ON ROUNDS Workforce Issues Take Center Stage in Healthcare The healthcare workforce will become the nation’s largest employment sector in the next decade, surpassing all other industries in job growth and representing one in four new jobs by 2024, according to recent data from the Bureau of Labor Statistics ... 5 TMA Outlines 2016 Legislative Priorities When the second year of the 109th General Assembly begins on Jan. 12, the Tennessee Medical Association will be ready to discuss legislation to help improve the healthcare environment for Tennessee doctors and patients ... 9 PRINTED ON RECYCLED PAPER January 2016 >> $5 FOCUS TOPICS OPHTHALMOLOGY HEALTHCARE DESIGN ONLINE: NASHVILLE MEDICAL NEWS.COM Evidence-based Design: Marrying Form & Function on the Front Line BY CINDY SANDERS When is a painting much more than just a pretty picture? When it promotes health and healing. Designers and healthcare industry leaders from around the nation recently gath- ered in Washington, D.C. for the annual Healthcare Design Conference. Convened by The Center for Health Design (CHD) and Healthcare Design Magazine, the four-day meeting and exposition unveiled the latest in evidence-based strategies and products. Rosalyn Cama, president and CEO of Connecticut-based health design firm CAMA, Inc. and the immediate past chair of CHD summed up the conference experi- ence as ‘awesome.’ “It’s rich in attendance with folks who are well-versed in the business of healthcare … not only how you design it, but how to build it and then manage it and sustain it over time,” Cama said of the multidisciplinary professionals in attendance. (CONTINUED ON PAGE 4) Shari Barkin, MD, MSHS PAGE 2 PHYSICIAN SPOTLIGHT (CONTINUED ON PAGE 4) Tennessee Improves, but Still Near the Bottom, in Annual Health Rankings BY CINDY SANDERS Last month, United Health Foundation released the 26 th annual re- port on the state of health in the nation. Hawaii received top honors in “America’s Health Rankings ® ,” while Louisiana came in dead last. Although Tennessee moved up two spots from last year, the state still finished near the bottom at 43 rd in the country. With a starting position of 42 nd in 1990, Tennessee hasn’t managed to gain much traction over the last 26 years despite increased attention and ef- forts to positively impact the determinants of health. The state’s worst show- ing came in 2005 with a rank of 49 th , and the best was in 2011 at 41 st . Rankings were determined by weighting more than 60 core measures and supplemental measures across the broad topics of physical and behav- ioral health, access to care, clinical quality targets, environment, policy and Follow us on @NashMedNews for updates and breaking news PRST STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.318 United Health Foundation Releases 26 th Annual Report on Health in America To begin receiving Nashville Medical News in print or on your tablet or smartphone SUBSCRIBE TODAY
Transcript
ON ROUNDS
Workforce Issues Take Center Stage in HealthcareThe healthcare workforce will become the nation’s largest employment sector in the next decade, surpassing all other industries in job growth and representing one in four new jobs by 2024, according to recent data from the Bureau of Labor Statistics ... 5
TMA Outlines 2016 Legislative PrioritiesWhen the second year of the 109th General Assembly
begins on Jan. 12, the Tennessee Medical Association will be ready to discuss legislation to
help improve the healthcare environment for Tennessee doctors and patients ... 9
PRINTED ON RECYCLED PAPER
January 2016 >> $5
FOCUS TOPICS OPHTHALMOLOGY HEALTHCARE DESIGN
ONLINE:NASHVILLEMEDICALNEWS.COM
Evidence-based Design: Marrying Form & Function on the Front Line
By CINDy SANDERS
When is a painting much more than just a pretty picture? When it promotes health and healing. Designers and healthcare industry leaders from around the nation recently gath-
ered in Washington, D.C. for the annual Healthcare Design Conference. Convened by The Center for Health Design (CHD) and Healthcare Design Magazine, the four-day meeting and exposition unveiled the latest in evidence-based strategies and products.
Rosalyn Cama, president and CEO of Connecticut-based health design fi rm CAMA, Inc. and the immediate past chair of CHD summed up the conference experi-ence as ‘awesome.’
“It’s rich in attendance with folks who are well-versed in the business of healthcare … not only how you design it, but how to build it and then manage it and sustain it over time,” Cama said of the multidisciplinary professionals in attendance.
(CONTINUED ON PAGE 4)
Shari Barkin, MD, MSHS
PAGE 2
PHYSICIAN SPOTLIGHT
(CONTINUED ON PAGE 4)
Tennessee Improves, but Still Near the Bottom, in Annual Health Rankings
By CINDy SANDERS
Last month, United Health Foundation released the 26th annual re-port on the state of health in the nation. Hawaii received top honors in “America’s Health Rankings®,” while Louisiana came in dead last. Although Tennessee moved up two spots from last year, the state still fi nished near the bottom at 43rd in the country.
With a starting position of 42nd in 1990, Tennessee hasn’t managed to gain much traction over the last 26 years despite increased attention and ef-forts to positively impact the determinants of health. The state’s worst show-ing came in 2005 with a rank of 49th, and the best was in 2011 at 41st.
Rankings were determined by weighting more than 60 core measures and supplemental measures across the broad topics of physical and behav-ioral health, access to care, clinical quality targets, environment, policy and
Follow us on
@NashMedNews for updates and breaking news
PRST STDU.S. POSTAGE
PAIDFRANKLIN, TN
PERMIT NO.318
United Health Foundation Releases 26th Annual Report on Health in America
To begin receiving Nashville Medical News in print or on your tablet or smartphone
SUBSCRIBE TODAY
2 > JANUARY 2016 n a s h v i l l e m e d i c a l n e w s . c o m
PhysicianSpotlight
Health in ActionDr. Shari Barkin Focuses on Preventing Childhood Obesity One Family at a Time
By MELANIE KILGORE-HILL
For Shari Barkin, MD, MSHS, improving public health isn’t just a profession. It’s a passion.
As director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, Barkin has dedicated her practice to the prevention of child-hood obesity – an epidemic plaguing 17 percent of American kids ages 2 to 19, according to the Centers for Disease Control and Prevention.
The Road to ResearchA Maryland native, Barkin
earned her undergraduate degree at Duke University, her medical degree at the University of Cincin-nati, and completed her pediatric residency at Children’s Hospital of Los Angeles. She was selected as a UCLA Robert Wood Johnson Clini-cal Scholar and completed a fellowship in Health Services Research.
“I started my research by looking at big public health issues and wondering what the role of the physician is in address-ing these,” Barkin said.
While in Los Angeles, that meant working with teachers, parents and pro-viders to identify ways to prevent violence. After accepting an academic position at Wake Forest University, however, Barkin witnessed another dangerous epidemic un-folding among pediatric patients: obesity.
“At a macro level, I saw children walk-ing through who were much larger than they had been a few years earlier,” Barkin said. “It made me ask questions, like why weight was outpacing height. What was dif-ferent? It wasn’t sudden slothfulness, glut-tony or technology, but a combination of many things.”
Barkin began writing grant propos-als to fund research to understand early growth trajectories in children and to learn why some stay healthy while others veer off toward obesity. Her focus became one of prevention rather than weight loss.
Taking it OutsideWhile Barkin attempted to answer
some of her questions by studying children in medical practices, she found many under a physician’s care were already obese.
“Once I established that health hap-pens in families and communities, I took my research out of doctors’ offices and developed a partnership between the university and the community, creating collaboratives to strengthen families and neighborhoods,” Barkin explained.
Among her accomplishments was de-velopment of a 90,000-square-foot learning center with teaching kitchens and space for health screenings and counseling. “It was a place for the community bring ideas to
us and vice versa, where we could develop ideas and test them,” she said of the North Carolina facility. “When I was recruited to Nashville in 2006, my vision was to expand that and build a series of collaboratives across the country to develop ideas to pre-vent obesity and increase public health.”
The Nashville CollaborativeOnce in Nashville, Barkin discovered a
natural partner in Metro Parks and Recre-
ation and former Mayor Bill Purcell. “Mayor Purcell had doubled
the number of community and rec-reation facilities, and wanted to focus on how they could be utilized to en-hance wellness and health,” she ex-plained.
In 2008, Barkin spearheaded a citywide effort to improve the health of families. Now in its eighth year, The Nashville Collaborative has re-ceived eight grants and been featured in 30-plus peer review publications.
Comprised of staff from Mon-roe Carell Jr. Children’s Hospital at Vanderbilt and Metro Parks and Recreation, the group works to-gether to improve the health of local children. All of the initiatives are community-centered, family-based, sustainable, and have measurable results.
