Premier Pulse News for Premier Health Physicians VOLUME 7 | ISSUE 5 | JULY 2020

Future of Health Care in the Era of COVID-19 By Matthew S. Reeves, DO, MBA, chief of integrated care, Premier Health

Acknowledging that vast swaths of providers and patients have shortage of severe magnitude, and we are nowhere near engaged in new means of providing health telehealth is a woefully underutilized tool in being out of the thick care that I think they’ll appreciate and want our toolbox. of COVID-19, there to continue. Until this change was forced With great disruption comes the opportunity are some lessons upon them, patients and providers could not for great innovation and leadership. This learned and trends fully understand or accept that change. will be a lesson learned from numerous developing. For example, telehealth, especially in the perspectives – telehealth being just one Over the long-term, outpatient setting, is changed forever. illustration. When we look back on this lower hospital admissions will be the new Patients will demand this ease of access. time, it will be identified as the tipping norm. Hospitals will move toward becoming Providers are going to feel a relief from point transforming our “sick-care” system centers of excellence and/or large intensive running the rat race to keep up by unloading to a “well-care” system. Out of necessity, care units caring for a smaller volume of some of the care to these more efficient new business models will develop that have higher acuity patients. models. Granted, limitations and possible greater vertical integration and collaboration As with any stress/crisis, the best and the abuse of telehealth is a reality. Patients across systems. Value creates volume. Those worst of us show up. With health care, may not accept or understand that not who get value right will see the volume. all moments of clinical value can occur we’ve realized tight capacity margins and The best of us is yet to come. unpreparedness on a national level. remotely based on their desire for ease of access. Hopefully doctors will not acquiesce As always, I’m interested in your viewpoint. Furthermore, the pandemic has forced the to inappropriate telehealth demands and Feel free to reach out to me at global health care system to embrace ways desires from their patients. What is for [email protected] or of doing business that we’ve sluggishly certain though is that we have a provider (812) 361-6876. tried to implement for some time. Now,

PremierHealth.com SERVICE LINE UPDATE: ONCOLOGY Redefining Cancer Care By Mikki Clancy, service line vice president, oncology

Premier Health Cancer Services is Officials with Premier Health cancer services also are pleased undergoing some exciting changes this to unveil our new marketing plan. This plan started with a very year. Under the leadership of Charles successful set of Cancer Survivor Day activities, including a well- Bane, MD; James Ouellette, DO, FACS; attended virtual event featuring the talents of Mark Marinella, and Ryan Steinmetz, MD, the Oncology MD, Beth Delaney, and Christine Broomhall; the Tree of Life Institute has redefined its vision for the mural of survivor photographs; and our survivor’s billboard future of cancer care in our region. The prominently displayed across our service area. vision of one cohesive program with The implementation of the cancer navigator program has a consistent experience for patients, families, and referring elevated the ease of traversing the scheduling, complexity, physicians is driving a reenergized approach to refining and treatment plan, and journey of dealing with a cancer diagnosis. building our oncology services. Our navigators’ kind, compassionate, and supportive nature Our affiliation with MD Anderson Cancer Network® has assists the patient and family during this scary journey. Nurse verified the outstanding quality provided by our care facilities navigators are available to assist with ANY new diagnosis of as well as the MD Anderson certified physicians and their cancer to ensure a cohesive patient experience. Please consider practices. We have been able to leverage this relationship by an oncology nurse navigator consult for inpatient or outpatient bringing additional programs to our cancer services that will patients via EPIC or the navigator referral form for non-EPIC be implemented over the next few months. Our MD Anderson users. affiliations provide patients access to local physicians certified Over the past several weeks we have been working on additional by one of the leading cancer centers in the nation, while programmatic additions, technology investments, and service receiving care close to home. Utilizing MD Anderson to verify changes for Premier Health cancer services. If you have our quality services provides patients with the ease of mind suggestions for improvement or new ideas, please reach out to and confidence because our local certified physicians have easy Dr. Bane, Dr. Ouellette, or me. access to MD Anderson faculty and best practices. PHYSICIAN PROFILE Collegiate Athlete Returns Home to Practice Sports Medicine

