Medical Staff Voice – October 21, 2019

JW Moore Tuesday Noon CME Conference – “Male Factor Infertility”

Daniel Rychlik, M.D., from Southern California Reproductive Center, will present a lecture on the “Male Factor Infertility.” He will discuss the etiology and treatment of male factor infertility.

The conference will take place on October 22nd, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1A CME will be available.

Traffic Impact on Access around CMH beginning Tonight

We have just received notification from Southern California Gas of two continuous road closures that may have an impact on traffic and access around CMH beginning tonight.
When:    October 16, 2019 at 1930 through October 18, 2019 at 0630
Where:   Intersection of South Mills Road and Telegraph & Intersection of East Main St.                       and Telephone Rd
Why:      Per Southern California Gas, construction repairs within the intersections

Please notify your fellow coworkers, physicians and staff members regarding this information, and share as appropriate.

CMHS Centers for Family Health Free Flu Shot Clinics for the Public

Ventura County Medical Association Membership Meeting

2019 CMHS Library Resources

Services

The Library provides collections and services to physicians, nurses, students and staff including:

  • Access to current peer review and specialty leader books
  • Document delivery with the National Network of Libraries of Medicine
  • Education, training, referral, and consulting
  • Literature Review service
  • Reference services
  • Proctoring Services
  • Publishing Support
  • National Network of Libraries of Medicine InterLibrary Loan Services
  • 3 networked computer workstations in the library
  • Access to the Intranet and Internet
  • Dedicated study location

Database Subscriptions – 24/7 access
(remote and mobile access granted through CMHS email username and password)

AccessMedicine IM
AccessMedicine Surgery
AccessMedicine Case Reports
AAP (American Academy of Pediatrics Collection)
BMJ Case Reports
CINAHL

Clinical Key
Lippincott Procedures
Micromedex

New England Journal of Medicine
New England Journal of Medicine Resident 360
Psychiatry Online

UptoDate

Contact
CMHS Medical Library
Janet Hobbs, Library Services Manager
147 North Brent Street
#720
Ventura, CA 93003
library@cmhshealth.org
805 948 5683

CMH Weekly Medical Staff Calendar – October 21- 25

MondayTuesdayWednesdayThursdayFriday
12:00 pm Cancer Cmte - NA (front)12:00 pm JWM Education Conf – NA
4:30 pm MEC FAC - BR
5:30 pm Surgery Cmte – BR
5:30 pm Credentials Cmte – NA (front)
12:00 pm General CA Conf – BR

OVCH Weekly Medical Staff Calendar – October 21 – 25

MondayTuesdayWednesdayThursdayFriday

5:30pm
CMHS Credentials Committee

Final Thoughts

“He that does good to another does good also to himself.”
– Lucius Annaeus Seneca

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

 

 

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Medical Staff Voice – October 14, 2019

JW Moore Tuesday Noon CME Conference – “Death Certificates and the Medical Examiner’s Office”

Christopher Young, M.D., Chief Medical Examiner, Ventura County, will present a lecture on “Death Certificates and the Medical Examiner’s Office”. He will: 1) Discuss the key components of the death certificate and 2) Identify circumstances of death that need to be reported to the medical examiner/coroner.

The conference will take place on October 15th, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1A CME will be available.

Dr. Jim Woodburn Update

Dr. Woodburn continues to improve and is out of the UCLA ICU as of last week.  Kay indicated that he should be home early this week and is doing great! She and Jim appreciate everybody’s thought and concerns.

West Corridor Open!

The first floor west corridor connecting the Ocean Tower to the Mountain Tower is open. The entrance in the Mountain Tower is just east of the lab and in the Ocean Tower just east of the main elevators.

Allscripts Electronic Prescribing

Allscripts has informed CMHS that they will performing a data migration on 10/15 at 7 PM. During this time electronic prescribing will be unavailable. This will effect controlled and non-controlled medications. Please use downtime procedures.
– CMHS IS Department

Attention to Mac Users and Catalina OS Upgrade

Mac users considering upgrading to the new Catalina OS may find incompatibilities with current software. Early adopters should proceed with caution.

Clinical Pearls

  1. Remember to follow up on STAT/urgent  dialysis to ensure that the dialysis is initiated promptly after placement of the dialysis orders.
  2. Dictating Op reports immediately after the procedure results in a much higher likelihood of accuracy and timeliness of the Op report availability to colleagues.