The Nashville Collaborative has received multiple awards from the
Tennessee Association of Pediatrics, and Barkin has been invited to present the com-munity health model in Italy, New Zealand and France. In 2014, Barkin was elected to serve as vice president of the Society for Pediatric Research, with succession to the presidency in 2016.
Obesity Prevention in 2016Barkin said there’s no golden ticket
when it comes to obesity prevention. “We
do ourselves a disservice if we look at only one factor at a time,” she said. “It’s most impactful when we consider the dynamic interaction between factors and understand that timing of these exposures matter, too.”
The problem is multi-faceted, from our western diets to the way we grow food and the size of our plates. And then there’s the simple lack of movement in both work and leisure environments, triggered by an abundance of technology … and of-tentimes, a perception of danger when it comes to outdoor play.
Attitudes about how we interact with resources also are a contributing factor, Barkin said. Socioeconomic status and early stressors in life can change a child’s physiology and inflammatory pathways, which alters how fat is stored and parti-tioned. There is also the incredibly com-plex science behind microbiomes (think gut bacteria changes), genetics and the evolving nature of protein expression from exposure to environmental factors.
“Our bodies are in a dynamic interac-tive state, and addressing one factor doesn’t allow us to make strides in a large public health way,” Barkin said. “Often these types of health issues, like obesity preven-tion, are really a family-focused health en-deavor. It’s not one child at a time; it’s one family at a time. We, as clinicians and pe-diatricians, have an opportunity to engage the whole family and develop family-based strategies for maximum health.”
The Nashville CollaborativeSince 2008, more than 1,200 Nashville youth have walked,
danced and eaten their way to healthier futures thanks to The Nashville Collaborative.
A project of Monroe Carell Jr. Children’s Hospital at Vanderbilt and Metro Parks and Recreation, the program brings the community together with researchers to create and test innovative programs aimed at keeping children healthy and active. Their goal is to help children maintain a healthy weight and to prevent chronic diseases like obesity and diabetes.
“Any projects we develop and test must meet four criteria,” said program founder Shari Barkin, MD, director of the Division of General Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. “They must be community centered, family based, have the potential of sustainability, and be measurable.”
Their current Growing Right Onto Wellness trial (GROW) includes 610 parent/child dyads and is just one of many studies underway in Middle Tennessee. Barkin said families often enroll additional siblings and family members once they realize the program’s added value. While educational, exercise and after-school programs strive to prevent obesity in youth, parents also are picking up better habits, learning how better lifestyle choices impact the overall wellness of the entire family.
The program has received international attention, with Barkin now a sought-after speaker across the globe. To date, The Nashville Collaborative has received $15 million in grants, most of that focused on programs in Middle Tennessee. The Nashville Collaborative meets monthly to develop ideas that meet their four criteria, write grants and disseminate information.
Barkin said they’re constantly looking for avenues and strategies to spread the information they’ve learned – not only to improve the health of Nashvillians but also to export the program beyond Tennessee’s borders. A recent grant from the National Cancer Institute will allow Barkin to expand one of their first projects, Salud con la Familia (Health with the Family), to four more states. The study, which was focused on reducing childhood obesity in Latino populations, showed that a simple 12-week program could improve early childhood growth and keep kids on a healthy growth curve.
“What’s exciting is that we have the potential to export these programs across parks and recreation to more than 230 million Americans,” Barkin said. “We’re really focused on that, and we believe it puts Nashville in a really good place.”
Dr. Shari Barkin, joined by then-Mayor Karl Dean, poses with a group of young participants in the interactive GROW project that engages both parent and child in wellness measures.
n a s h v i l l e m e d i c a l n e w s . c o m JANUARY 2016 > 3
The founding fathers would be sick to know that healthcare coding regulations could set you back so many Benjamins.
We have We have the remedy.the remedy.That’s just the way we do business.That’s just the way we do business.
If the name “Lucro” is new to you, it won’t be for long. Backed by Nashville-based Martin Ventures, Lucro is an online marketplace for buyers and sellers of healthcare solu-tions with the potential to truly disrupt the status quo in an indus-try overwhelmed by financial and regulatory pressures.
Lucro officially launches spring 2016 but is already being utilized by more than 1,000 early adopters including HCA, Community Health Systems and Tenet Health where de-cision-makers have embraced the new outlet to discover, compare and collaborate with peers around innovative industry solutions.
New Ideas for a New MarketplaceLucro’s groundwork traces back to
2009, when company founder and CEO Bruce Brandes found himself on the West Coast as a keynote speaker behind Steve Jobs. Soon, he was collaborating with Sili-con Valley’s top techies. Brandes later teamed with Martin Ventures – which provides capital, operational support and mentoring primarily for healthcare and technol-ogy entrepreneurs – as a managing director and served on the company’s investment committee.
“Through my experience, I made a couple of observations,” explained Brandes, a healthcare IT veteran. “Healthcare is a market that has been oversold and under delivered, and the industry has the scars to show for it.”
Brandes regularly saw companies ap-proach Martin Ventures in need of capi-tal – not to invest in a product … but to hire pricey sales execs. Brandes contended a better way for companies to grow was to redirect those dollars to help products and clients succeed.
Then, he made another observation. “As we went around talking to major healthcare executives about Martin Ven-tures, everyone had the same question: ‘Can you help us filter the universe of shiny things?’ There’s an explosion in the num-ber of new vendors out there, and no one knows how to filter through it all,” Brandes said.
“Either they’re wasting a lot of time in meetings with companies that aren’t a fit, or they’ve put up a wall to keep them out and then worry about innovations they might be missing out on,” he noted.
Simply put, they needed help ex-ecuting innovation with greater clarity and lower risk. It became clear the in-dustry-disrupting task ahead was bigger
than Martin Ventures itself. Brandes ap-proached his West Coast comrades to see what could be learned from other multi-sided platforms – top websites that shift the advantage to the buyers to make decision faster and cheaper.
“We know the way in which we buy a car or plan a vacation is radically differ-ent now than a couple years ago,” Brandes said. “How do we take those principles and apply them to healthcare where the mission is much more important than saving $10 on a hotel room?”
Conversations took place between world-class web developers and the na-tion’s top healthcare executives to identify missing links in the healthcare market-place. Before long, Brandes had a well designed website and a network of early adopters eager to help bring vendors on board.
“Vendors want to grow their business but can’t get in front of the right people,” Brandes said. “We’re giving them a vehicle to raise visibility and access solutions. It’s a new ecosystem with advantages to both sides, helping healthcare organizations to innovate faster with lower risk and giving the companies that should succeed a chance to build better solutions and be shared.”
So, What is Lucro?In a nutshell, Lucro is an online mar-
ketplace where providers, vendors and third party associates have a voice. It’s a single site where vendors can be rated and reviewed, ideas can be pinned and private groups can be created for peer discussion.
Lucro’s capabilities include:• A comprehensive catalog of estab-
lished and emerging companies and their products for healthcare,
• The ability to organize individual products within project boards, enabling the pinning of individual products to be grouped into a comprehensive solution,
• Insights from colleagues through rat-ings, reviews and polling,
• Private group collaboration to raise consistent best practices enterprise-wide, and
• Aggregation of specific, valuable third
party insights into a fuller con-text to inform more compre-hensive decision-making.
“We found most buy-ers don’t care about vendor websites. They care about what their trusted peers in their role at other hospitals are doing,” Brandes said. “’They want to know, ‘How are you solving this problem?’ Right now they’re doing that through hallway conversations and trade shows, which aren’t comprehensive.”
A Call to VendorsTo that end, Lucro’s staff
members are attempting to create a vendor profile solution card for every company selling into the health-care marketplace. Of the 22,000 vendors identified, more than 10,000 cards have already been entered based on publicly available facts.
Now, Lucro is putting a call out to vendors to connect to the marketplace, cu-rate their solution cards, and provide de-tails about specific services and capabilities – information that will expedite buyers’
searches. There is no charge for buyers or sellers to participate, which Brandes hopes will avoid friction in building out the Lucro community. He also hopes to reach out to third-party professional organizations, in-dustry analysts and other experts who have earned a trusted place as advisors in the healthcare community.
A Community Effort In building a truly comprehensive,
non-biased healthcare marketplace, Lucro has compiled a diverse board of advisors that includes Scott Becker, publisher of Becker’s Hospital Review, and board mem-bers and executives from RAND Health, Tenet Health, Oxeon Partners and Ascen-sion Health.
“This is a community effort. It’s not taking the place of something that already exists and is working,” Brandes said. “We’re well positioned to do something very signifi-cant in the industry, but it will only succeed if people look at how to align rather than protect their own turf on a legacy piece. The problem we’re striving to solve is a problem for everyone.”
