Memphis Medical News March 2015

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December 2009 >> $5 PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357 ONLINE: MEMPHIS MEDICAL NEWS.COM ON ROUNDS PRINTED ON RECYCLED PAPER March 2015 >> $5 FOCUS TOPICS ONCOLOGY HEALTHCARE MARKETING PATIENT ENGAGEMENT BY JUDY OTTO Perhaps it’s her risk-taker’s nature, or per- haps the skills she learned in the trenches, but Jan Conwill seems to have a special knack for strategically managing operations for an im- pressive list of groups, clinics and programs, including the new Family Cancer Center Foun- dation. With its five locations, nine physicians and 65 employees, the foundation is her latest en- deavor. It becomes effective this month, when the group’s physicians join the Baptist Medical Group, establishing the Baptist Cancer Center Physicians Foundation. “I’m excited to be a part of this new ven- ture,” said Conwill, the foundation’s COO. (CONTINUED ON PAGE 10) HealthcareLeader Jan C. Conwill COO, Family Cancer Center Foundation PAGE 3 PHYSICIAN SPOTLIGHT Memphis Hospitals Move Forward With Patient Engagement Efforts BY GINGER H. PORTER Memphis-area hospitals are encouraging patients to become invested in their own health – an effort embedded in Stage Two of the Meaningful Use Initiative governed by the Centers for Medicare and Medicaid Services. “How we engage with our patients is changing in the healthcare industry,” said Reginald Coopwood, MD, president and chief executive officer of Regional One Health. “The days when our responsibility to the patient ended at the point of discharge are gone. Now, hospitals are involved in the health of the patients at every phase of their care, including after they go home.” As healthcare moves from episodic care to preventative care, initial evi- dence is showing that active engagement results in better outcomes. “In this healthcare culture, the patients are involved with their clinical teams to participate in their care and recovery,” said Marilynn Robinson, senior vice president at St. Francis Healthcare. “This raises awareness of things they can do to improve their own health. It benefits all, as there is a stronger, more interactive partnership between the hospital and the patient.” In today’s era of mobile devices, patient portals are the baseline tech- nological tool to reach patients and facilitate this type of partnership. (CONTINUED ON PAGE 8) Tight Budgets Don’t Slow Changes in Healthcare Marketing    Digital use by hospitals, clinics continues to grow Growing costs are affecting every aspect of healthcare, including marketing. Fortunately for that seg- ment of the industry, the addition of an important new dynamic currently is being ac- complished despite the strong economic challenges ... 4 St. Jude Research Team Targets Ewing Sarcoma with New Approach During the past two decades there has been little improve- ment in the long-term survival rate of 75 percent for children and young adults with Ewing sarcoma whose cancer did not spread ... 5 [email protected] 501.247.9189 To promote your business or practice in this high profile spot, contact Pamela Harris at Memphis Medical News. Baptist OneCare MyChart has been heavily marketed since it went live locally in the beginning of 2014. Stephen W. Behrman, MD

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Memphis Medical News March 2015

Transcript of Memphis Medical News March 2015

Page 1: Memphis Medical News March 2015

December 2009 >> $5

PRSRT STDU.S.POSTAGE

PAIDFRANKLIN, TN

PERMIT NO.357

ONLINE:MEMPHISMEDICALNEWS.COM

ON ROUNDS

PRINTED ON RECYCLED PAPER

March 2015 >> $5

FOCUS TOPICS ONCOLOGY HEALTHCARE MARKETING PATIENT ENGAGEMENT

BY JUDY OTTO

Perhaps it’s her risk-taker’s nature, or per-

haps the skills she learned in the trenches, but Jan Conwill seems to have a special knack for strategically managing operations for an im-pressive list of groups, clinics and programs, including the new Family Cancer Center Foun-dation.

With its fi ve locations, nine physicians and 65 employees, the foundation is her latest en-deavor. It becomes effective this month, when the group’s physicians join the Baptist Medical Group, establishing the Baptist Cancer Center Physicians Foundation.

“I’m excited to be a part of this new ven-ture,” said Conwill, the foundation’s COO.

(CONTINUED ON PAGE 10)

HealthcareLeader

Jan C. ConwillCOO, Family Cancer Center Foundation

PAGE 3

PHYSICIAN SPOTLIGHT Memphis Hospitals Move

Forward With Patient Engagement Efforts

BY GINGER H. PORTER

Memphis-area hospitals are encouraging patients to become invested in their own

health – an effort embedded in Stage Two of the Meaningful Use Initiative governed by the Centers for Medicare and Medicaid Services.

“How we engage with our patients is changing in the healthcare industry,” said Reginald Coopwood, MD, president and chief executive offi cer of Regional One Health. “The days when our responsibility to the patient ended at the point of discharge are gone. Now, hospitals are involved in the health of the patients at every phase of their care, including after they go home.”

As healthcare moves from episodic care to preventative care, initial evi-dence is showing that active engagement results in better outcomes.

“In this healthcare culture, the patients are involved with their clinical teams to participate in their care and recovery,” said Marilynn Robinson, senior vice president at St. Francis Healthcare. “This raises awareness of things they can do to improve their own health. It benefi ts all, as there is a stronger, more interactive partnership between the hospital and the patient.”

In today’s era of mobile devices, patient portals are the baseline tech-nological tool to reach patients and facilitate this type of partnership.

(CONTINUED ON PAGE 8)

Tight Budgets Don’t Slow Changes in Healthcare Marketing     Digital use by hospitals, clinics continues to grow  Growing costs are affecting every aspect of healthcare, including marketing. Fortunately for that seg-ment of the industry, the addition of an important new dynamic currently is being ac-complished despite the strong economic challenges ... 4

St. Jude Research Team Targets Ewing Sarcoma with New Approach  During the past two decades there has been little improve-ment in the long-term survival rate of 75 percent for children and young adults with Ewing sarcoma whose cancer did not spread ... 5

[email protected]

To promote your business or practice in this high profi lespot, contact Pamela Harris at Memphis Medical News.

Memphis Hospitals Move Forward With Patient Engagement Efforts

Memphis-area hospitals are encouraging patients to become invested in their own health – an effort embedded in Stage Two of the Meaningful Use Initiative governed

“How we engage with our patients is changing in the healthcare industry,” said Reginald Coopwood, MD, president and chief executive offi cer of Regional One Health. “The days when our responsibility to the patient ended at the point of discharge are gone. Now, hospitals are involved in the health of the patients at

As healthcare moves from episodic care to preventative care, initial evi-

“In this healthcare culture, the patients are involved with their clinical teams to participate in their care and recovery,” said Marilynn Robinson, senior vice president at St. Francis Healthcare. “This raises awareness of things they can do to improve their own health. It benefi ts all, as there is a stronger, more interactive partnership between the hospital and the

In today’s era of mobile devices, patient portals are the baseline tech-nological tool to reach patients and facilitate this type of partnership.

(CONTINUED ON PAGE 8)

Baptist OneCare MyChart has been

heavily marketed since it went live

locally in the beginning of 2014.

Stephen W. Behrman, MD

Stephen W. Behrman, MD

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m e m p h i s m e d i c a l n e w s . c o m MARCH 2015 > 3

Stephen W. Behrman, MDNew Englander finds Memphis the right base for fight vs. pancreatic cancer

PhysicianSpotlight

BY RON COBB

For people living in the Northeast, the end is finally in sight for the brutal winter of 2014-15. Here in Memphis, New Eng-land native Stephen Behrman, MD, is not, as one might think, relieved that he missed all that record snowfall, but rather wistful about how he would have enjoyed it.

“That’s the stuff we live for as New Englanders,” he said.

Behrman is a professor of surgery in the division of surgical oncology at the University of Tennessee Health Science Center. His primary area of expertise is pancreatic cancer. He twice has chosen to locate in Memphis and has spent most of his career here, even though, as he says, “My heart will always be in New England, and I still go back quite often.”

He grew up in Needham, just outside Boston. He came from what he calls a blue-collar family and as a youngster ran track and cross country, played saxophone in the band, had a newspaper route and worked at McDonald’s. After earning a degree in biology at Boston University, he failed to get into medical school on his first attempt, so he took a job as assistant to the anesthesi-ologist at Shriners Burn Hospital in Boston.

“That gave me a lot of exposure to sur-gery and kind of confirmed that my passion was surgery and medicine,” he said.

After earning his medical degree at Boston U., he decided it was time to ex-perience life outside New England. For surgery training, he applied to programs in the South. He had an interview at North Carolina on a Monday and at Emory the following Saturday, and so to fill the time in between secured an interview in Memphis almost on a whim.

“I certainly didn’t know much about the program,” he said. “This is where I ended up matching. I feel fortunate that I did train here.”

Still, when he left UT to complete a fellowship in gastrointestinal surgery at Ohio State, he thought he’d seen his last of Memphis. But after career stops in New Hampshire and California, “my old chair-man, Dr. (Louis G.) Britt, asked me to come back here to work at the old Baptist down-town in ’97, and I’ve been here ever since.”

