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

August 19, 2012 Edition

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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.

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In This Issue...
Top News

Join Us Tuesday At The Medical Staff’s Max Restaurant “Chef to Farm” Dinner

Tuesday, Aug. 21

Rosedale Farms, Simsbury

Join the medical staff officers and other physicians this Tuesday, August 21 from 6-11 p.m. at Rosedale Farms in Simsbury for a special Max Restaurant Group “Chef to Farm” dinner. You’ll have an opportunity to socialize and enjoy each other’s company while celebrating the beauty and abundant bounty of our local farms. You’ll enjoy the freshest foods and produce in a beautiful setting. The evening will begin with a wine tasting reception with the guest winemaker; then we’ll head out for a tour of the farm; to see the fields and learn about the farm’s history, operations and products. The tour concludes in a tented area where tables dressed in white linen and candlelight offer a view of the al fresco kitchen. Each dinner is cooked from scratch and showcases that day’s best produce sourced daily from local farmers, ranchers and fishermen. The menu will vary depending on the day's harvest and the inspiration of the chef. Cost is $130 per person. As of Friday, 93 people had registered. Space is limited. Register here.


Brain scans of hoarders show abnormal patterns in decision-making regions

CBS News, Aug. 7

In a new study published in the August 6 issue of the Archives of General Psychiatry, Dr. David Tolin and researchers at the Institute of Living at Hartford Hospital used fMRI machines to measure the brain activity of people when they made decisions about whether to keep or throw away a possession. The researchers compared the scans of 43 people diagnosed with hoarding disorder, 31 people with obsessive-compulsive disorder (OCD) and 33 healthy individuals. According to the Mayo Clinic, hoarding may be a symptom of OCD but many people who hoard don't have other OCD-like symptoms. Compared with healthy people and those with OCD, the researchers found distinct patterns of abnormal activity in the anterior cingulated cortex (ACC) and insula in the brains of people who had a hoarding disorder. Those areas of the brain are tied to decision-making processes. When the researchers presented subjects with an object that did not belong to them, the hoarders showed lower activity in those brain regions than their counterparts' brains revealed on the fMRI scans.


Heart Transplant Recipient Was Guest at Yankees/Red Sox Game

Colby Salerno, the patient who captured national attention by blogging about his 166 day stay at Hartford Hospital waiting for a heart transplant, was a special guest yesterday of the New York Yankees. The team invited Colby to the Yankees vs. Red Sox game at Yankee Stadium, and he brought two nurses and a physician from Hartford Hospital, as well as another transplant patient, to the game with him. Salerno's blog, Tales From the 10th Floor, became an inspiration to many, and inspired Yankees manager Joe Girardi to call and ask if there was anything the team could do for him. Salerno said he would be thrilled if the team promoted organ donation to the fans. To do that, the Yankees invited Colby to Saturday's game, which they dedicated to organ donation. Everyone attending was asked to sign up to become an organ donor.


Backus and HHC Agree To Affiliate, Seek Needed Approvals

Backus Corporation and Hartford HealthCare have formally agreed to an affiliation. The health care systems now will seek state and federal regulatory approvals for the partnership. Once the affiliation is approved, Backus will become a member of the Hartford HealthCare system. The agreement outlines how a partnership of the health care systems would function and clears the way for the organizations to jointly file a Certificate of Need application with the Connecticut Office of Health Care Access, seek approval from the state’s Attorney General, and file for federal approval from the Federal Trade Commission. That process is expected to take several months. The affiliation agreement calls for the creation of a new Eastern Connecticut health region for Hartford HealthCare, comprised of New London and Windham Counties, with the Backus Health System serving as the region’s clinical nucleus. Working as a coordinated system, system members will develop a strategic plan for fully integrated health care delivery in the region. The plan, which will be developed after final approvals, will include information from existing health and human services organizations, community leaders and regional stakeholders. The agreement contains several key provisions, pending state and federal approval, including:

