From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD

The Seymour Street Journal is published every two weeks to communicate key messages pertinent to our hospital's physicians, and to promote alignment between the medical staff and administration. It will keep you informed on hospital news in a concise, convenient format. SSJ will be sent to your preferred email address every other Sunday at 6 p.m.

We'd like to hear from you. For any questions or suggestions, please contact Dr. Jeffry Nestler, medical staff president, at 860-836-7313, or jnestler@connecticutgi.org.

April 29, 2012 Edition

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HH Facts
1966 - Hartford Hospital was the recipient of the country's very first Medicare disbursement check.


Top News

 

Register Now for Medical Staff Spring Event May 23

The Board of Directors and Medical Staff Spring Event will be held on Wednesday, May 23 at Heublein Hall in the ERC at 6 p.m. There will be cocktails and a buffet, followed by an awards ceremony. The event is free. You are required to preregister, either online or by mail. To register online, go to https://www.harthosp.org/newseventsclasses/viewall/default.aspx?view=detail&type=event&detailid=c4225681-8082-43db-9977-8d048e89c427

HH Surgeons First In State To Perform New Single Incision Robot-assisted Gallbladder Surgery

A team at Hartford Hospital became the first in the state to perform a single incision, robot-assisted cholecystectomy recently approved by federal regulators. Led by Dr. Darren Tishler, the team removed the gallbladder using a da Vinci Surgical System on April 16. Using robotic assistance, the team was able to remove the gallbladder through a belly button incision of approximately one inch, making the procedure virtually scarless. Unlike traditional robotic surgeries requiring three to five small incisions, this new technology allows for a single incision in the belly button where the diseased, inflamed gallbladder is removed. The surgery can be performed in about one hour with a typical hospital stay of less than 24 hours. Potential benefits of single-site gallbladder surgery may include less pain, less loss of blood, faster recovery, and shorter hospital stays. The FDA approved the surgery using the da Vinci Robotic System late last year and it was first performed in December in California. Dr. Tishler is one of a small group of surgeons in the country who has received training to perform the surgery. "Combining robotic surgery with a single, belly-button incision to remove the gallbladder requires additional training and special equipment," says Dr. Tishler. "We are thrilled to be one of the first hospitals to offer this technically advanced surgery. We want to provide patients with the most up-to-date minimally invasive surgical options." More than 1 million people in the U.S. have their gallbladder removed each year. Most are performed with traditional laparoscopy using several incisions. Most people who require gallbladder removal are candidates for the robotic, single-incision surgery.

Hartford Hospital Physicians Author All Scientific Papers in April "Connecticut Medicine"

All four scientific papers in this month's edition of Connecticut Medicine were written by present or former medical staff members from Hartford Hospital. They are: "Ultrasound-assisted Catheter-directed Thrombolytic Therapy for Management of Acute Pulmonary Embolism," by Drs. Mohiuddin Cheema, Thomas Divinagracia, James Dougherty, Francis Kiernan, and Immad Sadiq, with Talhat Azemi, Firas Almahasneh, and Feras Elhash; "Pancreaticopleural Fistula: An Unusual Cause of Pleural Effusion," by Drs. David Curtis, Eric Shore, and Joshua Giacotto; "Major Adverse Cardiac Events Among Postpercutaneous Coronary Intervention Patients on Clopidogrel and Proton Pump Inhibitors," by Drs. Raymond McKay and Justin Lundbye, with Gilbert Ching, Dadong Li, William Baker, Patrick Hohl and Jeffrey Mather; and "Effect of Early Enteral Tube Feeding on Patient Outcome Following Pancreaticoduodenectomy," by Drs. David Eisenberg, Robert Piorkowski, and Ramon Jimenez with Georgios Georgakis and William Macaulay. In addition, a special article entitled "The ObGyn Clerkship: Are Students Denied the Opportunity to Provide Patient Care and What is the Role of Gender?" was coauthored by Dr. Peter Schnatz, formerly of HH, and now associate chair and residency program director of Ob-Gyn at the Reading Hospital and Medical Center in Reading, Penn.

