Premier Pulse News for Premier Health Physicians VOLUME 4 | ISSUE 10 | OCTOBER 2017 New Ohio Opioid Prescribing Rules Unveiled By Tammy Lundstrom, MD, JD, interim chief clinical officer and interim president, Premier Physician Network, Premier Health The Ohio Board of a prescription for acute pain cannot or CPT code to the prescription when of Medicine has exceed an average of 30 MED per day. prescribing opioids for acute pain becomes released the • Health care providers may prescribe effective in December 2017. On June 1, long-awaited opioids in excess of the day supply limits 2018, this will be a requirement for all rules on opioid only if they provide a specific reason controlled substance prescriptions. Our IT prescribing that documented in the medical record. team is working with the EPIC developers track the Centers on strategies to assist providers in meeting for Disease Control The new limits do not apply to opioids these requirements. The OSBM has also and Prevention prescribed for cancer, palliative care, end- announced that it intends to audit providers guidelines. These of-life/hospice care or medication-assisted who exceed the guidelines and promised rules took effect on August 31. They include treatment for addiction. Prescribers should strict enforcement per Gov. John Kasich’s the following basics that apply to the be aware that MED will be calculated direction. first opioid analgesic prescription for the on the maximum use potential on PRN The MED limit is one that will likely trip treatment of an episode of acute pain: prescriptions. Those allowing for more than four Vicodin tablets or the equivalent will be up some doctors. Four 5mg vicodin in a • No more than seven days of opioids can in violation of the limits. More details can be 24-hour period will max out the limit. Many be prescribed for adults. found in the following documents posted of the surgeons write for one to two every • No more than five days of opioids can be on the physician portal: six hours, and that will require supporting prescribed for minors and only after the documentation in the record. State of Ohio Board of Pharmacy written consent of the parent or guardian Ohio State Medical Board More information can be found on the is obtained. Ohio State Medical Association Ohio Automated RX Reporting System • Except as provided for in the rules, the (OARRS) MED calculator at An additional rule requiring the inclusion of total morphine equivalent dose (MED) ohiopmp.gov/MED_Calculator.aspx. the first four digits of the ICD-10 diagnosis premierhealth.com Delivering Difficult News to Be Focus of Cancer CME Miami Valley Hospital South will There is no charge to attend this event, but host an upcoming CME program space is limited. Registration is required by intended for primary care physicians, November 2. Call (866) 608-FIND (3463) to and physician specialists, including register. oncologists, cardiologists, dermatologists, This activity has been planned and gastroenterologists, general surgeons, implemented with the Essential Areas and radiologists, internal medicine, Policies of the Accreditation Council for nephrologists, neurologist, OB/GYNs, Continuing Medical Education (ACCME) pathologist, pulmonologists, urologists, and through the joint providership of Wright others who care for cancer patients. The State University (WSU) and Premier program, “Connecting Cancer,” takes place Health. WSU is accredited by the ACCME to in the cancer center’s conference rooms A provide continuing medical education for and B on Thursday, Nov. 9. The evening gets physicians. under way at 5:30 p.m. with registration, networking and heavy hors d’oeuvres. A WSU designated this live activity for a short presentation regarding the role of maximum of 1.0 AMA PRA Category 1 the advance practice nurse will be given Credits TM. Physicians should claim only before the formal program. Innovative Care the credit commensurate with the extent of Solutions will present the formal program, their participation in the activity. “Delivering Difficult News.” Midwest Health Collaborative Update Clinical teams from health systems including Premier Health Group’s (PHG) participating in the Midwest Health network of more than 6,000 employed and Collaborative have been meeting regularly independent providers. This network can with the goal of identifying evidence-based cover 90 percent of Ohio’s population. best practices which can be shared across By working together to identify best the systems. In addition, the collaborative practices, the collaborative will be able to is developing cost advantageous ‘big data’ offer a ‘playbook’ for care management and tools to assist systems in risk stratification population health. of their populations – with both Milliman and OptumInsight products. We believe that this work will result in a highly performing statewide network of The collaborative includes six of the largest physician and advanced practice providers health systems in Ohio: Premier Health, and hospitals. The collaborative is working TriHealth, OhioHealth, ProMedica, Aultman, to become a network whose guiding and Cleveland Clinic. The collaborative principle is a commitment to improve aspires to disrupt the Ohio health care the health of the communities we serve market and compete in the shift from through evidence-based population health volume to volume plus value. strategies. We intend to offer patients a The collaborative has created a statewide consistent experience across the system network of more than 17,000 providers, with best-in-class outcomes and efficiency. Wellness Committee Works to Combat Burnout By Tarek Sabagh, MD In a study published in the Archives of staff. The wellness committee is a medical Internal Medicine, October 2012, physician staff committee chaired by the president- burnout was found to be prevalent among elect of the medical staff and includes U.S. physicians at a rate of almost one in about 20 members of the medical staff. two physicians. The main symptoms are The Physician Wellness Fund is established emotional exhaustion, detachment from through the Miami Valley Hospital patient care, and lack of career satisfaction. Foundation to directly fund our functions. Burnout results in problematic alcohol use, The committee serves both physicians and broken relationships and early retirement. APPs on staff at the hospital. We recently Patient care is also affected in terms of had an evening out attending a Dragons safety, diagnosis and treatment. In the game. More than 100 staff and their study, higher education with master’s families attended. It was a success. We’ve degree or Ph.D. was associated with less a long way to go, but we are determined to burnout in contrast to MD/DO degree, stay the course. which was associated with much higher For information about the wellness burnout. This observation indicates that committee’s social activities, please see it’s not an individual problem but rather a Kelsey A. Pio, internal physician relations system or work-related issue. Physicians on manager in the hospital physician’s lounge. the front line of patient care in specialties like emergency medicine, family medicine For questions or information about the and internal medicine are most affected. wellness fund, vision or committee’s functions, please contact: Keith Bricking, Despite the magnitude of the problem, MD, president of medical staff, MVH at: there is not yet an authority on how to best [email protected]; or Tarek remedy it once it is identified. Fortunately, Sabagh, MD, president elect of medical staff, many attempts are under way to address MVH at: [email protected]. the problem in a structured manner. Miami Valley Hospital restructured its wellness committee to try to create a more collegial and friendly working environment for our SYSTEM NEWS Students Get Up Close; Organ Donation Campaign; and Community Benefit Grants Atrium Medical Center As a result of this agreement, we were able Miami Valley Hospital Cincinnati TAP MD students from to consolidate Atrium’s services to one Miami Valley Hospital has earned the throughout the Cincinnati area visited outpatient surgery site at Southwest Ohio Platinum Award in the 2017 Hospital Atrium Medical Center in August and Surgery Center on Breiel Boulevard. This will Organ Donation Campaign, sponsored by their tours followed the case of a stroke make our outpatient surgery scheduling the US Department of Health and Human patient. They learned about recognizing and operations process more efficient and Services. More than 1,000 hospitals across signs and symptoms of stroke, and visited reduce costs. the country participated, working with and heard from staff with emergency, donation organizations and state hospital For any questions about this change, medical imaging, rehabilitation and more associations to promote organ, eye, and please contact Tammy Laine, departments. Cincinnati TAP MD is a year- tissue donation by conducting awareness vice president of market development, at long educational program of The Health and registry activities in their facilities and [email protected] Collaborative, and students interested in communities. Together, MVH and other medical careers apply for a chance to get Good Samaritan Hospital participating hospitals added 26,975 donor up close to area hospitals and medical To equip new employees with the tools and registrations to state registries over a seven- practitioners. tactics for success, Good Samaritan Hospital month period, bringing