• An ongoing fund for medical staff development
• Maintenance of a trauma program at Backus, with a commitment that a LIFE STAR helicopter will be permanently stationed at the hospital
• Establishment of an extensive primary care and outpatient care network, with certified Patient-Centered Medical Homes, which are health centers that provide comprehensive primary care and promote ongoing relationships between patients, their families and a physician that coordinates their care
• Organization and development of a comprehensive cancer services network for the region, building on the existing Backus cancer center, using the expertise of local medical specialists
• Enhancement of cardiac care services in the region, using the expertise of local medical specialists
• Creation of a Preventive Medicine Institute at Backus, which would focus on helping people live healthier lives before they are hospitalized or develop chronic conditions
• Development of an outpatient surgery network in Eastern Connecticut
• Enhanced neonatology coverage at Backus, meaning that the birthing center would have more access to neonatology specialists
• The exploration of a Hartford HealthCare data center developed and housed within the eastern Connecticut region


Bliss 11-I: One Year, No VAPs

Over the last several years a multidisciplinary group has worked diligently to decrease the rate of VAPs in our ICUs. Strategies included maintaining patients in a semi-recumbent position, performing regular oral care with an antiseptic solution, instituting a set of procedures to be accomplished prior to transporting patients on ventilators, daily awakening of intubated patients and assessment of readiness to wean from the ventilator. As a result of this attention to best practice, we have seen a dramatic decrease in the number of VAPs in all of our ICUs. Specifically, Bliss 11I has been VAP free for 12 months, B10I has had only one VAP in 27 months and B9I has had only one VAP in 13 months. In addition, C9I, (neurotrauma unit) whose patients have a high risk of acquiring VAP due to the nature of their conditions, has decreased their rate of VAP from 8.7/1000 ventilator days in FY 2011 to 4.4/1000 ventilator days in FY 2012. We congratulate all of the staff responsible for this great work. It is a great example of collaborative focus and the consistent implementation of evidence-based practice.


One day, 5 CMEs for License Renewal at CSMS Annual Meeting

Mystic Marriott Hotel and Spa

Sept. 14

All Connecticut physicians are welcome to Join Connecticut State Medical Society on Friday, Sept. 14 to complete all five mandatory Continuing Medical Education courses for license renewal: cultural competency, sexual assault intervention and prevention; domestic violence; infectious disease; risk management: medical liability loss prevention. Courses will be held at the Mystic Marriott Hotel and Spa from 10 a.m.-5 p.m. It is the first day of the 220th CSMS Annual Meeting and House of Delegates, and will be followed by a cocktail reception and buffet dinner with keynote speaker Dr. Bob Arnot, international humanitarian and journalist. Additional events will be held the following day, including a vendor exhibition, education programs, award presentations, and luncheon presentations. For more information or to register online, go to


Hartford Hospital Programs Designated Cigna Centers of Excellence

Hip and knee replacement, spinal fusion, and bariatric surgery

Cigna has designated several Hartford Hospital programs as Centers of Excellence for Safeway employees and their dependents. “Centers of excellence” (COE) is a term Cigna uses for recognizing the highest performing medical facilities that maximize outcomes and cost efficiency, and they recommend them to their customers. The Hartford Hospital programs designated as COE are hip and knee replacement, spinal fusion, and bariatric surgery.


July Finances: Discharges and Outpatient Revenues Up

In the month of July, discharges were above budget by .7%, which exceeded last year’s figure by 1.8%. Outpatient revenues in the month were greater than budget by 1.1% thanks to Radiology, the Eye Center and Radiation Oncology. Year to date through June, inpatient discharges are greater than last year’s by 1.1%. Outpatient revenues are approximately 3.0% greater than budgeted.