Dr. Jamie Roche Addresses American College of Physician Executives

Dr. Jamie Roche, vice president of Patient Safety and Quality, spoke at the American College of Physician Executives 2012 Annual Meeting and Spring Institute on April 28 in San Francisco. His presentation, called "Hard-wiring Culture: How Hartford Hospital Works Yields Significant Improvements," was a "Difference-Maker Breakout Session" on Models in Leadership. He shared Hartford Hospital's H3W model and outcomes from the past three years.

Weekly Medical Rounds on WFSB Featuring Hartford Hospital Physicians Is Shot in Our TV Studio

Hartford Hospital is broadcasting a live weekly segment called "Medical Rounds" from our new TV studio located on the fifth floor of the Jefferson Building. It airs on Channel 3 (WFSB) News on Wednesdays at 5:45 p.m. The weekly interview with a medical expert is followed by a call-in session, which is open to the public. The first show was broadcast Feb. 29 featuring Dr. Paul Thompson, who spoke about exercise and heart health. He was followed by Dr. Adam Borgida, who discussed Maternit21, a new maternal fetal test that we're the first in the state to offer; Dr. Jeffry Nestler, who spoke on colorectal cancer screening; Dr. Raymond McKay, who discussed transcatheter aortic valve replacement for patients too ill for traditional open chest surgery; Dr. Patricia Sheiner, who spoke about organ donation; Dr. Pepe Wagner, who spoke about prostate cancer screening; and Dr. Pavlos Papasavas, who spoke about weight loss surgery and diabetes. A "Medical Rounds" archive is available on the WFSB website at http://www.wfsb.com/category/232428/medical-rounds.

 

Excellence

 

Drs. Tishler and Papasavas Speak to the Media About Bariatric Surgery

Two large prospective randomized studies in the New England Journal of Medicine demonstrated the superiority of bariatric surgery over medical treatment of T2-DM in obese patients. Dr. Darren Tishler discussed this with former Connecticut Governor John Rowland on WTIC-AM two weeks ago, and Dr. Pavlos Papasavas discussed it on WFSB-3 on April 18.

Dr. Andrew Salner Publishes Book Chapter on HH's Cancer Survivorship Program

Dr. Andrew Salner, director of the Helen & Harry Gray Cancer Center, is the author of a chapter in a book just published entitled Excellent Care for Cancer Survivors. The chapter, "A Major Urban Hospital's Cancer Survivorship Program," describes the development and implementation of Hartford Hospital's survivorship program in collaboration with the National Cancer Institute and other hospitals in the NCI's Community Cancer Center Program. It discusses the evolution of the cancer treatment summary and wellness plan, now routinely given to patients as they complete their active cancer therapy. Dr. Salner and his team have written numerous articles and made several national presentations concerning their research into survivorship. Their work has been funded both by the National Cancer Institute as well as the Lance Armstrong Foundation.

 

Innovative and Complex Care

 

ER Ultrasounds Improve Patient Care

Emergency physicians, like cardiologists, gastroenterologists, trauma surgeons, and Ob/Gyns, have been increasingly using ultrasound (US) at the bedside. For us it is in some ways analogous to the stethoscope, an extension of the physical exam, often referred to as Point of Care (POC) ultrasound. We perform a focused exam to answer a number of binary questions that help us make emergent clinical decisions rather than to completely study an organ or organ system. In many instances, POC ultrasound lowers the threshold for ordering comprehensive Radiology US imaging.

Several recent cases point out the utility of Emergency US. An 81-year-old male was transferred from another hospital hypotensive with chest pain. His EKG showed a new RBBB and ST elevations in the anterolateral leads, a presumed MI. He was sent for the Catheterization Laboratory who were activated but he didn't look quite right and complained of back pain. Per the resident's note: "we quickly did bedside POC U/S—pt with large pericardial effusion with tamponade physiology—we called CT surgery and pt taken directly to OR." He left the hospital in several days and without this timely information may not have done well.

Another case was a female who presented the morning after colonoscopy with abdominal pain presumably from an iatrogenic perforation. Because she was hypotensive a bedside ultrasound was performed and revealed a large stripe of free fluid in the peritoneum. She was given blood and fluids and subsequently diagnosed with a splenic injury. Additional cases include a patient who presented after cardiac arrest with a hypokinetic RV with apical sparing on bedside echo who was given TPA for a later confirmed PE and a young woman with viral gastroenteritis unaware that she was pregnant found to have a large tubal ectopic pregnancy on bedside ultrasound.