For more information or to become a part of the Lucro community, go online to lucromarketplace.com
The New Healthcare MarketplaceLucro is Redefining How Buyers, Sellers of Healthcare Solutions Connect
Bruce Brandes
HealthcareEnterprise
4 > JANUARY 2016 n a s h v i l l e m e d i c a l n e w s . c o m
No doubt the event also held special significance to Cama this year as she was presented with the Russ Coile Lifetime Achievement Award. Cama, who has served as CHD board chair for 14 years, was also named chair emeritus of the organiza-tion, which is dedicated to bringing together a community of designers, architects, executives, manufacturers and stu-dents to improve qual-ity of care and outcomes through evidence-based design principles.
With dozens of educational tracks, facility tours, and keynote presentations, Cama said the conference covered a broad spectrum of topics and provided insights for veteran designers, as well as those newer to the field. “Because this is a research conference, they are revealing new data,” she noted. “You can’t think that what you heard five years ago is how you are going to operate. Demographics change, culture changes, operational models change. You have to stay current.”
One major change, she continued, is how technology is integrated into care and the built environment. “Technology is forc-ing us to change dramatically. It affects how care is delivered and how patients move through space and the system.”
While technology dominated many conversations on the acute side of the equa-tion, Cama said, “On the ambulatory side, we heard a lot about patient experience – how to know your customers, deliver a more meaningful experience, and then measure
it.” Additionally, she noted there were an increasing number of conversations cen-tered on health and wellness and moving care from the hospital into the community.
Nature Equals NurtureRoger Ulrich, PhD, is often credited
as the pioneering researcher whose work transformed how nature is viewed within the healthcare setting. Cama noted a land-mark study Ulrich performed more than two decades ago underscored the differ-ence in outcomes between patients whose rooms had a view of a brick wall compared to those who saw a stand of trees. In the study, patients recovering from abdominal surgery with a view of nature required less pain medication, had fewer complications, and were discharged from the hospital earlier than their counterparts viewing the brick wall.
The study, Cama continued, caused healthcare designers to really consider how to create environments that speak to the human condition … particularly when that condition is in a fragile and vulnerable state. “Looking at a wall of technical outlets is not a calming view,” she pointed out.
However, Cama was quick to add that same clinical equipment is critical to quality care. Therefore, the task of the designer is to place technology in a way that is easily accessible to clinicians while preventing it from being the focal point for patients and families so as to lower their stress levels.
She said there are a number of ways to bring nature indoors – from rooftop gardens and water features to rooms with a view and artificial illumination that simulates natural lighting. Cama also pointed out these fea-
tures aren’t just for the benefit of patients but also speak to the needs of families and healthcare staff.
A Hint of HospitalityWhile much has been made of the hos-
pitality industry’s influence on healthcare, Cama cautioned that it should only go so far. “It can look inviting and beautiful if that’s how one interprets ‘hospitality.’ But it can’t be fussy, and it has to be clean,” she stressed of healthcare design.
Cama added products have evolved over time to give healthcare designers many beautiful options that marry the twin needs of form and function. “The manufacturing industry has grown up with us. Now there are so many more choices that have been engineered for this setting. Our kit of parts is much broader,” she said.
Cama noted one of the highlights of the conference is that it introduces attendees to new and improved products each year. Cama said there is now a luxury flooring product that truly has the look of hardwood. “I’ll look at real wood now and say, ‘Is that vinyl?’” she laughed.
This year, the designer was actually one of the exhibitors, as well. The IOA Cama Bed Chair (pictured on page 1) debuted at the 2015 meeting. Although designed for use in any number of care settings, Cama said the idea really emerged out of conver-sations and requests from worried parents.
Her firm does a lot of design for pedi-atric hospitals. For nearly 20 years, she has heard parents say they wished they could just crawl in the hospital bed with their chil-dren to comfort them at night. Since that option is neither safe nor feasible with chil-
dren who might be hooked up to monitors, Cama came up with a stylish alternative – a chair that rises and reclines. At night, a par-ent can stretch out at equal height to the hos-pital bed and easily touch and comfort their child without disturbing critical equipment.
“The research around the power of touch, is compelling” Cama added, point-ing to the work of Tiffany Field, PhD, di-rector of the Touch Research Institute at the University of Miami. Since the design conference, the Cama Bed Chair won the BOY (Best of Year) award in the Health-care Furniture Category.
The Time BetweenIn the inpatient setting, Cama noted
that increasing attention is being focused on the ‘time between’ seeing clinicians, going for tests, or waiting for a loved one to come out of surgery. “There are long bits of time where you’re waiting. Where do we allow people to relax and be nourished?” she questioned.
Whether it’s by creating a chair, design-ing a curated program, incorporating a heal-ing garden or botanical walk, or employing the power of local art to trigger pleasant memories, designers around the country are focused on enhancing outcomes by improv-ing the outlook, even for a little while.
other societal factors including education and poverty levels. Among core measures, Tennessee makes a good showing in several categories, including having a high rate of high school graduates and low prevalence of excessive drinking. However, we rank in the bottom third for obesity and physical inactivity and at or near the very bottom for diabetes (48), poor mental health days (50), smoking (47), and violent crime (47).
In the supplemental measures, the state ranks among the best for issues re-lated to binge and chronic drinking and having cholesterol checked. Unfortunately, knowing those lipid numbers haven’t done much to impact the rate of high cholesterol (30), or to slow down heart attacks (46) and heart disease (45). Tennesseans seemingly are among the worst for eating fruits (49) and administering the HPV immunization for females (50).
Unfortunately, Tennessee saw a 20 percent increase in poor mental health days over the last two years and an 11 percent increase in violent crime since the rankings were launched in 1990. With 591 violent offenses per 100,000 population, Tennes-see fares far worse than the top state of Vermont with only 121.1 such offenses per 100,000. Tennessee also compares unfa-vorably with much larger states often por-trayed as having big city dangers, including New York (393.7) and California (402.1).
Only Nevada (603), New Mexico (613), and Alaska (640.4), have a bigger issue with violent crime than Tennessee.
On the plus side, cardiovascular deaths are down 22 percent over the past decade from 382.3 to 299 per 100,000 pop-ulation. That’s still a far cry from the best state, Minnesota, which has a rate of 186.5 deaths per 100,000. Other positives include a 26 percent decrease in preventable hos-pitalizations over the past five years from 87.7 to 64.8 per 1,000 Medicare beneficia-ries, and a significant decrease of 28 per-cent over the last year in physical inactivity, which is down from 37.2 percent to 26.8 percent of adults self-reporting as inactive.
The State Weighs InIn light of the recent metrics, a spokes-
person with the Tennessee Department of Health offered the following commentary on the pluses and minuses of the state’s re-cent ranking with specific attention to the change in physical activity.
“While the Tennessee Department of Health is pleased to see data indicating an improvement in the number of resi-dents who are self-reporting being more physically active, we must all understand annual fluctuations in calculations and periodic shifting of survey methodology are factors that must be considered when reviewing new numbers. The effort to im-
prove physical activity across Tennessee is an important component of the Big Three Plus One initiative to improve health for all residents. The components include:
1). Reducing excessive caloric intake to reduce overweight/obesity;
2). Improving physical activity among all residents; and
3). Reducing the number of Tennesse-ans who use tobacco products; plus reduc-ing misuse/abuse of both prescribed and illicit drugs.”
Department of Health officials went on to point out that in addition to statisti-cal changes that might have been impacted by the way the question was phrased, they believe improvement is also attributable to the contributions of several new programs across the state aimed at enhancing fitness, including:
• Engaging in a partnership with Ten-nessee Department of Environment and Conservation to convene school running clubs across the state, providing non-com-petitive physical activity in an after-school setting to interested students.
• Funding for walking tracks at mul-tiple schools across the state.
• Encouragement and support for Go Noodle, which provides fun, physical ac-tivities in classroom settings in over 1,000 Tennessee schools.
• Construction on walking trails and
greenways across the state.• Implementing a program to provide
free access to recreation centers, as well as an exercise coach for citizens wanting to reduce weight and improve health.
• Encouraging increased physical ac-tivity through a series of healthy actions and challenges as part of the Small Starts tools developed and offered by the Gover-nor’s Foundation for Health and Wellness to engage Tennesseans at home, in the workplace and at worship.
• Statewide implementation of the Healthier Tennessee Communities initia-tive to motivate community-level owner-ship of population health and to support positive changes among fellow residents.
“These and other efforts focus on the importance of helping all individuals un-derstand the importance of physical activity and encouraging them to take action to be-come more physically active in meaningful ways,” concluded the TDH official.