Flu Shots Required This Year

One of our core values is safety, which is why Hartford Hospital and all Hartford HealthCare organizations have instituted universal influenza prevention for the coming flu season. It means that all staff members (employees, students, licensed independent practitioners, volunteers and vendors) are required to get a flu shot unless they are approved for a medical or religious exemption. Licensed independent practitioners who come on the premises (with any type of staff privilege) must receive the influenza vaccine. Practitioners without approved exemptions who fail to get a flu shot by Dec. 1 will have their privileges suspended. This program has the full support of the Medical Staff Leadership. Free flu shots will be available after Oct. 23 in Occupational Health, which is open from 7 a.m. to 5 p.m., Monday through Friday. There will be further information in October listing other times and locations for flu shots. After getting the shot, those receiving the vaccine at Hartford Hospital will receive the I.D. badge tags that describe the wearer’s vaccination status. (Exempted staff members will have to wear a mask during flu season in any area where they might encounter patients.) Those who receive the vaccine at a location other than Hartford Hospital should bring documentation to the Medical Staff Office. Documentation should include your name, date of birth, the date of vaccination, the vaccine product used, location and clinician who provided the vaccine. The Medical Staff Office will provide the I.D. badge tags. Those seeking medical or religious exemptions must submit forms by Oct. 1. Those forms are available on the Hartford Hospital Intranet homepage under “Employee Flu Prevention Program.” For questions and further information, please email:


Get The Word Out About Your Events and Speakers

Email to

If you are hosting any guest speakers or visiting dignitaries to Hartford Hospital, please let us know as soon as you can so that we can share the information. Email us at, and the information will go to all the editors in the Planning and Marketing Department. Please be sure to include all pertinent details, such as the guest’s name, title, date and time of visit, location of gathering, and topic of presentation (if applicable).


Dr. Daniel Schwartz To Perform Labor Day Concert With Hartford Pops

Dr. Daniel S. Schwartz, Emergency Medicine/Wound Healing and Hyperbaric Center, will perform in a free concert with the Hartford Pops Band on Monday, Sept. 3 (Labor Day) at 5 p.m. in Blue Back Square, W. Hartford. The Hartford Pops is a group of about 35 professional musicians.


Innovative and Complex Care

New Cardiac Surgery Outpatient Suite Opens in MOB

The Henry Low Heart Center Department of Cardiac Surgery integrated into a new suite in the Medical Office Building in mid-June. The suite, #919, is designed specifically for the comfort and convenience of patients. The space, appointed in keeping with Hartford Hospital design standards, offers multiple exam rooms, a consult and education room with state-of-the-art AV technology, and a calm and relaxing waiting room. All cardiothoracic surgeons can be reached through the new office number, 860-696-5520.


Research and Academics


28th Annual Winter Medical Meeting, "Trends in Medicine and Surgery," Scheduled for March 9-16, 2013

Vail, Colorado

Trends in Medicine and Surgery (TMS), an annual winter medical meeting sponsored by the Department of Medical Education of Hartford Hospital, has announced the dates and location for its 28th consecutive meeting. The conference will be held at the Vail Cascade Resort and Spa, from March 9-16, 2013. The meeting is open to all medical, nursing and allied health staff. CME credits will be awarded. $350 for physicians, $100 for fellows, residents and allied health personnel and $150 for nurses, plus cost of air and hotel. For further information, please contact Val Riccio in the Department of Medical Education at, or Mary Moretti at Huntington-Hay Travel at 860-678-1407or


Hartford Hospital Study was 2011’s Fifth Most Cited Article in High Impact Urogynecology Journal

International Urogynecology Journal

20(2):223-8, 2009 Feb

The research program is pleased to note that a Hartford Hospital research paper "A comparison of costs for abdominal, laparoscopic, and robot-assisted sacral colpopexy" by Dr. Minita Patel, Dr. David O’Sullivan and Dr. Paul Tulikangas (Ob/Gyn/Urogynecology) was the fifth most cited article in 2011 for the publication with the highest impact factor in the field of urogynecology (International Urogynecology Journal; 20(2):223-8, 2009 Feb). The list of the top 10 most cited IUJ articles was released in July by the journal’s editorial board. The study was generously supported by the Hartford Hospital Medical Staff.

Care Coordination

Sleep Disorder Center Moves To Wethersfield

Come to the ribbon cutting, Sept. 19

1260 Silas Deane Highway, Wethersfield

The Hartford Hospital Sleep Disorder Center has moved from C-11in the hospital to 1260 Silas Deane Highway in Wethersfield. The new four-bed sleep center and six-bed session space is designed to provide comprehensive services to patients with sleep disorders in a convenient setting. Please join us for a ribbon cutting ceremony to celebrate the opening of the new center at on Wednesday, Sept. 19 from 4:30-6 p.m. There will be remarks, refreshments, and tours.