Emergency US made a difference in these patients' outcomes. We are using and teaching our residents to use emergency US, a cutting edge technique that can save lives and decrease ED length of stay

 

Research and Academics

 

Fifth Annual Neil J. Grey, M.D. Lecture in Diabetes Will Be a Joint Grand Rounds

The 5th Annual Neil J. Grey, M.D. Memorial Lecture in Diabetes on May 15 will be a joint Grand Rounds with Cardiology. Hosting the event are Drs. Robert Oberstein, Paul Thompson and Michael Lindberg. It will feature nationally renowned researcher in diabetes and cardiovascular disease Dr. Henry Ginsberg, director of the Irving Institute for Clinical and Translational Research at Columbia University College of Physicians and Surgeons. His presentation is titled "Optimal Treatment of Diabetic Dyslipidemia." This annual lecture is supported by the generosity of donors who established the Neil J. Grey, M.D. Fund for Diabetes in 2008 as a lasting tribute to Dr. Grey, who founded Hartford Hospital's Diabetes LifeCare Program and was recognized for his pioneering efforts to care for patients with diabetes. Upon his death in 2007, Dr. Oberstein became medical director of the Diabetes LifeCare program. Under the leadership of Dr. Rocco Orlando, one of three chairs of the Fundraising Advisory Committee, more than 100 family members, friends and colleagues contributed to the establishment of the fund and continue to support the endowment. Expected to attend this lecture are Joan Grey, Hal Moffie – whose generous leadership gift helped establish the fund – and Rose Malajanian, who also served as a committee chair with Dr. Orlando and Moffie. For more information, contact Nicole Attardo at nattardo@harthosp.org.

23rd Oncology Symposium May 16 Focuses on Renal Cancer

The 23rd annual Mary Mulready Sullivan Oncology Symposium will be held May 16 in the ERC from 7:30 a.m.-1 p.m. It is entitled "Innovations in Renal Cancer: Diagnosis, Treatment and Patient Care." Guest faculty includes Dr. Steven Shichman, chair of the Department of Urology; Dr. Anoop Meraney, section chief of the uro-oncology program; Dr. David McDermott, director of the biologic therapy program at Beth Israel Deaconness Medical Center in Boston; and Marcia Caruso-Bergman, oncology nurse practitioner at Hartford Hospital. The fee is $50 for physicians; $20 for non-physicians; no charge for students and residents. Registration deadline is May 2. For more information, call Sandi Beggs at 860-545-2390.

Pharmacy Residency Survey Receives Positive Report

The American Society of Hospital Pharmacists (ASHP) conducted a survey of the Hospital Pharmacy Residency at Hartford Hospital on March 20 and 21. This occurs every six years and includes the PGY1 residency as well as the PGY2 specialized residency in Infectious Diseases. Three ASHP pharmacist surveyors spoke with residents, pharmacists, pharmacy technicians, physicians, nurses and many residency preceptors. Although the final official outcome will not be known until October, the exit conference revealed a very positive report, with few recommendations for improvement related residency standards. Of particular significance was the lack of any recommendations related to the pharmacy service component - almost unheard of in reviews conducted nationwide and a tribute to the exemplary service provided by the HH Department of Pharmacy.

Hartford Hospital Researchers Granted Access to NIDDK Database to Analyze Women's Health Outcomes

Drs. Hema Brazell (urogynecology), Paul Tulikangas (urogynecology), and David O'Sullivan (research program) to conduct research using data from the Boston Area Community Health (BACH) Survey. The BACH survey is an NIDDK-sponsored epidemiologic study focused on urological problems, including interstitial cystitis (IC), urinary incontinence (UI), benign prostatic hyperplasia (BPH), and sexual dysfunction. It represents approximately 6,000 men and women, ages 30 to 79, who were randomly sampled from neighborhoods in the Boston metropolitan area and contains information on nutrition, physical activity, access to health care and health insurance as well as important physical measurements and blood specimens for hormone, cholesterol, and lipid levels. The survey includes robust sample sizes from underrepresented populations to support further research into health disparities and social determinants of health. The research team at Hartford Hospital will use the BACH Survey data to study women's health and functional outcomes after prolapse surgery and other urogynecological procedures. In order to access the BACH study data, Drs. Brazell and O'Sullivan submitted a research proposal to the NIDDK, which was reviewed and deemed to be of high scientific merit by a panel of expert reviewers.