Several years later, one of his pancre-atic cancer patients, a dentist, Dr. Maurice Petrovsky, introduced him to the family of Herb Kosten, who had recently lost his life to the same disease. Petrovsky’s introduc-tion to the Kostens led to Behrman’s as-sociation with the Herb Kosten Pancreatic Cancer Research Foundation – an associa-tion that now is about eight years old.

“The unique thing about that family is they had no one involved in medicine at all, and yet when Herb died they really wanted to try to have an impact in our community and make the experience of anyone with pancreatic cancer better and hopefully lead

to an ultimate cure,” Behrman said.Behrman is the foundation’s medi-

cal adviser and established the Kosten Foundation Pancreatic Cancer Research Endowment Fund at UTHSC. The foun-dation’s primary fund-raiser is the Kick It 5K, scheduled for Sunday, March 23.

“The last five years we’ve had about 1,500 runners, making it one of the big-gest 5K races in Memphis,” Behrman said. “The best part is that almost everybody who shows up has some tie to pancreatic cancer – either they have a family member with it or know someone who died from it.

“So that whole day, which seems like it would be a somber day, is actually kind of a day of celebration. We have a sup-port group here in town, we bring in an internationally prominent speaker, and the Kostens fund two researchers in the basic science lab that I collaborate with. So it’s been a very rewarding relationship.”

The rising incidence of pancreatic cancer that Behrman has seen in the Mid-South, however, is a source of disappoint-ment, not to mention what the doctor says is a lack of funding and awareness.

“Because of the Kostens, the aware-ness in our community has gone up,” he said, “but I think many people are still not aware of it until it affects them or they know someone who’s been affected by it.

“What’s almost incredible is that pan-creatic cancer is one of the most lethal dis-eases, but it’s one of the least funded by the National Institutes of Health. For instance, breast cancer, which we basically have licked now – the vast majority of people with breast cancer are cured of it – gets the most funding by the NIH. Pancreatic can-cer gets the least. It’s not even on the radar screen. So it’s extremely frustrating.”

On the positive side, while a cure is not in sight, Behrman sees advances brought about by identifying gene mutations that occur in people with pancreatic cancer. By screening families, taking cancer tissue and performing gene sequencing, risk assess-

ments can be made.“I think what ultimately will happen

is it will be like many cancers now where we can actually do a blood test, especially with those who might be of higher risk for pancreatic cancer, and see if they have any mutations that we can say, yes, your risk of pancreatic cancer is 50 percent or 70 per-cent. And at that point we can recommend prophylactically taking out their pancreas.

“That is certainly a ways off, but I think that is going to be the future, because there’s not really a great way to pick it up” in its early stages.

Behrman spends a good portion of his time cooped up indoors, so in his free time he likes to go for runs or work in the gar-den. When he goes back to Massachusetts, he likes to kayak and bike. His wife, Robyn, a former nurse, is active in volunteering with the Kosten Foundation and other or-ganizations. Their daughter, Caroline, is a senior at the University of Memphis who plans to go to pharmacy school.

And Behrman’s heart, as stated earlier, is in New England, and it was warmed last month when the Patriots won the Super Bowl. The doctor watched the game at a friend’s house “surrounded by Seahawks fans,” who were as distraught as he was thrilled when the Pats scored an improb-able, last-minute victory.

“Miracles do happen if one has faith,” he said.

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Growing costs are affecting every as-

pect of healthcare, including marketing. Fortunately for that segment of the in-dustry, the addition of an important new dynamic currently is being accomplished despite the strong economic challenges.

Mid-South hospitals, clinics and medi-cal centers are turning to digital marketing, including search engine optimization, mo-bile marketing and social media, for cost-effective ways to reach the growing number of consumers who look online for health-care information.

The addition of digital marketing can be added to a total marketing effort without breaking a budget. Marketing teams need only decide what other segments of their overall effort should be scaled down.

“We have reallocated our funds from traditional marketing efforts to include our digital efforts,” said Jennilyn Utkov, senior director of marketing and communications for Le Bonheur Children’s Hospital. “We must focus on how things are presented vi-sually online, so we have invested more in video and photography to tie our message together.”

Reducing expenditures in other areas seems appropriate because some tactics have become less effective as the Internet becomes a more important tool for an ever-increasing segment of the population.

According to the Pew Research Cen-ter, 72 percent of Internet users say they have looked online for health information within the past year. The Internet, paired with advice from referring physicians, is helping patients make more informed healthcare choices.

“Our audience mainly consists of 25- to 44-year-olds with children, and they rely

less on traditional media and instead are accessing information online,” Utkov said. “We must meet their needs and provide the right content in the right place for the right audience.”

Michelle Hodges, brand marketing director at Memphis Orthopaedic Group, warns that marketers in the healthcare in-dustry shouldn’t lose sight of the overall picture.

“Marketing isn’t just about social media or traditional media; it’s any activity that moves a practice in a positive, desired direction,” Hodges said. “It takes a stra-tegic marketing plan composed of many elements (including traditional media) sup-porting each other to move the needle for-ward, and targeting physicians and medical practices is a large part of that strategy. It’s estimated it takes five or more encounters with a practice name for it be recognized.”

She said a mix of publications from general interest to niche such as medi-cal media is a vital element in supporting brand recognition and growth.

“Respected medical publications lend credibility to the practices that advertise. It’s all about your marketing mix. Adver-tising in a medical publication supports our grass roots efforts of personally calling on these physician offices to generate referrals and awareness of service lines/locations/hours. It’s a “no brainer” in terms of mar-keting strategy as it targets a very specific demo we are trying to reach,” she said.

Hospitals such as Regional One Health advertise on traditional media platforms such as radio, television and billboards, but the marketing focus is on building brand awareness, not services, ac-cordingly to Allison Vance, director of cor-porate marketing for Regional One.

“Consumers come to our website to

take action. For example, they want to see what specific healthcare ser-vices we provide and find a physician,” she said. “They can access that eas-ily from our site.”

Content manage-ment and search engine optimization is a key fac-tor in delivering targeted, measurable results online. Healthcare marketers can identify information consumers are access-ing and what information is critical. For example, Utkov can identify that Le Bon-heur’s practical parenting blog on family-relevant topics is a popular feature on its website. In addition, content must be brief, specific and responsive.

“The average person online has an at-tention span of eight seconds,” said Darnell Settles, web marketing manager for Baptist Memorial Health Care. “A large percent-age of (web) traffic comes from organic research, which means someone is actively looking for information, and it must be concise and extremely targeted.”

Mid-South marketing experts agree that mobile marketing is a growing trend. Consumers access healthcare information from their mobile phones. According to the Pew Research Center, 52 percent of smart-phone owners use their phone to research health-related information, and 19 percent have downloaded a smartphone app to track or manage health.

“We track our web analytics and we have discovered that over half of our web traffic comes from consumers accessing our website from their smartphone,” Utkov said. “It is necessary to make your website readable from a smartphone.”

Consumers can access all Mid-South

hospitals’ websites in a mobile format.In addition, smartphone apps create

convenience for patients. Baptist designed a smartphone app called “Minor Med Rest & Relax at Home.” Patients can pre-register and check in to one of their four minor medical facilities directly from their smartphones.

Health-related non-profits know that mobile marketing can assist them in their efforts. The Mid-South Transplant Foun-dation, the Mid-South’s federally desig-nated organ procurement organization, plans to implement a program in which residents can register to become organ and tissue donors by swiping their driver’s li-cense on a smartphone.

“Residents can go to our website and register to become an organ and tis-sue donor any time now,” said Randa Lipman, community outreach manager for Mid-South Transplant Foundation. “Eventually, donors will be able to regis-ter simply by swiping their ID on a phone. This is already being done by Donate Life Arizona.”

Social media gives hospitals and clin-ics the chance to share patient stories and connect consumers. Marketing depart-ments manage content, respond in real time to consumers’ questions and monitor dialogue on social media platforms such as Facebook, Twitter and Instagram.

“We strategically reach out to our clients and their needs on social media platforms,” said Ed Rafalski, PhD, senior vice president of strategic planning and marketing for Methodist Le Bonheur Healthcare. “Facebook is effective in reaching out to cancer patients and support groups.”

The West Cancer Center’s “Fight On” cam-paign, a partnership with the University of Tennessee Health Sci-ence Center and Methodist Healthcare, created a forum for cancer fighters, survi-vors and supporters to share their stories on Facebook.

Also, Le Bonheur uses its Facebook page to highlight practical parenting tips from its blog. Former patients can post testimonials directly on the hospital’s Face-book page.

Healthcare marketers research what social media platforms are appropriate for their audiences, which vary in age.

“We realize that not all demograph-ics use Facebook, so our presence varies there,” Rafalski said. “Millennials, Gen-eration X and Baby Boomers all have dif-ferent needs, and we are doing research to find out where these audiences are getting their information.”