The Big PictureThe interactive report, which also in-
cludes data specific to seniors, allows com-parison of Tennessee to other states and national averages for the broad range of measurable metrics. Custom reports, state infographic and summary, and ‘take ac-tion’ resources to improve rankings are all available at AmericasHealthRankings.org.
Tennessee Improves, but Still Near the Bottom, continued from page 1
Evidence-based Design: Marrying Form & Function, continued from page 1
Rosalyn Cama
Mark Your CalendarThe next Healthcare Design
Conference is scheduled for Nov. 12-15, 2016 in Houston, Texas. For more information, go online to healthdesign.org.
n a s h v i l l e m e d i c a l n e w s . c o m JANUARY 2016 > 5
Scott MertieKraft Healthcare Consulting, LLC615-782-4292www.krafthealthcare.com
Serving Nashville’s healthcare industry for more than 50 years.
The healthcare workforce will be-come the nation’s largest employment sec-tor in the next decade, surpassing all other industries in job growth and representing one in four new jobs by 2024, according to recent data from the Bureau of Labor Statistics.
The year 2016, however, is when healthcare providers will need to come to terms with the growing workforce chal-lenge – how will they recruit and manage the healthcare professionals they need in an era of rising patient demand and in-creasing clinician shortages that plague the industry?
Healthcare workforce experts recently gathered in Nashville to search for answers to the challenge. The 2015 Healthcare Workforce Summit was a collaborative, in-novation-focused forum of the most influ-ential leaders in the healthcare workforce industry – including C-suite executives; leaders from human resources and fi-nance; and nursing, physicians and allied leadership.
Susan Salka, president and CEO of AMN Health-care, the leading sponsor of the Healthcare Workforce Summit, explained to the au-dience that healthcare added nearly a half million jobs from November 2014 to Novem-ber 2015, an unprecedented era of growth. She added this high-demand environment for healthcare professionals is expected to con-tinue. Since workforce supply cannot keep up with demand, she noted, “business as usual just won’t work.”
Instead, Salka said new and innova-tive solutions must be developed. The two days of panel discussions, presentations and networking included:
Release of the AMN “2015 Survey of Registered Nurses,” which revealed for the first time that the surge in nurse retirements might be about to happen. The survey of nearly 9,000 nurses showed that about two-thirds of Baby Boomer nurses are con-sidering retirement now that the recession is over. Of those experienced nurses con-sidering retirement, 62 percent said they would retire within the next three years.
A presentation on workforce supply and demand showed healthcare employ-
ment grew in unprecedented numbers – nearly a 500,000 jobs in the last year. However, job openings are growing at an even faster pace than job hires, creating a widening gap of unfilled healthcare jobs. Demand for quality healthcare profession-als is growing due to the increase of people with health insurance under the Afford-able Care Act, the aging of the U.S. popu-lation, and other forces at work.
The need for workforce planning to become a strategic initiative throughout the industry is underscored by the fact that labor is the largest budget item for nearly any healthcare enterprise, comprising more than half of operating expenses. Technol-ogy-enabled strategic planning services are now available in healthcare to accurately predict patient demand and workforce needs up to three months in advance and to apply advanced labor management tech-niques to meet those staffing needs.
Since Millennials will comprise half of the workforce in 2020 and three-quar-
ters of it by 2030, healthcare providers need to analyze current generational demo-graphics and their impact on workforce planning. Millenni-als, who are used to working in teams, might be well suited to new care delivery and payer models. Millennials have proven they can acclimate to new team-based healthcare approaches, and their affinity
for integrated technology could be par-ticularly well suited to the strong IT com-ponent of accountable care.
The need to focus more attention on workforce challenges facing healthcare be-came even more evident with the Decem-ber release of new employment projections by the U.S. Bureau of Labor Statistics. Total job openings for healthcare will ex-ceed 5 million from 2014-2024. For regis-tered nurses alone, there will be nearly 1.1 million jobs that need to be filled.
In concluding the healthcare work-force summit, Salka said healthcare providers would increasingly find they couldn’t go it alone as workforce chal-lenges become too great. Partnerships between providers and workforce experts will become essential to the healthcare in-dustry, she concluded.
Workforce Issues Take Center Stage in Healthcare
Susan Salka
Fourth Quarter Finishes with a FlourishThe fourth quarter of 2015 was a busy one for a number of local healthcare
companies with a national footprint.
AmSurg’s Physician Services Division, Sheridan, acquired Valley Anesthe-siology & Pain Consultants in Phoenix. Valley is one of the country’s largest in-dependent anesthesiology practices and has more than 240 physicians providing services to 21 hospitals and 25 ambulatory surgery centers. In December, the divi-sion also acquired Northside Anesthesiology Consultants in Atlanta.
Capella Healthcare completed the transition to make KershawHealth offi-cially part of the Capella-MUSC Health Network in South Carolina.
Community Health Systems, which previously announced the plan to spin off Quorum Health Corporation, unveiled the executive team over the fall. Thomas Miller will serve as CEO, Michael Culotta as CFO, and Martin Smith as executive vice president of Operations. During the fourth quarter, CHS also announced the divestiture of the 72-bed Barstow Regional Medical Center in Florida and the 126-bed Memorial Hospital of Salem County in New Jersey. In other news, H. James Williams, PhD, the former president of Fisk University joined the CHS board for a one-year term, and 118 CHS-affiliated hospitals got the nod from The Joint Com-mission as “Top Performers on Key Quality Measures®.”
HCA acquired 14 urgent care centers in Las Vegas with the pur-chase of Urgent Care Extra’s Nevada operations. The company also announced Jonathan B. Perlin, MD, president of clinical services and chief medical officer, was honored with election into member-ship in the National Academy of Medicine (formerly the Institute of Medicine). Additionally, The Joint Commission recognized 106 of HCA’s licensed hospitals, 78 percent of the company’s U.S. hospi-tals, as “Top Performers on Key Quality Measures®.”
LifePoint Health agreed to acquire the struggling 376-bed St. Francis Hospi-tal in Columbus, Ga. Duke LifePoint and Tenet Healthcare reached an agreement for the sale of Tenet’s North Carolina hospitals and affiliated operations. Addition-ally, 18 LifePoint facilities were recognized by The Joint Commission as “Top Per-formers on Key Quality Measures®.”
RegionalCare Hospital Partners, led by chairman and CEO Marty Rash, signed a definitive agreement in November to be acquired by Apollo Global Man-agement. Day-to-day operations, however, were not anticipated to change for the eight-hospital system.
Dr. Jonathan B. Perlin
6 > JANUARY 2016 n a s h v i l l e m e d i c a l n e w s . c o m
deck
By CINDy SANDERS
A collaborative effort between Bas-com Palmer Eye Institute and Florida In-ternational University (FIU) has resulted in what the team of biomedical engineers and physician-scientists believe to be a true breakthrough in retinal imaging.
Building on the foundation of tra-ditional optical coherence tomography (OCT), the group created technology to image the light-sensitive receptor protein rhodopsin. Three years of hard work re-cently culminated in the successful test of the first technology based on visible-light optical coherence tomography (VIS-OCT).
Shuliang Jiao, PhD, an associate pro-fessor of biomedical engineering at FIU who led the project, said OCT is an established imaging technique that has been used exten-sively in clinical settings and allows ophthalmolo-gists to map and measure layers of the retina.
Yet, OCT on its own has limits to the in-formation it can yield. Byron Lam, MD, and Rong Wen, MD, PhD, both profes-
sors of ophthalmology at Bascom Palmer and key members of the research team, said OCT is very good at uncovering the anatomy of the retina but cannot tell whether a cell is functional or not.
Assessing FunctionalityWen explained the photoreceptors in
the retina that convert light signals to the neuronal signals degen-erate at rates that vary by patient and condi-tion. Currently one of the most common ways to assess the extent of vision loss is to simply ask a patient ‘what’ and ‘how well’ they see. As Wen pointed out, it’s a reasonable test but also a subjective one. “We wanted to come up with an objective way to tell if the photo-receptors are functional,” he said.
To assess functionality, the research team focused on rhodopsin, also known as visual purple, which converts light into electrical signals and is exclusively found in the photoreceptors of the retina. Wen
explained rhodopsin has two states – dark adapted and light adapted.
“Rhodopsin will flip a switch after it absorbs a photon, and that flip of the switch starts a process called phototrans-duction that will send out a signal to the brain. In that flip of the switch,” he con-tinued, “rhodopsin’s optical absorption spectrum changes.”
Lam added, “It’s really the first step of how we see. It’s the cornerstone of the visual process.”