 

Operational Update

 

SCM Changes Begin May 1 To Support Stage 1 of Meaningful Use

Starting May 1, changes will occur in Sunrise Clinical Manager (SCM) that support the requirements for Stage 1 of Meaningful Use as well as the HHC Balanced Score Card initiative for the Discharge Process. Stage 1 requires a 90-day attestation period of compliance to the requirements, and our attestation period will start June 1. Provider support is paramount in the success of this process. The changes will affect Orders; VTE Prophylaxis; Discharge Instructions; Patient Education/Exit Care and Stroke Patients neurology notes. (Click here for more information about these changes.) 

Please note that the rollout of the new electronic Discharge Instructions note in SCM will be staggered to provide adequate clinical user support. Go-live support will be available 6 a.m. to 9 p.m. from Tuesday, May 1, through Thursday, May 17. The Command Center will be located in CB5 Training Room B. Command Center phone number is 5-6036, or call the Help Desk. The Discharge Instruction structured note and report will be available according to this schedule:

Medicine: May 1 and 2 (Tuesday and Wednesday) 
CB5, N12, N11, B11E, B11/SD, B11I, C12

Surgery: May 3 and 4 (Thursday and Friday)
B5, B7E, B7I/SD, B8, C8 inpt

Cardiology: May 7 and 8 (Monday and Tuesday)
B9E, B9I/SD, B10E, B10I/SD, C10, N10

Ortho/Neuro/Oncology: May 9 and 10 (Wednesday and Thursday)
CB4, CB6, N9/SD, C9WI, CB2 

Womens Health: May 14-17 (Monday-Thursday)
B6, L & D, N8

6% Malpractice Discount Available Again in 2012 for Completing Risk Management Education

CHS Insurance LTD is continuing participation in the Annual Risk Management Educational Program (RMEP) available to all CHS voluntary attending physicians. By successfully completing the program, eligible participants (CHS Insurance policyholders effective January 1 of this policy year) qualify for a credit of 6% on their malpractice insurance premium. Please feel free to call 860-920-5475 with any questions. There are four sessions scheduled in May:

  • ED: Wednesday, May 2, 12-1:30 p.m., Gilman Auditorium
  • Women's Health: Thursday, May 3, 7:30-8:30 a.m., Special Dining Room
  • ED: Thursday, May 17, 8:15-10 a.m., Dining Room B & C
  • Medicine: Thursday, May 17, 4:30-6 p.m., Gilman Auditorium (PLEASE NOTE NEW DATE)

Handling Media Inquiries and Interviews

Hartford Hospital welcomes inquiries from print, broadcast and Internet outlets. All inquiries must come through the Media Relations Department. The hospital's media relations team is happy to connect reporters and producers with our experts. If a reporter wants to interview you, please call or email the Media Relations team at 860-545-4285 or rstewart@harthosp.org to arrange interviews. It is important to remember that before reporters can interview patients or their doctors, patients must sign a release form. To protect the privacy of all other patients and families, someone from Media Relations must accompany all reporters and photographers on Hartford Hospital's campus.

New Physicians Join Hartford Hospital

Dr. Yasser A. Al-Baghdadi, Hartford Anesthesiology Assoc., Inc.
Dr. Faiqa A. Cheema, Infectious Disease, CT Multispecialty Group, PC
Dr. Siobhan C. Collins, Dermatology Surgical Associates, LLC
Dr. Patrick J. Corcoran, Cottage Grove Cardiology, PC
Dr. Adam M. Debin, Hartford Anesthesiology Assoc., Inc.
Dr. Roger R. El-Hachem, Internal Medicine, Hartford Medical Group
Dr. Thomas H. Farquhar, Jefferson Radiology, PC
Dr. Dennis S. Gianoli, Oral-Maxillofacial Surgery, Dennis S. Gianoli, DDS, PC
Dr. Aized A. Imtiaz, Hospital Medicine, CT Multispecialty Group, PC
Dr. Mandeep Kumar, Hospital Medicine, CT Multispecialty Group, PC
Dr. Shannon C. Peterson, Obstetrics & Gynecology, Womens Health Group
Dr. Benjamin H. Schmidt, General Surgery, Hartford Hospital

Report Problems With Library Databases

Library database usage is growing and the staff in the Health Science Libraries is very happy to see this growth. There is now a "Database Problem Reporting" form on the Library Intranet/Internet under the category "Request/Registration Forms."  For more information, call or email Sheila Hayes at 860 545-2416 or shayes01@harthosp.org.