CMH Weekly Medical Staff Calendar – October 14- 18

MondayTuesdayWednesdayThursdayFriday
5:15 pm QA & Improvement Cmte – BR9:45 am CMHS Infection Control Cmte – QA Conf. Rm.
12:00 pm JWM Education Conf – NA

4:30 pm Anesthesia Cmte - BR
4:30 pm MEC FAC – NA (front)
7:45 am- Pediatrics Cmte/Neonatal Cmte-NA (back)

12:00 pm General CA Conf – BR
12:15 pm OB/GYN Dept – NA (back)


5:30 pm Disaster Preparedness Cmte - BR

OVCH Weekly Medical Staff Calendar – October 14 – 18

MondayTuesdayWednesdayThursdayFriday
12:30pm
Medicine Department
10:00am
@CMH Quality Office
CMHS Infection Control Committee
11:00am
P.I. Patient Safety Committee

12:30pm
Pharmacy & Therapeutics Committee

Final Thoughts

“While we are postponing, life speeds by”
― Lucius Annaeus Seneca

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Medical Staff Voice – October 7, 2019

JW Moore Tuesday Noon CME Conference – “Prescribing High Risk Medications (HRM) in Elders”

Robert Deamer, PharmD, from Kaiser Permanente Medical Center, will present a lecture on the “Prescribing HRM in Elders.”

Lecture objectives: 1) Recognize medications that are deemed “high risk” 2) Alternative therapy to patients that are utilizing high risk medications inappropriately, and  3) Identify and appropriately utilize tools when assessing patients for high risk medications.

The conference will take place on October 8th, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1A CME will be available.

Obituaries published for Drs. Burger and Edwards

The obituaries for our two esteemed mentors and colleagues were published yesterday in the Ventura Star.  Links are provided to both. They highlight some of their respective history and accomplishments that better reflect why they were so highly regarded and loved.  Click on the name for the complete Obituary: William Burger, M.D.  and P.K. Edwards, M.D.

Mobile Heartbeat (MH) Upgrade for Android Users

Android users need to upgrade their Mobile Heartbeat app as the newest Android 10 operating platform release, is not currently compatible with the previous (or older) versions of Mobile Heartbeat. The newly published version of the MH app (19.1.8) is now compatible with all operating platforms for Android, including Android 10. We’d like all Android users, whether or not they decide to upgrade their phone’s software, on the latest release of the MH app.

For Android devices only: uninstall the current version of MH-Cure Brown. Go to the Google Play store and download the latest version of MH-Cure Brown (19.1.8). Once downloaded, launch the app and enter the one-time device configuration code- ‘cmhs-p’ into the username field (no password) and hit the Login button. After this, proceed with logging in normally.

First Annual CMHS Chili Competition

CMH Weekly Medical Staff Calendar – October 7- 11

MondayTuesdayWednesdayThursdayFriday
Columbus Day7:00 am Medicine Cmte – BR
8:00 am – MERP – NA (front)
12:00 pm JWM Education Conf – NA
4:30 pm MEC FAC – NA (front)
Yom Kippur

12:00 pm General CA Conf – BR
10 6:30am HIM Cmte- BR

12:00 pm QA & Patient Safety Cmte – BR

12:15 pm Cardiac Division Cmte – NA (front)

5:30 pm Bylaws Cmte - BR

OVCH Weekly Medical Staff Calendar – October 7 – 11

MondayTuesdayWednesdayThursdayFriday
7:30am
MERP

12:00pm @CMH
Quality Board
7:30am
Emergency Medicine Department

Final Thoughts

“Fortune befriends the bold.”
– 
Emily Dickinson

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-5662

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Medical Staff Voice – September 30, 2019

JW Moore Tuesday Noon CME Conference – “When to Collaborate With Palliative Care”

Dr. Charles Pankratz, M.D., CMHS, will present a lecture on the “When to Collaborate With Palliative Care.” He will: 1) Employ expanded definitions of palliative care in conversations with your patients, 2) Describe the benefits of early integration of palliative care in severe illness, 3) Identify common symptoms experienced by patients with severe and life-threatening illness and understand their prevalence.

The conference will take place on October 1st, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1A CME will be available. If you would like to view this lecture online, please contact CME Coordinator, Erin Parker eparker@cmhshealth.org or by phone 805-948-5638.

Medical Staff Physicians – Cafeteria Meal Plan Change

Starting October 1st your complimentary meal plan will include entrees, grill items, packaged house-made on the go salads, sandwiches, salad bar, fresh desserts, fountain soda, fresh brewed iced tea and hot coffee, etc.