Operational Update

Organ Donation Table in Lobby

August 22

10 a.m.-4 p.m.

There will be an information table in the main lobby on Wednesday, August 22 from 10 a.m.-4 p.m. to educate staff and the public about the importance of minorities registering to be organ donors. Stop by the table to talk with Vicie Brooks, community liaison nurse, and other staff members who are registered donors, and sign up to be a donor yourself.


Dr. Justin Lundbye Becomes Chief of Cardiology at HOCC

Dr. Justin Lundbye left Hartford Hospital to become chief of Cardiology at the Hospital of Central Connecticut in New Britain on Aug. 3. His phone number at HOCC is 860-224-5274, and his email is His former assistant at HH, Kathryn Kircher, remains here and is available at 860-545-4398 for further questions.


Golf Tournament to Benefit Helen & Harry Gray Cancer Center

Pequabuck Golf Club in Terryville

August 25

The 2nd annual Wayne Levesque Memorial Golf Tournament will be held this Saturday, Aug. 25 at Pequabuck Golf Club in Terryville to benefit The Helen & Harry Gray Cancer Center. Registration is at 12:30 p.m. and Tee Time is 1:30 p.m. Cost is $150 per player (includes: golf, beverages on course, practice greens, tournament contests, dinner at 5 p.m.) Cost for dinner only is $50. Wayne Levesque was 42 when he died in April of 2011 after a three-year battle with cancer. He had been treated by oncologist Dr. Jeffrey Kamradt.Proceeds from the tournament will be for the benefit and support of patients receiving infusion therapy. The space will be refurbished, to include new furniture and equipment as well as a new mixing area for infusion therapy treatments. This is the area where Levesque was treated, and where his picture and plaque are now hanging. For more information, contact Al at 203-947-2765, Glenn at 860-798-0577or Bob at 860-280-5719.


Medical Groups Step Up in Support of the Black & Red

Jefferson Radiology, Connecticut Multispecialty Group and Connecticut GI Become Sponsors

Under the leadership of Dr. Patricia Sheiner as chair of the Black & Red 2013 Medical Staff Advisory Committee, medical groups are stepping up as early sponsors for the gala, which will be held on January 5, 2013 featuring Earth, Wind & Fire. The groups participating to-date include: Producer sponsor, $20,000, Jefferson Radiology; and Director sponsors, $10,000, Connecticut Multispecialty Group and Connecticut GI. To further distinguish the 2013 Black & Red as the preeminent charitable event in the region, plans are being explored with FoxCT for a one-hour live broadcast as guests enter the gala, devoted to building awareness of organ donation. Funds raised through the gala will be used to refurbish the Outpatient Transplant Center. For more information and to support the gala, please contact Carla Burgess at 860-545-1932 or


23rd Annual Auxiliary Golf Tournament to Benefit Epilepsy Center

Tumble Brook Country Club in Bloomfield

Sept. 10

The 23rd Annual Hartford Hospital Auxiliary Golf Tournament will be held September 10 at the Tumble Brook Country Club in Bloomfield. Proceeds will benefit the hospital’s Epilepsy Center. For more information, contact Shelli Sigel, 860-490-3062 or Lori Flaks, 917-748-0531.

Library Resources Expand to Include Psychiatry and Drought

Point of Care Tools

UpToDate - one of the "Point of Care Tools" on the Library Intranet site, now has Psychiatry as one of its topics. You can use this link to take a quick look. If you would like to access UpToDate from the library site go to this link. It is listed under "Point of Care Tools" on the left hand side of the site. From the UpToDate link go to the "What's New" Tab and you will see the link to "What's New in Psychiatry." UpToDate is a data base that is only accessible from within the hospital environment. It is not accessible from the HH Portal. A "Drought" resource has been added to the Library Intranet site under the category "Featured Resources;" after clicking on this category "Click" on "Drought Information Center" to access this resource. You can also go directly to this link. If you have any questions about these resources call/email Sheila Hayes at 860-972-2416 or