 

Care Coordination

 

Connecticut Multispecialty Group Names President and CEO

Connecticut Multi-Specialty Group announces a new CEO (Dr. Jarrod Post) and new president (Mark Vye). Dr. Post has been with CMG since 1998 as a nephrologist and internal medicine physician. He has held extensive executive leadership positions at both CMG and Hartford Hospital. His leadership skills come from a background of ongoing patient care as well as the administrative experience to meet the challenges of medical delivery in today's changing health care environment. Vye has been promoted to president of CMG. He has been with CMG since 1998, previously serving as the group's chief financial officer. Vye has over 20 years experience in health care management and is a key business advisor for the physicians of CMG. Vye will report to Dr. Post. CMG offices are in Rocky Hill.

 

HH In the News

 

Drug Shortages and Their Consequences
Harford Courant, April 13

More than 200 drugs are on the Food and Drug Administration's list of shortages. It's a national problem that's been growing since 2006, when only 50 drugs were on the shortage list. Sterile injectable drugs, including several oncology and anesthesia drugs, make up about 80 percent of the drugs plagued by supply shortages. Michael Rubino, Hartford Hospital's director of pharmacy, said the hospital currently has mitomycin available, although it's been touch-and-go for the past few months. His main concern at the moment is anesthetics. "We're scrambling all the time for the anesthesia drugs," he said. "The biggest thing that's happened recently is [a shortage] of propofol. We're good for a couple weeks, but if we don't get it then, we have to look."

The Secrets To Buying The Right Mattress
Harford Courant, April 13

Dr. Patrick Troy, a pulmonologist at the Hartford Hospital's Sleep Center, says people may not be aware that their mattresses are affecting their sleep. "Your whole environment has to be conducive to falling and staying asleep and that includes your bed," says Troy. "If you are sleeping on an old mattress that doesn't keep your body aligned in a neutral position, it can cause you to be restless during the night. Your partner's movements can also disrupt your sleep. The mattress that works for them might not be right for you, so you'll have to compromise."

Kidney dialysis patients more likely to survive in Connecticut, research shows
Post-Chronicle, April 17

The $20 billion kidney dialysis business keeps growing with mixed results, but here in Connecticut the news is mainly good — with only one of 40 clinics showing worse-than-expected mortality rates. The New London Dialysis Center has the highest mortality rates. The state and national death rate for dialysis patients is 20 percent, but at the New London center it was 30 percent, 22 percent worse than expected when the patient mix is adjusted. The first-year mortality rate at the New London Center was 40 percent, also higher than expected, where the average for the state and nation is 27 percent. On the plus side, nine clinics from around Connecticut had better than expected survival rates, including Hartford Hospital with 16 percent mortality.

State Tests For Cause Of Veterans' Home Flu Outbreak
Hartford Courant, April 17

State public health workers tested patients at the Connecticut State Veterans Home in Rocky Hill Tuesday to determine the cause of an outbreak of the flu. As of Tuesday, 22 people were sent to the hospital with flu-like symptoms. Dr. Jack Ross, director of infectious diseases at Hartford Hospital, said this has been the quietest flu season they've seen in a long time. "This has been the strangest flu season in probably 40 years," Ross said. "It's been a very mild flu year." Ross said he hasn't heard of any strains of the flu emerging this season that weren't covered by the vaccine and that, so far, the vaccine has proven to be a "good match" for the strains that were common this season.

 

In the HHC System

 

Quinnipiac's new medical school, MidState preparing for partnership
Meriden Record-Journal, April 13

The partnership between Quinnipiac University and Meriden's hospitals has lasted for years and preceded the 1998 opening of MidState Medical Center, but now the relationship is being taken to a new level. Quinnipiac's medical students will have the chance to gain clinical experience working alongside doctors at MidState. "We have agreed to work together to educate students that eventually end up at the medical school," said Dr. Bruce Koeppen, founding dean of the medical school. "They're very supportive of our mission of inter-professional education and patient care.