It’s also measurable. Lam explained that by quantifying the efficiency of pho-ton absorption, it should be feasible to assess the functionality of rod photore-ceptors in the retina. By calculating the difference between the two states of rho-dopsin – light adapted and dark adapted – the theory was that the research team should be able to accurately determine the amount of rhodopsin in the retina … thus providing an objective answer to the ques-tion of visual acuity.
“When you want to detect rhodop-sin, you want to use the wavelengths at the peak of the absorption spectrum,” Wen continued. “That particular wavelength for rhodopsin is around 500 nanometers. We actually used 520 nm.”
Noting that visible light isn’t easy
to handle, Wen explained conventional OCT uses the much longer wavelength near-infrared light, whereas VIS-OCT employs green light.
Jiao added that in order to see the difference in dark-adapted absorption and light-adapted absorption, it was im-perative to have both resolution and con-trast, which necessitates the use of shorter wavelengths in the visible spectrum. “The intensity of the reflection from photore-ceptors is affected by the bleaching state of rhodopsin,” he noted.
Crunching the NumbersObtaining an objective measure of
rhodopsin is the first step in being able to improve diagnostics and treatment of retinal disease, Lam said. “The important clinical implication is that it can give you a gauge of how the photoreceptors are func-tioning,” he noted.
That, in turn, could give ophthalmol-ogists a new diagnostic tool and a baseline number to assess how disease is progress-ing and to evaluate therapeutic effective-ness. “It also gives you a topographical map so you also know the specific areas where rhodopsin is functioning … or not,” Lam added.
A Clearer Picture: Imaging Rhodopsin Could Shed Light on Retinal Disorders
Dr. Shuliang Jiao
Dr. Byron Lam
Dr. Rong Wen
(CONTINUED ON PAGE 8)
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n a s h v i l l e m e d i c a l n e w s . c o m JANUARY 2016 > 7
By CINDy SANDERS
VVRC Investigators Receive National Eye Institute Grant
Vanderbilt Vision Research Cen-ter’s Kevin Dieter, PhD, and the lab of Randolph Blake, PhD, recently received a presti-gious National Eye Insti-tute NRSA grant for the project, “Psychophysical and Neural Correlates of Eye Dominance in Human Vision.”
The project, which builds on the recent dis-covery that sensory eye dominance (SED) might vary idiosyncratically throughout the visual field, investigates how patterns of SED vary and searches for influences of regional SED on binocular function. Using functional magnetic resonance im-aging, Dieter plans to investigate how neural activity underlying visual field re-gions with strong SED imbalance differ from those sub-serving regions where both eyes contribute equally. The hope is that the research could lead to a deeper under-standing of typical and atypical binocular vision function, potentially leading to trans-lational applications to improve diagnosis and treatment of binocular visual disorders.
In PrintNashville eye surgeon Ming Wang,
MD, PhD, has recently published a new textbook, his eighth in the field of ophthalmol-ogy, on new treatment options for presbyopia. Published by SLACK Inc., Wang was joined by more than 30 contribut-ing experts – including Tracy S. Swartz, OD, MS, FAAO, who served as associate editor – in compiling the com-prehensive Refractive Lens Exchange: A Surgical Treatment for Presbyopia.
The publishing house notes permanent surgical treatment for presbyopia remains “the hereto unconquered ‘last frontier’ in anterior segment surgery. Over the years, continuing innovations like Phacoemulsi-fication, Radial Keratotomy, LASIK, and premium intraocular lenses have pushed toward this ultimate goal, but now anterior segment surgery is closer than ever with the advent of modern laser-assisted presbyopic lens implantation.”
Highlights of the textbook that is meant for ophthalmic surgeons, optom-etrists and technicians include:
• Overview of all surgical treatments for presbyopia,
• Dysfunctional lens syndrome and pathophysiology,
• Patient education and preoperative assessment,
• Assessing dysfunctional lens syn-drome,
• New technologies in mapping cor-
nea and lens for refractive lens ex-change,
• Presbyopic lens types, indications, and contraindications for refractive lens exchange,
• Postoperative care and complication management, and
• Many other technology and treat-ment considerations.
Wang noted this is the first book to guide clinicians through “this exciting new field that is emerging as a safe and effec-tive primary surgical treatment for presby-opia.”
On a personal note, Wang’s autobi-ography is also being published in Janu-ary 2016. From Darkness to Sight: A Journey from Hardship to Healing features a forward by Sen. William Frist, MD. From Wang’s escape from China’s Cultural Revolution to earning degrees from Harvard Medical School and MIT, the renowned eye sur-geon said the point of the book is to share his deep appreciation of America and the opportunities that exist in this country.
Toyos Clinic Presents at AAO 2015
Tennessee ophthal-mologist Rolando Toyos, MD, presented new treatments in dry eye, cataract, refractive lens exchange, blepharoplasty and facial rejuvenation at the recent American Academy of Ophthalmol-ogy (AAO) annual meet-
ing. He is the founder of the Toyos Clinic with locations in Middle and West Tennes-see, as well as Mississippi.
Toyos, the inventor of Intense Pulse Light (IPL) for Dry Eye Disease (DED), has been presenting his research on the treat-ment for more than a decade at AAO. Last year, three papers were published in peer review journals on Dermamed Diamond IPL, which Toyos helped develop. At AAO 2015, he presented his current research utilizing the Dermamed Diamond IPL for DED. Additionally, Toyos presented infor-mation on his new at home LED treatment called the Q, which has taken six years to develop to help patients with DED find ad-ditional relief. The Q is intended for use in conjunction with IPL.
Vanderbilt Physician Named President of National Orthoptic Group
David Morrison, MD, associate professor of Ophthalmology and Pediatrics at Vanderbilt, has been named the new president of the Ameri-can Orthoptic Council and will serve a two-year term.
The AOC accredits and certifies orthoptists, who are trained to assist pediatric ophthalmologists in evaluat-ing vision and alignment of children and adults with strabismus. Orthoptics is a two-year, post-graduate certification.
“Orthoptists are critical as physician
extenders in pediatric ophthalmology,” said Morrison. “They allow us to serve a larger patient population by measuring vi-sion in preverbal children and accurately measuring eye alignment in pediatric and adult patients. They also improve quality of care by counseling families on appropriate treatment regimes for the physician.”
Morrison, who has been active on the AOC executive committee for several years, has already gotten to work. “To date, I have revised the testing system for orthoptists, transitioning to an electronic format for the written exam, as well as re-structuring the oral/practical portion of the exam to include digital media such as vid-eos demonstrating ophthalmic diseases and motility abnormalities,” he said.
Mark Your CalendarsJanuary: The Tennessee Academy
of Ophthalmology is holding 2016 CODE-quest/CPT Coding Seminar on Saturday, Jan. 16 at One Century Place Conference Center in Nashville. The half-day seminar is geared towards physicians and non-phy-sician office staff with more than two years of coding and documentation experience. Space is limited, and registration deadline is Jan. 14. For information or to register, go online to tneyemds.org.
August: The 39th Annual Midwest Glaucoma Symposium is set for Aug. 5-6, 2016 at the Nashville Marriott at Vander-bilt University. Featured speakers include Allen Beck, MD, of Emory Eye Center; Marlene Moster, MD, of Willis Eye Hospi-tal; and Keith Barton, MD, FRCP, FRCS,
Field of VisionOphthalmic News from the Nashville Area
Dr. Kevin Dieter
Dr. Ming Wang
Dr. Rolando Toyos
Our annual Women to Watch issue is coming in May 2016, and we want your inputon women in Middle Tennessee impacting healthcare at home and beyond.
Help us honor clinicians, researchers, administrators, policy makers, and other industry experts by nominating these outstanding professionals.
To nominate, please visit nashvillemedicalnews.com and click the Women to Watch icon.
Nomination Deadline: Feb. 15, 2016
Women
TO WATCH2016
CALL FOR NOMINATIONS
Dr. David Morrison
8 > JANUARY 2016 n a s h v i l l e m e d i c a l n e w s . c o m
Wen, a photoreceptor cell biologist, also believes VIS-OCT could be useful to study future photoreceptor regeneration, including transplant stem cell-derived photoreceptors, gene therapies and neu-roprotection therapies.
“The rapid development in regenera-tive medicine to restore vision has raised a hope that regeneration of photoreceptors and restoration of photoreceptor function will become reality in the near future,” Wen said. “When that time comes, this technology will be used to see whether the new photoreceptors are functional.”
Moving from Bench to BedsideWhile this first successful test was con-
ducted in vivo on rats, Lam said it should be relatively easy to transition the imaging technique to humans. Wen stressed VIS-
OCT is “absolutely non-invasive” and that the ultimate goal is to make the test office-based and widely accessible.