“Consumers have many choices for healthcare due to insurance increasing its provider networks and the evolution of re-tail clinics,” Vance said. “There are more options than there were five years ago.”

Tight Budgets Don’t Slow Changes In Healthcare Marketing     Digital use by hospitals, clinics continues to grow

Allison Vance

Dr. Ed Rafalski

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BY LAWRENCE BUSER

During the past two decades there has been little improvement in the long-term survival rate of 75 percent for children and young adults with Ewing sarcoma whose cancer did not spread.

Survival for those whose disease re-turns after treatment is completed remains a dismal 20 percent or less.

“For us at St. Jude Children’s Re-search Hospital, this is just not good enough,” said Elizabeth Stewart, MD, a research associate in the hospital’s De-partment of Oncology. “This was an op-portunity for us to spend some extra time studying it and, because these tumors are rare, it makes for a more challenging study.

“But with advanced technology in combination with some of the efforts of the Pediatric Cancer Genome Project, we’re discovering new ways to learn about the biology of these tumors and how else to treat them.”

Ewing sarcoma (EWS) is a cancerous tumor that grows in the bones or soft tis-sue and can occur in the legs, the pelvis, the ribs, the arms, the spine or just about any bone in the body. It spreads most often to the lungs, but can spread to other

bones or into the bone marrow. EWS is considered rare, yet is the

second-most common type of bone can-cer seen in children. About 200 children or young adults are found to have EWS each year in the United States and about half of those involve patients ages 10 to 20.

St. Jude sees 10 to 15 newly diagnosed EWS patients each year, while also doing

considerable consultation and treating other patients whose disease has returned.

That posed a challenge for a team of doctors that includes both PhD and MD training.

“At St. Jude, these types of collabora-tive research efforts between PhDs and MDs are the norm,” said Michael Dyer, PhD, director of the hospital’s Division of

Developmental Biology. “In fact, St. Jude was founded on the principle that to im-prove outcomes for childhood cancer, we must work across disciplines and bring the best science to the clinic.”

The current treatment for EWS in-volves a combination of surgery, chemo-therapy and radiation, but soon a pair of clinical trials will begin, one using a two-drug combination for patients age 1 and older. A second trial – in collaboration with researchers at the Dana-Farber/Har-vard Cancer Center in Boston – will use a three-drug combination for patients 16 and older.

The trials involve two chemotherapy drugs now being used to treat EWS with experimental drugs called poly-ADP ri-bose polymerase (PARP) inhibitors that interfere with DNA repair. PARP inhibi-tors already are in clinical trials in the treatment of some breast and ovarian cancers and other solid tumors.

The two-drug trial involves the use of the chemotherapy drug irinotecan with the PARP inhibitor talazoparib. Three-drug trial includes the chemotherapy drug temozolomide and irinotecan and the PARP inhibitor olaparib.

The trials are the result of a study that

St. Jude Research Team Targets Ewing Sarcoma with New Approach

St. Jude researchers, from left, Anang Shelat, PhD; Michael Dyer, PhD; Elizabeth Stewart, MD

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(CONTINUED ON PAGE 10)

Sutherland Cardiology Clinicis proud to congratulate our colleagues at

Methodist Primary Care Groupas a 2014 Million Hearts® Hypertension Control Champion.

Helping patients manage high blood pressure is essential to reducing the risk of heart attack and stroke.Through this program, the U.S. Department of Health and Human Services recognizes 30 practices across

the country as Hypertension Control Champions.

At Sutherland, we are proud to have a Champion in our Methodist Healthcare family.

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BY CINDY SANDERS

As the ‘official sponsor of birthdays,’ the Ameri-can Cancer Society (ACS) found a reason to rejoice in their latest report – Cancer Facts & Figures 2015. Since hitting a peak in 1991, cancer deaths have fallen 22 percent over two de-cades in the United States, which means more than 1.5 million deaths have been avoided … and more birthdays celebrated.

An ACS infographic showed 3.3 mil-lion cancer survivors in the United States in 1973. Today, there are more than 14.5 million cancer survivors, and that num-ber is projected to jump to 18.9 million by 2024.

Each year, the ACS compiles the most re-cent data on cancer in-cidence, mortality and survival using data from a variety of sources in-cluding the National Cancer Institute, National Center for Health Statistics and the Centers for Disease Control and Preven-tion. The most recent

five-year data (2007-2011) showed the overall cancer incidence rate held steady in women and declined by 1.8 percent per year in men. The decrease in men was attributed to rapid declines in colorectal cancer (3.6 percent per year), lung cancer (3 percent per year) and pros-tate cancer (2.1 percent per year).

By the Numbers: The Latest Stats on CancerDeath rates down, more work awaits

President Obama’s Precision Medicine InitiativeAfter first introducing the topic during the State of the Union Address,

President Barack Obama held an event at the White House at the end of January to unveil details about the Precision Medicine Initiative, a major research push to pinpoint the best, most precise treatment options for individual patients considering genetic profile, environment and lifestyle.

In a fact sheet created for the program, White House officials stated, “The Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge and therapies to select which treatments will work best for which patients.”

While the move away from ‘one-size-fits-all’ medicine is not limited to cancer research, oncology is at the centerpiece of the initiative and a recipient of significant funding. If passed, President Obama’s 2016 budget includes a $215 million investment in the program including $130 million to the National Institutes of Health to develop a voluntary national research cohort of a million or more volunteers to propel the science forward and to create a model for responsible data sharing. Additionally, $70 million is specifically earmarked for the National Cancer Institute to scale up efforts to identify genomic drivers to various cancers, and a major objective of the initiative is to create ‘more and better treatments for cancer.’

In response to the Jan. 30 announcement, American Association for Cancer Research CEO Margaret Foti, PD, MD (hc), said, “We live in an extraordinary time when the scientific opportunities and our ability to translate this new knowledge into ways to both save and improve the quality of life of patients are simply astounding. This is why we are so excited about today’s event at the White House and specifically about President Obama’s major investment in the enormous potential of precision medicine, which is in the very early stages of transforming healthcare.”

Similarly, the Pancreatic Cancer Action Network voiced their appreciation and support for the initiative. “The Pancreatic Cancer Action Network applauds President Obama for his new Precision Medicine Initiative and for making an important investment to advance cancer research and arm the scientific and medical community with the cutting edge tools and resources needed to fight cancer,” said Julie Fleshman, president and CEO of PanCAN. “This is especially welcome news for patients fighting pancreatic cancer who face a five-year survival rate of just 7 percent.”

With personalized medicine for pancreatic cancer still in the early stages, she added, “We recognize, as President Obama highlighted, that the “one-size-fits-all” approach does not work for pancreatic cancer and recently launched Know Your Tumor, a personalized medicine service available through our patient services program. In addition to providing molecular profiling that may help a patient’s oncologist determine the best treatment options, we will collect tumor information from thousands of pancreatic cancer patients to assist with future research and development of new therapies and diagnostics for pancreatic cancer.”

(CONTINUED ON PAGE 16)

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Loving daughter. Dental student. Conquered breast cancer at 22.Cancer will pick a � ght with anyone, including students like Savanah, who got picked on by cancer about the same time she was picking a dental school. Family and friends are important to Savanah, so she chose West Cancer Center to help her � ght back. Pioneering leaders in cancer research, the doctors at West combine groundbreaking technology with years of expertise to treat cancer, of all types, at every level. Perhaps best of all, their world-class resources are here in the Memphis area; this kept Savanah close to home as she got closer to pursuing her lifelong dream of becoming a dentist.

The � ght against cancer is here at home. See Savanah’s remarkable story and those of

others who are � ghting cancer, and � nd more information about West Cancer Center at

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Regional One Health launched its portal last fall.

“Currently, patients who sign into the portal can view discharge information and lab results,” said Angie Golding, director, corporate strategic communications at Regional One. “Additional features are being added, and in the future, users will be able to see their visit notes, request ap-pointments and prescriptions and send messages to their provider.”

At St. Francis, every patient is asked to sign up for the patient portal, where he or she can access their medical re-cords. The hospital system is marketing its

screening mammogram services through the portal and encouraging patients to use it to make appointments for those mam-mograms. In the future, the plan is for patients to make their own appointments for hospital outpatient tests through the portal.

Methodist has two portals for two areas: the inpatient/ambulatory acute side and primary care practices. Each has standard features providing the opportu-nity to connect to the patient’s doctor and ability to view lab results as well as access electronic health records. Le Bonheur has these features as well. Eventually, Meth-

odist sees adding telemedicine elements to portals to be able to monitor chronic conditions, among other features.

“You are going to see an evolution over the next few years,” said Ed Rafalski, senior vice president, strategic planning and marketing. “There will be function-alities that will allow a person who wakes up with a sore throat to call in and speak with their physician online. People will be able to transmit electronically through a portal on a regular basis through a Blue-tooth device or smart app — from diabe-tes management and monitoring glucose to ordering contact lenses.”

