March 9, 2016 | | JFAS | Contact Us

News From ACFAS

Available Online Now: 2016 Annual Conference CME
Visit today to print your certificate of attendance/Continuing Medical Education (CME) credits via certificate of attendance, curriculum listing or both, whichever you need for your license or privileging.

To print your certificate, log into or the CME Transcripts website. Your username is your ACFAS member ID number, and your password is your ACFAS member ID number plus your first and last initial (lower case). You may also log in using the unique login and password you created.

If you have any questions regarding your online CME transcript, please contact Sheila Alegria or Maggie Hjelm in the ACFAS Education Department.
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Introducing…the Brand-New FootNotes
The marketing resource you trust to promote your practice and educate your patients just got a clean, fresh look! ACFAS’ FootNotes patient education newsletter has been redesigned to more closely align with the style of our other publications, but rest assured, it will still feature the timely articles and useful tips your patients count on each season.

Download the Spring 2016 issue from our Marketing Toolbox, customize it with your practice contact information and share it with your patients. With articles on common foot care myths and how to keep ankle injuries and bunionettes at bay, this latest edition has just what your patients need to put a little spring in their step!
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Congrats to Our Lucky Winners!
Went down to Austin for the great educational opportunity and came home a double winner! As if ACFAS 2016 couldn’t be more rewarding, several attendees won incredible prizes during drawings held each day in the ACFAS Quad booth. Congratulations to the following:

GoPro Hero4 Silver Bundle
Eric C. Palmquist, DPM, FACFAS

Apple Sport Watch
Matt Q. McCammon, DPM
Todd M. Chappell, DPM

AMEX Gift Cards
$200 – Bailey M. Griffin, DPM, AACFAS
$100 – Vivek N. Patel, DPM
$100 – Lady Paula J. DeJesus, DPM, AACFAS
$50 – Kyle E. Johnson, DPM, AACFAS
$50 – Raquel K. Sugino, DPM
$50 – Lisa G. Reinicke, DPM, FACFAS

ACFAS also congratulates David Waters, DPM, AACFAS, from Division 4, and David Kim, DPM, FACFAS, from Division 9, who each won an Apple iPad Mini 4 in the Division Presidents Council’s raffle held during their Divisions’ membership meetings. Visit for more on ACFAS Division activities.
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Foot and Ankle Surgery

A Robot Will Likely Assist in Your Future Surgery
A new robot developed at the University of Pittsburgh Medical Center could revolutionize surgery. Created by Dr. Umamaheswar Duvvuri, the technology is a snake-like robot that can make its way to any place in the body and cause less damage to soft tissue. Robots have long been proven to be successful in surgery. In 2008, studies showed that a surgical robot led to shorter hospital stays, faster recoveries and fewer complications. A Florida hospital in 2015 used a robot to perform remote surgery on patients. Skilled surgeons are still a necessity in the operating room, but robots are becoming increasingly popular as "assistants." They join the procedure tableside and may someday allow people with only basic medical knowledge to perform complex operations outside of a hospital setting. Surgical robotics are expected to double in worth to about $6.4 billion by 2020, according to Allied Market Research. These robots have their limitations, such as issues concerning large tumors, but they still provide a valuable tool for surgeons who want the best outcomes possible for their patients.

From the article of the same title
CIO (03/02/16) Mearian, Lucas
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Arthrodesis of the Ankle Using an Anterior Sliding Tibial Graft for Osteoarthritis Secondary to Osteonecrosis of the Talus
A recent study compared the results of vascularized and non-vascularized anterior sliding tibial grafts in the treatment of osteoarthritis (OA) of the ankle secondary to osteonecrosis of the talus. Twenty-seven patients were assessed. All patients underwent either vascularized or non-vascularized grafts. After 24 to 68 months, researchers used the Mazur and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores to measure endpoints. Both mean outcome scores increased significantly. The Mazur score jumped from 36.9 to 74.6 in the vascularized group. The AOFAS scale climbed from 49.6 to 80.1 in the same group. The non-vascularized group saw the mean Mazur score go from 35.5 to 65 and the mean AOFAS scale increase from 49.2 to 67.6. Complete fusion was achieved in 76 percent of the vascularized group but only in 40 percent of the non-vascularized group. The report concluded that vascularized sliding tibial grafts may be an effective option.