To conduct the study, the research team designed and built a 3D retinal den-sitometry system. Jiao said he is currently modifying the design a bit to improve the prototype and make the system easier to use in a clinical setting.
While there is still a long way to go … and no one could commit to an exact timeframe … Wen said it was feasible this technology could be available within the next five years.
For those tasked with diagnosing and treating a range of conditions from retinitis pigmentosa to age-related macular degener-ation, any new technology that could more accurately assess a patient’s condition should be a welcome addition to the toolkit.
Last month, the seasoned healthcare team behind Emergency Physician Part-ners (EPP) announced the formation and launch of this new company focused ex-clusively on partnering with emergency medicine physicians. EPP plans to col-laborate with leading emergency medicine practices nationwide to help physicians preserve clinical independence while being positioned for financial success in an ever-changing and highly regulated healthcare environment.
Claritas Capital Equity Group – a Nashville-based investment firm which primarily focuses on healthcare, technol-ogy, and business services companies –has granted the physician partnership organi-zation access to more than $25 million to close the acquisition of emergency medi-cine physician practices, which is expected to start this first quarter of 2016.
“Successfully operating the admin-istrative side of an emergency medicine practice has become more difficult and demanding in today’s complex healthcare environment,” said Christopher Kelly, EPP founder, chairman, pres-ident and CEO. “We founded EPP because we understand how valu-able true partnership can be to physicians during these uncertain times. Our unique model allows emergency physicians to preserve their clinical independence, provide bet-ter quality care, and have an experienced business partner to handle the administra-tive burdens of running their practices.”
Kelly brings more than 20 years
of senior management experience with healthcare companies, including AmSurg Corp., The Little Clinic, Quorum Health Resources and, most recently, U.S. Anes-thesia Partners.
In addition to Kelly, EPP’s senior management team includes hospital fi-nancial management veteran Brady Stur-geon, who serves as founder, executive vice president and chief financial officer for the new company. Previously, Stur-geon was vice president of Development for LHP Hospital Group. In addition, founder Brian White will serve as execu-tive vice president and chief operating officer. White was most recently founder and managing partner of Competitive Solutions, a management consulting firm specializing in hospital-employed physi-cian management and physician practice operations.
EPP is the first single-specialty orga-nization dedicated to partnering exclu-sively with emergency medicine physician groups. Today, approximately 20,000 of the country’s 45,000 emergency physi-cians remain independent. Hospital and payer consolidation have increased signifi-cantly following the passage of the Afford-able Care Act, making the environment more difficult and uncertain for emer-gency medicine physicians.
“The emergency medicine space remains largely unconsolidated, with nearly 3,000 of the country’s 5,000 hos-pitals contracting directly with indepen-dent emergency physician groups,” said Don McLemore, founder and partner at Claritas. “We share EPP’s vision for the opportunity to strengthen these physician practices by bringing them together.”
On Dec. 7, the Nashville Health Care Council, along with Fellows co-directors former U.S. Senate Majority Leader Bill Frist, MD, and health-care economist Larry Van Horn, announced the 2016 class of the Council Fellows.
The 30 senior lead-ers from various sectors of the healthcare indus-try will address national challenges and collabo-rate to find transformative solutions. The group will participate in orientation later this month before beginning the first ses-sion in February. The year’s final session and graduation is slated for late May.
The comprehensive curriculum will address issues such as the rise of the healthcare consumer, disruptive tech-
nology, integrated delivery networks, reimbursement shifts, population health management and globalization.
“As these new market drivers emerge, Fellows offers an opportunity to think dif-ferently about how we can create a better sys-tem,” said Van Horn, a leading expert in health-care management and economics, and profes-sor at Vanderbilt Uni-versity’s Owen Graduate School of Management.
“Today’s healthcare decision-makers must be able to draw upon a diverse set of skills to effectively lead their organizations through the unprecedented changes our health system is facing,” said Frist in mak-ing the announcement. “This year’s cur-
riculum will provide a rare opportunity for the class to collaborate with innova-tors who are truly shaping our healthcare system. I am excited to see what we learn together.”
Members of the 2016 Fellows Class:
Tim Bewley, first vice president, SunTrust Bank
Hamilton Bowman, COO, Ena-bleComp
Barbara Brennan, RN, MSN, COO and chief nursing officer, Alive Hospice
Shannon Hooper, senior vice presi-dent and practice leader, ReviveHealth
Eric Keen, general partner, Council Capital
Daniel Lieber, COO, Altegra Health
Brian Marger, COO, TriStar Cen-tennial Medical Center
Ricardo Martinez, MD, chief medical officer, North Highland World-wide
John McClellan, vice president, Operations, Division 5, Community
Health SystemsMichele Molden, senior vice presi-
dent and partner, The Advisory Board Company
Neal Patel, MD, chief medical in-formatics officer, Vanderbilt University Medical Center
Amy Rock, senior director, Regula-tory and Scientific Affairs, Cumberland Pharmaceuticals
Matthew Russell, chief technology officer, Digital Reasoning
Dexter Samuels, PhD, senior vice president and executive director, Robert Wood Johnson Foundation for Health Policy, Meharry Medical College
Mark Thompson, vice president, Operations Finance, Healthways
Mike Uchrin, CEO, Health ChoiceMarc Watkins, MD, vice president
and corporate medical director, The Little Clinic
Morgan Wills, MD, president and CEO, Siloam Family Health Center
Dakasha Winton, director, asso-ciate general counsel State Government Relations, BlueCross BlueShield of Ten-nessee
Chris Wyatt, CFO, HCA Informa-tion Technology and Services, HCA
“Fellows is a venture that could only take place here in Nashville, a $73 billion healthcare hub, where we have immediate access to the industry’s founders, as well as a host of respected healthcare experts, innovators and academic institutions,” said Hayley Hovious, Council president. “When you consider the unmatched reach and diversity of our healthcare commu-nity, there’s no question why this is the place to hold these important conversa-tions and inspire the advancements that will reshape our business.”
Council Fellows is presented in part-nership with BlueCross BlueShield of Tennessee, Community Health Systems, HCA, Healthways, LifePoint Health, and Vanderbilt University Owen Graduate School of Management.
Council Fellows Announces 2016 Class
Larry Van Horn
Dr. Bill Frist
A Clearer Picture, continued from page 6
n a s h v i l l e m e d i c a l n e w s . c o m JANUARY 2016 > 9
When the second year of the 109th General Assembly begins on Jan. 12, the Tennessee Medical Association will be ready to discuss legislation to help im-prove the healthcare environment for Tennessee doctors and patients.
During the upcoming session, TMA will focus on an agenda to craft a system that is patient-centered and physician-led, make sure insurance companies are more accountable when changing fee schedules and payment policies, and protect medical malpractice caps, among other issues.
“TMA is looking out for the future of Tennessee healthcare, working to make sure it evolves in ways that allow doctors to provide the best care possible to their patients. The issues on our 2016 agenda reflect our mis-sion as an organization,” said TMA President John W. Hale, Jr., MD.
The full list of 2016 priorities is available at tnmed.org.
The Doctor as Team LeaderOne of the key pieces of legislation on
TMA’s list of priorities is the Tennessee Healthcare Improvement Act. The bill would put in place a team-based health-care delivery model with doctors as the team leader in patient care coordination. It calls for collaboration between physi-cians and advanced practice nurses to make sure patients receive care from the appropriate providers with coordinated collaboration.
The TMA-backed bill is being offered as an alternative to the Nurse Independent Practice/Full Practice Authority Bill. The Tennessee Nurses Association has long advocated for legislation to remove scope-of-practice barriers, which has put the two major provider organizations at odds on this issue.
“Having the proper collaboration from a physician in diagnosing and treat-ing a patient ensures the highest qual-ity of care and patient safety,” stated Hale. “We want to knock down silos among providers, increase care collabo-
ration and create a model that supports the best possible patient outcomes. The Healthcare Improvement Act will allow advanced practice nurses to use the full extent of their training but make sure that a physician is involved in the care of every patient. It’s in the best interest of all Tennesseans.”
Reimbursement StabilityTMA will also advocate for the
Healthcare Provider Stability Act during the upcoming legislative session. The act, sponsored by Sen. Bo Watson (R-Hixson) and Rep. Jon Lundberg (R-Bristol), would limit how often insurance companies could change fee schedules and payment policies and require adequate notice of those changes to make the process more transparent.
“It’s impossible for a physician to make sure the business side of a practice runs smoothly when health plans can cut reimbursement mid-contract with no re-course for the physician,” Hale said.
Clarifying Malpractice CapsA third major initiative for TMA in
the upcoming session is to work toward a constitutional amendment clarifying that the General Assembly has the authority to set caps on noneconomic damages in cases including medical liability actions.
