January 25, 2012

News From ACFAS

San Antonio Attendance Soaring
Attendance for the March 1-4 Annual Scientific Conference is on a pace to exceed all previous conferences, including those held in Las Vegas. But there’s still room for you; register today at the web link below!
Share Facebook  LinkedIn  Twitter  | Web Link
ACFAS 2012 Hotel Rooms Filling Fast
If you haven't yet made your hotel reservation for the Annual Scientific Conference in San Antonio on March 1-4, be sure to book today, space is limited.

To book your room at the specially negotiated rates exclusively for conference attendees, email

For more information on this year's conference in San Antonio, visit the web link below.
Share Facebook  LinkedIn  Twitter  | Web Link
Privileging Advisors Team Organizes
The ACFAS Credentialing and Privileging Advisors Team (CPAT) met for the first time last weekend in Orlando, Florida, to learn the latest developments in the field from a credentialing/medical staff consultant and an attorney who specializes in privileging for both hospitals and physicians. All ten members of the the CPAT adivsory team have served on hospital governing or privileging committees. The team then analyzed actual case studies of ACFAS members who faced privileging obstacles.

After the March 1-4 Annual Scientific Conference, ACFAS members who are encountering credentialing or privileging challenges can be assigned to a peer advisor who will help step them through the process. Watch this column and the ACFAS Update newsletter for more details.
Share Facebook  LinkedIn  Twitter 

Legal Briefs

Physicians Subject to Professional Action From Complaints Not Related to Care
A federal court has found that physicians may be subjected to professional review actions stemming from complaints that do not directly relate to quality of patient care. Claims brought against a Florida hospital and medical staff members by an orthopaedic surgeon who was the subject of a professional review action lacked merit or were barred by the Health Care Quality Improvement Act (HCQI), Pierson v. Orlando Regional Healthcare Systems. The surgeon was involved in medical staff peer review action that was initiated in response to complaints lodged by colleagues against him.

The appeals court noted that complaints focused on the surgeon’s practices in scheduling and performing surgeries and that they did not raise patient care issues directly. It also reviewed the course of the professional review action, which saw him removed from the trauma and emergency call list and which resulted in a recommendation by an appeals panel that Pierson be given an opportunity to correct identified deficiencies. The hospital alleged that the surgeon “refused to recognize any validity to the concerns expressed and refused to modify any of the practices.” The hospital sent notice of his removal from trauma and call lists to the National Practitioner Data Bank. The court affirmed that the hospital and medical staff had immunity because they were conducting professional review actions in good faith.

The investigation into the surgeon’s surgical practices noted four areas of concern: excessive surgical length; inappropriate scheduling of surgical time; delay in dictating operative notes; and elective cases being performed as urgent or semi-urgent. At no time were his clinical privileges affected, and he was reappointed to the active medical staff in 1998, 2000, and 2002.

From the article of the same title
BNA Health Care Policy Report (01/18/12)
Share Facebook  LinkedIn  Twitter  | Web Link - Publication Homepage: Link to Full Text Unavailable

Foot and Ankle Surgery

Effect of Multilayer High-Compression Bandaging on Ankle Range of Motion and Oxygen Cost of Walking
Researchers carried out a study to assess the impact of multilayer high-compression bandaging on ankle range of motion, oxygen consumption, and subjective walking ability in healthy subjects, using a sample of 22 volunteers. Among the intervention methods used were treadmill-walking at self-selected speed with and without multilayer high-compression bandaging selected at random. A 4 percent decrease in total ankle range of motion was observed with compression, while no change in oxygen cost of walking was seen. Fewer than 50 percent of the subjects reported a negative effect on walking-shoe comfort or walking distance.

From the article of the same title
Phlebology (02/01/2012) Vol. 27, No. 1, P. 5 Roaldsen, K.S.; Elfving, B.; Stanghelle, J.K.; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Examining Neuromuscular Control During Landings on a Supinating Platform in Persons With and Without Ankle Instability
Researchers evaluated preparatory and reactive neuromuscular control when landing on a custom-designed ankle supinating device in individuals with ankle instability (AI), individuals with a history of lateral ankle sprains without instability (LAS), and uninjured controls (CON). Forty-five participants (15 per group) were asked to land on a device built to simulate the mechanism of a lateral ankle sprain (supination) while kinematics and muscle activity of the lower extremity were monitored. The AI group displayed significantly increased preparatory (P = .01) and reactive (P = .02) peroneal activation, while the LAS group demonstrated a trend toward increased preparatory tibialis anterior muscle activation (P = .07), leading to a decreased plantar flexion of the ankle at landing.