Aloiya Earl, MD office. I started shadowing my own sports What is the last book you read? What is your clinical medicine physician when I was 14 and knew Lessons by Gisele Bundchen this was my dream career. I started watching specialty? Primary What is your favorite song in your playlist? care sports medicine YouTube videos of gruesome sports injuries “Tennessee Whiskey” by Chris Stapleton with Premier to desensitize myself when I was a freshman in high school. What is your favorite food? Orthopedics Three-way tie between tacos, pizza, and ice Who are the people who influenced and/or Where did you go to cream school? mentored you? What is your favorite hobby? I went to University of South Carolina for Dr. Luke Ragan – my own sports medicine Volleyball, watersports/lake days, traveling undergrad, University of Toledo for medical physician and subsequent mentor; Dr. Fred school, The Ohio State University for Miser at Ohio State, who showed me the What is your favorite animal, and why? residency, and University of Alabama for compassionate humanity of medicine and Penguins because they lie on their stomach fellowship. the importance of a primary care foundation; to slide across ice and they search for the and Dr. Jimmy Robinson, my fellowship smoothest perfect pebble to give to their What brought you to Premier Health? director at Alabama who I suspect invented love interest I was excited to come back to my home the musculoskeletal system because that’s Where is your favorite vacation spot, and state of Ohio and join a group where I how well he knows and teaches it. could practice 100 percent sports medicine. why? Premier Health has also given me the What is one thing most people don’t know Hawaii! It has vibrant green mountains and opportunity and flexibility to incorporate about you? teal blue water. It feels like a different planet. My childhood (and still) career aspiration nutrition, sports psychology, sports Describe something (a thing, person, place, was (is) to be a Zamboni driver for an ice rink. performance, and exercise prescription into experience, etc.) for which you are especially my practice. Where is your hometown? thankful: My support system Why did you choose medicine as a career? Lambertville, Mich. (near Toledo, Ohio) I grew up as a distance runner and volleyball What, if any, sports team(s) do you cheer for? Pick a side player, but I had several overuse injuries Alabama Crimson Tide, South Carolina throughout high school and into college Gamecocks, Ohio State Buckeyes, Kentucky iPhone or Android which kept me visiting the sports medicine Wildcats iPhone Early bird or night owl Night owl Beach bum or mountain hiker? Beach bum Dress shoes or tennis shoes? Dress shoes Paperback or e-reader? Paperback because I love the smell of book pages Coffee or tea? Coffee Cooking or baking? Baking Sweet or salty? Sweet PHYSICIAN ADVISOR’S CORNER Clinical Documentation Andrew B. Maigur, MD, system director, Premier Physician Advisor Program

It’s imperative metrics (abstracted from coded data). Your • It is in the hospital’s best interests. The as physicians to quality measures are publicly available hospital is being judged by certain quality realize that Clinical for review on Medicare’s Physician measures, and rewarded or penalized for, Documentation Compare (https://www.medicare.gov/ in turn. If our hospital looks substandard Integrity is a quality physiciancompare/) and may guide on Hospital Compare (https://www. initiative. Accurate, potential patients’ choice of provider. medicare.gov/hospitalcompare/search. high-quality clinical • It is also important that physicians html?,) patients and payers may avoid documentation understand the process of audits and our services. If our sites of care look bad improves communication, increases denials and the financial impact on the in value-based purchasing, they may lose recognition of comorbid conditions that are hospital. At this time, most physicians money. No margin, no mission. responsive to treatment, validates the care have not felt any repercussions from a Some of you might think, “I don’t care about that was provided, and shows compliance recovery audit contractor (RAC) denial, the hospital’s reimbursement.” I would ask, with quality and safety guidelines. As a but the impact on a hospital is very is it fair that the hospital provides state-of- fellow physician, I am positive that I would tangible. Not surprisingly, the top 10 the-art care for your sick patients and incurs not have to persuade you to want to take RAC-denied diagnoses are often similar soaring costs of care but does not receive the excellent medical care of your patient. to the top 10 queried diagnoses. Hence, appropriate reimbursement? Absolutely not! Here are four reasons why you should be good documentation done concurrently I would ardently encourage you to consider invested in optimal documentation: will only help to improve the outcome CDI and Coding as your allies to facilitate of a RAC audit. CMS issued Transmittal • It is in the patient’s best interests. We owe accurate, codable, clinical documentation to 541 that allows Medicare Administrative our patients an accurate medical record. reflect the excellent care you provide to our Contractor (MACs) and Zone Program patients! • It is in the provider’s best interests. Integrity Contractors (ZPICs) to deny Not just the hospital’s, but your quality “related claims.” This means when the References: Clinical Documentation Improvement-A Physician Perspective by Adele Towers, MD, MPH AHIMA metrics (LOS, readmissions, SOI-Severity facility receives a denial if an admission is of Illness score, ROM-Risk of Mortality found to not be medically necessary, they Physician Engagement Includes Physician Documentation score, PSI-Patient Safety Indicator, post- can also deny the corresponding physician by Erica Remer, MD, FACEP, CCDS icd10monitor op complications) are also derived from claims. observed–to–expected risk–adjusted Provider Praise