From the article of the same title
The Bone and Joint Journal (02/16) Kodama, N.; Takemura, Y.; Shioji, S.; et al.
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Rotational Dynamics of the Normal Distal Tibiofibular Joint with Weight-Bearing Computed Tomography
Little is known about the normal rotational dynamics of the distal tibiofibular joint in upright weight-bearing conditions. Researchers conducted a study to assess these dynamics on weight-bearing cone beam computed tomography (WBCT), under physiological conditions. Thirty-two patients received low-dose WBCT scans, and the normal intersubject and intrasubject variation in neutral position and changes in maximal internal and external rotation of the ankle were studied. Measurements included sagittal translation of the fibula, anterior and posterior widths of the distal tibiofibular syndesmosis, tibiofibular clear space (TFCS) and rotation of the fibula. The fibula was located anteriorly in the tibial incisura in 88 percent of patients. When rotated, mean anteroposterior motion was 1.5 mm and mean rotation of the fibula was three degrees. No significant change existed in TFCS between internal and external rotation. The researchers concluded that the internal control of the contralateral ankle seemed to be a better reference than the population-based normal values.

From the article of the same title
Foot & Ankle International (02/16) Lepojarvi, Sannamari; Niinimaki, Jaakko; Pakarinen, Harri; et al.
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Practice Management

3 Tips for Disciplining Staff
Disciplining bad behavior can be an uncomfortable proposition, but doing so is sometimes necessary. It can be a particularly effective tool in medical practices where rude receptionists and ill-tempered employees occasionally show up. Here are three tips for disciplining your staff members:
  1. Get out your employee handbook. Employees should know the handbook well. When dealing with an unruly staff member, it is important to "use it, enforce it and refer back to it," according to Dianna Graves of the St. Paul Eye Clinic.
  2. Seize teachable moments and be equitable. Provide discipline in the moment and refuse to let bad behavior slide. Make every disciplinary moment a teaching exercise and distribute punishment as equally as possible–do not pick favorites.
  3. Tap into staff members' motivation. Figure out what drives your employees. This information can be used to discipline them so that they become stronger performers on your team.
From the article of the same title
Fierce Practice Management (03/02/16) Cryts, Aine
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Protecting Your Practice and Patients from Cyberattacks
Healthcare data is among the most valuable commodities for hackers in 2016. What was once a risk only with lost and stolen devices is now a threat to practices and physicians alike. Malware, phishing scams and extortion have raised the cybercrime bar, and medical practices are at the heart of the issue. Cybercrime is a real threat that continues to grow, so practices must implement policies to combat the inevitable. The best solution is to take cybersecurity seriously and make it a high priority. The only way to properly defend your data is to use a long-term, carefully crafted plan involving risk assessments, new technologies and employee awareness. Two-factor authentication should become standard at your practice, as should intrusion detection and log systems, all of which must be monitored for unusual activity. And do not skimp on physical security either—new fences, locks, cameras and guards could prevent unauthorized assailants from extracting data from the inside. The most important change is the one within your practice. Your staff must be all-in on the plan and must be knowledgeable about the threats you face. Often, it will be members of your staff who point out irregularities that could lead to uncovering a breach.

From the article of the same title
Physicians Practice (03/04/16) Haugen, JoAnna
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Study Links Patient-Perceived Physician Empathy with Medical Care Satisfaction
Patient-perceived physician empathy improves outcomes and medical care satisfaction, according to a new study. Presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons, the study assessed patient-reported personal interaction with the physician and required participants to complete a health literacy test. Patients also answered questions about pain and depression. The results showed that 65 percent of patient satisfaction among 112 patients was attributed to physician empathy. This satisfaction was not changed by factors such as waiting time or time with the surgeon. Study leaders David Ring called the results "really powerful" and indicated that surgeons and residents should be coached to develop more effective empathy and communication strategies. Since value-based care and patient satisfaction are becoming the main drivers of the industry, learning these skills is now more important than ever.

