of January and is looking at adding or expanding educational and clinical opportunities for a host of other disciplines such as dentistry, nursing, lab technicians, dental hygienists, nurse prac-titioners and physical therapists.

However, she noted, “That’s a multi-

year planning process to be able to build the infrastructure and the capabilities to provide all of that in Middle Tennessee.”

The hope also is that medical stu-dents might be able to complete part of their education in Middle Tennessee … whether that be just spending their final year in Nashville or perhaps more. Simi-larly, preliminary discussions are already underway to establish a Nashville presence for the College of Dentistry as part of the expanded partnership.

Wells said Saint Thomas Health sees the expanded UTHSC relationship as nothing but complementary to partner-ships the health system already has in place with Marian University and Aquinas, as well as its relationships with other local universities including Belmont, Lipscomb, and Vanderbilt.

“We are really a community-focused institution who believes in training the next generation of providers to care for people in the community in our mission of holistic and reverent care,” Wells said. “For those who want to live and work in Middle Ten-nessee, this just gives us another training opportunity.”

UT Health Science Center Plans Major Expansion in Middle Tennessee

GrandRounds

Joseph Webb

Jessica Wells


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GrandRounds

Belmont University Announces New Four-Year Dual PharmD/MBA Degree

Starting this fall, prospective phar-macists can pursue the only dual Phar-mD/MBA degree available in Middle Tennessee at Belmont University. Un-like similar programs around the coun-try that require a minimum of five years of study or offer MBA courses primarily online, Belmont students can complete all the requirements for both degrees within four years and at a reduced tu-ition cost from doing the programs separately.

“The modern practice of pharmacy is constantly evolving, and now – more than ever before – it’s imperative that new PharmD graduates also enter the workforce with a strong business acu-men,” said Dr. Phil Johnston, dean of Belmont’s College of Pharmacy. “Re-gardless of whether a graduate works in a retail, institutional or research site, they must possess robust entrepreneur-ial skills in business forecasting, employ-ee management, corporate finance and more. A PharmD/MBA dual degree is a timely addition to Belmont’s offerings.”

Applicants to the dual PharmD/MBA degree must meet the require-ments for both the Pharmacy and MBA programs. Prospective PharmD/MBA students should visit the dual-degree program’s information web page for specific application instructions, cur-riculum information and admissions representative contact information (bel-mont.edu/pharmacy). The application deadline is March 1, 2015 for Fall 2015 admission.

Curcumin’s Potential to Fight Alzheimer’s Studied

A promising new treatment for Al-zheimer’s disease might already be in

many people’s kitchens. Curcumin, a natural product found in the spice tur-meric, has been used by many Asian cultures for centuries, and a new study indicates a close chemical analog of curcumin has properties that might make it useful as a treatment for the brain disease.

“Curcumin has demonstrated abil-ity to enter the brain, bind and destroy the beta-amyloid plaques present in Alzheimer’s with reduced toxicity,” said Wellington Pham, PhD, assistant pro-fessor of Radiology and Radiological Sciences and Biomedical Engineering at Vanderbilt and senior author of the study, published recently in the Journal of Alzheimer’s Disease.

“One of the difficulties in the treat-ment of Alzheimer’s disease is how to deliver drugs across the blood brain barrier,” Pham said. “Our body has de-signed this barrier to protect the brain from any toxic molecules that can cross into the brain and harm neurons. “But it is also a natural barrier for molecules designed for disease-modifying thera-py,” Pham said.

Pham and colleagues at Shiga Uni-versity of Medical Science in Otsu, Ja-pan, developed a new strategy to deliv-er a molecule similar to curcumin more effectively to the brain by developing an atomizer to generate a curcumin aerosol. The Japanese researchers de-veloped a molecule similar to curcumin, FMeC1, a perfluoro compound, which can be tracked by the biodistribution in the brain noninvasively using magnetic resonance imaging.

“In this way the drug can be breathed in and delivered to the brain,” Pham said.

Children’s Hospital at TriStar Centennial Welcomes New CMO

Last month, TriStar Centennial

Medical Center an-nounced Jill Obremskey, MD, has joined The Chil-dren’s Hospital at TriStar Centennial as chief medi-cal officer.

Obremskey has over 20 years of experience in pediatrics. Previously, she spent more than 12 years at Vanderbilt Children’s Hospital and was instrumental in the development of strategic relationships that have improved the overall care of pediatric patients for that facility. Most recently she was the medical director of a new service line, the Pediatric After Hours Clinics. She spearheaded devel-opment of the clinics to assure clinical quality and operational efficiency.

Obremskey received her medical degree from the University of North Car-olina followed by residency training at Seattle Children’s Hospital. She complet-ed her coursework in Maternal and Child Health at the University of Washington School of Public Health. The board-cer-tified pediatrician also holds a master’s in healthcare management from Vanderbilt Owen School of Management.

Centerstone’s Dede Wallace Campus Now Offering Autism & Related Disorders Support

Centerstone’s Dede Wallace Cam-pus recently announced additional supports and services to Nashville area children with autism spectrum disorder (ASD) and their families. Christina Fri-erson, LPC-MHSP, an autism spectrum specialist who leads the services, is based at the state-of-the-art Nashville clinic located on White Avenue.