Baptist OneCare MyChart has been heavily marketed since it went live lo-cally in the beginning of 2014. It has about 75,000 users, and in January of this year there were 1,299,000 hits. It now is being expanded throughout the regional system.

“It’s the largest project in the his-tory of Baptist,” said Beverly Jordan, vice president and chief clinical transformation officer. “We sought an integrated health-care record.”

MyChart is available via PC or smartphone. Patients can message their physician or nurse practitioner, schedule appointments, see test results and access their medical records. Additionally, they can request medication refills, access pa-tient education information and arrange relevant lab work by chronic medical con-dition.

Chris Hopper, director, Baptist On-eCare, points out that sickness does not always necessitate a visit to a physician’s office, especially when there is a shortage of primary care physicians nationally.

“Getting an appointment is difficult,” he said. “MyChart has eased a lot of that anxiety. We hear from numerous patients about the ability to contact their doctor more (frequently). Lots of times you go in for an appointment and there are ques-tions you forgot to ask. With this app, you can reach out to that physician at any time or to his or her staff to get answers.”

Both Baptist and Methodist have vi-sions for patient engagement that go be-yond the technological side and into the personal touch side. Methodist points to its “Project 38109” efforts in south Mem-phis to help people gain access to health-care and put them in appropriate levels of care, applying some of the principles used in their 500-church congregational health network efforts. The 38109 project is funded by Cigna. Methodist officials hope they will find additional corporate sponsorship for other areas of the city.

“The medical home example is the right thing to do and get them connected with a primary care physician,” Rafalski said.

Baptist emphasizes teaching patients while in the hospital so they know how to take care of themselves or their loved ones when they go home. Patients enter-ing Baptist clinics or hospitals should be educated about their medications, their diseases, their activity level and their dis-charge plan.

“Our tag line now is ‘Get better.’ It shows an action verb. It’s not sitting around passively, waiting for something to happen,” Jordan said. “The healthcare system is reaching out to our community, and our community is reaching out to us. That’s the work we want to do better.”

Memphis Hospitals Move Forward, continued from page 1

REPRINTS: If you would like to order a reprint of a Medical News article in a PDF format or request an additional copy of an issue, please email: [email protected] for information.

Page 9: Memphis Medical News March 2015

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Addressing Complexity with Certainty

“This will be an opportunity to streamline care and provide many cancer services under one roof, which is the wave of the future, and is in keeping with Baptist’s commitment to put patients first.”

The foundation’s contribution to the venture is to provide a comprehensive re-search program with the Baptist Cancer Center, Conwill explained.

“We are developing our own clinical trials program and received a National Cancer Institute grant to promote can-cer clinical trials focusing on minority and underserved groups,” she said. “We also have a strong collaboration with the Vanderbilt-Ingram Cancer Center to fur-ther promote clinical research to better serve our community. VICC is a National Cancer Institute-designated Compre-hensive Cancer Center and a nationally recognized leader in personalized cancer medicine.”

Conwill is hopeful the affiliation will enhance the level of available cancer care in the Memphis region, and advance Bap-tist’s cancer prevention, treatment and re-search mission. Patients will benefit from this collaboration, Conwill said, through access to more leading-edge clinical trials, joint conferences for the Baptist physicians with disease-specific experts to discuss best treatment options, and expanded cancer awareness, education and cancer preven-tion programs.

A native of Baldwyn, Miss., Conwill began her healthcare career in Tupelo at the North Mississippi Medical Center, where she worked her way up the ladder, serving in the business office and physician practices, gaining foundational knowledge of organizational management and apply-ing it to challenges she faced as program coordinator for the first free-standing fam-ily practice residency program in north Mississippi.

“It was part of the North Mississippi Medical Center and affiliated with the University of Mississippi-Jackson,” she

said. As one of its first three employees, Conwill opened the program in 1994 and managed it for seven years, until she moved to Memphis to serve endocrine, neurology, primary care and cardiology groups and clinics.

At each stage of her professional de-velopment, Conwill said, “I was fortunate to have good mentors who saw leadership potential in me and shepherded me in that direction. As a person who loves interact-ing with people and is goal driven, health-care was my niche. I love to help people. As I progressed, I realized I have a passion for oncology.”

“In most practices, patients aren’t terminally ill, as many oncological pa-tients are,” she added — a situation that inspires her to provide them with the best care possible. She recalls one patient who was angry because the last precious days of her life would likely be spent in the can-cer clinic instead of outside with her fam-ily. “I can be mad if I want to!” the patient

claimed defiantly. “In fact,” Conwill said, “that totally

changed my perspective on patient care.” Although her attention to patients is some-times limited to small services, even minor gestures of caring and thoughtfulness are important.

“You may be that last face they see,” she said. “If there’s something you can do to make their lives more pleasant, it’s worth the effort.”

Since joining the Family Cancer Center Foundation in 2013, she said, her greatest challenge has been working for a group of physicians owned by the Baptist Medical Group, and ensuring that deci-sions are made with the involvement and to the satisfaction of all parties. “I try to seek the best solution for all involved, al-ways asking first, ‘What is best for the pa-tients?’”

Fortunately, she thrives on chal-lenges, and notes that working with a great team helps. She believes in an open-

door policy that engages staff on the front lines to share their opinions before she makes decisions — and emphasizes that, as a servant-leader style manager, she is always available to them and strives to lead by example.

A summa cum laude graduate of Union University, where she earned her BS in organizational leadership, Conwill also has an MBA with healthcare con-centration from Bethel University — and plans to earn a doctoral degree in health-care administration.

A past president of the Mid-South Medical Group Management Associa-tion, she continues to play an active role in the national organization, with whom she hopes to soon fill a seat on their board. She urges other practice managers to join and enjoy the regional organization’s many member benefits.

“MGMA is a great place to network with other practice administrators,” she said. “Timely issues of real concern are addressed, and speakers offer programs and resources that help you do your job better. Topics address effective use of a manager’s time, how to communicate effectively with physicians, how to get in-volved with ACOs, and how to deal with reimbursement issues — especially con-cerning high-dollar drug reimbursement under the 340B discount program — and how to qualify for it.

“It’s more than a collegial network of friends; each meeting offers CEUs and opportunities.”

Conwill’s proudest personal accom-plishments include her family — a nurse-practitioner daughter, self-employed son, three granddaughters and two shih tzus — and her education.

In her spare time she volunteers with the Make a Wish Foundation, the Ameri-can Cancer Society and Hospice. She loves to sky dive — the “most exhilarating experience I have ever had” — and she hopes to certify soon to “dive” solo.

Healthcare Leader: Jan C. Conwill, continued from page 1

built on earlier research showing EWS cells in the laboratory were sensitive to olaparib. The new study noted that EWS cells have a defect in DNA damage repair and that this defect can be exploited to help patients by combining DNA-damag-ing chemotherapy with a PARP inhibitor.

Dyer said more than 30 experts have contributed to the research project.

“It really took a village to do this type of study,” added Stewart. “Fundamen-tally, the training for PhDs and MDs is dif-ferent, but we capitalized on the strengths of both to find the best treatment for these children at St. Jude.”

Stewart, Dyer and Anang Shelat, PhD, an assistant member of the St. Jude Department of Chemical Biology and Therapeutics, are the corresponding au-thors of the study.

The clinical trials, which are expected to last two to three years, will begin as soon as FDA approval is given.

St. Jude, continued from page 5

Conwill pursuing one of her many passions.

Page 11: Memphis Medical News March 2015

m e m p h i s m e d i c a l n e w s . c o m MARCH 2015 > 11

BY JULIE PARKER

America’s free and charity clinics are undergoing a transformation, and not nec-essarily in a good way.

According to a 2014 report by the National Association of Free and Chari-table Clinics (NAFCC), patient demand has spiked 40 percent while donations have dropped 20 percent.

“As soon as there was the perception of universal healthcare, the likelihood of receiving donations goes down,” Colin McRae, JD, told the Wall Street Journal in December.

For the last two fi scal reports ending June 30, Orlando-based Shepherd’s Hope, one of the nation’s most successful free clinic networks, experienced a 22 percent increase in patient volume, seeing 16,973 patients in 2012-13, and nearly 21,000 pa-tients in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fi scal year.

“It’s a concoction of the most toxic kind without the resources to resolve it,” said Marni Stahlman, CEO of Shepherd’s Hope, noting a May 2013 report by the Congressional Budget Offi ce showed that even though the healthcare law is expected to reduce the number of uninsured by 25 million in 2023, 31 million Americans will remain uninsured. “The role of the free clinic is more critical than ever.”

Medicaid expansion, or the lack of it, lies at the heart of the problem.

In Medical News’ coverage area, Arkan-sas and Kentucky are among 28 states that have expanded Medicaid.

Alabama, Florida, Georgia, Louisiana, Mississippi, Missouri, North and South Carolina, Tennessee, Texas, and Virginia are among 18 states that haven’t expanded Medicaid and aren’t likely to, with the ex-ception of Tennessee, one of four states an-ticipated to possibly expand in 2016.

