Latest Conference Articles

Making sense of the data is paramount to leveraging stakeholders and to make incentives to bring them all together.

Today's panel discussion on improving the quality of care through quality, innovation, and service included some all star presenters. If this team were a baseball team they'd be the Yankees; we're talking about some big names. We have Dr. Delos M. Cosgrove, president and chief executive officer of Cleveland Clinic; Dr. William Wright, Executive Medical Director Colorado Permanente Medical Group; and Dr. Gary S. Kaplan, Chairman and CEO of the Virginia Mason Health System.

Dahl and Rahman sought to help attendees analyze performance systems management and apply applications to their practice, establish core measurements and define collection processes, and compare improvement tools, such as root-cause analysis and “what-if” analyses.

Anne Huben-Kearney, vice president, risk management, ProMutual Group, Boston, MA, today presented “EMR with Clinical Risk Management = Patient Safety: A Model for Success.” We spoke with her to learn about her experiences working with a health information exchange and professional liability carrier and how and why risk management components can and should be implemented into an EMR.

Electronic Health Records – the three words that you’ve probably heard a billion times. They are the words that lead to other words that you hear over and over again: incentives, penalties, integration, etc. Many physicians admittedly hesitate to implement an EHR in their practice for numerous reasons. But aside from the big ones, such as cost, security, and the time it takes, there’s one major barrier – interoperability.

Although private practices are usually using debt financing because they don’t have the funds, hospitals do have the funds. And if you don’t join them, they’ll go buy their own physician who is in your specialty.

This session focuses on the recently released ICD-10 regulation and its impact on your practice. This session addresses critical issues such as practice compliance dates; the intersection of ICD-10 and the latest version of the Health Insurance Portability and Accountability Act (HIPAA) electronic transactions standards; how physician practices can address the many challenges ICD-10 will bring in the areas of payer contracting, encounter documentation, staff training, research and benchmarking data, and software modifications; and how to work with vendors and payers to comply with this mandate.

Today’s discussion on EHR incentive payments and implementation included a lot of issues that regular MDNG readers are familiar with: HITECH, “meaningful use,” and annual incentives. Although it may seem like the same old song and dance, the reality is that all those dates you’ve been hearing about are fast approaching.

Decision-making in medical practices is often stalled by competing interests, conflicting goals and misunderstandings. In this session, you will learn from real-life examples why impasses occur and the problems they create for physicians, staff and patients. You will discover how to gain agreement through using a voting matrix and how to test alternatives and devise voting options. In addition, you will learn the role of confidentiality in protecting future working relationships in the medical practice.

Leah Cohen, a Government Affairs Representative for MGMA, led off her presentation today by announcing to the large crowd that she is “only the messenger.” It was a great way to break the ice, and her comment got many laughs from the physicians in the audience who were looking to her to sort out some of the legislation that affects them.

Dr. Michelle Koury began her session by explaining the goals of her session: to help attendees learn to organize leadership to pursue and achieve accreditation, apply strategies and tools to assist in accreditation success, and understand the organizational, financial, regulatory, and political advantages of accreditation.

The easiest way to avoid any kind of HIPAA problems is to make sure that your patients’ personal health information (PHI) is secure – by definition, secure PHI cannot be breached. Best to get prepared now because as HIPAA informs, the penalties they-are-a-comin.

Today's MGMA session on Web 2.0 was a very interesting session to sit in on, not only because of the subject matter, but also because of the audience interaction.

The uninsured, higher co-pays and consumer-directed plans are changing the dynamics of the physician economic relationship. Patients seek less costly care while others approach decisions in consumer retail mode. Fortunately these trends are spurring adoption of Internet tools that deliver accessible, affordable and convenient care. Physicians easily interact online with patients on non-urgent symptoms. Point-of-service and self-service capabilities drive collections and develop payment plans. Testimonials illuminate the convergence of clinical and financial Web tools translated to savings and better outcomes.

Moderate deep inspiration breath-hold using an active breathing control device reduces cardiac irradiation during left-sided breast cancer treatment, reported Todd A. Swanson, MD, PhD, William Beaumont Hospital, Royal Oak, Michigan, at the 2009 ASCO Breast Cancer Symposium during a poster discussion.

Researchers from the William Beaumont Hospital in Michigan conducted a comparative analysis of the three modalities used in accelerated partial breast irradiation (APBI) in women with early stage breast cancer and found all three methods comparable in terms of local control, survival, and cosmesis. The methods examined included interstitial brachytherapy (low and high dose), 3-D conformal external beam radiotherapy (3-D CRT), and MammoSite (MS). MammoSite is the newest of these methods, approved by the FDA in May 2002.