The research suggests that individuals with AI can increase peroneal activation when necessary to dynamically stabilize the ankle, indicating the potential for training/rehabilitation. Further, the LAS group may deploy a different control strategy after injury to protect the ankle from subsequent sprains, which deserves investigation during activities of daily living. A greater understanding of these strategies will lead to the development of more appropriate treatment paradigms after injury to minimize the incidence of instability, said the researchers.

From the article of the same title
American Journal of Sports Medicine (01/01/12) Vol. 40, No. 1, P. 193 Gutierrez, Gregory M. ; Knight, Christopher A. ; Swanik, Charles B.; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Use of the Reamer-Irrigator-Aspirator Technique to Obtain Autograft for Ankle and Hindfoot Arthrodesis
Researchers assessed using the reamer-irrigator-aspirator system to facilitate autograft for ankle and hindfoot arthrodesis, using the intramedullary canal as a harvesting site for bone graft material. Twenty-eight patients undergoing 30 arthrodesis procedures on the hindfoot had an average of 48 cubic centimeters of bone harvested locally from the hindfoot or the tibial shaft by antegrade or retrograde reaming. None of the patients suffered a fracture of the calcaneum, talus, or tibia. No morbidity was observed, with the exception of a single complication when the reamer breached the medial tibial cortex, and this healed without incident.

From the article of the same title
Journal of Bone and Joint Surgery - British Volume (01/01/12) Vol. 94-B, No. 1, P. 75 Herscovici Jr., D.; Scaduto, J.M.
Share Facebook  LinkedIn  Twitter  | Web Link

Practice Management

Doctors' Money Mistakes
Many physicians are making novice-type errors in running their own businesses, with American Health Network's Jeffrey Meltzer observing that doctors are poor at business because they "tend to be so engrossed in the medical part." Among the business challenges doctors must contend with are contracting reimbursement from both Medicare and private insurers and bewilderment concerning new health reform legislation. Sometimes the difficulty stems from bad financial decisions, such as young physicians leaving residencies having racked up school debt, yet continuing to spend lavishly; another major mistake is not asking for advice and ignoring the advice given when it is asked for. Making risky investments in things such as radiology centers and expensive equipment is another costly error, but more doctors are starting to concede their lack of business savvy and seek help from financial advisers, according to experts.

From the article of the same title
CNNMoney (01/16/12) Kavilanz, Parija
Share Facebook  LinkedIn  Twitter  | Web Link

Small Medical Practices Greatly at Risk for Data Breaches
Small medical practices are frequent targets of cybercriminals because they lack sophisticated security measures, use outdated technology, and overlook basic safeguards. To correct these problems, managing director of Kroll Fraud Solution's Cyber Security and Information Assurance unit Jason Straight recommends that the practices create a culture of data security that governs the behaviors of all practice members, using continuous training and enforcement of existing policies. A second recommendation is to establish an active incident response plan and team that is involved in day-to-day operations. Small practices should include all staffers and possibly a third-party contractor on the team, with the contractor helping to develop the response plan and offering aid if a breach transpires. Straight's third piece of advice is for the practice to put a document retention policy in place, and he notes that many organizations retain more data than necessary because of the ease of storing data within an electronic medical record system.

From the article of the same title
American Medical News (01/16/12) Dolan, Pamela Lewis
Share Facebook  LinkedIn  Twitter  | Web Link

Telemedicine as Talent Strategy
For years, hospitals and other health providers have been testing telemedicine as an alternative to office-based visits, but it is only recently that it has gone significantly beyond experimental applications; the use of telemedicine systems has always been hindered by difficulties that include whether health plans would compensate for them and whether doctors would oppose them. MissionPoint Health Partners CEO Jason Dinger believes such obstacles have been overcome with the rollout of a new solution that integrates high-definition television, voice technology, and the ability to remotely operate sophisticated instruments with the help of an onsite nurse or other midlevel practitioner. The HD television functions as a monitor through which all communication is facilitated, with the onscreen physician instructing the assistant on procedures while the assistant operates the equipment for the doctor. "We've satisfied ourselves and our patients that you can have a very useful clinical interaction through this system," says cardiologist Don Chomsky at Saint Thomas Heart in Nashville.