David W. Strong, who will leave the University of North Carolina (UNC) Health Care system next month to take over as CEO of the expansive Orlando Health network in Florida, pointed out an aspect of Medicaid expansion that doesn’t get much press.

“It’s important to note the bulk of every state’s Medicaid program is already funded by the federal government,” said Strong. “All states are relying on signifi cant federal funds now. Unfortunately, by not

expanding Medicaid, Florida and North Carolina are among the biggest losers in the country because of the population base. Ultimately, we all bear the burden for the lack of expansion because people will con-tinue to seek care in our emergency depart-ments and facilities.”

Much national attention has been placed on Florida, the nation’s fourth most populated state with 18 million residents

and the highest percentage of 65 and older adults. The sunshine state ranks 41st on the list of highest volume of uninsured residents nationwide.

“What you have is a really bad sand-wich. Without resources, insurance, or ac-cess to healthcare, many Floridians who’ve been captured in the healthcare cover-age (Medicaid) expansion gap fi nd them-selves without anything,” said Stahlman.

“There’s also a gap on the high end.”According to a 2014 Modern Health-

care report, the nation’s busiest emergency room is Florida Hospital, with 206,800 visits to emergency departments at Florida Hospitals in Altamonte, Apopka, Celebra-tion Health, East Orlando, and Kissimmee – and Winter Park Memorial Hospital.

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12 > MARCH 2015 m e m p h i s m e d i c a l n e w s . c o m

Medical Center accounted for the nation’s fifth busiest ER, including emergency de-partments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hos-pital, Lucerne Hospital, South Seminole Hospital and the Winnie Palmer Hospital for Women & Babies.

“Florida is at a particular disadvan-tage because we have one of the highest uninsured rates in the nation, and a com-paratively smaller percentage of residents on employer healthcare plans to absorb the cost,” said Florida Hospital CEO Lars Houmann. “Federal, state and local fund-ing sources cover some but not all costs. And so the burden is passed on to insured patients and their employers in what’s com-monly called the cost shift … a hidden tax applied to premiums, co-pays and deduct-ibles.”

University of Florida economists pre-dict $4.7 billion in Medicaid dollars will be sent to other states in 2016, including nearly $400 million to Ohio, where Re-publican Gov. John Kasich has reduced the state’s budget by $404 million over two years by expanding coverage.

Despite previous opposition to the idea, recently reelected Florida Gov. Rick Scott announced more than two years ago that he supports a legislature-approved, three-year Medicaid expansion. However, Scott, a Re-publican, hasn’t marked it priority.

Even with gubernatorial support, Tampa General CEO Jim Burkhart said Medicaid expansion won’t be an easy sell to state lawmakers.

“It’s going to be a pretty heavy lift because there are lots of people who think they know a different way, or don’t think we should do it at all, or only believe we should do it for people that don’t match up with what the federal government says you have to have in your criteria for the money to be made available,” he said. “At least discussion is ongoing. We’re hopeful it’ll continue and lead to something concrete.”

Mississippi Gov. Phil Bryant, a Repub-lican, has firmly said no, thanks. “For us to enter into an expansion program would be a fool’s errand,” in case Obamacare is repealed or altered in a way that forces states to foot the bill,” he told the Associ-ated Press. “We’d have no way to continue the coverage.”

While states continue to determine the best solution, ER visits are piling up. The average admission cost of an ER visit is roughly $4,600 versus the average cost of a visit to the free clinic valued at $77, said Stahlman, referring to 21,000 visits antici-pated this fiscal year.

“Do the math on 21,000 visits last year, each valued at $77 ($1.6 million) ver-sus $4,600 ($96.6 million),” she said. “The role of the free clinic is more critical than ever.”

BY JULIE PARKER

During a critical time when free and charitable clinics for the uninsured in the United States are under increased eco-nomic pressure and in some cases clos-ing, one nonprofit healthcare provider has adopted an unduplicated, recognized national model so highly regarded that its principal leaders were invited in 2012 to the White House as part of a delegation to discuss national intervention strategies for the uninsured.

Founded in 1997 by Rev. William S. Barnes, PhD, Shepherd’s Hope has grown into a network of five free clinics in Cen-tral Florida that’s re-mained not only viable, but is flourishing.

“We’re unaware of any free clinic in the country that takes the elaborate array of multi-faith, community, hospi-tals, and clinical and lay volunteers and weaves them all together with no one group’s agenda superseding the mission,” said Marni Stahlman, CEO of Shepherd’s Hope. At least in Florida, the nation’s fourth most populous state with 18 million residents and the highest per-centage of adults 65 and older, “no other model has the intricate system of pri-mary and secondary disciplines in place to provide the delivery of high-quality, compassionate patient-centered care to this medically underserved and uninsured segment of the population.”

Responding to Community Needs

Even though the original mission of Shepherd’s Hope was to serve the urgent health needs of the uninsured who were living at 200 percent or below the federal poverty guidelines, Shepherd’s Hope has morphed into the role of secondary/spe-cialty care clinical provider.

“Over the last few years, we’ve seen a new mix of individuals who find them-selves entering the safety net community for healthcare services for the first time in their lives,” said Stahlman. “Some were even previous donors! Now they’re stand-ing in line, telling us, ‘I’ve never not had a doctor, I have no idea what to do.’ We’ve become the alternative to the emergency department, hoping to mitigate the finan-cial impact to our community.”

For the last two fiscal reports ending June 30, Shepherd’s Hope has experi-enced a 22 percent increase in patient vol-ume, providing 16,973 patient visits and medical services in 2012-13, and nearly 21,000 patient visits and medical services in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fiscal year.

Roughly one-third of Shepherd’s Hope urgent care patients return for sec-ondary specialty care services.

“For example, we might have a fe-male patient with upper respiratory prob-lems who hasn’t had a mammogram in eight years,” said Stahlman. “We’ll refer them for a screening with our partners. Then if a breast cancer diagnosis is made, they’re referred to our other specialty partners.”

A Very Busy LandscapeCentral Florida is already one of the

nation’s busiest metropolitan areas for ur-gent and emergency care. According to a 2014 Modern Healthcare report, the na-tion’s busiest emergency room is Florida Hospital, with 206,800 visits to emer-gency departments at Florida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Win-ter Park Memorial Hospital.

Orlando Regional Medical Center accounted for the nation’s fifth busiest ER, covering emergency departments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne

Hospital, South Seminole Hospital and the Winnie Palmer Hospital for Women & Babies.

Both hospital systems, along with Central Florida Regional Hospital, are Shepherd’s Hope’s primary partners. Last year, the trio of healthcare networks provided the free clinics with nearly $22 million of in-kind contributions and ser-vices. Many of the more than 500 volun-teer doctors, physician assistants, nurse practitioners and nurses at a Shepherd’s Hope clinic nightly are coming from work as an employee at one of these hos-pitals.

“The average admission cost of an ER visit is roughly $4,600,” Stahlman pointed out.

“We reported roughly 21,000 patient visits and medical services last year, where we didn’t charge patients anything. Those visits are valued at $77. Do the math on that ($1.6 million), versus $4,600 times 21,000 ($96.6 million), you can easily see why it’s a good investment for Shepherd’s Hope to be here. Our hospital partners get it right away.”

Momentum has prompted other healthcare providers to jump on board. In 2014, Shepherd’s Hope initiated a pilot project to attract more pediatric providers.

“Only about 8 percent of our popu-lation is 18 and under,” Stahlman ex-plained. “It’s not because they don’t come; it’s because we don’t have enough pedi-atric clinical volunteers. We approached Nemours in late July to streamline a pro-cess for uninsured children to get required school physicals at Shepherd’s Hope. With no primary medical home of their own, over two days, our two teams saw 108 children at two locations. That’s re-markable.”

Last October, Shepherd’s Hope and Sand Lake Imaging aligned for a Pink Oc-tober initiative, which garnered 219 free mammograms.

And while other free and charity clinics across the country are floundering because of funding shortfalls and what some experts view as the misperception of universal healthcare, Shepherd’s Hope augments its operating budget with three successful, community-rooted annual fun-draising events – Call to Hope Breakfast in April, Celebrity Golf Classic in July, and Famous Faces Masquerade Ball in Octo-ber.

“We’re very grateful for the support of the local physician and practitioner community,” she said. “Their support makes us very distinctive.”

Shepherding a FlockHow Shepherd’s Hope bucked trend with innovative healthcare model and thriving network of free clinics

Marni Stahlman

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Historically there has been relatively little enforcement focus on the typical physician-owned ambulatory surgery centers (ASCs). A recent qui tam settlement involving a Nashville ambulatory surgery center indicates that qui tam relators are leaving no stone unturned as they look for new targets. Although the federal government declined to intervene in U.S. ex. rel Thomas Reed Simmons v. Merid-ian Surgical Partners, et.al (Civ. Act. 3:11-CV 00439), Meridian agreed to pay $5.1 million to settle False Claims Act allegations brought by a former employ-ees whistleblower “to avoid the financial costs and distractions that would have come with further legal proceedings.” Meridian maintains that the charges were without merit.