As medical groups feel more pressure from the government, payers and other third parties to get health information online as part of emerging performance-based reimbursement programs, many providers are challenged with how best to automate their practices and adequately participate in these programs. This session will explore how some of the country's largest academic medical groups to solo practices to emerging care deliver organizations, like retail clinical, are now leveraging software-enabled services (SeS) in order to better document and report clinical and financial data as part of performance-based reimbursement initiatives.

While always uncertain, the future seems more so in economic hard times. How can you know how best to respond to changes in patient volume or reimbursement?

Many women who survive breast cancer spend a lot of time worrying about the risk of recurrence, but a study presented at the ASCO Breast Cancer Symposium in San Francisco suggests at least three-quarters of the women have as much risk of suffering a serious cardiovascular event, such as heart attack or stroke. Aditya Bradia, MD, a fellow at Johns Hopkins School of Medicine, presented the data from the study, which was a 2009 Breast Cancer Symposium Merit Award Recipient.

There remains a great deal of uncertainty surrounding the economic stimulus package incentives and the steps practices must take to receive these incentives. This session will provide an overview of HIT, EHR and TeleHealth incentives related to the stimulus package and prepare practices for what they must do to adopt and "meaningfully use" certified EHRs . An HIT and government affairs expert will help create a roadmap for the term "meaningful use" and inform practices on how to follow this map.

Poly(ADP-Ribose) Polymerase (PARP) inhibitors have been gaining increasing attention as a possible breakthrough in the treatment of triple negative breast cancer and cancers with mutations in BRCA1, BRCA2, or PTEN genes. Several studies attesting to the efficacy of PARP inhibitors in breast and ovarian cancer were presented at the 2009 ASCO Annual Meeting. Antoinette Tan, MD, assistant professor, The Cancer Institute of New Jersey, provided an “Update on the Clinical Status of PARP Inhibitors for the Treatment of Breast Cancer” in a special session at the Breast Cancer Symposium in San Francisco, California.

The identification of an association between mutations in BRCA 1/2 and hereditary breast and ovarian cancer has allowed many women to learn of their increased cancer risk at a young age and take measures to identify developing tumors early. According to Jennifer Litton, MD, assistant professor, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, women positive for a deleterious eVmutation in one of the BRCA genes typically receive a breast cancer diagnosis 6 years earlier than did mothers or aunts with the mutation who had breast or ovarian cancer.

Breast cancer survival outcomes vary significantly according to race in the United States, but a University of Texas MD Anderson Cancer Center found that race/ethnicity did not significantly affect the rate of pathologically complete response (pCR) in women with locally advanced breast cancer treated with neoadjuvant chemotherapy.

Quality of life (QOL) is an important consideration for clinicians when treating patients. Treatments that diminish QOL can result in the patient discontinuing therapy or switching to another drug. Either can thwart efforts to control tumor growth. Beth Sherrill, MS, Global Head, Biometrics, RTI Health Solutions, Research Triangle Park in North Carolina, and associates sought to determine the effects on QOL of adding lapatinib (Tykerb) to letrozole (Femara) in women with HER2-positive metastatic breast cancer (MBC).

HER2-positive breast cancer has long been recognized as an aggressive disease, but women with small node-negative tumors are considered low risk for recurrence and do not always receive adjuvant therapy. Data presented by Heather L. McArthur, MD, MPH, Memorial Sloan-Kettering Cancer Center in New York, and colleagues in a poster session at this week’s Breast Cancer Symposium in San Francisco suggests perhaps they should. In comparing outcomes between women who received adjuvant trastuzumab for low-risk HER2-positive tumors and those treated before trastuzumab was available, they concluded adjuvant trastuzumab (Herceptin) reduces recurrence rates and mortality.

In 30% of women with early stage breast cancer who were scheduled for lumpectomy, axillary ultrasound (AUS) combined with fine-needle aspiration cytology (FNAC) allowed researchers to detect macrometastases in axillary lymph nodes prior to resection, sparing the patients from subsequent sentinel lymph node biopsy (SLNB). Data were presented at the ASCO Breast Cancer Symposium in a general session titled “Controversies in the Management of the Axilla.”

Ductal carcinoma in situ (DCIS) typically begins in a milk duct and is the most common type of noninvasive early stage breast cancer. It represents nearly one-quarter of new breast cancer diagnoses annually.

In the quest to improve personalization of cancer treatment, the CALGB (Cancer and Leukemia Group B) Cooperative in Canada discovered that women with basal type breast cancer benefit from adding paclitaxel (Taxol) to standard chemotherapy.

The results of a large, randomized, population-based study presented at the 2009 ASCO Breast Cancer Symposium indicate that the rate of death from breast cancer is 56% for women not participating in mammogram screening programs versus 4.7% for those on the recommended screening schedule.

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