NCMGMA News Sponsor

MSOC Health AdTwice monthly, NCMGMA News will feature a sponsor on our site. Our sponsors are a vital part of our organization, enabling us to provide the high level of products and services our members have come to expect from NCMGMA.

Our sponsor this period is MSOC Health.

Learn more about MSOC Health by viewing their ad on NCMGMA News and on our website. You can also visit MSOC Health’s website at https://www.msochealth.com/.

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2018 NCMGMA Membership Survey

NCMGMA values your membership and our leadership is always looking to improve our resources to add value back to you. Our goal is to be the leading resource for networking, advocacy and education for practice administrators and managers.

Please take a moment to complete our brief membership survey at the link below. The survey should take no longer than 10 minutes and will close on October 3rd.

https://www.surveymonkey.com/r/S6CMLM6

We appreciate your time!

Access to Displaced Patients’ Records Post Hurricane Florence

Please note: We are posting the following press release from NC HealthConnex in an effort to share information provided to us that may be helpful to our members.

NC HealthConnex Builds Emergency Connections to Neighboring State and Regional HIEs to Improve Access to Patient Records During Hurricane Florence

In the event the storm forces patients to seek health care outside of their communities, North Carolina’s statewide health information exchange – NC HealthConnex – has enabled connectivity to neighboring state and regional HIEs to support access to patient records.

NC HealthConnex opened the gateway for bidirectional query and exchange of patient records via the national eHealth Exchange Network, part of the Sequoia Project, to:

  • Coastal Connect HIE (Wilmington, NC)
  • ETHIN (East Tennessee)
  • GRAChiE (Augusta, Ga.)
  • MedVirginia (Richmond, Va.)
  • SCHIEX (South Carolina)

Existing connections already in place:

  • GaHIN (Atlanta)
  • VA HIE (Veterans Administration)

Major disasters such as Hurricane Florence have an effect on health care information needs – even before they make landfall.

“Hurricane Florence has already resulted in the evacuation of millions who left their local area where health care records are housed,” said the North Carolina Department of Information Technology’s Secretary Eric Boyette. “Our agency has been working to allow exchange of health records across state lines to provide additional support to the providers who will be treating them. We’re glad to have a part in making sure people get the best care possible.”

Health information exchanges (HIEs) are networks that allow doctors, nurses, pharmacists, other health care providers, and patients to access and securely share a patient’s vital medical information electronically such as medications, allergies, procedures, labs, diagnoses, etc. – improving the speed, quality, safety, coordination, and cost of patient care.

“Health data is critical during natural disasters,” said Yvonne Hughes, CEO of both Coastal Carolinas Health Alliance and Coastal Connect Health Information Exchange. “Our connection with NC HealthConnex helps us provide the best care we can during Hurricane Florence. We’d like to recognize our board, our staff, NC HealthConnex, Medicity, and Orion Health for working so hard to make this connection happen.”

“The genesis of health information exchanges was to enable the secure exchange of health care information using technology during emergent situations,” said Christie Burris, Executive Director of the NC Health Information Exchange Authority. “Use cases for widespread adoption of this type of technology during emergencies continues to emerge. We are pleased to able support this infrastructure for the State of North Carolina.”

During Hurricane Irma, GRAChIE established nine emergent connections in 24 hours to facilitate access to clinically relevant information on any Florida resident that may arrive in Georgia for care. GRAChIE’s experience and guidance helped the NC HealthConnex team to implement emergent connections to five HIEs in 48 hours.
For more information, visit www.nchealthconnex.gov.

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About the NC Health Information Exchange Authority
The North Carolina Health Information Exchange Authority (NC HIEA) operates North Carolina’s state-operated health information exchange, NC HealthConnex. NC HealthConnex is a secure, standardized electronic system in which providers can share important patient health information. See how it works.

The NC HIEA is committed to its mission: to connect health care providers to safely and securely share health information through a trusted network to improve health care quality and outcomes for North Carolinians. For more information about the NC HIEA visit: https://hiea.nc.gov/about-us/about-nc-hiea.