“Christina’s expertise in working with children and families touched by autism spectrum disorder is a welcome addition to the Dede Wallace Campus and the surrounding community,” said Centerstone CEO Robert N. Vero, EdD, adding more and more families in the area face an ASD diagnosis.

Frierson’s primary focus is children over the age of five who need assis-tance overcoming social communica-tion challenges, coping with sensory sensitivity, repetitive and restrictive behaviors, and managing anxiety and depression. While most of her patients are children to young adults, her work extends to the whole family. Frierson provides parent coaching and guidance with behavior planning, linking parents to community resources with trainings, workshops and support groups for both children and parents.

Frierson, who has been a therapist and clinical supervisor with Centerstone since 2012, previously founded and served as executive director of Norris Academy, a 31-bed specialty residential treatment center and school for chil-dren and adolescents with ASD and de-velopmental delays in Norris, Tenn. She received her degree in psychology with a focus in neuroscience from Davidson College and a master’s in mental health counseling from the University of Ten-nessee – Knoxville.

Leadership Health Care Presents 2014 AwardsAt the end of last year, Leadership Health Care (LHC), an initiative of the

Nashville Health Care Council, presented a number of awards to industry leaders. The inaugural

Legacy of Leadership Award was presented to James V. (Jim) Lackey, Jr., chairman of Complete Holdings Group, in recognition of his support of LHC and of the profes-sional development of emerging healthcare leaders since the pro-gram was founded in 2002. Sarah Cook, vice president of account services at Healthcare Bluebook and LHC board member, re-ceived the Health Care Emerging Leader of the Year award. Jordan Kendig, di-rector of healthcare implementations at W Squared, was named Ambassador of the Year, a new award recognizing an individual member who has shown dedica-tion and commitment to LHC and serves as a positive reflection of the organiza-tion’s mission and goals. LBMC Healthcare Services was named the Supporting Organization of the Year for its ongoing commitment to LHC and enriching the next generation of healthcare industry leaders.

2014 Leadership Health Care award recipients (L-R): Josh Brummett and Jayme Parmakian with LBMC Healthcare Services, Jordan Kendig, Jim Lackey, and Sarah Cook.

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Dr. Jill Obremskey


Dr. Matthew Neuhaus

More Grand Roundsnashvillemedicalnews.com

GrandRoundsLet’s Give Them Something to Talk About!

HCA’s strong performance has earned the company a spot on the presti-gious S&P 500.

Nashville-based Virsys12 President and Founder Tammy Hawes recently was presented with an Excellence in Business Award and inducted into the East Tennes-see State University Hall of Fame for the College of Business and Technology.

Andrew McDonald, FACHE, has been elected president of the Ameri-can College of Health-care Executives of Middle Tennessee (ACHEMT). McDonald, partner in the Healthcare Consulting arm of LBMC, will lead the 2015 board. Bob Fink, FACHE, chief pharmacy executive for Community Health Systems, is president-elect.

Matthew Neuhaus, DPM, FACFAS of Neu-haus Foot & Ankle was recently voted “Favorite Podiatrist” in the 2014 Ruthies Awards, which are voted on by the people of Rutherford and Cannon Counties.

The Music City chapter of HDI, a community of technical support pro-fessionals, has selected UL Workplace Health & Safety customer support pro-fessional Bradley Jones as its 2015 Ana-lyst of the Year.

LBMC Private Com-pany Segment Leader and Director of Market-ing Strategy Leisa Gill was honored with the Paul Harris Award at the Brent-wood Rotary at the end of last year. The Paul Harris Award, named after the Rotary Founder, goes to individuals who strive to make a difference in their communities.

Additionally, LBMC Founder and Managing Partner David Morgan, CPA/PFS received the 2014 Tennessee Tech University College of Busi-ness Outstanding Busi-ness Leadership award. The award recognizes out-standing contributions in the field of business and is presented annually to an individual that has made significant impact by years of hard work and dedication to their profession.

Nashville-based Clearwater Compli-ance CEO and Founder Bob Chaput has been named to the 11-person Advisory Board of the Association for Executives in Healthcare Information Security (AE-HIS) Foundation. The national organiza-tion, which was founded by the College of Healthcare Information Management Executives (CHIME), is the first profes-sional organization serving healthcare’s senior IT security leaders.

Wishes GrantedThe American Institute for Cancer

Research (AICR) has awarded approxi-mately $2.9 million in scientific research grants to 17 innovative studies, all de-signed to better understand the relation-ship of diet, nutrients, and physical activ-ity to cancer. The awardees include Jay H. Fowke PhD, MPH, Vanderbilt Uni-versity Medical Center, for “A Prospec-tive Analysis of Obesity and Progression from HGPIN to Prostate Cancer.”

The Community Foundation of Middle Tennessee, which serves 40 Middle Tennessee counties, recently an-nounced $967,198 in grants to Davidson County nonprofit organizations, includ-ing many that touch the healthcare in-dustry including Faith Family Medical Clinic, Meharry, and the Interfaith Dental Clinic.