Premier Health patients she is the BEST. She listens of the staff is as pleasant as submit thousands of to you intently and explains they come! This office is the comments each year things fully. best and that’s why I drive one acknowledging physicians Dr. Wolf is a fantastic doctor, hour, one way to see them! across our health system he is professional, personable, My experience was excellent. for providing excellent care. knowledgeable, and spends all Dr. Mesker is one of the finest Here is a random sampling of the time I need to ensure I am doctors I have had experience appreciation received in recent well-versed in my condition. with. Both my husband and I months: Dr. Toth is a very caring doctor highly recommend him. My visits with Dr. Songer are and truly cares about his Dr. Kim is so wonderful. He the most positive of all my patients. He took very good always listens to me and tries doctor visits. I always look care of me with my rectal to help reduce my migraines. forward to my visits! surgery. I would definitely recommend Dr. Zeidan is excellent as a Dr. Sulentic is one of the best him to anyone with acute or physician. I am a nurse and orthos I’ve ever met! The rest chronic migraines. know many physicians, but

Healthgrades Recognizes Atrium, Upper Valley Medical Centers for Patient Safety

Atrium Medical Center and Upper Valley of advanced, innovative care as a Level III Medical Center have been named recipients Trauma Center and Primary Stroke Center. It of the Patient Safety Excellence Award™ by is also the only accredited Chest Pain Center Healthgrades. in Warren County. Atrium offers maternity, This recognition ranks Atrium Medical cancer, orthopedics, and heart care. Center and Upper Valley Medical Center Upper Valley Medical Center, which has among the top 10 percent of hospitals in the received the Patient Safety Excellence nation for patient safety. The Patient Safety Award™ for four consecutive years, offers Excellence Award™ recognizes hospitals for a wide range of advanced care, including their performance in safeguarding patients emergency, heart, cancer, maternity, from serious and potentially preventable behavioral health, long-term care, and complications during their hospital stay. much more. The hospital is the only Level II Along with the Patient Safety Excellence Special Care Nursery between Dayton and recognition, which it has received every Lima. Both Upper Valley Medical Center year since 2015, Atrium Medical Center was and Atrium Medical Center have achieved named among America’s 100 Best Hospitals Magnet® Recognition, which is widely seen by Healthgrades earlier this year. This as the highest standard for excellence in distinction places it among the top 2 percent professional nursing. of hospitals in the country for demonstrating Healthgrades methodology for the Patient clinical excellence across a broad spectrum Safety Excellence Award™ uses inpatient of care. The hospital also was named among data from the Medicare Provider Analysis the top 10 percent of hospitals in the nation and Review database and software from the for critical care. Atrium offers a broad range Agency for Healthcare Research and Quality. Race Relations and What We Must Do By Mary Boosalis, president and chief executive officer, Premier Health