About the NC Department of Information Technology
The Department of Information Technology provides Technology services to state agencies and other government customers across North Carolina. Our services include hosting, network, telecommunications, desktop computing, project management services, data analytics and unified communications such as email and calendaring. The department operates under the leadership of the State Chief Information Officer (SCIO), as appointed by the Governor. The State CIO provides direct management over IT operations and has statewide IT responsibilities, including technical architecture, procurement, project management and security.

About Coastal Connect Health Information Exchange
Coastal Connect Health Information Exchange (CCHIE) was established in 2009 by hospital stakeholders who deployed HIE technology in 2011 as a way to securely connect unaffiliated ambulatory and acute healthcare providers in southeastern North Carolina for electronic sharing of patient care information to support patient-centric care transition between providers, reduce redundant testing, and realize efficiencies in workflow. CCHIE is governed by a multidisciplinary board composed of representatives from stakeholder hospitals community practices, the state Medicaid management entity, and a community representative. CCHIE’s sustainability model is supported by its founding stakeholders as well as ambulatory provider participation fees. Over 7.2 million patient encounters are indexed on the HIE’s Patient Search tool which allows HIE participants access to care documents from over 110 acute and ambulatory data contributors; including lab results, pathology results, radiology results, discharge summaries, encounter information, demographics and CCDs.

Provide Exceptional Care by Reshaping your Healthcare Culture

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2018 Fall Conference
October 17-19, 2018
Charleston Marriott | Charleston, SC

berrett300aBritt Berrett, PhD, FACHE, and the co-author of Patients Come Second: Leading Change by Changing the Way You Lead, is bringing his game-changing program to the Fall Conference in October. Dr. Berrett will teach us how to understand our practice’s healthcare culture. He will show us how to identify our culture, learn from it and ultimately shape it to provide the best care possible to our patients.

Here’s what Dr. Berrett will be presenting in October:

  • General Session:
    Patients Come Second: Leading Change by Changing the Way You Lead – Part I
    Thursday, October 18th, 8:00 am – 9:30 am
    How did we get here? We are told that “culture eats strategy” but what does that mean? What is the “culture” of a healthcare organization? We will discuss the cultural dynamics in healthcare and the historical context of evolution. Personal stories will be shared on how the culture of a healthcare organization strengthens or weakens its ability to provide exceptional care.
  • General Session:
    Patients Come Second: Leading Change by Changing the Way You Lead – Part II
    Thursday, October 18th, 10:30 am – 11:45 am
    How do you measure culture? Why do some co-workers believe the culture is toxic and others praise its vibrance? There has to be some way to measure organizational culture! This course will introduce the Cultural IQ or CIQ: a tested, self-evaluation tool that organizations can use to identify cultural perceptions. We will also share ideas on how to strengthen the ten dimensions of organizational culture.
  • Breakout Session:
    Creating a Culture Development Plan
    Thursday, October 18th, 1:00 pm – 2:00 pm
    Time to get into the weeds! How do you develop a vibrant culture? We have gotten past the “Why” and now we are focusing on the “How.” Participate in an interactive workshop that invites an exchange of ideas and experiences. Learn from others and be led to the creation of an organizational culture development plan.

Don’t miss these ground-breaking sessions and more: register today! To view the full list of Fall Conference offerings, please visit the schedule of event page here.

Registration

Registration is open for the 2018 Fall Conference in Charleston so sign up today. Click on the links below to access our online and print registration forms. For complete details on registration costs, follow this link. Early registration discounts end September 24th.

PLEASE NOTE: Non-member conference registration includes a complimentary Active membership (for qualifying registrants) in the North Carolina Medical Group Management Association (NCMGMA) for now through the end of the 2018-19 membership year. Visit the General Information page here to see if you qualify for an NCMGMA Active membership.

Hotel Accommodations

All events for the Annual Conference are scheduled at the Charleston Marriott, located at 170 Lockwood Blvd. in Charleston, SC. We are pleased to offer our attendees the discounted group rate is $174 per night (plus 14% tax + $2.24 destination fee). Hotel reservations can be made online by clicking here. The hotel room block cutoff is September 24th.

