Health ICT’s approach to accomplishing its mission of preventing and combating diabetes, obesity, heart attack and stroke is a multifaceted one. One of those facets focuses on the clinical care side and has involved using a mix of technology and collaboration to target diabetes and other metabolic conditions.
Dr. Justin Moore, medical consultant for the grant-funded Health ICT, said efforts involving data mining and app-based monitoring of diabetes are in synch with the national shift from volume-based fee for service to an outcomes-based model that rewards prevention and chronic disease management. Health ICT is interesting in doing even more along those lines, and would be glad to hear from doctors and practices with ideas.
So far, Health ICT has helped bring the software app Twine to Dr. Steve Davis’ practice at Wichita Family Medicine Specialists, where the messaging program was used to track blood sugar and other vitals and put the information into a digestible format. Health ICT’s work in that case involved arranging for medical students in Dr. Bob Badgett’s Population Health in Practice class to study work flows and help with implementation.
The technology “allows, probably a nurse or health coach, and in some cases the doctor, to make changes to the patient’s therapy without actually seeing the patient in the office,” Dr. Moore said. “Our goal isn’t to go into offices and ask doctors to do more for less money. Our goal is to make this at the very least a break-even proposition for providing slightly better care or, if it really goes well, improves the care and makes some money.”
“As long as you can capture 20 minutes per month of interaction with the patient outside of your office, and as long as that care applies to a couple of chronic conditions, then the provider is eligible for chronic care management reimbursement. It isn’t a huge amount of money, $40-$45 a month depending on the region, but if you have substantial chronically ill Medicare population it can really add up,” Dr. Moore said.
It is also a good use of time for doctor and patient. “I have long felt kind of guilty about the hoops we make patients jump through in order to receive care that ought to be almost automatic or routine, like having them miss half a day of work for a 15-minute office visit,” said Dr. Moore, an endocrinologist. “For a lot of these, it’s mostly about asking a couple of questions and checking the numbers.”Read More
Starting in July, Wichita and other KU School of Medicine campuses will phase in a new curriculum intended to give medical students more hands-on, team-based training and teach them in ways they’ll better retain the information.
Dr. Scott Moser, associate dean for curriculum, said an overarching goal of ACE (short for Active, Competency-Based and Excellence-Driven) is to close the divide that’s long existed between the first two years of medical school – traditionally lecture-intensive passive learning – and the final two years.
“There will be a greater emphasis on clinical skills during those first two years, taking histories, for example, so they’ll be better prepared for their clinical years, the last two years,” he said.
The curriculum will be rolled out over four years at the Wichita, Salina and Kansas City campuses. “It represents enough of a change that throwing students into it at different levels wouldn’t have been good,” said Dr. Moser, adding that the four-year time frame will make fine-tuning easier.
The Active component of the curriculum has two major pieces during the first two years, with each class of 28 students divided into four small groups of seven:
Problem-based learning. KUSM-W has had this piece for a while but will expand the approach. Each session involves a small group, facilitated by a faculty member, looking at a patient case. “The focus of cases is very much on diagnosis and diagnostic reasoning. They depend on some of the basic science they’re getting, but they’re applying it to clinical problem solving,” Dr. Moser said.
Case-based collaborative learning. These once or twice weekly sessions will focus on learning basic science in a small group session, and involve pre-session non-graded homework and a quiz. The case, including diagnosis, is introduced to students over two hours and “pulls out the basic science principles.” The small groups will then come together for a large group session, typically led by the faculty member who wrote the case. “There’s evidence that students do just as well in knowledge after these sessions and they retain it much better over time,” he said. “We’re very excited about this. We’re cutting back on the number of lectures.”Read More
by Denis Knight, DO
The Medical Society of Sedgwick County and the Kansas Medical Society continue to represent the interests of physicians, patients and quality health care in both Topeka and Washington, D.C. I would like to acquaint our membership with several legislative bills introduced at the Kansas Statehouse this session that could have a significant impact on the physicians and citizens of Sedgwick County.
The fate of these bills is far from certain at this point – KanCare expansion had just been tabled as the newsletter went to press — but I wanted to tell a bit about why we have been behind them.
HB2064 and SB38 address the need to expand KanCare, the state’s managed care program to include individuals earning up to 133 percent of the federal poverty level. Regardless of anyone’s political persuasion or their position on the Affordable Care Act (ACA), or Obamacare, the fact remains that many of the “working poor” fall into a tough gap. They are ineligible for public assistance with Medicaid but do not earn enough to pay rising premiums and deductibles in the Kansas marketplace through the federal exchange.
I see these patients in my practice regularly, and see the burden it places on them and their families. I am also sure that there are patients I don’t see because they delay seeking care, allowing conditions to worsen. We have supported – and should continue to – legislation that aims to increase Kansans’ access to health care.Read More
This year MSSC members again have the chance to mark Doctors’ Day in a different way, by going into schools and sharing why and how they became physicians.
Last year, more than a dozen doctors visited Wichita Collegiate, Independent, East High and Trinity Academy. If you’re interested in taking part on March 30, please contact Denise Phillips at 316-683-7558 or firstname.lastname@example.org.