From the article of the same title
HealthLeaders Media (01/10/12) Betbeze, Philip
Share Facebook  LinkedIn  Twitter  | Web Link

Health Policy and Reimbursement

MedPAC Recommends Small Increase In Payments for Ambulatory Surgical Centers
The Medicare Payment Advisory Commission has recommended that Congress raise Medicare reimbursements for ambulatory surgical centers (ASCs) by 0.5 percent in 2013 but that the ASCs be required to submit cost data to the Centers for Medicare & Medicaid Services. The commissioners also approved a second recommendation to Congress that it require implementation of a value-based purchasing program for ASCs.

From the article of the same title
BNA Health Care Policy Report (01/16/12) Yochelson, Mindy
Share Facebook  LinkedIn  Twitter  | Web Link - Publication Homepage: Link to Full Text Unavailable

Medicare Names 73 Innovation Advisers
The Centers for Medicare and Medicaid Services (CMS) has named an initial group of 73 innovation advisers to support the Center for Medicare and Medicaid Innovation, a key element of the Obama administration's healthcare reform strategy. The advisers will help the CMS Innovation Center test new models of care delivery in their local communities and share ideas that could be replicated elsewhere.

From the article of the same title
InformationWeek (01/06/2012) Versel, Neil
Share Facebook  LinkedIn  Twitter  | Web Link

Oklahoma Nonphysicians Can Determine Workers' Comp Cases
A rule allowing only MDs and DOs to serve as independent medical examiners in workers' compensation cases has been declared unconstitutional by the Oklahoma Supreme Court. The rule, enacted as part of an August 2011 workers' compensation law, prevented chiropractors and others from acting as qualified examiners or testifying as experts in such cases.

From the article of the same title
American Medical News (01/16/12) Gallegos, Alicia
Share Facebook  LinkedIn  Twitter  | Web Link

Medicine, Drugs and Devices

EHRs Linked to Errors, Harm, AMA Says
A new report on patient safety from the American Medical Association (AMA) warns that clinicians can introduce errors by copying and pasting patient data into electronic health records (EHRs), while also posing further potential of patient harm are poorly designed systems with difficult-to-use interfaces, data entry errors, and software configuration problems. Researchers expressed no favorable or unfavorable position on EHRs, according to consultant to the AMA David Classen. In spite of EHRs' disadvantages in patient care, they seem to be vital for quantifying the types of safety issues that the AMA report highlights, such as incorrect prescribing, misdiagnoses, and failure to act on abnormal test results. "Performance improvement in the future will be electronic, because the ability and the time and cost and resources to conduct such studies without EHRs will probably become prohibitive," Classen said.

From the article of the same title
InformationWeek (01/13/2012) Terry, Ken
Share Facebook  LinkedIn  Twitter  | Web Link

SRA Wins Tech Contract for Doc Database
SRA International has won a contract from the U.S. Department of Health and Human Services' Health Resources and Services Administration (HRSA) to support the National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB). The NPDB archives information about negative actions involving provider licensure, hospital privileges, and professional societies involving quality-of-care issues in addition to malpractice payments, and in November HRSA reopened its public-use physician data file, but with strictures concerning the use of its information. The HIPDB was designed to fight fraud in Medicare and Medicaid programs, and it collects data concerning licensure and certification actions and exclusions of providers from federal and state healthcare programs, along with "healthcare-related criminal convictions and civil judgments and other adjudicated actions or decisions as specified in regulation," according to a description of activities on the HIPDB website.

From the article of the same title
Modern Physician (01/09/12) Conn, Joseph
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Free Registration

U.S. to Force Drug Firms to Report Money Paid to Doctors
The federal government is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment. Under the new standards, if a company has just one product covered by Medicare or Medicaid, it will have to disclose all its payments to doctors other than its own employees. The data will be posted on a website, where it will be available to the public. Companies will be subject to a penalty up to $10,000 for each payment they fail to report. A company that knowingly fails to report payments will be subject to a penalty up to $100,000 for each violation, up to a total of $1 million a year.

The new requirements will take effect soon. Under the healthcare reform law, the administration was supposed to establish payment-reporting procedures by Oct. 1, 2011. The public will have until Feb. 17 to comment on the proposals. After considering the comments, Medicare officials will issue final rules with the force of law.

From the article of the same title
New York Times (01/16/12) Pear, Robert
Share Facebook  LinkedIn  Twitter  | Web Link

Copyright © 2012 American College of Foot and Ankle Surgeons

To change your email address, please click here. If you wish to unsubscribe click here.

Abstract News © Copyright 2012 INFORMATION, INC.
Powered by Information, Inc.