All pre-packaged items can be purchased using cash, apple/google pay, or credit card. A pre-packaged item is defined as an item with a barcode that must be scanned at the register when checking out. Barcoded item examples: Bottled Soda, Bottled Water, Bottled Coffees, Packaged Chips, Packaged Candies, Packaged Snack, etc.

These changes have been supported by Medical Staff leadership.

If you have any questions please reach out to Jordan Dennis or at ext 5373 or your Medical Staff leadership.

Thank you,

Jordan Dennis, MS, RD, CSP, CNSC
Director of Food and Nutrition Services
Phone: (805) 948-5373, Email: Jdennis.con@cmhshealth.org

Well Wishes for Dr. Jim Woodburn

Our thoughts are with Dr. Jim Woodburn, Kaye and their family for well wishes and a speedy recovery from his illness.

Physician Forum – All Medical Staff Invited – Pressing Questions at CMHS & Beyond

Celebration Of Life – PK Edwards, MD

DEA raids some West Coast Kaiser Permanente pharmacies

Federal narcotics agents from the Drug Enforcement Administration raided several Kaiser Permanente pharmacies along the West Coast Sept. 18, according to The Oregonian

The inquiry is part of a Los Angeles-based investigation. Federal narcotic officers from the agency’s diversion control office used administrative inspection warrants to search records to determine if legitimately made controlled substances were being diverted for illicit drug use.

“We are fully cooperating with the DEA to provide the agency with the information they are seeking. As always, we are committed to complying with all state and federal regulations and ensuring the safety of our patients and members,” Mike Foley, a spokesperson for Kaiser Permanente, told The Oregonian. 

It is unclear how many warrants were served, but a pharmacy in Portland, Ore., Woodland Hills, Calif., and Riverside, Calif., were searched, according to California news station KTLA 5.
September 18th, 2019

CMH Weekly Medical Staff Calendar – September 30 – October 4

MondayTuesdayWednesdayThursdayFriday
Rosh Hashanah12:00 pm General CA Conf – BR
12:30 pm – Interdisciplinary Practice Cmte – Quality Conference Rm
4:30 pm MEC FAC - BR
5:30 pm MEC - BR
12:00 pm General CA Conf – BR
12:15 pm OB/GYN Cmte – NA (front)

OVCH Weekly Medical Staff Calendar – September 23 – October 4

MondayTuesdayWednesdayThursdayFriday
12:30pm Interdisciplinary Practice Committee12:30pm MEC

Final Thoughts

“My opponent is my teacher. My ego is my enemy.’
– Renzo Gracie

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

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Medical Staff Voice – September 23, 2019

JW Moore Tuesday, Noon CME Conference – “Perioperative Clinical Pearls”

Dr. Christina Desai, M.D., CMHS Hospitalist, will present a lecture on the “Perioperative Clinical Pearls.”

She will: 1) Identify which patients benefit from noninvasive cardiac testing prior to surgery, 2) Discuss how to become familiar with different surgical risk stratification tools, 3) Discuss perioperative pulmonary evaluation, 4) Define screening tools for identifying patients at risk for OSA and Alcohol Withdrawal, 5) Review optimal timing and goals for perioperative glycemic control, 6) Review medication management strategies.

The conference will take place on September 24, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1A CME will be available. If you would like to view this lecture online, please contact CME Coordinator, Erin Parker eparker@cmhshealth.org or by phone 805-948-5638.

Dr. Reghunathan – New Medical Staff ENT/Laryngology Subspecialty

Saranya Reghunathan MD is a board certified Otolaryngologist with additional fellowship training in Laryngology. She has joined Centers for Family Health (CFH) and will be seeing patients at the Vineyard CFH clinic. Dr. Reghunathan practices the entire range of adult and pediatric ENT. Her fellowship training distinguishes her further as she specializes in the medical and surgical treatment of dysphagia, dysphonia and other conditions of the larynx. Dr. Reghunathan is a native of Southern California and is excited to share her expertise with Ventura County.

Meditech (MT) Downtime – Thursday, 12:05 am – 7:00 am

Meditech will be unavailable for approximately 6-7 hours beginning at 12:05 am on 9/26/19. This is to allow IT to remediate server issues that were discovered during the last server patching. It is important to do this to allow us to resume applying security patches on a routine schedule.

During the downtime Meditech will be completely unavailable, paper procedures will need to be followed. Other inpatient applications will remain available, but it is important to note that there will be no communication to/from MT. This means the following will be available, but without communication to/from MT:

  • PK – no CPOE
  • PICIS
  • Mobile Heartbeat
  • Rauland
  • Kronos
  • Perigen
  • Teletracking

October – Breast Cancer Awareness Month – Let your Patients Know!