Both the Wichita City Council and the Sedgwick County Commission recently agreed to fund Project Access at the same levels as last year.
Project Access will receive $200,000 through the city, while the county will supply $175,000. This year, both the city and county votes were unanimous.
The pink TPOPP form that allows patients to communicate their wishes about medical care is undergoing changes. Although the form has been revised, physicians can use the existing version until exhausting their supplies.
TPOPP – for Transportable Physician Orders for Patient Preferences – is designed to improve the quality of care people with chronic, advanced or terminal illnesses receive at the end of life by translating their treatment goals and preferences into their medical orders. The forms come from the Center for Practical Bioethics, with the local effort organized by the TPOPP Wichita Steering Committee (tpoppwichita.com).
The most substantive change to the form is the Signature of Authorized Healthcare Provider information in Section D. The form must contain the name of the authorized provider and physician. The form can be signed by authorized healthcare providers working within their scope of practice or under the direction of a physician.
The other important change is in how medical interventions are listed in Section B. Full treatment is now listed first, followed by Selected Additional Interventions, then Comfort Measures Only. By listing interventions in this order, it is clear TPOPP is appropriate for a wide range of treatment preferences.
To order copies, contact the Center for Practical Bioethics, 816-221-1100, or call the MSSC office, 316-683-7558.
Physicians from 27 specialties graded their burnout on a scale of 1 to 7 in a recent Medscape survey – one being that it does not interfere, and seven indicating thoughts of leaving medicine. All but one specialty selected a four or higher.
Emergency medicine was most affected, with nearly 60 percent of ED physicians saying they feel burned out, up from half in 2013. In the survey, “Medscape Lifestyle Report 2017,” physicians cited too many bureaucratic tasks, spending too many hours at work, feeling like just a cog in a wheel and increasing computerization of practice as reasons. More than 14,000 physicians surveyed designated those four concerns as the top causes.
Other specialties with high percentages of burnout included OB/GYN, family medicine and internal medicine. In more than half of the 27 specialties, a majority of doctors reported feeling burned out.
“We need to stop blaming individuals and treat physician burnout as a system issue. … If it affects half our physicians, it is indirectly affecting half our patients,” Tait Shanafelt, MD, a burnout researcher at the Mayo Clinic, said in June.Read More
The Zola N. and Lawrence R. Nell Educational Trust Scholarship Program is now accepting applications through April 15, 2017, for grant funds to assist students studying medicine or other health practitioner programs at the post-baccalaureate level. For an application, contact Deanne Newland at MSSC at 683-7557.
Completed applications and official transcripts should be mailed by April 15 to: The Commerce Trust Company, ATTN: Brian Adams, PO Box 637, Wichita, KS 67201-0637. Each application should provide an address and phone number for communications between April and June.
MSSC extends its condolences to the family of Dr. Smith.
Pathologist Alvin L. Smith, MD, died Jan. 23, 2017. Dr. Smith graduated from Marquette University Medical School and completed his internship at Columbia Hospital in Milwaukee, Wisc., in 1958. He finished his pathology residency at Wood VA Hospital in Milwaukee in 1962 and then practiced in Milwaukee and later Orange County, California. Dr. Smith joined St. Francis Hospital in Wichita in 1972. He served as the associate director of the St. Francis laboratory and later director of AMS Laboratory, retiring in 1998.
Members of the Society who know a good and sufficient reason why any of the following applicants are not eligible for membership are requested to communicate with the Medical Society of Sedgwick County office.
[BC] Board Certified [R] Residency [F] Accredited Fellowship [F*] Unaccredited Fellowship [AT] Additional Training
Reinstated to Active
Charles Soebbing, MD
Sara Ann Winchester, MD
Keep your 2017 Roster current by adding the information listed below and in the Membership section of this issue of the MSSC News:
Bruce Buhr, MD
Laximi P. Dhakal, MD
Joshua Linnell, MD
Michael C. Scheve, DO
Thuy Dang, MD
Robert J. Dole V.A. Medical Center
5500 E. Kellogg, 67218
Gretchen Dickson, MD name changed to Gretchen Irwin, MD
Mila Means, MD
Healthy Strategies Family Doc
OFF: 858-1351 / FAX: 858-1355
6611 E. Central
Andrew Barclay, MD
Jennifer Cheng, DO
Andover Family Medicine, LLC
2117 N. Keystone Cir
Andover, KS 67002
OFF: 316-733-5120 / FAX: 316-733-1280
Holly M. Allen-Terrell, MD
No longer at HealthCore
Christiane M. Smith, MD
Focus Direct Family Medicine
310 W. Central, S-M, Andover, KS 67002
Daniel Alvarez, DO
Randee Lipman, MD
G. Whitney Reader, MD
Kansas Cardiology Consultants
8110 E. 32nd St. N.
Shawky N.F. Habashy, MD
C. Eric Shrader, MD
Samrah Mansoor, MD
Kyle Goerl, MD
Wichita Health Information Exchange – Creating a secure electronic exchange of health data across the local medical trade region, in collaboration with the provider-led Kansas Health Information Network. WHIE non-profit, provider-led organization to improve patient care in Wichita-Sedgwick County through the prompt, secure electronic exchange of clinical information within the medical trade region.