3 Questions I Would Ask Legislators at Breakfast

 Suffolk County Medical Society's next Legislative Breakfast is next Friday, October 1 from 8 - 9:30 am at SCMS Headquarters in Islandia.  The following members of the NYS Assembly and State Senate have agreed to attend:

• Philip Boyle
• James D. Conte
• Stevn Engelbright
• Ginny Fields
• Michael J. Fitzpatrick
• representative for Dean Murray
• Andrew P. Raia
• Fred W. Thiele, Jr

• John J. Flanagan
• Brian X. Foley
• representative for Kenneth P. LaValle

The new Candidate Selection Committee has drafted a brief survey that will be sent to all our NYS Legislators AND their opponents in the upcoming election.  Responses to this survey will be published on the SCMS website and distributed widely (including, if I feel like it, here on Maria's List) prior to the election.  Three questions, focused on key legislation will be posed and the candidates asked to indicate Y or N as to their position.  The   candidates/ legislators will then have an opportunity to elaborate BRIEFLY on their answers.

2010 Suffolk County Medical Society Legislative Candidate Questionnaire

1.  As you are aware, the health insurance industry in NY State has become dominated by a small handful of companies, leaving physicians unable to advocate effectively for their patients or themselves.  The Physicians’ Collective Negotiation’s Bill S5204-A (Breslin) and A4301-B (Canestrari) are companion bills that would allow physicians to collectively negotiate contract provisions with insurance plans in NY State under state oversight, which would level the field so that physicians can collectively negotiate with insurance plans to improve conditions for patients and practicing physicians.

Will you Co-Sponsor this legislation?                         (Please circle answer: Yes       No)

Will you advocate with Senate/Assembly leadership to bring this legislation in its current form to the floor for a vote during the first half of 2011?      (Please circle answer: Yes       No)

Please discuss your answer (150 words or less)

2.  Regulatory and legislative reform of the medical liability adjudication system remains a priority for the physicians of New York State.  When poor outcomes are considered results of negligence, an expensive and wasteful culture of blame, fear, mistrust and defensiveness is supported, and the physician-patient relationship compromised.  Legislation to establish a “no-fault” system to provide for the needs of neurologically impaired infants has been introduced by Senator Hannon (S. 6801) and with companion bills in the senate and assembly (S. 2744 Golden/A. 2214 Calhoun).

Will you Co-Sponsor this legislation?                         (Please circle answer: Yes       No)

Will you advocate with Senate/Assembly leadership to bring this legislation in its current form to the floor for a vote during the first half of 2011?      (Please circle answer: Yes       No)

Please discuss your answer (150 words or less)

3.  Those who cannot remember the past are doomed to repeat it. – George Santayana.  Doctors need a way to help each other learn from mistakes so they won’t be repeated.  Peer-review sessions lack transparency, accountability, and educational opportunities because doctors fear that remarks can be used against them or their colleagues in court.  To encourage physician participation in peer review and quality improvement committees, the medical society supports legislation that assures that physician statements made as part of these proceedings are immune from discovery (A.1596, Gottfried/S.2821, Hannon)

Will you Co-Sponsor this legislation?                         (Please circle answer: Yes       No)

Will you advocate with Senate/Assembly leadership to bring this legislation in its current form to the floor for a vote during the first half of 2011?      (Please circle answer: Yes       No)

Please discuss your answer (150 words or less)

Please join me on October 1st for the next SCMS Legislative Breakfast...and bring your questions, or post them here (Click on Comments, below)!

Dept of Surgery has theirs -- Do You Have Yours?

At the July Mather Medical Board Meeting (and in subsequent meetings), Mather Medical Staff President, Lloyd Lense, admonished all departmental directors to appoint an "IT Liason," to serve as each department's resource as Mather's clinical information system (Allscripts/Eclipsys Sunrise) is implemented.  This IT Liason will remain updated and participate with the Physician Advisory Council and Chief Medical Information Officer, Joe Ng, as the implementation progresses, reporting periodically to the department and communicating needs and concerns from the department to the physician council and the CMIO.

Mike Arato, Director of Gyn/Ob, has appointed Gus San Roman,who has already participated by commenting on Maria's List.  Director of Dept of Surgery, Randy Schrager, has appointed me, and Ed Borden, in his usual generous manner, has offered his assistance and plans to attend meetings and stay involved with the Physician Advisory Council.

If you would like to be involved, please contact your departmental director, Joe Ng at JNg@matherhospital.org , Joan Faro at JFaro@matherhospital.org, or me, Maria Basile at MBasile@matherhospital.org .

The next meeting of the Physician Advisory Council is Thursday, September 30th at 7am in the Sunrise Room.

A Letter from Mather's New CMIO -- Meeting Schedule for the Physician Advisory Council

September 22, 2010

Dear fellow Physician Advisory Committee members,

I would like to thank all of you who have responded to Dr. Basile’s request and my own to review the order sets. Our next order of business will be to go “full steam ahead” and start understanding the processes that Eclipsys has in their system and for us as a physician group to weigh in on what we would like Sunrise system to do and look like after seeing what the processes are. Therefore, I would implore you to attend to as many of the following meetings as possible.

The following meetings of the Physician Advisory Council have been scheduled.  The location listed is “Sunrise Room 3”.  This room is on the third floor of the hospital and is located in the space where our pharmacy used to be.  Please make every effort to attend the September 30, 2010 meeting at 7:00 am where we will discuss order sets and a see a demonstration of the Sunrise Clinical Manager System.  Your input is vitally important to ensure that physicians work flow needs are optimally addressed by this system.  We will also discuss the agendas of the remainder of the upcoming meetings at the September 30^th meeting.