The brutal murder of George Floyd in Minneapolis has provoked reactions of rage and heartbreak, spurring demand for much needed change locally and around the globe. Premier Health has been a strong leader in diversity and inclusion for decades, but in recent weeks I have learned that we have not done nearly enough. The discussion has widened to better address race relations and what we can do to better ensure everyone at Premier Health feels safe in sharing their feelings, expressing their thoughts, and in being celebrated for who they are. The same is true for how we treat our patients and their family members. We don’t have all the answers right now, but we are committed to placing much more focus on achieving a culture that consistently welcomes, understands, and applauds our differences and the value of each and every person. Our diversity committee of the Board of Trustees and our facility-based diversity committees are making plans for broader and more meaningful actions. This includes a diversity leadership forum and employee listening sessions on Hurt, Healing, and Hope. Medical Executive Committee Update: Unifying Medical Staff By Marc Belcastro, DO, system chief medical officer, Premier Health

This summer, the Medical Executive Committee (MEC) will move forward with a vote for our Premier Health system medical staffs to organize and unify as one medical staff. If the vote by each MEC is to proceed, we will communicate this in September through various forums. We will also continue to utilize the Premier Pulse newsletter for communication. A move to one medical staff would be a bylaws change and therefore will require a vote of the entire medical staff at all sites. We hope to have the voting sent in October.

The benefits of one medical staff are listed below. The first bullet point is underlined and in bold due to its importance and value for our medical staffs. • BRINGS TOGETHER ONE UNIFIED VOICE TO THE BOARD (THIS CURRENTLY DOES NOT EXIST) • SPEED of process resolution with greater communication • EFFICIENCY – The approval process for vital changes is reduced • SHARING – One credentials committee • STANDARDIZATION - Where needed • CULTURE - Preserves the unique culture of each facility • CULTURE – Adds a new culture of cohesion for physicians

Under this proposed structure, wellness and peer review will remain local. Credentialing will become centralized under one committee. We will preserve the local MECs as operating committees and create a central MEC. Please reach out to your local chief medical officer or medical staff presidents with any questions. More information and detail will be forthcoming in each month’s Pulse. CompuNet Plans for Enhancement CompuNet Plans for Enhancement

With the Sunquest Lab Information System CompuNet with proximity to I-75 and is conversion completed at the core laboratory, strategically placed near multiple provider CompuNet is planning some service offices. enhancements for providers and patients in To find a CompuNet patient service center, the coming weeks. visit compunetlab.com/locations. Appointment Scheduling COVID-19 PCR Collections CompuNet will soon roll out patient As the need continues to grow for testing appointment scheduling utilizing the SOLV to detect an active infection of COVID-19, scheduling platform. CompuNet will first CompuNet will soon introduce swab pilot appointment scheduling in a handful collections for COVID-19 PCR testing at of patient service centers, with plans to select patient service centers. Staff is add all locations soon after. Details will be currently undergoing training to collect forthcoming. specimens using a nasopharyngeal swab. New Locations CompuNet phlebotomists who have been As CompuNet expands business in the trained on COVID-19 collections currently Cincinnati region, new patient service staff the collection tent at the collection centers will be essential for providing site at the University of Dayton Arena. Their convenient access to lab services. On June experience at this collection site allows 13, CompuNet opened its second Cincinnati them to become thoroughly proficient patient service center in Montgomery. and develop confidence in their abilities CompuNet opened its first Cincinnati-area to collect a potentially infected COVID-19 location at the Liberty Family Medicine patient. building in 2019. CompuNet will communicate the availability of both appointment scheduling and COVID-19 PCR collections to providers in the CompuNet Montgomery Patient Service Center coming weeks. 11135 Montgomery Road, Suite 200 SARS CoV2 IgG Antibody Testing Cincinnati, OH 45249 Demand is growing from patients to Phone: (513) 832-1400; Fax: (513) 832-1434 understand whether or not they have had a past infection of COVID-19 infection. SARS Hours: CoV2 IgG Antibody testing can provide the Monday - Friday 8 a.m. - 12 p.m.; 1 p.m. - 5 p.m. answer. CompuNet performs this test on the Drug Screen Hours: Abbott Architect platform which received 7:30 a.m. - 12 p.m.; 1 p.m. - 4:30 p.m. Emergency Use Authorization from the Food and Drug Administration in April 2020.