At the Bowl 2019 with the Spazmatics & Boogie Knights!

SATURDAY, OCTOBER 12, 2019 • LIBBEY BOWL • OJAI – Join us for this benefit concert supporting the construction projects of Community Memorial Health System.
www.cmhsatthebowl.org

 

In Memoriam – Dr. William Burger

Dr. Burger, the consummate Family Physician, passed on September 9, 2019. He mentored many of us in Obstetrics and Family Medicine at VCMC.  He will be remembered with respect and fondness. No service has been announced.

In Memoriam – Dr. Paul K. Edwards

It is with sadness that I announce the passing last week of Dr. PK Edwards, Anesthesiologist.  He trained many of us in anesthesia during our Family Medicine residency at VCMC.  Dr. Edwards will be remembered for his strength, kindness and sense of humor. He is survived by his wife, Dr. Nellie Mac. No service has been announced.

CMH Weekly Medical Staff Calendar – September 23- 27

MondayTuesdayWednesdayThursdayFriday
12:00 pm CME Committee – BR8:30 am ED Division – NA (front)
12:00 pm Board of Trustees – BR
! ! 12:00 pm JWM Education Conf – NA
5:30 pm Surgery Cmte – BR
5:30 pm Credentials Cmte NA- (Front)
12:00 pm General CA Conf – BR
12:00 pm Bioethics Cmte – NA (front)
12:15 pm Pharmacy & Therapeutics Cmte - NA (front)

OVCH Weekly Medical Staff Calendar – September 23 – 27

MondayTuesdayWednesdayThursdayFriday
12:00pm
-Board of Trustees -CMH -CME Lecture
5:30pm
CMHS Credentials Committee - Medical Staff Office

Final Thoughts

“The measure of a man is what he does with power.”
– Plato

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

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Medical Staff Voice – September 16, 2019

 

JW Moore Tuesday Noon CME Conference – “(Not so) Resistant Hypertension”

Florian Rader, M.D., Co-Director, Clinic for Hypertrophic Cardiomyopathy, Cedars-Sinai Smidt Heart Institute, will present a lecture on the “(Not so) Resistant Hypertension”.  He will: 1) Review the clinical workup of resistant hypertension, 2) Identify treatment plans for patients with resistant hypertension, and 3) Discuss the update on renal denervation.

The conference will take place on Tuesday, September 17, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Erin Parker eparker@cmhshealth.org or by phone 805-948-5638.

Chef Appreciation Week

September 16th – 20th 

JOIN US in the Brent Street Cafe next week as we celebrate Chef Appreciation Week with daily specials!
Monday September 16th: Chef Brian’s Breakfast Sandwich Extravaganza
Cheeseburger or Impossible Burger with bacon, hash brown patty, fried egg, lettuce, tomato, onions and your choice of salsa (house red or tomatillo).

Tuesday September 17th: Chef Brian and Chef Nancy present “Greek Yogurt Pizza Crust” served meat-lovers style or with roasted vegetables.

Wednesday September 18th: Chef Nancy’s Blenders

Thursday September 19th: Stop by and show your appreciation or come meet Chef Brian for the first time and receive a FREE Chef Brian’s Chocolate Chip Cookie with the purchase of a Brand Entree.

Friday September 20th: “Up and Coming Chefs”
Our Brand Cooks, Ricardo and Mo, will be working together to present their favorites on the Brand Station for lunch and dinner.

A huge THANK YOU to Chef Brian and his entire team for everything they do to ensure that our patients, physicians, and staff have access to tasty, nutritious food!  Happy Chef Appreciation Week!