A 2011 cap on noneconomic dam-ages is currently being threatened by law-suits. The proposed amendment must pass two separate General Assemblies before it goes on the ballot for a vote in 2018. If the amendment doesn’t pass the 2016 Gen-eral Assembly, the earliest the issue could be up for a statewide vote would be 2022.
“The General Assembly needs to act now to prevent us from going backwards on the issue of a noneconomic damages cap,” said Hale. “The cap fosters growth in Tennessee’s healthcare industry by cut-ting back on frivolous lawsuits and the costs that come with them. I’m confident Tennessee voters will support it if given the chance to have their voices heard.”
TMA Outlines 2016 Legislative Priorities
Dr. John W. Hale, Jr.
GrandRoundsRice Named Chief Quality Officer for Capella
Last month, officials with Capella Healthcare announced Dana Rice, RN, MHA, CCM, has been appointed senior vice president and chief qual-ity officer. With more than 20 years of healthcare experience, Rice will be responsible for working with the company’s hos-pitals on clinical operations and quality performance.
Previously, Rice served as senior di-rector of Hospital Operations for Kaiser Permanente, acting as an administrative liaison to 11 hospitals in the Colorado region, and as regional director of Re-source Stewardship. Before joining Kai-ser, Rice spent two years as COO for a Capella hospital in Olympia, Wash. She holds an associate’s degree in nursing, a bachelor’s in health services manage-ment, and a master’s in health adminis-tration.
Fre$h Savings Program Launched
With $4.3 million in support from UnitedHealthcare and the USDA, the AARP Foundation and participating gro-cers and farmers markets have launched the Fre$h Savings program in Tennessee and Mississippi, which aims to help Sup-plemental Nutrition Assistance Program (SNAP) recipients live healthier lives by making fresh food more affordable.
The program, which debuted in late 2015, provides coupons for 50 percent off the future purchase of fresh fruits and vegetables whenever SNAP recipi-ents buy fresh produce at select Kroger
stores in West Tennessee and participat-ing farmers markets in Memphis, Nash-ville, Murfreesboro, Chattanooga and Knoxville.
As noted in United Health Founda-tion’s America’s Health Rankings (see page 1), Tennessee ranks among the worst in the nation for the consumption of fruits and vegetables. Tennessee also ranks 47th in the nation in food insecurity among seniors, with approximately 21 percent of Tennessee seniors considered food insecure.
News from the Nashville Entrepreneur Center
The Nashville Entrepreneur Center (EC) recently announced an 18-month engagement with the Kauffman Foun-dation to strengthen the city’s capacity to support entrepreneurs. One of only two cities selected for the award, an ini-tial project is the new Diversity Initiative, which is also supported by Google for Entrepreneurs. The program has a focus on creating a more inclusive entrepre-neurial environment in Nashville.
From a staffing standpoint, CEO Stuart McWhorter announced Sam Lingo as EC’s new president and COO. He has served as COO since July 1, 2011 and added his responsibilities as president last month. A Nashville na-tive, Lingo earned his de-gree in economics from Vanderbilt.
Also, John R. Ingram, board chair for EC, re-cently announced Beth R. Chase, founder and CEO of C3 Consulting, has been named EC’s
chairman-elect, effective this month. She will serve a year in her current position before taking over as chairman in Janu-ary 2017. Other new board members be-
ginning terms this month include Jason Epstein, Jose Gonzalez, Angela Hum-phreys, Janet Miller, Chris Sloan, and Yiaway Yeh.
Neighborhood Health Opens New ClinicsWith the opening of two new clinics in Inglewood and Lebanon, Neighborhood
Health now has a dozen locations serving Davidson, Wilson and Trousdale counties. In December, Neighborhood Health at Lebanon celebrated the new location
with a ribbon-cutting ceremony and community open house. A physician and nurse practitioner provide comprehensive preventive and primary care. A licensed behav-ioral health provider also is available for counseling. The clinic, which is located on East High Street, is projected to serve 2,500 individuals annually. The clinic was made possible by $495,000 in Affordable Care Act funding. The grant was part of a $101 million national initiative to fund 164 new community health centers across the na-tion.
In November, a similar ribbon-cutting ceremony was held for the Inglewood Clinic, located on Gallatin Pike, which brings access to care for this medically under-served area. Neighborhood Health cited need – nearly 40 percent of the residents are low-income; about 7,000 do not have access to affordable primary healthcare; and 20 percent of the children live in households under the poverty line – as the impetus for opening the new clinic.
Dana Rice
Sam Lingo
Beth R. Chase
10 > JANUARY 2016 n a s h v i l l e m e d i c a l n e w s . c o m
Let’s Give Them Something to Talk About!Awards, Honors, Achievements
The Society of Urologic Oncology has honored Joseph Smith, Jr., MD, professor of Urologic Sur-gery at Vanderbilt Univer-sity Medical Center, with the prestigious Huggins Medal. The organization bestowed its highest hon-or upon Smith for his life-time contributions to the progress in treatment for patients with genitourinary neoplasms.
Steve Corbeil, president and CEO of HCA TriStar Division, was recently ap-pointed to the Federation of American Hospitals Board of Directors. The FAH is the national representative of more than 1,000 investor-owned or managed community hospitals and health systems throughout the United States.
The Greater Nashville Affiliate of Su-san G. Komen has named Justin Balko, PharmD, PhD, an assistant professor of Medicine and Cancer Biology at Vander-bilt-Ingram Cancer Cen-ter, a member of the 2016 Class of Pink Tie Guys. The honorees are community leaders who have a per-sonal connection to breast cancer and are committed to making a difference in the effort to find a cure for the disease. Balko, who is Leader of Molecular Oncology in the Center for Cancer Targeted Therapies at VICC, has already received multi-year fi-nancial grants from Komen to support his breast cancer research.
For two decades, Publix Super Markets, Inc. has worked alongside the March of Dimes to give all babies a healthy start in life. This year, during their annual three week in-store March for Ba-bies fundraising campaign, Publix cus-tomers and associates raised $6,050,470, an 18 percent increase from 2014, bring-ing their 20 year total to an impressive contribution of $57 million for stronger, healthier babies.
This fall, Saint Thomas Health hit a major milestone, serving the 10,000th patient through the “Our Mission in Mo-tion” mobile mammography unit. Nearly half, 46 percent to be exact, of the mam-mograms were provided as charity care.
POZ magazine, an award-wining publication for people living with or af-fected by HIV/AIDS, recently honored 100 individuals from across the nation making a difference in the fight against HIV/AIDS. Joseph Interrante, PhD of Nashville CARES and Larry Frampton of Nashville Regional AIDS Planning Council have both been named to the POZ 100.
A. Bapsi Chakravarthy, MD, profes-sor and residency director of Radiation Oncology, has been named a Fellow by the American Society for Radiation On-cology (ASTRO). She is one of 17 ASTRO members named to the 2015 class of Fel-lows.
Independent hospital watchdog The Leapfrog Group recently identified five TriStar Health hospitals as earning an ‘A’ grade for patient safety in this elite na-tional ratings program. TriStar Centen-nial, TriStar Skyline, TriStar Southern Hills, TriStar StoneCrest and TriStar Summit medical centers all received top marks.
A clinical practice improvement module developed at the University of Tennessee Health Science Center (UTHSC) was one of five national winners in the inaugural Practice Innovation Chal-lenge sponsored by the American Medi-cal Association and the Medical Group Management Association. The UTHSC “SafeMed” module, which encourages safe and effective medication use in an outpatient setting, could be used in clinics around the country in the future through the AMA’s STEPS Forward initiative.
CapStar Adds Another Veteran to Healthcare Team
CapStar Bank continues to build its healthcare team with the addition of John Teasley as senior vice president. Teasley, who has nearly 15 years of corporate lending experience, was most recently with Fifth Third Bank. Before that, he spent a decade with SunTrust in various divisions. Teasley joins Buddy Bacon and Mark Mattson to spearhead healthcare efforts for CapStar.
ServisFirst Bank Nashville Names Vieira President
Birmingham-based ServisFirst Bank, which first opened in Nashville in June 2013, has promoted Bradford Vieira to the role of president. The Nashville native will lead long-term strategy in Tennessee including oversight of banking operations including commercial, private and retail banking, along with cash management services. ServisFirst recent-ly announced the opening of its new 10,400-square-foot retail banking center and corporate office at Palmer Plaza, 1801 West End Ave., which is slated to open this month.