Focus On Operating Efficiency Paying Off for Area Hospitals
Hartford Business Journal, April 16

For years, Connecticut hospitals have relied on investment income as a key source of revenue to boost slim operating margins. But the stock market's recent uneven performance has made this more unpredictable, forcing a sea change in the way hospitals are doing business. To create more stable long-term finances, Connecticut hospitals are focusing on improving operating efficiency, which has led to a wave of merger activity, tense contract negotiations with insurance companies, cost cutting initiatives, and the implementation of new more efficient ways to deliver health care services. For the first time in many years, Connecticut hospitals saw their average operating margin creep over 3% in 2011, to 3.12%. Eight Connecticut medical centers lost money in 2011, double the number of a year earlier. The money losers included Griffin, Milford, New Milford, St. Francis, Windham Hospital, Rockville, Johnson Memorial, and John Dempsey hospitals. Affiliating or merging with a larger entity has become a common trend. A spokeswoman for the Hospital of Central Connecticut said the hospital's recent affiliation with Hartford HealthCare has led to outright savings as a result of joint purchasing of supplies, blood and medical equipment. The 356-bed facility posted a 6.12% operating margin in 2011, its first full year as a member of HHC, compared to a 0.45% operating loss in 2010. The hospital also saw greater patient volumes, reduced malpractice insurance costs, and reduced IT expenses. Only six Connecticut Hospitals — Hospital of Central Connecticut, Backus, Bridgeport, Manchester, Middlesex, and Norwalk — had operating margins at or above 4% in 2011.

Smaller Connecticut Hospitals Struggle With Deficits
Hartford Courant, April 17

Eight of Connecticut's 30 acute-care hospitals ended the last fiscal year in the red -- double the number that reported losses the year before. The data is a mixed bag of news about the financial health of the state's hospitals. It shows that only six hospitals had operating losses in the 2011 fiscal year in contrast with nine in 2010. In net operating income, Yale-New Haven Hospital led the pack, with a $52.9 million surplus in 2011 -- down slightly from 2010. UConn's John Dempsey Hospital reported the largest operating loss at $16.6 million. Showing the biggest improvements since 2010 were the Hospital of Central Connecticut, William W. Backus Hospital, Bridgeport Hospital and Norwalk Hospital. The Hospital of Central Connecticut affiliated with Hartford Hospital in February 2011, becoming part of a network that includes Windham Hospital and MidState Medical Center. Central Connecticut had ended 2010 with a $1.7 million operating loss; in 2011, it reported a $24 million gain. Backus Hospital had the biggest positive margin in 2011 -- a 9 percent edge in revenues over expenses. To view the report: http://www.ct.gov/dph/lib/dph/ohca/publications/2012/hospital_statementof_ops_2011.pdf

Backus Openings Lure Hundreds
Norwich Bulletin; April 17

Several hundred people showed up to apply for jobs at the soon-to-open William W. Backus Hospital emergency care center in Plainfield. They met with hospital hiring managers in hopes of landing one of the approximately 50 full-time and part-time positions being offered at the emergency center, which will open July 9.

 

Health Care News In the Region

 

Seven Massachusetts Hospitals To Offer New Approach To Malpractice Claims

Baystate Health System hospitals in Springfield, Greenfield, and Ware are among seven Massachusetts hopsitals that plan to offer patients harmed by medical errors a prompt apology and financial settlements before they resort to lawsuits. It is part of a major new initiative to improve the state's cumbersome medical malpractice system. In a front-page story, the Boston Globe (4/18) reports that "a coalition of physician, hospital, and patient groups released details of the initiative, which they predict will increase reporting of medical mistakes and cut down on lengthy litigation that drives up health care costs and fuels distrust between caregivers and patients." The AP (4/18, Salsberg) reports, "The program, called Disclosure, Apology and Offer, targets 'defensive medicine' -- often unnecessary or excessive tests and procedures ordered by doctors wary of being sued by their patients." The Boston Herald (4/18, McConville) reports that proponents said the program "won't entirely prevent litigation. Patients who have received bad medical care can still sue." The other hospitals that will test the initiative are Massachusetts General Hospital, and Beth Israel Deaconess Medical Centers in Boston, Needham, and Milton.