Anti-Factor Xa Heparin Assay

BACKGROUND:
Continuous intravenous heparin requires continuous monitoring and adjustments to ensure safe and efficacious use. Activated partial thrombin time (aPTT) has been the standard assay for heparin monitoring for decades. aPTT measures the intrinsic and common pathways of coagulation serving as an indirect surrogate marker of heparin activity. In addition to the challenges associated with inability to standardize, frequent re-calibration, and adjustment of nomograms, aPTT measurements are prone to interference. Preanalytic, analytic, and biologic factors are known to influence aPTT.
The anti-factor Xa assay (AXA) offers an alternative to aPTT and has been adopted by a growing number of institutions. The AXA is a direct measurement of heparin activity with less variability and less potential for interference.
PROTOCOL FOR ADJUSTING HEPARIN BASED ON ANTI-XA RESULTS:
ACCP guidelines recommend a therapeutic heparin level of 0.3 to 0.7 units/mL measured by an anti-Xa assay. Heparin order sets will be converted to utilize AXA for heparin infusion monitoring and adjustment protocols.
SPECIAL CONSIDERATIONS:
Oral Factor Xa inhibitors such as apixaban and rivaroxaban have a strong effect on AXA. aPTT monitoring is recommended for the first 48 hours of heparin infusion if patient was maintained on a Xa inhibitor prior to initiation.
Baseline aPTT is still recommended to identify inherited or acquired bleeding risks (Acquired Vitamin K Deficiency, Chronic Liver Disease, DIC, etc).
Because the assay is a colorimetric assessment, substances that interfere with absorbance of 405 nm light can produce spurious results. Common interfering substances include bilirubin (hyperbilirubinemia with Tbili greater than 6.6 mg/dL) including increased bilirubin due to sample hemolysis, and triglyceride (triglyceride level greater than 360 mg/dL). The laboratory will notify physicians of samples that may result in errors.
SUMMARY:
Based on available clinical evidence, AXA monitoring is safe and provides several advantages over aPTT. On September 24th, 2019 CMHS will transition to AXA as the preferred monitoring assay for IV heparin therapy. aPTT will remain available for baseline assessment of coagulopathies, monitoring patients recently exposed to Factor Xa inhibitors, and for argatroban monitoring.
– P&T Committee/CMHS Pharmacy

Radiology Requests

When requesting imaging, always use a sign or symptom or diagnosis as the indication for an imaging study (i.e. x-ray, etc.)  If the study is a follow-up for a known diagnosed condition, a diagnosis may be submitted as an indication for a study. Never put the rule out (R/O) as the primary reason for the reason for the request.  R/O may be used after providing the sign or symptom, i.e.; shortness of breath – r/o pneumonia.
Reminder: When ordering an interventional radiology study, consider ordering a consult and enhance the value of the study by discussing the case directly with the interventional radiologist, physician to physician.

Radiology phone numbers

The best way to communicate directly with the radiologist you’re looking to speak with is by contacting them using the Mobile Heartbeat app.

  • Interventional Radiology (IR) Hotline 805–879–7568.
  • Pueblo answering service 805–879–7595
  • ATR/nighthawk 888–225–0386

A list of covering Radiologists, with cell phone numbers, is posted in the reading room area in the department.
This list is updated each day and sent to the house operator, emergency room, nurse supervisor and intensive care units.

CMH Weekly Medical Staff Calendar – September 9 – 13

MondayTuesdayWednesdayThursdayFriday
12:00 pm Cancer Cmte – BR 12:00 pm JWM Education Conf – NA

See Tonight's Meeting Schedule at top of MSV
7:45 am- Pediatrics Dept - NA (back)

11:30 UR Cmte – NA (back)

12:00 pm General CA Conf – BR
12:00 pm Radiation Safety/Radiology Division – NA (front)

OVCH Weekly Medical Staff Calendar – September 9 – 13

MondayTuesdayWednesdayThursdayFriday
12:00pm
CME Lecture


11:00am
P.I. Patient Safety Committee

Final Thoughts

“The object of the superior man is truth.”
– Confucius

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

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Medical Staff Voice – September 9, 2019

JW Moore Tuesday, September 10, 2019 CME Conference – “Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia”

Li Sheng Kong, M.D., West Coast Vascular Surgeon, will present a lecture on the “Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia”.  He will discuss how to assess the current guidelines for treating chronic limb-threatening ischemia.

The conference will take place on Tuesday, September 10, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez cvazquez1@cmhshealth.org or by phone 805-948-5638.

Dr. Dalmania (ZDoggMD) – Has got it right again! – How to Fix Healthcare!

Both the Left and the Right have gotten healthcare wrong. Here’s what we need to know if we’re going to fix medicine for both patients and caregivers while saving us all from bankruptcy.  Click on the link to watch the 7 min video: Link

Antibiotic Sensitivity Testing – Turn-Around-Time Delays

This is to inform you that there will be a temporary delay in the reporting of Antibiotic Sensitivity Testing due to unforeseen circumstances. The instrument used for performing this test is temporarily out of service. While we work through getting the instrument back on line, we will be sending the test to our reference laboratory, ARUP, for testing.

We are still able to perform the identification of the organism(s) in house and these results will be on the initial report. In addition, a second report will follow for the sensitivity testing. Expect a TAT of 72-96 hours.