HH In the News

"Health Care Matters" Radio Show Featured President of AHA

This morning, Hartford HealthCare president and CEO Elliot Joseph and Hartford Hospital director of Media Relations Rebecca Stewart were joined by Rich Umdenstock, president and CEO of the American Hospital Association, on “HealthCare Matters,” Hartford HealthCare's monthly radio show on WTIC News Talk 1080 (AM). “HealthCare Matters” furthers the conversation about health care and health care reform. For more information, go to:


In the HHC System

HCC may cut ties with pair of health insurers

New Britain herald, Aug. 7

The Hospital of Central Connecticut, in a letter to area business owners, is warning employers it may soon sever its relationship with insurance companies United HealthCare and Oxford Health Plans. In the letter sent out this week to business leaders, Clarence J. Silvia, president and CEO of the hospital, said: “Unless United changes course and we can jointly negotiate a contract, Hartford Hospital and The Hospital of Central Connecticut will be out-of-network with all United and Oxford commercial plans on October 28, 2012. Health systems and insurance companies negotiate new contracts all the time, and most of the time these negotiations are settled without controversy. Unfortunately, not all negotiations go smoothly, and this year we received a termination notice from United.” “United Healthcare has always been focused on renewing its contract with Hartford HealthCare, which is why we extended our original contract to October 28 to allow more time for our negotiations,” said spokesman Ben Goldstein. “It is unfortunate that rather than focusing on negotiations, Hartford HealthCare instead elected to create concern among employers about a possible termination given three months still remain to reach a new agreement. United Healthcare is keeping its focus on establishing a new contract before October 28.”


The Latest Mammogram Controversy: Density

The Wall Street Journal, Aug. 6

In studies of thousands of patients, Thomas Kolb, a New York radiologist who specializes in breast-cancer detection, showed that mammograms missed 60% of cancers in women with the densest breast tissue that were found on ultrasound. Dr. Jean Weigert, a radiologist at Hospital of Central Connecticut and an executive with the Radiological Society of Connecticut, lobbied against the notification bill there on the grounds that it would increase costs and anxiety without much benefit. But once it passed, in 2009, she was impressed with its impact. Pooling data on 78,000 women in six different practices, Dr. Weigert found that about half of the women, or 8,651 patients, with dense breast tissue went on to have ultrasounds which found 28 cancers that weren't visible on mammograms. "We are definitely finding more cancers, most of them at very early stages," says Dr. Weigert. Connecticut, the first state to pass a notification bill, also requires insurers to pay for ultrasounds for women with dense breasts. According to Dr. Weigert's analysis, the additional screening for those 8,652 women cost $2.15 million, or $110,000 for each additional cancer found. Finding cancers early saves many times that amount compared with the cost of late-stage cancer treatment, she notes.


High Readmission Rates Force Hospitals To Forfeit Medicare Funds

Hartford Courant, Aug. 13

Twenty-three Connecticut hospitals will forfeit Medicare funds in the next year under a new federal policy that penalizes hospitals with significant numbers of patients who are readmitted within a month of discharge. Four of the 23 hospitals will lose the maximum amount allowed under the federal policy: 1 percent of their base Medicare reimbursements. They are the Hospital of St. Raphael in New Haven, Griffin Hospital in Derby, Masonic Home and Hospital in Wallingford, and MidState Medical Center in Meriden. Three others will lose close to the maximum amount: Yale-New Haven Hospital, Bristol Hospital and St. Vincent's Medical Center in Bridgeport. Eight of the state's 31 hospitals, including Hartford Hospital, Middlesex Hospital, Windham Community Memorial Hospital and Backus Hospital, will face no penalty. The 23 Connecticut hospitals are among more than 2,200 nationwide that will be penalized by the federal government, starting in October, under provisions in the 2010 federal health care law. A total of 278 hospitals nationally will lose the maximum amount allowed; others will lose fractions of 1 percent of their Medicare funding.


Hospital Of Central Connecticut, New Britain EMS Partner For Training

Hartford Courant, Aug. 10

Five students in the New Britain Emergency Medical Services Academy are getting hands-on training and guidance from experienced healthcare professionals at The Hospital of Central Connecticut (HOCC). As part of the new partnership, students come to the hospital for a three-month clinical internship after completing 690 hours of classroom instruction.

