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  Medical Staff Updates

In the news: Coffee drinking and mortality in 10 European countries; Association of coffee consumption with total and cause-specific mortality among Nonwhite populations; and Association of coffee drinking with total and cause-specific mortality

by jmiller on July 12, 2017

“Coffee consumption was inversely associated with total and cause-specific mortality.  Higher consumption of coffee was associated with lower risk for death in African Americans, Japanese Americans, Latinos and whites.  Bottom line:  “Although drinking coffee cannot be recommended as being good for your health on the basis of these kinds of studies, the studies do suggest that for many people, no long-term harm will result from drinking coffee.”  Two of these studies are from the most recent posting in Ann Intern Med, and one from NEJM.  Click here to read full-text.

Collaborative Care Network Update

by Medical Staff Office on April 19, 2017

Chaired by Robert Hanley, MD, of Anne Arundel Urology, the Collaborative Care Network (CCN) is our local, physician-led platform that allows the health system to join forces with independent and employed physicians to share data, resources and opportunities to improve care, create efficiencies, and demonstrate the value that an integrated, cohesive medical community can deliver. The CCN is the platform that helps practices prepare for voluntary, local Advanced Alternative Payment Models (AAPMs) as they become available over time.

The CCN’s board, committees and staff have worked tirelessly to build our foundation. In the past year we have:

  • Signed 630 members, representing 73 primary care and specialty practices within our community.
  • Hosted educational events to prepare our medical community for MACRA, MIPS and AAPMs.
  • Provided care coordination resources to our membership such as:
    • On-call care management.
    • Behavioral health navigation.
    • Care alerts.
    • Community-based care management.
    • Home-based primary care services.
  • Engaged in conversations with commercial insurers to discuss value-based and shared savings contracts for CCN members.
  • Developed clinical integration measures to help us learn about the populations we serve, set the foundation for and identify opportunities for clinical transformation, and demonstrate the value of our network.
  • Created data analytics tools and processes for collecting shared data.
  • Prepared for participation and success in AAPMs being developed at the federal and state levels.

The CCN will continue to aggressively move forward to accomplish our objectives:

  • AAHS and clinicians together taking responsibility for the cost and quality of care for populations.
  • Better coordination of care across settings and clinicians.
  • More effective management of chronic disease by both clinicians and patients.
  • Measurable improvement in health outcomes.
  • Successful performance in pay-for-value programs.
  • Building a “community of practice” recognized and preferred by patients.

 

For more information on the CCN, or to learn how your practice can join, please contact Renee Kilroy at rkilroy@aahs.org or 443-481-6619.

Introduction to AAMG Neuropsychology Specialists

by Medical Staff Office on March 28, 2017

Dear colleagues,

I am writing to introduce myself and my practice, AAMG Neuropsychology Specialists, as a new resource for your respective practices. The focus of my practice is assessment of acquired cognitive impairment or cognitive complaints in the context of established medical and neurologic illness. Referrals most commonly involve:

  • Differential diagnosis of mild cognitive impairment, other memory disorders and dementias
  • Characterization of cognitive impairment in the context of:
    • Stroke or other cerebrovascular conditions
    • Epilepsy
    • Parkinson’s disease or other movement disorders
    • Multiple sclerosis
    • Cancer, both brain and non-brain
    • Traumatic brain injury
    • Cardiovascular disease/diabetes
    • Post-surgical cognitive changes

My practice is limited to adults/geriatrics ages 18 and up. Referral questions regarding new-onset or acquired cognitive impairment, meaning that when the referral reason is developmentally focused (e.g., learning disability, ADHD, autism, or pervasive developmental disorders) or psychiatrically focused (e.g., differential diagnosis of personality or psychiatric disorder), these referrals are best directed to a pediatric/lifespan neuropsychologist or general clinical psychologist, respectively. Below I have listed resources for both of these referral types:

  • Pediatric neuropsychologist:
    • Kennedy Krieger Neuropsychology Department: 443-923-9400. Locations in Columbia and Baltimore.
    • Thinking Tree Psychology: 443-906-1132. Located in Severna Park, does not accept insurance.
  • General clinical psychologist and lifespan neuropsychologist:
    • PsychCare Psychological Services: BaltimorePsychologist.com. Locations in Columbia, Silver Spring and Baltimore.