We understand the inconvenience this will cause and as a guide, we have attached the current CMH outpatient antibiogram for your reference.

If you have any questions, please feel free to call: 805-948-5324.
Meeae Y. Kwon, M.D., Laboratory Medical Director

How to code flu shots correctly from Family Practice Management -2019

New flu shot codes and payment allowances go into effect each year on Aug. 1 for Medicare, allowing vaccination efforts to begin as soon as the seasonal influenza vaccine is available. To determine the correct vaccine code, you need to know the following:

  • What vaccine was provided, including the brand,
  • Whether the product was trivalent or quadrivalent,
  • Whether the product was preservative free.

For example, here are two commonly used codes and their associated products:

Code Labeler name Drug name Payment allowance
90686, “Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use.” GlaxoSmithKline

Sanofi Pasteur

Seqirus

Fluarix quadrivalent (2019/2020) (preservative free)
Flulaval quadrivalent (2019/2020) (preservative free)
Fluzone quadrivalent (2019/2020) (preservative free)
Afluria quadrivalent (2019/2020) (preservative free)
$19.03
90688, “Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use.” GlaxoSmithKline

Sanofi Pasteur

Seqirus

Flulaval quadrivalent (2019/2020)
Fluzone quadrivalent (2019/2020)
Afluria quadrivalent (2019/2020)
$17.84

For a full list of current codes and payment allowances for flu vaccines billed to Medicare Part B, see Seasonal Influenza Vaccines Pricing(www.cms.gov). Codes not included in the full list likely represent products not available for the current flu season.

Don’t forget the immunization administration code

Payment for vaccine codes is intended to cover only the costs associated with the vaccine itself. To get paid for the costs associated with administering the vaccine, including staff time and supplies, be sure to report a code for the administration. To choose the correct administration code, consider the following questions and consult the table below:

  • Is the patient 18 years old or younger?
  • Did a qualified health professional provide specific counseling to the patient or parent/guardian on the date the vaccine was administered?
  • How many vaccines were given, and how many components were in each vaccine?
  • Is the patient a Medicare beneficiary?
CODE DESCRIPTION
90460 Immunization administration through 18 years of age (any route) with counseling by physician or other qualified health care professional, first vaccine/toxoid component
90461 Immunization administration through 18 years of age (any route) with counseling by physician or other qualified health care professional, each additional vaccine/toxoid component
90471 Immunization administration (percutaneous, intradermal, subcutaneous, intramuscular), first vaccine
90472 Immunization administration (percutaneous, intradermal, subcutaneous, intramuscular), each additional vaccine
90473 Immunization administration (nasal or oral), first vaccine
90474 Immunization administration (nasal or oral), each additional vaccine
G0008 Administration of the influenza vaccine, Medicare insurance
G0009 Administration of the pneumococcal vaccine, Medicare insurance

CMH Weekly Medical Staff Calendar – September 9 – 13

MondayTuesdayWednesdayThursdayFriday
7:00 am Medicine Cmte – NA (front)

10:00 am Audit & Compliance Cmte – BR

12:00 pm JWM Education Conf – NA
12:00 pm General CA Conf – BR

12:30 pm Family Medicine Cmte – NA (back)

12:00 pm QA & Patient Safety Cmte – BR

12:15 pm Cardiology Division – NA (front)

OVCH Weekly Medical Staff Calendar – September 9 – 13

MondayTuesdayWednesdayThursdayFriday
12:00pm
CME Lecture
12:00pm
Quality Assurance Committee -CMH
7:30am
Emergency Medicine Department

Final Thoughts

“It is not in the stars to hold our destiny but in ourselves.”
– William Shakespeare

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

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Urgent Call to Action – Oppose AB 1404 – Medical Staff Voice Special Edition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Medical Staff Voice – September 2, 2019

JW Moore Tuesday, September 3, 2019 CME Conference – “Ketamine Infusion Therapy”

Stefany Wolfsohn, M.D., Ventura Center for Advanced Therapeutics, will present a lecture on the “Ketamine Infusion Therapy”.  She will: 1) Review the history of ketamine treatments for various diagnosis, and 2) Assess ketamine therapy as a treatment plan for depression and anxiety disorders.

The conference will take place on Tuesday, September 3, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez cvazquez1@cmhshealth.org or by phone 805-948-5638.

Mobile Heartbeat – Best way to text Colleagues & Nurses – HIPAA Compliant

Mobile Heartbeat (MH) continues to be a boon to HIPAA compliantly sending patient info and discussing patients with colleagues, nurses caring for your patient and Hospital staff, including physical therapists, respiratory therapists, case management and others.  Take advantage of this seamless and user friendly app and encourage colleagues to come on board!  You can find the app in the iPhone App store and the Android Play Store.  