Health Care News In the Region

Children’s Med eyes regional expansion

Hartford Business Journal, Aug. 6

Martin Gavin, CCMC's chief executive officer, has ambitions to turn Connecticut Children's Medical Center into a regional hub for health care. The 187-bed hospital's recent partnership with Springfield's Shriners Hospital for Children was the medical center's first attempt to extend its brand beyond the Nutmeg State's borders. But that move, says Gavin, was just the start of an aggressive five-year strategic plan, in which the hospital will invest up to $100 million in new technology, infrastructure, research, and services to expand its footprint and position itself as the go-to provider of children's medical care. There are also plans to build a new primary care center in Hartford by the end of 2013. The medical center has quietly expanded to 17 locations around the state over the years. That expansion has included small practices and specialty care hospitals. Gavin said they also plan to invest $7 million to expand their research capabilities, including finding new partnership opportunities with the UConn Health Center and Jackson Laboratory on genomics research relevant to pediatric diseases. And as part of that effort, Connecticut Children's is changing its vision statement from being an institution that provides the best health care for children to trying to make "children in Connecticut the healthiest in the country."


Jackson Lab's Progress At UConn 'On Track,' Officials Say

Hartford Courant, Aug. 3

Last fall, when Gov. Dannel P. Malloy announced his intention to have Jackson Laboratory build a genetics research lab on the University of Connecticut Health Center campus, the proposal moved swiftly, despite objections from some elected officials. Nearly a year later, the pace on the project itself hasn't slowed and officials say they expect the Jackson Laboratory for Genomic Medicine to be up and running on schedule, by late 2014. The Connecticut facility will be an expansion for Jackson, which is based in Bar Harbor, Maine. "Things are 100 percent on track," said Frank Torti, UConn Health Center's new vice president of health affairs. "That is not a trivial statement: That has been a real challenge." By 2020, Jackson Laboratory in Connecticut will employ 300 people, including at least 90 senior scientists. By 2030, it will employ 600 people.


CT Children’s launches Down syndrome program

Hartford Business Journal, Aug. 14

Hartford's Connecticut Children's Medical Center is launching a new Comprehensive Down Syndrome Program (CDSP) that aims to facilitate a coordinated and integrated system of care for children with Down syndrome from birth to 18 years of age. The program is being run as a collaborative effort with the Connecticut Down Syndrome Congress. Services offered for children with Down syndrome will include consultative evaluation; care coordination; referrals to Connecticut Children's sub-specialists; support services for children with Down syndrome, their families and caregivers; and transitional assistance to provide continuity of care as patients reach adulthood.

Coming Events

August 21 (Tuesday)

Medical Staff “Chef to Farm” Dinner

Rosedale Farms, Simsbury

6-11 p.m. Cost is $130 per person. To register, visit:


August 25 (Saturday)

10th Annual Skip McDermott Memorial Golf Tournament to benefit Hartford Hospital’s Transplant Program

Blue Box Run Golf Course, Avon

Includes golf, lunch and dinner.
$125 per golfer, $600 w/4 golfers, $350 w/2 golfers and $40 for dinner only.
Tom Arcari; 860-688-3417.


August 29 (Wednesday)

Clinical Ethics Rounds - "When Moral Obligations Compete"

Gilman Auditorium, 11:30 a.m.-12:30 p.m.

All physicians, nurses, social workers, pastoral care, case coordinators, therapists, and all health care professionals invited. Lunch provided. CMEs and CEUs for physicians, nurses, and social workers.

Sept. 10 (Monday)

23rd Annual Hartford Hospital Auxiliary Golf Tournament

Tumble Brook Country Club, Bloomfield

The 23rd Annual Hartford Hospital Auxiliary Golf Tournament will be held September 10 at the Tumble Brook Country Club in Bloomfield. Proceeds will benefit the hospital’s Epilepsy Center. For more information, contact Shelli Sigel, 860-490-3062 or Lori Flaks, 917-748-0531.


For more coming events, click here.