I look forward to assisting with any patients you send my way. If you have any questions, please do not hesitate to contact me directly at cwendell@aahs.org or 443-481-1994.

 

Sincerely,

Carrington R. Wendell, Ph.D.

Neuropsychologist

Anne Arundel Medical Group

Belcher Pavilion, 5th Floor

www.MyAAMG.org/neuropsychology-specialists

Appointments: 443-481-1270

Fax: 443-481-1480

 

CCN Partners with Health Visions Delmarva – a Practice Transformation Network

by Medical Staff Office on March 28, 2017

The AAMC Collaborative Care Network (CCN) has partnered with Health Visions Delmarva Practice Transformation Network in order to help our network accomplish our goals. Health Visions Delmarva (HVD) is able to provide support to our member practices with 2017 MIPS reporting, but that is just one small part of why the CCN chose to work with HVD. HVD will assist our clinicians in changing the way care is delivered by integrating quality and process improvements to build on and spread existing change methodologies, practice transformation tools, published literature, key learnings, and technical assistance programs. HVD is not a quality data or registry vendor. They will not do your MIPS reporting for you. They are 1 of 29 organizations that CMS has funded to provide support to clinicians across the country to prepare for payment reform.

Care redesign – this is how we will accomplish our CCN aims and be successful in future Advanced Alternative Payment Models (AAPMs) and value based contracts.  This is how we will build and sustain a thriving medical community.

Participation with HVD is an opportunity available to CCN member practices. If you are a member, please complete the CCN – Practice Transformation Enrollment Form and return it to aamccollaborativecarenetwork@aahs.org. If you are not yet a CCN member, but would like more information about how to join, please contact Renee Kilroy at rkilroy@aahs.org or 443-481-6619.

Opioid-prescribing patterns of emergency physicians and risk of long-term use

by jmiller on March 15, 2017

Article concludes: “Wide range of opioid prescribing existed among physicians practicing within the same emergency department, and rates of long-term opioid use were increased among patients who had not previously received opioids and received treatment from high-intensity opioid prescribers.”  (NEJM, Feb 16)  Click here to read full text.

Folic Acid Supplementation for the Prevention of Neural Tube Defects: An Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

by jmiller on February 2, 2017

“In studies conducted before the initiation of food fortification in the United States in 1998, folic acid supplementation provided protection against neural tube defects. Newer postfortification studies have not demonstrated a protective association but have the potential for misclassification and recall bias, which can attenuate the measured association of folic acid supplementation with neural tube defects”  (JAMA, Jan 10)  Click here to read full text.

Clinical Guideline: Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians

by jmiller on February 2, 2017

“ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for stroke or cardiac events. (Grade: weak recommendation, low-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.”  (Ann Intern Med, Jan)   Click here to read full text.

In the news: Use of CT and chest radiography for lung cancer screening before and after publication of screening guidelines, intended and unintended uptake

by jmiller on February 2, 2017

“The National Lung Screening trial (NLST) released its main findings in 2011,concluding that the use of low-dose findings in 2011, concluding that the use of low-dose computed tomography (CT) to screen for lung cancer reduced lung cancer deaths by 20% compared with chest radiography.  The subsequent publication of new lung cancer screening (LCS) guidelines may raise the public’s awareness of the clinical application of low-dose CT in screening, leading to increased demand for screening not only by individuals who meet the eligibility criteria recommended for LCS but also by those who do not.  The first finding show a high rate of incidental findings (41%), a low rate of detection of lung cancer, and all for a highly resource-intensive program.  From the data reported, we calculate that for every 1000 people screened, 10 will be diagnosed with early-stage lung cancer (potentially curable), and 5 with advanced-stage lung cancer (incurable); 20 will undergo unnecessary invasive procedures (bronchoscopy and thoracotomy) directly related to the screening; and 550 will experience unnecessary alarm and repeated CT scanning.  Screening should be limited to patients most likely to benefit. (JAMA Intern Med, early online)  Click here to read full-text.

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