Reminder!!

If you have not already done so, Personal device users MUST upgrade to the latest Mobile Heartbeat app version on their phones, v19.1.3.
By Thursday, 9/5, if you have not already upgraded to the latest version, you WILL be losing important app functionality!
*iPhone users may update the “MH-Cure Brown” app via the update available in the Apple “App Store”. Once the app is upgraded no further configuration is required for Apple device users.
**Android users need to open a web browser on the phone and go to https://urldefense.proofpoint.com/v2/url?u=http-3A__bit.ly_mhbcmhs2&d=DwIFaQ&c=vSEGPfzYkbZZtql2Eyrr8Q&r=nQNWCjvEd5ZAH0Zwt-saqtINvM66W9-6_R0ctDFpiIQ&m=LLWh2k5yuCaYw5sHeq4bG2-k5r4apVEfmHB5qGJbRjc&s=rY2kCKJPpbvDw-vhdQBVvRzPpra5NvdD8KDpKBGXfsY&e=  and follow the instructions to appropriately complete the update for Android devices. If you have any issues or require assistance, please call the Helpdesk at (805) 948-5090.

US Biggest Health Insurers Raked in more than $11 Billion in Profit 2nd Quarter

The country’s biggest health insurers raked in more than $11 billion in profit in the second quarter, particularly as recent mergers and newly-launched business lines began to bear fruit.

The clearest example of this trend is CVS Health, which posted a Q2 profit loss in 2018 but saw profits return to the black and revenues increase significantly following its acquisition of Aetna.

Cigna posted similar results, with its revenues skyrocketing from $11.5 billion in the second quarter of 2018 to $34.4 billion in Q2 2019, thanks in large part to its purchase of Express Scripts, the nation’s largest pharmacy benefit manager.

Click on the link for the rest of the article and some impressive graphs: Medical Insurers Profits
– FierceHealthCare.com

AntiMOC Lawsuit Update – Westby G. Fisher, MD

As the summer winds on, I have been approached by more and more people who would like an update on where the litigation filed against the many member boards of the American Board of Medical Specialties stand since the lawsuits were filed. I will do my best to briefly summarize the status of those lawsuits as I understand them. (For background on why these lawsuits have been filed against so many of the American Board of Medical Specialties specialty boards, please review this video).

The antitrust suit against the American Board of Internal Medicine (ABIM) was originally filed 6 Dec 2018 and amended 23 Jan 2019 to include RICO charges, the antitrust lawsuit against the American Board of Radiology was filed 26 Feb 2019, and the antitrust lawsuit against the American Board of Psychiatry and Neurology (ABPN) was filed 6 MAR 2019. These cases were filed by a law firm based in Chicago. A fourth lawsuit was filed by a separate law firm in Southern District Court of California on 19 Feb 2019 against the American Board of Medical Specialties (ABMS), the American Board of Emergency Medicine (ABEM), and the American Board of Anesthesiology (ABA).

To read the rest of this article, click on the link: AntiMOC Lawsuit Update

 

CMH Weekly Medical Staff Calendar – September 2 – 6

MondayTuesdayWednesdayThursdayFriday
Labor Day12:00 pm JWM Education Conf – NA
5:30 pm MEC - BR
8:00 pm Nominating Cmte - BR
12:00 pm General CA Conf – BR
12:15 pm OB/GYN Cmte – NA (front)

OVCH Weekly Medical Staff Calendar – September 2 – 6

MondayTuesdayWednesdayThursdayFriday
LABOR DAY12:00pm CME Lecture12:30 pm Medical Executive Committee

Final Thoughts

“Good questions outrank easy answers.”
– Paul Samuelson

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

 

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Medical Staff Voice – August 26, 2019

JW Moore Tuesday Noon CME Conference – “When Words and Actions Matter Most: Responding to Patient Harm”

Timothy McDonald, M.D., J.D., Clinical Service Chief-Anesthesia/Medical Director for Quality & Safety of Sidra Medical and Research Center, will present a lecture on the “When Words and Actions Matter Most: Responding to Patient Harm”.  He will: 1) Discuss the comprehensive, principled, and systematic approach to preventing and responding to patient harm from establishment of a psychologically safe culture and management of harm from event through resolution, 2) Apply the interconnectedness of all of the domains of harm prevention and a response to harm including Just Culture and High Reliability, and 3) Employ empathic communication skills with patients, loved ones, and the clinical care team following unexpected patient harm.