About the Marriott
Experience true southern hospitality and modern accommodations at its finest at the Charleston Marriott. Our location, overlooking the Ashley River, offers easy access to beautiful downtown historic Charleston, the old city market, local area beaches, The Citadel, and of course, great dining and entertainment. Our downtown Charleston hotel offers luxurious hotel amenities including high-speed wireless internet, shuttle service to the historic district, state of the art business and fitness centers.

Questions

For questions or more information about the Fall Conference in Charleston, please email us at info@ncmgm.org, or call us toll free at 800-753-MGMA (6462).

Don’t Complicate your Complications

By Marshaleen King, MD

2018 Alliance sponsor feature article courtesy of MagMutual

Case Scenario

A 64-year-old woman presented to the emergency room (ER) with right sided abdominal pain. Her ER evaluation revealed cholelithiasis with thickening of the gall bladder wall. The patient was admitted by the surgical team on call and underwent laparoscopic cholecystectomy. Approximately 12 hours after surgery, the patient developed fever and tachycardia followed by tachypnea and abdominal rigidity. On evaluation by the surgical team, a decision was made to take her back to the operating room (OR) for an exploratory laparotomy. During her exploratory laparotomy the surgeon discovered a transection of her common bile duct and decided to perform a repair. The complication was addressed using a technique that included a choledochoduodenostomy.

Post-operatively, the patient developed septic shock complicated by multi-organ failure and her condition rapidly declined. On hospital day 4, the surgeon had a discussion with the patient’s family and a decision was made to transfer her to a tertiary care center. At the time of transfer, the patient was on mechanical ventilation and required several vasopressors to maintain her blood pressure. Following transfer to the tertiary care center, concerns were raised about breakdown of her common bile duct anastamosis. A second exploratory laparotomy was then performed, at which time she was noted to have separation of her choledochoduodenal anastomosis with leakage of bile and duodenal contents into the peritoneal cavity. A hepaticojejunostomy was then performed, along with placement of a gastrostomy-jejunostomy tube and percutaneous transhepatic cholangiography (PTC) drain. Following surgery, the patient recovered from severe sepsis but her renal failure persisted, warranting initiation of hemodialysis. In addition, she had difficulty being weaned from mechanical ventilation and had to undergo a tracheostomy.

The patient’s family was angry because they were not notified of the surgical complication until the option of transferring her to a tertiary facility was being considered. The family sued, stating that, 1) there was a delay in recognizing and appropriately treating her surgical complication, and 2) the delay in transferring the patient to the tertiary center resulted in her severe sepsis and renal failure.

Discussion

Doctors feel a sense of responsibility to their patients and often want to personally manage complications that arise from the procedures they perform. However, physicians should be cognizant of their capabilities and recognize when the intervention required to address a complication is beyond their scope. In instances where a higher skill level is required to address a complication, the physician should seek to expeditiously transfer the patient to a facility where they can receive the appropriate level of care. Any delay in doing so puts patients at risk for worse outcomes related to their procedural complications and exposes physicians to the risk of litigation.

When a physician recognizes that a complication has occurred, it is crucial for him or her to inform the patient, and/or the patient’s family, in a timely manner. Delays in informing the patient/family about the complication may be perceived by the patient/family as an attempt to hide or misconstrue information. In the clinical case presented, the surgeon may have averted litigation had he:

  • Informed the patient/family of the complication at the time it was recognized
  • Discussed the options for handling the complication with the patient/family
  • Involved the patient/family in the decision-making process regarding management of the complication

Instead, the surgeon attempted to correct the complication on his own, even though the ideal approach would have been to transfer the patient to a tertiary care center to address the complication. One of the claims against the surgeon included the allegation that the ideal, more technical, surgical procedure required to repair the common bile duct transection was beyond the surgeon’s scope. Although the surgeon felt confident in his skills because he had used this alternative surgical approach before, his delay in transferring the patient was perceived as an attempt to avoid discovery of the complication. The case was settled for a significant amount of money.

Disclaimer
The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.

Regulatory Alert: Share your concerns in MGMA’s 2018 Regulatory Relief Survey

Originally printed in the September 10th issue of MGMA’s Washington Connection. Reprinted by permission from MGMA.