In celebration of their 50th anniversa-ry, the 61 employees of Delta Dental of Tennessee directed $50,000 in Smile180 grants to selected organizations across the state at the end of last year.

Accreditations & CertificationsThe Accreditation Council for Con-

tinuing Medical Education has awarded the Tennessee Medical Association provisional accreditation as a provider of continuing medical education content to physicians. TMA has achieved provision-al accreditation status, which is the first tier of ACCME accreditation for initial applicants, for a two-year period. TMA already offers a range of proprietary in-person and online CME content to Ten-nessee physicians and other healthcare professionals by working with third party accreditors. Its newly acquired ACCME status allows the Association to produce and internally accredit more of its own education content, and make more ex-clusive CME resources available to the market.

The American College of Surgeons (ACS) Committee on Trauma has verified the Vanderbilt Trauma Center with its Level 1 ranking – the only one in Ten-nessee to receive the distinction for the delivery of care to adult trauma patients. Verification by ACS goes beyond state-level requirements and takes into ac-count the entire spectrum of care offered to patients at trauma centers, including outreach and prevention, along with ef-forts to improve performance and con-duct outcomes-based research.

Life Care Center of Hickory Woods, a skilled nursing and rehabilita-tion facility in Antioch, recently earned accreditation from The Joint Commis-sion after an extensive onsite review. The survey must be completed at least once every three years for the facility to main-tain accreditation. This was the first year the facility was eligible, and the survey accredits it through autumn 2017.

Riverview Regional Medical Cen-ter in Carthage and Sumner Regional Medical Center in Gallatin have both been recognized as a “Top Performer on Key Quality Measures®” by The Joint Commission.

Andrew McDonald

Leisa Gill

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Andrew works with a team of experienced healthcare professionals that possess diverse backgrounds in valuation, accounting, coding/compliance, information technology consulting, revenue cycle management and general healthcare management. During a 27-year career as either full-time administrator or consultant to a broad range of healthcare organizations, he is experienced in providing fair market value compensation opinions, practice valuation, EMR assessment, billing/coding/collection, strategic planning, human resource management, fi nancial analysis, practice development, and general practice management services to organizations preparing to meet the challenges presented by an ever-changing healthcare environment.

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Aegis Sciences Corporation Acquires Diagnovus

Last month, Nashville-based Aegis Sciences Corporation, one of the na-tion’s leading laboratory sciences com-panies, announced the acquisition of Diagnovus LLC, a local molecular diag-nostics laboratory providing individual-ized genetic information.

“The asset acquisition of Diagnovus allows Aegis to expand our healthcare laboratory testing services,” stated Ae-gis Founder, Chairman and CEO David L. Black, PhD. “The delivery of patient-specific genetic information to physicians will improve management of disease and prescribing of necessary medication.”

Diagnovus has developed multiple molecular diagnostic assays, including a buccal swab test, which provides insight into an individual’s response to certain medications based on genetic structure.

Feldhaus Joins Nashville Medical Group

Saint Thomas Health recently an-nounced Jennifer Feldhaus, MD, has joined Nashville Medical Group in the Nolensville Road office. A native Ten-nessean, the physician, who is dual board certi-fied in Internal Medicine and Pediatrics, received her undergraduate de-gree from the University

of Tennessee Knoxville and her medical degree from UT Health Science Center in Memphis. Feldhaus, who is fluent in Spanish, completed a combined resi-dency in her areas of specialty at the University of Alabama Birmingham. In addition, she earned a Health Policy certification during medical school.

Waddey Appointed Chief of Staff for LifePoint

Brentwood-based LifePoint Hospi-tals recently named Melissa Waddey to the newly created role of chief of staff.

“As LifePoint con-tinues to grow, the pace, complexity and size of our company require addition-al executive resources to provide focused oversight for top-priority initiatives and projects,” said Bill Carpenter, chair-man and CEO of LifePoint.

Waddey joined LifePoint in 2010 and has more than 15 years of hospi-tal operations and strategy and service line development experience. She most recently served as vice president of the LifePoint’s strategic resource group and previously served in a variety of op-erational leadership roles at HCA for 11 years. A former chair of Leadership Healthcare, Waddey is the founder and a former board member of the Ameri-can College of Healthcare Executives’ Middle Tennessee chapter.

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THE OBVIOUS CHOICE FOR CANCER CARE IN TENNESSEE

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· Clinic Locations: Franklin and Springfield · Education: Doctor of Medicine East Carolina University, Internship, Residency, Fellowship and Masters in Clinical Investigation at Vanderbilt Medical Center · Experience: Medical Oncologist at Vanderbilt-Ingram Cancer Center for 10 years · Board Certification: Medical Oncology · Special Interest: Breast Cancer Dr. Means-Powell has researched and co-written several studies about the disease.

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“I am committed to caring forpatients with the utmost respectand compassion, understandingeach patient’s goals andpriorities to help him or herachieve them.”

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