The conference will take place on Tuesday, August 27, 2019, at noon, in Nichols Auditorium. Lunch will be provided and Category 1 & 1-A CME will be available.  If you would like to view this lecture online, please contact the CME Coordinator, Christeva Vazquez cvazquez1@cmhshealth.org or by phone 805-948-5638.

New Centers for Family Health Regional Medical Directors

We are excited to welcome and congratulate Dr. Kellie Zaylor and Dr. A. Jaime Lara as our lead Medical Directors for Ambulatory Medicine. Dr. Lara will be the North Region Medical Director responsible for our clinical practices just north of the 126 including Ojai Valley, Ventura, Santa Paula & Fillmore. Dr. Zaylor will be the South Region Medical Director responsible for our outpatient clinical practices south of the 126 including Oxnard, Port Hueneme, & Camarillo.

Dr. Kellie Zaylor has been an associate medical director for CFH focused on our urgent cares. Prior to coming to California, Dr. Zaylor was the site medical director for the University Hospitals Urgent Care in Ohio.

Dr. Jaime Lara was previously a chief medical officer for a community health center in Los Angeles. Prior to that, he established a Look-Alike FQHC with a 340B program, for which he was the lead physician and CEO.

We are very fortunate to have had such a robust talent pool and look forward to great accomplishments.

Also, we are very grateful to Dr. Victor Dominguez’s leadership over the past 7+ years as our Ambulatory Medicine/CFH Medical Director. We are very excited for Dr. Dominguez as he plans to dedicate himself fully as a physician in our clinics.

Please help us in welcoming Dr. Lara and Dr. Zaylor to these exciting new roles.

Anthony Russell, MD MBA MPH
Chief Administrative Officer, Ambulatory Medicine

Ventura County Medical Association Membership Dinner Meeting

California Is Facing A Primary Care Physician Shortage And It’s Only Going To Get Worse

Not enough newly minted doctors are going into primary care, and a third of the doctors in the state are over 55 and looking to retire soon, according to a study by the Healthforce Center at UC-San Francisco. That means by 2030, the state is going to be in dire need of physicians. Studies show the state could be down by as many as 10,000 primary care clinicians, including nurse practitioners and physician assistants. Some areas — the Central Valley, Central Coast and Southern Border region — will be hit especially hard. So too will be remote rural and inner-city residents, communities of color, the elderly, those with mental illness or addiction, and those without health coverage. New doctors “take these specialty areas that pay higher, and that leaves us with a shortage of primary care physicians including pediatricians, internists, family practice physicians and OB/GYNs,” said John Baackes, CEO of LA Care Health Plan, which has the largest number of Medi-Cal members in the state. He said in rural areas, veteran doctors who are solo practitioners are having a hard time bringing in new doctors to take over. Read more from Elizabeth Aguilera of CalMatters.

US Doctors Traveling to Mexico To Perform Surgeries at Lower Costs

A new development in medical tourism: American doctors traveling to Mexico on their days off to give cheaper surgeries to American patients and getting paid more. Hospital costs in the US are now high enough that it makes financial sense for American patients and doctors to perform medical procedures in private Mexican hospitals. American company NASH has re-created medical tourism, signing up patients and doctors. For the New York Times report, click here.

CMH Weekly Medical Staff Calendar – August 26 – 30

MondayTuesdayWednesdayThursdayFriday
8:30 am ED Division – NA (front)
12:00 pm JWM Education Conf – NA
5:30 pm Surgery Cmte – BR
5:30 pm Credentials Cmte NA- (Front)
12:00 pm General CA Conf – BR

OVCH Weekly Medical Staff Calendar – August 26 – 30

MondayTuesdayWednesdayThursdayFriday
5:15pm@OVCH MSO CMHS Credentials Committee12:00@CMH CMHS Bioethics Committee

Final Thoughts

“All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”
– Arthur Schopenhauer

Keep the faith,

Stan Frochtzwajg, M.D.

Chief Medical Officer
Community Memorial Health System
sfrochtzwajg@cmhshealth.org
www.cmhshealth.org/voice – Medical Staff Voice Blog link

Tracey Shoop – Physician Liaison – tshoop@cmhshealth.org & (805) 490-3860
Megan O’Neill – Business Development Manager – moneill@cmhshealth.org & (805) 207-8216
Scott Goodfriend, M.D. – Physician Advisor – sgoodfriend@cmhshealth.org & (805) 701-3514
Medical Staff Office – (805) 948-566

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