Hot Topics in Healthcare

Obama Administration Issues New Rules To Cut Red Tape For Doctors And Hospitals, Saving Up To $9 Billion, Aug. 7

Health and Human Services (HHS) Secretary Kathleen Sebelius announced today the release of a new rule that will cut red tape for doctors, hospitals, and health plans. In combination with a previously issued regulation, the rule will save up to $9 billion over the next ten years. The regulation adopts operating rules for making health care claim payments electronically and describing adjustments to claim payments. “These new rules will cut red tape, save money and ensure doctors spend more time seeing patients and less time filling out forms,” said Secretary Sebelius. Studies have found that the average physician spends three weeks a year on billing and insurance related tasks, and, in a physician’s office, two-thirds of a full-time employee per physician is necessary to conduct these tasks. Many physician practices and hospitals receive and deposit paper checks, and manually post and reconcile the health care claim payments in their accounting systems. By receiving payments electronically and automating the posting of the payments, a physician practice and hospital’s administrative time and costs can be decreased.


The Growing Role of Emergency Departments in Hospital Admissions

NEJM, Aug. 2

Growing use of U.S. emergency departments (EDs), cited as a key contributor to rising health care costs, has become a leading target of health care reform. ED visit rates increased by more than a third between 1997 and 2007, and EDs are increasingly the safety net for underserved patients, particularly adult Medicaid beneficiaries. Although much attention has been paid to increasing ED use, the ED's changing role in our health care system has been less thoroughly examined. EDs serve as a hub for prehospital emergency medical systems, an acute diagnostic and treatment center, a primary safety net, and a 24/7 portal for rapid inpatient admission. Approximately a quarter of all acute care outpatient visits in the United States occur in EDs, a proportion that has been growing since 2001. We examined the proportion of hospital admissions that come through the ED, hypothesizing that use of the ED as the admission portal had increased across conditions.


Cents and Sensitivity — Teaching Physicians to Think about Costs

NEJM, July 12

Imagine your first medicine rotation. You present a patient admitted overnight with cough, fever, and an infiltrate on chest x-ray. After detailing a history and physical, you conclude, “This is a 70-year-old man with community-acquired pneumonia.” Dead silence. “Perhaps,” the attending finally says. “But what else could this be?” Your face reddens. “Pulmonary embolism,” you say. The resident nods. “Heart failure.” Now you're talking. “Churg–Strauss,” you add. “The patient does have a history of asthma.” The attending smiles. “How might you investigate these other possibilities?” he asks. Next thing you know, the patient's lined up for a chest CT, lower extremity Dopplers, echo, and a rheum panel. You get honors. And so it begins. Our profession has traditionally rewarded the broadest differential diagnosis and a patient care approach that uses resources as though they were unlimited. Good care, we believe, cannot be codified in dollar signs. But with health care costs threatening to bankrupt our country, the financial implications of medical decision making have become part of the national conversation.

Voices Of Our Patients

Kudos To Dr. Kirk Watson, The Hand Center and the Ortho Staff

To whom it may concern:

I would like you and the staff of the Orthopedics unit (Conklin Building, 6th Floor) to know that their skill, dedication and kindness during my stay following hand surgery in June were not only appreciated but were critical in my recovery.

I had come to HH for outpatient surgery but, due to the seriousness of the infection I was being treated for, was admitted instead of being sent home. Throughout my stay, the nurses, aides, and ALL other hospital staff were attentive to my medication, wound care and other medical needs.
But they also took the time to speak with me on a personal level, ask about my job and family, and shared stories about their own lives, which left me feeling connected and reassured.

One young aide, also a nursing student, even helped me troubleshoot to set up my Internet connection via your WiFi service, so that I could work from my room -- a small act of kindness that made a huge difference in my peace of mind.

I could go on, but I’m due back at work in my art studio, happy and productive, thanks to the tremendous skill of Dr. Kirk Watson and his colleagues from the Hand Center, AND the care I received while at Hartford Hospital.

I owe all the staff there on the Orthopedics floor where I stayed my heartfelt gratitude, and I hope you will pass this on to them as well as to your hospital administration.

Many thanks and may God bless you in your work.

Wendy West


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.