MGMA’s 2018 Regulatory Relief Survey is your chance to voice your thoughts on the impact of federal government rules and requirements on your practice. As a practice leader, you know the most challenging regulations facing your practice, and we want to hear from you. The findings of this survey will help guide MGMA advocacy efforts in Washington to reduce those burdensome regulations on group practices.

Survey results will be shared at MGMA’s Annual Conference in Boston during the Regulatory Relief Forum. Don’t miss this chance to make an impact on the policies that matter to you most.

Questions?

Contact MGMA Government Affairs by e-mailing govaff@mgma.org or calling 202-293-3450 or toll free 877-275-6462.

 

NCMGMA-NCMSF September 18th Webinar: Understanding Student Loan Debt

September NCMGMA-NCMSF Webinar:
Understanding Student Loan Debt

Tuesday, September 18, 2018
12:00 PM – 1:00 PM

Wondering how you can get your student debt under control? In this complimentary webinar, speaker Alex Macielak from Laurel Road will help you gain a greater understanding of federal repayment options, including loan forgiveness and refinancing.

Speaker

Alex Macielak manages business development and partnerships for Laurel Road, an FDIC-insured bank offering student loan refinancing, mortgages and personal loans. He has over seven years of experience in the student loan industry and has helped thousands of physician borrowers determine their optimal repayment strategy. He has a degree in Economics and Finance from Bentley University.

Registration

This webinar is complimentary but space is limited! After you register, you will receive an emailed confirmation with webinar and phone-in instructions.

Continuing education credit may be granted through your professional organization (MGMA, PAHCOM, AHIMA, etc.). Please self-submit for these organizations.

Questions

For questions or more information please contact the NC Medical Society offices at ncmsfoundation@ncmedsoc.org

Hurricane Florence Preparedness

Dear Colleagues,

Hurricane Florence will make landfall later this week, bringing potential flooding and power outages across the region. Our top priority is the health and safety of you and your patients. We have information and resources available for patients before, during, and after the storm. We are asking for your assistance in spreading this information. In addition, we are continuing to work with CMS and other partners on other flexibilities that will help during the storm and after. More information and updates will be forthcoming.

Tips for patients and providers:

  • Follow mandatory evacuation orders and evacuation routes. This will be a dangerous storm. Do not ride it out.
  • Never drive through standing water – turn around, don’t drown!
  • Don’t use gas-powered generators/burners inside your house.
  • Stock up and have ready emergency kits, take care of pets, check in with neighbors.
  • Make sure you have your medicines and fill your prescriptions before the storm hits. Many insurers are allowing early refills to make it easier.
  • People that rely on electricity-dependent medical devices should notify their local Department of Social Services as soon as possible. This will help authorities prioritize services during a power outage. Local DSS contact information can be found here: https://bit.ly/2N6zWon.

Important information for people in the Medicaid program:

  • Medicaid will cover a physician/clinician visit for beneficiaries who are evacuated, including those evacuated out-of-state.
  • Medicaid will cover early prescription refills by a Medicaid pharmacist. Beneficiaries are encouraged to refill their prescriptions before the storm

Important information for people in the Food and Nutrition Service program:

  • Electronic Benefits Transfer (EBT) cards can be used at any authorized retailer, even if they are in a different state.
  • Current Food and Nutrition Services households (people receiving SNAP benefits) that have a food loss may request replacement benefits through their county DSS.
  • Lost/Damaged EBT cards can be replaced by calling the EBT Call Center at 1-888-622-7328.

Other Resources:

  • Call 211 for non-emergency needs.
  • Download the ReadyNC app to a smartphone – provides details on how to prepare an emergency kit, where shelters are open, and other essential information. ReadyNC also may be accessed at https://readync.org/EN/Index.html.
  • Look out for NC Emergency Management’s latest updates at https://www.ncdps.gov/florence.

Stay safe,

Betsey

Elizabeth Cuervo Tilson, MD, MPH
State Health Director
Chief Medical Officer
Office of the Secretary
NC Department of Health and Human Services

Office: 919-855-4800
Fax: 919-715-4645
Betsey.Tilson@dhhs.nc.gov