The complaint alleged that several common aspects of the ASC’s’ ownership and operations constituted federal anti-kickback violations and, as a result, were false claims. The lawsuit focuses on the manner in which:

• TheASCoperatingagreementdefinedbuy-out“triggeringevents”: The relator argued that the “triggering events” in that operating agreement allowing the ASC to buy back physician inves-tors’ interests upon the physician’s retirement, relocation, or exclusion from Medicare evidenced that the center was illegally requiring physician investors to refer Medicare patients as a condition of their investment.

• TheASC’spurchasepricewasdetermined:The relator alleged that the purchase price that was based on a multiple of the center’s EBITDA (eight times the center’s 2006 earnings), rather than on asset value, was in effect a payment for the surgeons’ referrals to the center.

• TheASCpaidprofitdistributions: The relator alleged that because the pur-chase price was excessive, the distributions paid to physician partners in the center were “above-market distributions to referring shareholders,” constituting illegal kickbacks.

• Minorityinterestswerepriced: The relator also argued that the price dif-ferential for minority and controlling interests evidenced a violation of the anti-kickback statute.

Many healthcare lawyers believed the case had little merit since many of the factors cited by the relator as evidence of kickback violations are fairly standard in the ASC industry. Buying back interests held by physician investors upon certain “triggering events” is the best way to maintain compliance with the ASC Safe Harbors to the federal anti-kickback statute. Likewise, pricing a center on a multiple of earnings is a commonly accepted methodology for determining fair market value. However, at least one OIG Advisory Opinion (AO 09-09) noted that valuing an ASC on a multiple of earnings could potentially be viewed as taking into account the volume or value of the physicians’ referrals in violation of the anti-kickback statute.

According to news reports, the whistleblower will receive approximately $900,000 under the settlement, which is likely to encourage similar suits. ASCs should proactively increase compliance strategies including compliance programs, exit interviews and adoption of a formalized valuation methodology for pricing surgery center acquisitions and physician interests. If a surgery center company uses a multiple of EBITDA for its pricing, the company would be better positioned to deflect challenges to its pricing if it has a consistently applied policy or methodol-ogy. Other compliance strategies include avoiding punitive buy-back or repurchase prices and clearly articulating to physicians and company employees the legitimate, clinical and quality-of-care rationales for the buy-back and other provisions of the ASC’s partnership or operating agreement.

With hungry qui tam relators looking for potential targets, adopting a rigorous compliance program and providing clear guidance and information about valua-tions and operating agreement requirements will go a long way toward forestalling legal attacks.

Lawsuit Settlement Could Signal a New Era of Scrutiny for Ambulatory Surgery CentersBy Nora L. Liggett and Denise D. Burke

Denise Burke

Nora L. Liggett

www.wallerlaw.com

Page 14: Memphis Medical News March 2015

14 > MARCH 2015 m e m p h i s m e d i c a l n e w s . c o m

BY CINDY SANDERS

January is National Birth Defects Pre-vention Month. March is in the name. No-vember is National Prematurity Awareness Month.

But for the staff of March of Dimes Tennessee, every month … every day … is another opportunity to advocate on behalf of mothers and children to build a stron-ger, healthier state. Each year, one of eight babies in Tennessee is born prematurely.

While the organization hosts a num-ber of fundraisers, the premier event is March for Babies, and 76 percent of the money raised from those walking events across the state goes to fund research and programs supporting the mission.

Tamara Currin, MS, MCHES, as-sociate director of Program Services and lead for Advocacy & Government Affairs for MOD Tennessee, noted, “For our program plan, we have three main initiatives that we’re looking at for at least three years.” She added the key objectives focus on early elective deliveries, tobacco usage in women of childbear-ing age, and disparities in

preterm birth.

Early Elective DeliveriesCurrin said March of Dimes nation-

ally spearheaded a partnership with the Tennessee Department of Health, Tennes-see Hospital Association, Tennessee Initia-tive for Perinatal Quality Care (TIPQC) and other interested entities in 2012 to ad-dress the issue of elective early inductions. She noted the ‘Healthy Babies are Worth the Wait’ campaign has been a successful example of how collaborative efforts can

really make a difference. Although babies are born prematurely

every day naturally, Currin said the con-cern is over those times when labor is elec-tively induced. “We know that the longer babies are in mom’s body, the healthier they will be,” she said. “The lungs and the brain are some of the last things to develop in utero.”

An infant’s brain at 35 weeks weighs only two-thirds what it will at 39 to 40 weeks. Even being born just a few weeks early could hamper a newborn’s ability to coordinate sucking, swallowing and breathing.

Currin credited the partnership for building awareness among the healthcare community. A letter was sent to birthing cen-ters across the state asking them to pledge to put in a ‘hard stop’ for scheduled inductions before 39 weeks. Currin explained clinicians now have to speak with a designated physi-cian in the facility to explain why an early induction is medically necessary.

Other efforts have included aware-ness campaigns for consumers. The ‘Don’t Rush Your Baby’s Birth Day’ public ser-vice announcement encourages moms with healthy pregnancies to allow labor to begin naturally.

The results have been stunning. In 2012, Tennessee ranked poorly nationally with close to 15 percent of all births being early elective inductions. By 2014, the aver-age between January and August had fallen to around 2 percent.

“This is just a remarkable improve-ment and much credit to the partnership,” Currin said.

Tobacco Cessation“We have 23 percent of women of

childbearing age who smoke in Tennes-see,” said Currin. “That’s a leading risk fac-tor for prematurity and low birth weight.”

In addition to MOD programming, she said the organization also has a state-wide community grant-funding effort to target specifi c areas or objectives. “We ac-tually have a grant we’re funding in John-son County,” she said of an effort in Upper East Tennessee. “As a part of a prenatal program, they are providing Baby & Me: Tobacco Free, an evidence-based approach to primarily cessation, but it also addresses

the environment and other smokers in the home.” The goal is to achieve a 20 percent quit rate among participants.

Currin noted the Tennessee Depart-ment of Health also provides funding to a number of local health departments across the state to host smoking cessation pro-grams for pregnant women.

Addressing DisparitiesWhile Hispanic and Caucasian

women in Tennessee have preterm rates of 11.4 percent and 11.3 percent respectively, African-American women have a prematu-rity rate of 17.2 percent.

Currin said MOD is currently fund-ing two community grants in the Memphis area. One targets pregnant women who are homeless. The second, Fit4Me, addresses obesity among women of childbearing age and looks at a healthy body weight before and between pregnancies with a focus on overall nutrition.

In Chattanooga, Currin said a grant initiative is just wrapping up that ad-dresses both disparities and tobacco ces-sation by utilizing churches, which play a prominent role in the black community, to bring about change. “They built partner-ships with African-American churches and provided training on how to quit smoking to the leadership spearheaded by the ‘fi rst lady’ of the church … the pastor’s wife,” she explained.

Healthy Babies, Healthy Business

Phil Toothman, state director of Com-munications and Marketing for March of Dimes, said the organization is attacking the problem of prematu-rity from multiple angles. Knowing businesses wind up absorbing the cost of prematurity in terms of in-creased health premiums, lost productivity and absen-teeism, the hope is to enlist the help of state businesses to help spread the word about the importance of prenatal health.

“The average cost of caring for a pre-term baby versus a healthy, full-term baby is 12 times,” Currin said. “The healthy baby is $4,389 on average, and a preterm baby is $54,194,” Toothman added of medical costs.

He also noted the medical costs could soar to $1 million or more for the tiniest babies who required months of hospitaliza-tion. MOD estimates preventing prematu-rity in Tennessee could equal an annual savings of up to $515 million.

Making ProgressAlthough there is a long way to go,

Toothman and Currin said Tennessee has made measurable progress over the last several years led by the impressive improvement in the rate of elective early deliveries.

March of Dimes: Making a Difference for Tiny Tennesseans

Tamara Currin

Phil Toothman

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m e m p h i s m e d i c a l n e w s . c o m MARCH 2015 > 15

Who Benefits From Mergers & Acquisitions In the Healthcare Sector?

BY BILL APPLING

MedicalEconomics

Gregg Lemkau, co-head of global mergers and acquisitions in the Investment Banking Division of Goldman Sachs said, “We have seen twice as many mergers & acquisitions (M&A) activity by July 2014 as we saw for the same period of 2013.

I think the biggest driver of the recovery (in M&A) is the return of the strategic acquirer. There haven’t been this many M&As (70 percent) since 2007.”

What is driving the increase in M&As?