Anthem, CCMC Still At a Standoff Over Contract Terms
Hartford Courant, April 18

Anthem Blue Cross and Blue Shield in Connecticut — the state's largest health insurer — and Connecticut Children's Medical Center are still at a standoff after their previous contract expired Sunday. People who have Anthem Blue Cross and Blue Shield in Connecticut as their health insurer are faced with paying higher, out-of-network rates or going elsewhere for medical services at in-network rates. It is the most recent of many contract disputes between hospitals and insurance companies which, when contracts lapse, leave patients scrambling to find alternatives. Those who want to continue service with familiar clinicians end up paying much more themselves.

Eastern CT Health Network Launches iPhone App

Now there's a whole new way to manage your healthcare. It's the official iPhone app for Eastern Connecticut Health Network. Find a physician, locate an office, get directions, keep track of important health information, and more. The ECHN iPhone app puts access to the entire Eastern Connecticut Health Network, right at your fingertips. ECHN is a nationally recognized network of hospitals, outpatient service centers, and hundreds of physicians, specialists and other providers serving more than 25 communities throughout eastern Connecticut.

Waterbury Hospital Officially Signs on For New Hospital
Republican American, April 23

Pending approval by state regulators, the future of health care in Waterbury will change forever, as Waterbury Hospital officially filed to enter a joint venture with LHP Hospital Group, a Texas-based hospital management company, and Saint Mary's Hospital. The goal is to build a new, state-of-the-art medical center.

 

Coming Events

 

May 11 (Friday):
CT Department of Public Health: Healthy People 2020 Grand Rounds Presentation

Cancer Genomics: Best Practices in Hereditary Breast and Ovarian Cancer (HBOC) and Lynch Syndromes
Keynote Speaker: Jennifer Stroop, MS, CGC. Introduction by Linda Steinmark, MS, CGC. The project goal is to increase the number of families identified as at-risk for hereditary cancer, and integrate into practice the evidence-based genetic testing guidelines for HBOC and Lynch syndrome. Gilman Auditorium, 8-9 a.m

May 16 (Wednesday):
25th Anniversary Clinical Integration Educational Forum:

Major Employer Groups, What do they want from health care systems and practitioners?
Keynote Speaker: Dr. Paul Grundy,IBM's director of Healthcare, Technology and Strategic Initiatives for IBM Global Wellbeing Services and Health Benefits. Hartford Club, 46 Prospect Street, Hartford, 4-6:30 p.m

May 18 (Friday):
Stroke Conference:

"Fantastic Voyages: Current Endovascular Management of Stroke, Aneurysms and Brain AVMs"
Friday, May 18, 6:45 a.m.-4 p.m., ERC. Presented by the Stroke Center, this program will be of interest to neurologists, neurosurgeons, radiologists, emergentologists, APRNs, PAs, nurses and technologists involved and interested in the care and treatment of patients with complex cerebrovascular disease. Conference faculty includes Hartford Hospital physicians Gary Spiegel, Howard Oakes, Martin Ollenschleger, Isaac Silverman and Inam Kureshi. Other faculty members are keynote speaker Dr. Alejandro Berenstein from Beth Israel Medical Center and St. Luks'-Roosevelt Hospital Center; Dr. P. Kim Nelson from NYU Langone Medical Center; Drs. David Fiorella and Henry Woo from Stonybrook University Medical Center; and Dr. Robert Lesser from UConn School of Medicine. Registration is $150 for physicians, $50 for non-physicians and $25 for HH staff members. There is no charge for medical students, residents, fellows and nursing students. You can register online at www.harthosp.org/event/607 or by calling our Health Referral Service at 860.545.1888 or 1.800.545.7664.

May 23 (Wednesday):
Annual Medical Staff Spring Event

More events

 

Hot Topics in Healthcare

 

4 Things to Worry About When It Comes To Your Medical Staff: When are docs too old, too stressed, too fat or too dishonest?
Hospitals & Health Networks, April 18

The relationship between hospital executives and physicians has always been fraught. They need each other, but that doesn't mean they have to like each other. It'll be interesting to see how that changes as younger physicians opt out of private practice and go to work directly for hospitals and as more physicians move into hospital management ranks. One hot potato as baby boomers hit their 60s and 70s is the idea of a mandatory retirement age for physicians. An article last fall in the Annals of Emergency Medicine compared medicine with other high-risk professions like aviation, which require their practitioners to step down at a specific age.