CompuNet’s third Cincinnati-area location To order SARS CoV2 IgG Antibody testing, will open in early August in West Chester it is recommended that patients be at the newly renovated Tylersville Point asymptomatic for 10 days prior to testing. shopping center at the corner of Cox and To place an order, please use EPIC order code Tylersville roads. This is a prime location for LAB 6596. Boosalis Named to Modern Healthcare’s 50 Most Influential Clinical Executives

Premier Health is proud to announce that Boosalis is a member of the Ohio News, and has been recognized as an Ohio its president and CEO, Mary Boosalis, has Hospital Association, Midwest Health Most Powerful and Influential Woman by been recognized by Modern Healthcare Collaborative, and the Greater Dayton the Ohio Diversity Council. The Dayton as one of its 50 Most Influential Clinical Area Hospital Association. She currently YWCA has recognized her as a Woman Executives. serves as chair of the University of Dayton of Influence, and she was honored as an The 50 Most Influential Clinical Executives Board of Trustees, and as a member of inaugural member of the Dayton Business awards and recognition program honors the Dayton Development Coalition Board, Hall of Fame. individuals in health care who are deemed the Dayton Business Committee, the City by their peers and the senior editors of Manager Advisory Council, and the board Modern Healthcare to be paving the way of Hub Group, Inc. She is a past member to better health through their executive of the Sinclair Community College Board, responsibility, leadership qualities, the Life Connection Board, and is a innovation, community service, and past chair of the Dayton area’s achievements inside and outside of their American Heart Association respective organizations. Board. Boosalis joins notable names such as Dr. Modern Healthcare named Anthony Fauci, director, National Institute Boosalis as one of its 2019 of Allergy and Infectious Diseases; Dr. Top 25 Women Leaders. Deborah Birx, ambassador-at-large, Boosalis has been coronavirus response coordinator, Trump named to the Top administration; and Dr. Jerome Adams, 10 Women U.S. surgeon general, U.S. Department of list by the Health and Human Services; plus fellow Dayton Ohioans Dr. Amy Acton, chief health Daily advisor to Ohio Governor Mike DeWine, and Dr. Tomislav Mihaljevic, president and CEO, Cleveland Clinic. SYSTEM HOSPITAL NEWS YMCA Partnership; Enhancing Philanthropy; Hospital President Retires