• Very low interest rates• Large cash balances (balance sheet)• Abundant capital available • Low inorganic opportunities• Increase in equity marketsLet me hit on a few industries, so

this doesn’t turn into a term paper. Drug makers, health insurers and biotechnology companies in the S&P’s 500 Index returned 12 percent in 2013, including reinvested dividends. That’s the first time in 15 years that the industry has led during the first 79 days into a new year. (Bloomberg, March 22, 2013)

The last time healthcare companies led the S&P during the first three months of the year was 1998 when the industry surged 42 percent in the third-biggest gain on record. (According to data compiled by Bloomberg.) The US equity benchmark posted an annual gain of 27 percent.

PHARMACEUTICAL The pharmaceutical industry seemed

designed on all sides, with declining R&D productivity, expiring patents on blockbuster products and relentless downward pricing pressure that forced companies to look closely at the bottom line. One effect of this onslaught has been an upsurge in the level of M&A activity as players within the industry consolidate to cut costs, expand research pipelines and lengthen geographic outreach.

Novartis and GlaxoSmithKline agreed to swap a series of assets in a multibillion-dollar deal that will reshape two of the world’s biggest drug makers. For Novartis, the “transformational” deal would strengthen the company’s position in the high-value but fiercely competitive area of cancer drugs, where it is number two to Swiss rival Roche.

“Diversity is still important but this will allow us to focus on businesses where we are holding a leading position,” said Joe Jimenez, CEO of Novartis to Financial Times, referring to the group’s three remaining core units: pharmaceuticals, eye care and generic drugs.

In addition to acquiring GSK’s existing cancer treatments, which had sales of $1.6 billion last year – Klavartis will have opt-in rights for new oncology products emerging from the UK group’s research and development pipeline. (Financial Times, April 2014.)

The complex transaction adds to a flurry of merger and acquisition activity among the pharma groups. Activist investor Bill Ackman and Valent have teamed up to launch a bid worth more than $50 billion for Allergan, the maker of Botox ( Financial Times)

• Now more than ever, life sciences companies are conducting clinical research outside the U.S. ( ACE )

• Pfizer has rallied 31 percent in the past year after the U.S. Food and Drug Administration approved its arthritis and blood thinner drugs and the company divested its infant nutrition and animal health business. ( Financial Times)

• In the wake of Pfizer’s $68 billion mega-merger with Wyeth in 2009 the company laid down plans to trim its manufacturing and shut down eight sites in 2010 and further earmarked six to close by 2015, affecting over 6,000 workers.

• Similarly, Merck & Co. has continued to cut back following its $41 billion merger with Schering-Plough in 2009 and then announced in November a further ten sites would be closed.

• Fresh off Pfizer’s acquisition of Hospira for $17 billion, Ian Read, CEO, at this year’s BIO CEO Conference, said discussions are still in the works, though it still needs to iron out details, of whether its innovative and established products businesses are “sustainable if they’re independent.” Ultimately, he said the decision will be made to create maximum shareholder value.

At the same conference, Read said that Pfizer has had discussions with several partners looking at portfolio / geographic swaps, adding that the industry has to consolidate.

And as far as acquisitions moving, Read said the “problem is that when we look at opportunities other companies are willing to pay more because of their tax situation or to fill in or pipeline.”

INSURANCEThe stock price of United

HealthGroup Inc., America’s largest healthcare company is up 263 percent since the ACA was signed into law just

over four years ago. Over the 10-year period prior to the ACA, UnitedHealth stock (UNH) was down by 10 percent. United Health is the 17th largest company in Fortune Magazine’s top 500 U.S. companies.

Through subsidiaries in 50 states and Puerto Rico, United Health provided 70 million Americans with health insurance – about 22 percent of the nation. The message shareholders are learning is that a decade of competitively providing healthcare is grim, but for years of partnership with ACS – PARTY TIME.

There would have been no ACA in 2010 if the White House had not given into demands from the giant profit-making health insurance groups. Had he not done so, Obama’s healthcare bill – his priority promise made during the 2008 presidential campaign – would not have passed.

Morgan Stanley’s Andrew Schenker estimates health insurers will get $90 billion in revenues.

With the price of insurance stocks now spiked by elimination of competition,

all the major health insurance stocks were Dow Jones’ top performers in 2013. United Health stock was up 33 percent; WellPoint rose by 50 percent, Aetna ticked up by 46 percent and Cigna jumped by 60 percent.

Other points to note:• Profits have risen so impressively

even though ACA had language that specifically was supposed to limit the profits earned to 20 percent of the revenues.

• The healthcare industry is exempt from the Federal Anti-Trust Law, but there are opportunities for collusion. They are even better at threatening physicians, hospitals and other providers to take or leave it.

This is bloody scandalous and should be a cause for concern for both Republicans and Democrats.

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During the same time period, the av-erage annual decline in cancer death rates was 1.8 percent in men and 1.4 percent in women. Lung cancer, while still the dead-liest form of the disease, has declined 36 percent between 1990 and 2011 among men. Women have also seen double digit declines attributable to reduced tobacco use. On another happy note, breast can-cer death rates for women are down more 35 percent from peak rates, and prostate and colorectal cancer deaths are down by nearly half (47 percent).

Despite the good news, though, ACS officials also noted there is much more

work to be done. “The continuing drops we’re seeing in cancer mortality are rea-son to celebrate, but not stop,” stated John R. Seffrin, PhD, chief executive officer for ACS, when the report was released in January. He added cancer was still re-sponsible for nearly one in four deaths in the United States in 2011. Furthermore, Seffrin noted the country’s second leading cause of death overall is actually the top cause of death among adults ages 40 to 79.

Looking to this year, the ACS has projected 1.658 million new cancer cases will be diagnosed in 2015, and 589,430 Americans will lose their battle with the

disease. Of the new cases, the estimate is that men will account for about 848,000 diagnoses across all sites and women 810,000. Prostate, lung and colorectal cancers will account for about half of all cases in men with prostate cancer account-ing for around 25 percent of all new di-agnoses. Among women, it is anticipated the three most common diagnoses in 2015 will be breast, lung and colorectal cancers. Of those, breast cancer is expected to ac-count for 29 percent of all new cancers for women this year.

Of the 589,430 estimated deaths in 2015, the gender breakdown is 312,150

men and 277,280 women. The most com-mon causes of cancer death are lung, prostate, colorectal and breast cancer with these four accounting for almost half of all cancer deaths. More than a quarter of all cancer deaths (27 percent) will be attribut-able to lung cancer.

While death rates have declined, the report noted mortality improvements aren’t equal from coast-to-coast. In fact, cancer death rates vary by state and region with the Southeast being on the lower end of improvement scale (15 percent decline in overall cancer mortality) and the North-east on the higher end (between 25-30 percent decline). The variation has been attributed to a number of reasons includ-ing risk factor patterns (such as the num-ber of smokers), distribution of poverty, and access to healthcare.

Risk AwarenessA recent survey by the American In-

stitute for Cancer Research found there is an ‘alarmingly low’ awareness of key can-cer risk factors, and many Americans put fear before facts. The Cancer Risk Aware-ness Survey, released on Feb. 4 in con-junction with World Cancer Day, found Americans worry about factors over which they have little or no control … such as genetic risks or food additives … with less than half recognizing the correlation be-tween an increased risk of cancer and al-cohol, obesity, lack of physical activity and poor diet.

The findings of the biennial survey give providers and other health experts an idea of whether or not cancer messaging is being heard by the American public. This year’s results were decidedly mixed.

Only 42 percent surveyed were aware a diet low in vegetables and fruit increases cancer risk. This number has trended downward since 2009, when it stood at 52 percent.

Only 43 percent knew alcohol in-creases cancer risk, an increase of five per-centage points since the 2013 survey.

And only about 1 in 3 Americans (35 percent) realized diets high in red meat have been convincingly linked to colon cancer. This figure has not changed since the survey was last conducted in 2013.

Awareness that carrying excess body fat is a cancer risk factor is rising. In this latest survey, 52 percent realized obesity and overweight impact cancer risk, a rise of 4 percentage points.

Awareness that being inactive in-creases cancer risk jumped 6 percentage points, from 36 percent in 2013 to 42 per-cent in 2015.

There was a high recognition of sev-eral known risk factors for cancer includ-ing 94 percent of those surveyed correctly identifying tobacco use and 84 percent cit-ing excessive sun exposure as risks.

However, a significant number of those surveyed also worried about risks for which research has yet to provide a defini-tive answer. Pesticide residue on produce (74 percent), food additives (62 percent), genetically modified foods (56 percent), stress (55 percent), and hormones in beef (55 percent) were all cited as concerns.

By the Numbers: The Latest Stats on Cancer, continued from page 6

Page 17: Memphis Medical News March 2015

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GrandRounds

Kenneth Batts Joins HealthChoice

Kenneth Batts has joined Health-Choice as a Complex Care Manager. Batts, who is certified in case management, will be responsible for the overall assessment and coordination of services and care needed by patients with complex conditions to help them achieve an optimal level of health and productivity.

Prior to joining HealthChoice, Batts was employed at Methodist Le Bon-heur Germantown Hospital, where he worked for seven years as a RN case manager.