Making the Best of Hospital Pay for Performance
NEJM, April 18

Over the past decade, "pay for performance" in health care has evolved from concept to policy with remarkable speed. In October 2012, U.S. acute care hospitals will begin to be paid for performance under the Medicare Hospital Value-Based Purchasing (VBP) program. Accumulating evidence, however, raises serious doubts about whether the program will improve value in health care. How did we get to this point, and what can be done to redirect the policy as VBP is rolled out nationally?.

The Confusion of Hospital Pricing
The New York Times, April 23

Hospital charges are all over the map: according to the report published Monday in the Archives of Internal Medicine, fees for a routine appendectomy in California can range from $1,500 to — in one extreme case — $182,955. Researchers found wide variations in charges even among appendectomy patients treated at the same hospital.

The Doctor Will See You – If You're Quick
The Daily Beast, April 9

Studies show a steep decline over the last three decades in patients' sense of satisfaction and the feeling their doctors are providing high-quality care. And things don't seem much better from the other side of the stethoscope. In a recent survey by Consumer Reports, 70% of doctors reported that since they began practicing medicine, the bond with their patients has eroded. At the heart of the problem, say many doctors and policy experts, is the fraying of the doctor-patient relationship. And this is not just a question of touchy-feely good vibes: a growing body of research now points to the critical importance of having a connection to a trusted physician

Focus on Quality of Life May Cut Health-Care Costs
Wall Street Journal, April 16

A new focus on patient well being and quality-of-life issues could improve health-care outcomes and reduce costs, as WSJ explains in today's special report on innovation in health care. Well-being and quality of life may seem like fairly vague concepts for doctors, compared to say, blood-pressure readings and cholesterol levels. But researchers are finding links between well-being and health care expenditures. According to a study in the latest issue of Population Health Management, respondents from one health plan with low scores in well-being assessment had 2.7 times the median annual health expenditures of individuals with high-well being. Prescriptions-drug costs were three times higher for individuals with low well-being compared with the high-well-being group.

Some Physicians Offer Service Based on Monthly Retainers
USA Today, April 22

A new Oregon law allows the opening of so-called "retainer practices," where patients pay a set monthly fee in return for specific health care services — leaving out insurance companies altogether. The law, which took effect Jan. 1, requires such practices to register with the state, but exempts them from insurance regulations. Retainer practices aren't the "concierge" or "boutique" medical practices that cater to the wealthy. Instead, they're designed for people with high-deductible or catastrophic insurance who need affordable primary care. Dr. Steven Butdorf of Eugene, Ore., opened a retainer practice on Feb. 1. He charges patients between $39 and $79 per month, depending on their age, plus $20 for each office visit. He says he devotes an average of 30 minutes to each appointment, and 60 minutes for an annual physical.

 

Voices Of Our Patients

 

Kudos to Dr. Aized Imtiaz

Recently my mother Anna Cosgrove completed a three–week stay at Hartford Hospital. During her hospitalization my family and I had the pleasure of working with Dr. Aized Imtiaz. Although both my mother and father have been admitted to Hartford Hospital before, we have never met anyone with Dr. Imtiaz's extraordinary level of professionalism and compassion.

My mother is an 89-year-old dementia patient. All too often, we find that caregivers fail to view her as an individual and simply attribute every medical issue to progression of her disease. Dr. Imtiaz never made that mistake. He diagnosed diligently, developed an individualized treatment plan, tried innovative interventions, tapped other physicians and resources within the hospital when necessary, and modified the treatment plan according to my mother's changing needs.

During our daily interactions with Dr. Imtiaz, we found him to be intelligent, articulate, thorough in explaining the reasons for his medical decisions, open to entering into a dialogue with family members, and patient in answering our (many!) questions. In addition, we discovered in Dr. Imtiaz a compassionate man who sincerely share our joy when my mother's condition improved.

I understand the Dr. Imtiaz is a relatively new member of the medical team at Hartford Hospital. We feel that the hospital is very fortunate to have him on board, and we know that many patients and families will benefit from the quality care that Dr. Imtiaz will provide in the months and years to come.

Sincerely,
Ann M. Cosgrove

 

 


The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital's physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. Back issues can be viewed here. For any questions or suggestions, please contact Dr. Jeffry Nestler, Medical Staff President, at (860) 836-7313.