Atrium Medical Center physical therapy services located at the Thomas Yunger, MD, Anuj Goyal, MD, and the YMCA. Whitney Hare, AT, will provide the interventional pulmonary team at Atrium athletic training services at Countryside Medical Center treated two patients in YMCA. May with the Zephyr Valve, a less-invasive Miami Valley Hospital Campuses treatment option for COPD and emphysema. The Ohio Hospital Association and the Ohio The procedure was the first completed in Department of Health awarded the “Ohio the Cincinnati area, according to PulmonX, First Steps for Healthy Babies” recognition manufacturer of the Zephyr Valve. to Miami Valley Hospital and Miami Valley Countryside YMCA, one of the world’s Hospital South. The maternity centers largest YMCAs, has teamed with Atrium earned this recognition for their great Medical Center to offer athletic training work related to the Ten Steps to Successful services to its members. A full-time Breastfeeding program. athletic trainer will provide free injury Betsy Chapin Taylor, FAHP, president of assessments, treatment, and injury Accordant Philanthropy, is currently working prevention advice to YMCA members as with the Premier Health foundations on part of an enhanced relationship between a philanthropic strategic plan for 2021 Atrium and Countryside YMCA. The services through 2023. Among the areas of emphasis began in June at will be to enhance a philanthropic culture Countryside YMCA by engaging with system leaders to align in Lebanon. Atrium with the foundations’ fundraising goals and and Countryside health system’s strategic objectives. The YMCA have enjoyed a plan will also include modifying fundraising positive relationship responsibilities among existing foundation for many years, with staff, providing more focus on major gifts, sports medicine and planned giving and developing a grateful patient strategy. Ms. Taylor is an award- sewed and donated more than 15,000 face Upper Valley Medical Center winning author, speaker, and consultant masks to address the shortage of personal Tom Parker, president with more than 25 years of experience, protective equipment. of Upper Valley including 17 years as chief philanthropy The City of Dayton began a massive Medical Center, has officer in academic, community and pavement replacement project on the south announced plans to children’s hospitals. The report should be side of Miami Valley Hospital on Wyoming retire from Premier complete by the end of August. Street. Our facilities team has been working Health effective July The Good Samaritan Foundation-Dayton with the city to ensure minimal disruptions 31. board awarded 16 scholarships to children to the emergency department, surgery Parker began his of former Good Sam employees. Each parking garage, and the main hospital career locally in scholarship was $1,000 with the checks loading dock. Wyoming Street is expected the Miami County Probate/Juvenile Court mailed in June. Since 2015, the Foundation to fully reopen by the end of August. The system in 1980 before transitioning to has awarded 74 scholarships totaling project will include replacement of the oversee behavioral health services for UVMC $120,500. One student recipient wrote, “I pavement, as well as installation of new in 1992. He progressed through various key am so grateful to have been chosen as a street lighting and medians. leadership roles at UVMC, including vice recipient of the Good Samaritan Foundation president of operations, senior vice president The Miami Valley Hospital Diabetes Youth Scholarship. It is an honor to have of operations, chief operating officer, and Center is now seeing patients at their new the foundation’s support as I pursue my chief executive officer. location on the north campus. The center education and work toward becoming a is located on the first floor, next to the Parker has also held Premier Health system compassionate health care professional, financial counselor’s office. Appointments roles, including those for service lines furthering the mission and values of Good are available Monday through Thursday, and the hospitalist program. In 2015, Sam. Thank you so much for your support!” 8 a.m. to 6 p.m. Diabetes Center leaders he became the chief experience officer, As Miami Valley Hospital celebrates 130 include certified diabetes educators Tambra leading numerous system initiatives and years, it is interesting to note that the recent Samuels, RN at (937) 734-5719 and Carol spearheading efforts to continuously donations of hand sewn masks echo back to Nartker, RD at (937) 734-6175. Additionally, enhance and hardwire an excellent the hospital’s earliest days, when volunteers the order in EPIC is now called “Consult experience for patients. He has continued stitched gauze for surgical dressings and to MVHN Diabetes Center”- CON30140. leading the system’s patient experience work sewed towels, night gowns, aprons, and Under scheduling instructions, please type and in 2018 became president of UVMC. tablecloths. During the Great Depression “Eval” and “Treat” to assess the patient and Parker has worked tirelessly to position and World War II, community volunteers determine how they best learn - group or UVMC as the health care leader in the donated thousands of pieces of linens to the individual. With this new addition on the region’s northern communities. Most hospital. Once again in our time of need, the MVHN campus, the administration office has recently, he has exemplified and modeled community stepped up with their support. re-located to the second floor, Suite 239. the true spirit of Premier Health’s core During the COVID-19 pandemic, volunteers values and mission, leading the UVMC team through the COVID-19 pandemic with the utmost compassion and excellence. The very first hospital dedicated October 14, 1894 as the Protestant Deaconess Hospital; “Tom is known for his fierce compassion and January 1903, the hospital name was changed to Miami Valley Hospital to better reflect commitment to both improving the lives its mission. of our patients and supporting the staff who make it all possible. He has also taken an active part through various community initiatives and partnerships to improve the overall health in Miami County,” said Barbara Johnson, executive vice president and chief operating officer for Premier Health. “While we will deeply miss Tom’s unwavering devotion to UVMC, we are grateful for his many contributions and excited that he will be able to begin a very well-deserved retirement,” she added. The plan for the UVMC president role will be communicated as it becomes final, Johnson said. Our care lives here more than ever. Now just behind a mask.

We know getting care comes with a little uncertainty right now. But behind these masks, you’ll find unwavering dedication, compassion, and protection for you and the care we provide to you. You won’t find us backing down. As long as you need us, we’ll be here, standing strong. Because it’s who we are, and care is behind everything we do.

Our Care Lives Here. Still.

For more information on the steps we are taking to keep you safe, visit PremierHealth.com/KeepingYouSafe

Editorial Board: Dr. Marc Belcastro, Dr. Roberto Colon , Dr. Andre Harris, Dr. Scott Kanagy, Dr. Matthew Reeves | Chief Marketing and Communications Officer: Kathy Harper Director, System Communications: Ben Sutherly; Editor: Tim Carrico

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