Batts is a member of HealthChoice’s newly-formed Population Health team, which works collaboratively with pa-tients and their physicians to improve their health status. This initiative, which is offered to patients whose employers have engaged HealthChoice, aims to educate and empower the patient, help them in navigating the complex health-care system, and ensure appropriate provider care.

St. Jude President, CEO Honored

James R. Downing, MD, president and chief executive officer of St. Jude Children’s Research Hospital, has received the Distinguished Service Award for his studies on the genetic basis of cancer and for im-proving the treatment of children with cancer. The award, which was presented at the 2015 Miami Winter Symposium in February, honors exceptional contribu-tions to science that have helped bio-logical research and its practice to ad-vance on a broad front.

Downing presented the Distin-guished Service Awardee Lecture at the meeting. Downing is internationally recognized for his seminal contributions to understanding the genetic missteps driving childhood cancer. Downing was instrumental in launching the St. Jude-Washington University Pediatric Cancer Genome Project, the world’s largest project devoted to understanding child-hood cancer. He has been published in prestigious journals and holds member-ship in numerous academic and profes-sional societies. In 2013, he was elected to the Institute of Medicine.

Methodist Le Bonheur Names Cashman MLH Affiliated CEO

Methodist Le Bonheur Healthcare has named Eugene K. Cashman III its MLH Affiliated CEO.

Cashman comes to Methodist with more than ten years of healthcare expe-rience, having served as CEO at Select Medical Corporation’s 186-bed long-term care facility in Columbus, Ohio before becoming CEO of Crittenden Regional Hospital in 2012. Prior to his tenure with Select, he served in a variety of leadership positions with Vanderbilt University Medical Center, most recent-ly as director of Perioperative Adminis-trative Operations.

A native Memphian, Gene holds a Bachelor of Arts degree from Auburn Uni-versity and a Master of Health Administra-tion degree from the University of Mem-phis.

MOGA and WPG Merge Practices; Combined Staff Offers 22 Physicians

Memphis Obstetrics and Gyneco-logical Association PC (MOGA), the larg-est private provider of women’s health-care in the region is growing has an-nounced today the merger of practices with Women’s Physician Group (WPG).

WPG has become a division of MOGA. The fusion of the two indepen-dent groups will create a unified practice totaling 33 licensed medical providers, including 22 physicians, five nurse prac-titioners from MOGA and five physicians and one nurse practitioner from WPG.

Officials said the merger allowed both practices to remain independent rather than owned by a larger system. Although daily operations and current locations will remain intact, combining these two practices also permits MOGA and WPG to share resources, expertise, and services -- all considered major ben-efits as healthcare continues to change.

MOGA’s four locations are in East Memphis, Germantown, Wolfchase and Desoto County. The merger with WPG now allows patients to be seen in Mid-town Memphis as well.

Kenneth Batts

Dr. James R. Downing

UTHSC’s Edward Chaum Receives Grant for Ocular Trauma Research

Edward Chaum, MD, PhD, and Plough Professor of Retinal Diseases at the Uni-versity of Tennessee Health Science Center (UTHSC), has received a grant totaling $999,488 from the U.S. Army Medical Research Acquisition Activity to study the ef-fects of ocular trauma.

Significant eye injuries are common in military personnel who have served in Iraq and Afghanistan.

The award will be used to support a project titled, “Nutlin Analogues for the Prevention and Treatment of Proliferative Vitreoretinopathy in Ocular Trauma,” and will be distributed over three years. The project explores the use of a new class of drugs for the treatment of ocular injuries, in particular those that prevent the scarring caused by traumatic injury, which often leads to blindness.

The candidate drug molecules being tested are variants of a known drug cur-rently in clinical trials for the treatment of cancer.

In partnership with Focal Point Pharmaceuticals, a Memphis startup company, the goal of Dr. Chaum and his research team is to prove the effectiveness of these drugs in ocular trauma and other eye diseases, and to develop them commercially for military and civilian clinical use.

Groundbreaking at Sears Crosstown Signals Official Start of Construction

On February 21, work officially began on the site of the old Sears building at 420 North Cleveland, exactly 88 years from the date when Sears, Roebuck & Co. execu-tives broke ground on a new retail and distribution center in 1927. Although the February event signaled the official start of construction, crews have been working at the site since early January.

The founding partners of the new facility at the site hope to be able to move either a portion of all of their offices into the building in 2017. The founding partners include, Methodist Le Bonheur Healthcare, the Church Health Center, St. Jude Chil-dren’s Research Hospital and the Southern College of Optometry.

More than $200 million has been raised for the project from more than 20 sourc-es including, public, private, and philanthropic.

Workers pour molds during the groundbreaking ceremony to mark the official beginning of construction at the old Sears building site on Cleveland. The ceremony included brand unveiling of the site, now named Crosstown Concourse.

Edward Chaum confers with Yaqin Li of the Hamilton Eye Institute.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.

Page 18: Memphis Medical News March 2015

18 > MARCH 2015 m e m p h i s m e d i c a l n e w s . c o m

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GrandRoundsBluff City Medical Society Installs New Officers

Lanetta Anderson, MD, who has been practicing at the Women’s Physi-cians Group since 1996, has been has been installed as president of the Bluff City Medical Society.

Dr. Anderson earned her medical degree from Johns Hopkins University School of Medicine, graduating in the top 20 percent of her class. Her intern-ship and residency were completed at Northwestern University. Dr. Ander-son is board-certified by the American Board of Obstetricians and Gynecolo-gists.

Other newly elected officers of the Bluff City Medical Society include, Perisco Wofford, MD, President-Elect; Brenda M Hardy, MD, Vice President; Danielle H Hassel, MD, Treasurer; LaTo-nya Washington, MD, Secretary; Henry Stamps, MD, Chaplain; Janice P. Coo-per, Executive Assistant. Walter Ray-ford, PhD, MD. MBA, is the Immediate Past President.

The Bluff City Medical Society was founded in 1885 by a group of African-American physicians with the purpose of promoting wellness education and decreasing healthcare disparities be-tween African-Americans and non-Af-rican Americans. The organization has grown to more than 200 members.

Three Organizations Set Linking Hands Event for April

In celebration of April as National Donate Life Month, the Mid-South Transplant Foundation, Lifeblood, the Mid-South Regional Blood Center and Be the Match National Marrow Donor Program will hold the ninth annual Link-ing Hands for Life on Sunday, April 19.

The public is invited to run or walk the certified 5K and 10K course through midtown Memphis at noon and then enjoy a free live Music Fest at the Over-ton Square Tower Courtyard at 2 p.m.

To register for the 5K or 10K online visit www.racesonline.com or for more information visit www.midsouthtrans-plant.org or call 901-328-4438.

UT Initials Added to Name of Methodist University Hospital

The initials of the University of Ten-nessee are now appearing on a Mem-phis hospital for the first time since 2004, when the UT Bowld Hospital closed its doors.

The bright orange UT icon has been added to the exterior signage at Methodist University Hospital, and the hospital will be referred to as Methodist UT Hospital in recognition of the grow-ing partnership between the University of Tennessee Health Science Center (UTHSC) and the Methodist Le Bonheur Healthcare system.

The new signage was unveiled last month.

Eric H. Benink Named CMO at Regional One Health

Eric H. Benink, MD, MBA, FAAEM, has joined Regional One Health as Senior Vice President and Chief Medical Officer (CMO). Prior to joining Regional One Health he was the CMO at Northwest Com-munity Hospital in Arling-ton Heights, Illinois and also previously held the CMO position at OSF Saint Anthony Medical Center in Rockford, Illinois. Spe-cializing in emergency medicine,

Dr. Benink also served in the United States Air Force during the Gulf War. He was a clinical instructor and assistant professor for the emergency medicine residency program at OSF Saint Francis Medical Center and held faculty posi-tions at the University of Illinois Col-lege of Medicine Peoria and Rockford campuses. During his career in trauma, emergency and medical flight care, he held several leadership positions at OSF Healthcare.

Dr. Benink graduated from Rush Medical College in Chicago, Illinois. He completed his residency and served as Chief Resident at Christ Hospital and Medical Center in Oak Lawn, Illinois. He also earned a Master’s in Business Administration from The George Wash-ington University in Washington, DC.

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Don’t fight for their attention.

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the loop on. Medical News, America’s largest

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for healthcare professionals.

Don’t fight for their attention.

Get it.Never before have physicians and other

healthcare professionals been so strapped

for time. And never before has so much

information been vital for them to be in

the loop on. Medical News, America’s largest

network of healthcare newspapers, plays a role in

providing important information on national topics

and showcasing local trends – all written specifically

for healthcare professionals.

Don’t fight for their attention.

Get it.Never before have physicians and other

healthcare professionals been so strapped

for time. And never before has so much

information been vital for them to be in

the loop on. Medical News, America’s largest

network of healthcare newspapers, plays a role in

providing important information on national topics

and showcasing local trends – all written specifically

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