Thursday 10/21 7am - 9am

Title - Physician Advisory - Physician Documentation Process

Location: Sunrise Room 3

Tuesday 11/9 4pm - 8pm

Title - Physician Advisory - Admission Process

Location:  Sunrise Room 3

Thursday 11/18 7am - 9am

Title - Physician Advisory - Transfer Process

Location:  Sunrise Room 3

Thursday 12/2 7am - 9am

Title - Physician Advisory - Discharge Process

Location:  Sunrise Room 3

Tuesday 12/14 4pm - 8pm

Title - Physician Advisory - Physician Documentation Design

Location:  Sunrise Room 3

Thursday 1/13 7am - 9am

Title - Physician Advisory - Wrap-Up Session

Location:  Sunrise Room 3

Sincerely,

Joseph Ng, MD

Joseph Ng, MD
Chief Medical Information Officer

MSSNY President to Attend October Medical Staff Meeting

Leah S. McCormack, M.D., a board-certified dermatologist from Queens, was elected President of the Medical Society of the State of New York in April.  She will attend our quarterly medical staff meeting on October 18th. Also planning to attend are Mr. Rick Abrams, executive director of MSSNY, and Suffolk County Medical Society executive director Mr. Stuart Friedman.  Dr. McCormack is a tireless advocate for the medical profession and has spoken and written about changing societal attitudes, their economic effects and the response of organized medicine to society and governmental changes.  A copy of her passionate inaugural address is available here.

If you have any questions for Dr. McCormack, or the state or county societies' directors, please post them HERE or click on "comments," below.

Physician Advisory Council -- Assignment #1

Please review the following preliminary list of "order sets," that we can start working on soon.  This list is drawn from a list of about 200 pre-made order sets that we will have to review/revise in the next few weeks.  Your assignment, should you choose to accept it, is to click on "Comments" below and provide some feedback on this list. In your feedback, please answer the following questions:

1. What is on this list that applies to your specialty or your interests?
2. What, if anything, has been left out that should be included on this list? 
3. Imagine the day Eclipsys "goes live," with the following list of pre-written (and vetted by us) order sets available to anyone making rounds.  What are the ways this will make rounding easier?  What are the barriers that you anticipate to implementation?

Feel free to be as succinct or as verbose as you please.  Emotional, critical, and negative comments are welcome, but sometimes not as helpful as feedback that is specific, measurable, actionable, realistic, and timely (S.M.A.R.T. feedback).

To be clear, this is just a list of the titles of order sets which we as a group are charged with prioritizing and honing.  Clicking on any of these titles will not bring you directly to the order set (yet!).  Leave your comments, below, based on this list.  More to follow!

General Admission Orders (ADCAVANDIMML)



General Transfer Orders


Discharge Orders


Specific Admission Orders for:


Sepsis


Stroke


TIA


ST Segment Elevation MI


Non-ST Segment Elevation MI


Congestive Heart Failure


COPD


Community Acquired Pneumonia


Health-Care Facility Related Pneumonia


Syncope


Atrial Fibrillation


Cellulitis


Osteomyelitis


Total Hip Replacement


Total Knee Replacement


Distal Bypass Surgery


Carotid Endarterectomy


Colon Resection


Hysterectomy


Gastric Banding


Gastric Bypass


Chemotherapy General Order Set


Protocols:


Specific Chemotherapy Protocols (5 top)


VTE Prophylaxis


Insulin Infusion


Weaning Protocol


Immunization (Flu)


Immunization (Pneumovax)

Thanks, as always, for ALL you do.  Looking forward to your comments, and to working together with you soon.

The Top Ten Ways Health Care Reform Will Affect Your Practice

A breakdown of the Affordable Care Act, published online by the Annals of Internal Medicine, compiled by current and former members of the Obama administration, includes the following list of Key Summary Points of the law that will change the way medicine is practiced in the US:

• 
  
  Focusing care around exceptional patient experience and shared clinical outcome goals.
• 
  
  Expanding the use of electronic health records with capacity for drug reconciliation, guidelines, alerts, and other decision supports.
• 
  
  Redesigning care to include a team of nonphysician providers, such as nurse practitioners, physician assistants, care coordinators, and dietitians.
• 
  
  Establishing, with physician colleagues, patient care teams to take part in bundled payments and incentive programs, such as accountable care organizations and patient-centered medical homes.
• 
  
  Proactively managing preventive care—reaching out to patients to assure they get recommended tests and follow-up interventions.
• 
  
  Collaborating with hospitals to dramatically reduce readmissions and hospital-acquired infections.
• 
  
  Engaging in shared decision-making discussions regarding treatment goals and approaches.
• 
  
  Redesigning medical office processes to capture savings from administrative simplification.
• 
  
  Developing approaches to engage and monitor patients outside of the office (e.g., electronically, home visits, other team members).
• 
  
  Incorporating patient-centered outcomes research to tailor care appropriate for specific patient populations.  
  Medscape went to the American College of Physicians for an opinion.  ACP President says that it's not time to write off small practices yet.  What do you think?  Click on comments, below, to let me know.

WSJ: Only 2% of Hospitals Ready for Meaningful Use

The Wall Street Journal reported online this week that only 2% of hospitals in the US reported having electronic clinical information systems in place that would qualify for "meaningful use" incentive money.  This based on a study published by Health Affairs, a leading health policy journal.