Prior to his new role, Vieira served
as senior vice president and commercial banking manager for ServisFirst and has been instrumental in the bank’s growth in Tennessee. Prior to ServisFirst, he was a vice president with Fifth Third Bank and began his career in the Healthcare Fi-nance Division of First American National Bank. A graduate of Belmont University, he currently serves on the board of the Junior Diabetes Research Foundation of Middle Tennessee, Nashville Capital Net-work, Nashville Sports Council, and Bel-mont University Athletic Bruin Club.
NuSirt Receives FDA Fast Track Designation
Last month, NuSirt Biopharma an-nounced the U.S. Food and Drug Ad-ministration (FDA) has granted Fast Track designation for its development program focused on non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).
“NAFLD and NASH represent se-rious unmet medical needs for which there are no approved therapies,” said Joseph C. Cook, Jr., president and ex-ecutive chairman of the board of NuSirt Biopharma. “It is estimated that 75-100 million people in the U.S. have NAFLD, and 10-20 million have progressed to NASH.”
NuSirt’s patented technology com-bines a naturally occurring amino acid, leucine, with existing pharmaceuticals. In pre-clinical studies, NuSirt’s triple combi-nation of leucine, metformin and silde-nafil showed the potential to reverse NAFLD, reduce symptoms of the dis-ease, and prevent the onset of NAFLD and NASH. Additional animal stud-ies have shown the triple combination could reverse obesity-induced liver fat accumulation, inflammation and fibrosis in mice. This research was presented at the American Association for the Study of Liver Diseases (AASLD)’s annual The Liver Meeting® in November 2015.
NuSirt also announced the start of enrollment for its Phase 2A clinical trial targeting this disease at nine U.S. re-search sites. The Phase 2A clinical trial, named TRIPLN, is a randomized, 16-week, placebo-controlled, double-blind study. Initial results are expected in the second half of 2016.
sus, a nationwide network of community-based hospice programs and palliative care services, recently announced the addition of Dennis Wade as senior vice president of Human Resources and Or-ganization Development.
Wade comes to Compassus from Corizon Health, where he served as ex-ecutive vice president and chief human resources officer. There, he was account-able for the administration of personnel policies, programs, compensation and benefits for more than 12,000 employees in 27 states. Wade earned his bachelor’s degrees in business and psychology from Birmingham-Southern College.
SOUTHCOMM BUSINESS MEDIAChief Executive Officer Chris Ferrell
Chief Financial Officer Ed Tearman
Chief Operating Officer Blair Johnson
Director Of Financial Planning And Analysis Carla Simon
Vice President Of Human Resources Ed Wood
Vice President of Content Patrick Rains
Vice President Of Production Operations Curt Pordes
Chief Revenue Officer Dave Carter
Director Of Digital Sales & Marketing David Walker
Controller Todd Patton
Creative Director Heather Pierce
Read More Grand Rounds online. NashvilleMedicalNews.com
Dr. Joseph Smith, Jr.
GrandRounds
Dr. Justin Balko
Dora Okine (center) poses with two mobile mammog-raphy technologists who have taken life-saving screen-ings on the road.
Bradford Vieira
n a s h v i l l e m e d i c a l n e w s . c o m JANUARY 2016 > 11
GrandRounds
Herrington Joins Nashville Child & Family Wellness
Pediatric psychologist, Katie Her-rington, PhD, recently joined Nashville Child & Family Wellness, which offers an array of behavioral health ser-vices under one roof. She brings to the West Nash-ville practice a mission to help families and chil-dren dealing with chronic stress. Where stress used to be mostly confined to the middle-aged, overworked individuals, more and more psychologists are seeing children and adolescents dealing with anxiety.
Herrington earned a degree in child development and a doctorate in clini-cal psychology from Vanderbilt Univer-sity. She fulfilled her clinical internship at the University of North Carolina School of Medicine at Chapel Hill and com-pleted a post-doctoral fellowship at the Vanderbilt Kennedy Center Treatment and Research Institute for Autism Spec-trum Disorders (TRIAD) and the Division of Developmental Medicine at Monroe Carell Jr. Children’s Hospital.
Mid-Tennessee Bone & Joint Welcomes Sykes
Kenneth T. Sykes, MD, PhD, recently joined the practice of Mid-Tennessee Bone and Joint. Sykes, whose specialty is inter-ventional pain manage-ment, takes an active role in treating patients with chronic pain through a multi-disciplinary ap-proach that includes advanced treatment op-tions.
Sykes earned his medical degree from the University of Iowa Carver Col-lege of Medicine. He earned two doc-torates in pharmacology and chemistry, and completed his pain management fellowship and anesthesia residency at Washington University School of Medi-cine in St. Louis. He is board certified in anesthesiology and pain medicine.
McDuffie Joins Tennessee Oncology
Jeremy S. McDuffie, MD, a board certified medical oncologist and hema-tologist, recently joined Tennessee Oncology at the large, physician-owned practice’s Mur-freesboro location.
Previously, McDuff-ie cared for patients at Northwest Georgia On-cology Centers’ Marietta Cancer Center. He was also a researcher with the cancer practice’s William S. Gib-bons Cancer Research Institute. McDuff-ie completed a fellowship in medical oncology/hematology at Vanderbilt University and his residency and intern-ship in internal medicine at Washington
University/Barnes-Jewish Hospital in St. Louis.
Daniel Named CFO at PhyMed Healthcare Group
Nashville-based PhyMed Health-care Group, a physician-led and owned leader of anesthesia and pain manage-ment services, recently announced Sam E. Daniel has been named chief financial officer where he is responsible for all as-pects of PhyMed’s financial operations and provides strategic financial guid-ance to drive growth.
Daniel brings more than 30 years of financial leadership with an emphasis on healthcare organizations to his new po-sition at PhyMed. Previously, Daniel was CFO of Comprehensive Pharmacy Solu-tions, and also served as CFO at Ameri-can Pathology Partners. Daniel has also held leadership roles at various labora-tory and specialty pharmacy companies throughout his career. A certified public accountant, Daniel earned his account-ing degree from Freed-Hardeman Uni-versity.
Hagerty Named to Avondale Advisory Board
Avondale Partners has announced that William F. (Bill) Hagerty, former Tennes-see Commissioner of Eco-nomic Development under Gov. Bill Haslam, has joined the firm’s Advisory Board.
Hagerty is managing director of Hagerty Peter-son & Company, LLC, a merchant bank and private equity investment firm that he co-founded. He served as a state com-missioner through January 2015.
Dr. Katie Herrington
Dr. Kenneth T. Sykes
Dr. Jeremy S. McDuffie
Dr. Katie Herrington
Wang Vision 3D Cataract & LASIK Center615.321.8881 | WangCataractLASIK.com
The doctors’ doctor:Dr. Ming Wang
Harvard & MIT (MD, magna cum laude); PhD (laser physics)
Performed surgeries on over 4,000 doctors
Inventions & Patents1. LASERACT: All-laser cataract surgery U.S. patent fi led.
2. Phacoplasty U.S. patent fi led.
3. Amniotic membrane contact lens for photoablated corneal tissue U.S. Patent Serial No
5,932,205.
4. Amniotic membrane contact lens for injured corneal tissue U.S. Patent
Serial No 6,143,315.
5. Adaptive infrared retinoscopic device for detecting ocular aberrations U.S. Utility Patent
Application Serial No. 11/642,226.
6. Digital eye bank for virtual clinical trial U.S. Utility Patent
Application Serial No. 11/585,522.
7. Pulsed electromagnetic fi eld therapy for nonhealing corneal ulcer U.S.patent fi led.
8. A whole-genome method of assaying in vivo DNA protein interaction and gene expression regulation U.S. patent fi led
Dr. Ming Wang, Harvard & MIT (MD, magna cum laude); PhD (laser physics), is one of the few cataract and LASIK surgeons in the world today who holds a doc-torate degree in laser physics. He has performed over 55,000 procedures, including on over 4,000 doctors (hence he has been referred to as “the doctors’ doctor”). Dr. Wang currently is the only surgeon in the state who offers 3D LASIK (age 18+), 3D Forever Young Lens surgery (age 40+) and 3D laser cataract surgery (age 60+). He has published 7 textbooks, over 100 papers including one in the world-renowned journal “Nature”, holds several U.S. patents and performed the world’s fi rst laser-assisted artifi cial cornea implantation. He has
received an achievement award from the American Academy of Ophthalmology, and a Lifetime
Achievement Award from the American Chinese Physician Association. Dr. Wang founded a 501c(3) non-profi t charity, the Wang Foundation for Sight Restoration (www.Wangfounda-tion.com), which to date has helped patients from over 40 states in the U.S. and 55 countries worldwide, with all sight restoration surgeries performed free-of-charge.
Wang Vision 3D Cataract & LASIK Center615.321.8881 | WangCataractLASIK.com