From the article of the same title
News-Medical (03/02/16)
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Health Policy and Reimbursement

Burwell Unveils Industry Pledges on Electronic Health Records
The U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell announced that the Obama administration has received commitments from various healthcare companies to help improve the flow of electronic health records (EHRs). Physicians and healthcare organizations around the country have longed for EHR improvements, particularly regarding interoperability. The partnerships will now allow for easier access for both patients and physicians. Pledges came in from health IT developers that provide 90 percent of EHRs used by hospitals, as well as the five largest healthcare provider systems. The plan has three components: 1) companies pledge to make it easier for patients to access electronic data; 2) data sharing will be easier and will reduce bureaucratic impediments; and 3) systems will use the same "language" and be able to talk to each other. This will lead to both better care and more efficient services. HHS plans to check back in the fall to see how well the companies have lived up to their pledges.

From the article of the same title
The Hill (02/29/16) Sullivan, Peter
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CMS' Slavitt Affirms Physician Input into Feds' Value-Based Planning
Andy Slavitt, acting administrator for the Centers for Medicare and Medicaid Services, attended HIMSS16 and discussed making IT work better for doctors. "We need a user-centered approach to designing policy. The consumer is more mobile, more demanding than ever before," he said. Slavitt has collected feedback from providers and physicians who believe the government is not taking their frustrations with technology seriously. From this feedback, Slavitt outlined three conclusions: 1) physicians are frustrated by the lack of interoperability; 2) current regulations create a documentation burden that slows physicians; and 3) many physicians find electronic health record technology cumbersome. Slavitt said the hope is that the upcoming Medicare Access and CHIP Reauthorization Act will help physicians by bringing value-based care to practices every day. He also noted that leading vendors and health systems will begin collaborating to share data, give consumers access to data, use agreed-upon interoperability standards and not block the flow of information.

From the article of the same title
Healthcare Informatics (03/02/16) Leventhal, Rajiv
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ICD-10 Claim Denial Rate Remains Low Among Most Providers
ICD-10 claim denial rates are low, signaling that the change has not had a particularly negative effect. In the lead-up to ICD-10 implementation, experts warned that claims denials could rise as the industry settled into new codes. But the 1.6 percent denial rate, which encompasses 262 million claims, has not differed significantly since November. While the rate of denial has not increased, there is still a one in five chance that any given claim could be denied or delayed, which many experts view as too high.

From the article of the same title
RevCycle Intelligence (02/29/16) Gruessner, Vera
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Medicine, Drugs and Devices

3D Printers Are Revolutionizing Medicine
Future surgeons could use 3D printing to make operations safer, faster and more efficient than ever. 3D-printed models of organs, tumors and bones can educate patients and physicians and lend a hand in planning complex surgeries. These models can even be inserted into bodies as replacements. Many experts believe 3D printing will be the routine tool for surgical procedures in the future, and the lower cost associated with the process could make it a viable solution. In addition, the technology can help the medical device industry design and test new products. The novel methods are so new that research has not caught up with the trend, but anecdotal evidence tells a powerful story. Some surgeons have used 3D printing technology dozens of times for multiple procedures. As the field grows, surgeons will have even more ways to operate on their patients in the most efficient way possible.

From the article of the same title
Providence Journal (02/28/16) Sohn, Emily
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Report: Healthcare Cyberattacks Occur Almost Monthly
A recent poll revealed that 48 percent of healthcare IT and IT security practitioners experienced a breach involving compromised patient information in the past year. In addition, the average healthcare organization faces about one cyberattack per month, and only 33 percent rate their organization's cybersecurity posture as very effective. Despite widespread publicity, many organizations still do not have the tools in place to combat the increasingly common attacks. System failures, unsecured medical devices, identity thieves and compromised mobile devices were all cited as reasons for the troubles. Only 27 percent of organizations include medical devices in their cybersecurity strategies. This can compromise patient information and even put patients in danger.

From the article of the same title
Fierce HealthIT (03/02/16) Hall, Susan D.
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Surgery, Anesthesia No Longer Linked to Cognitive Impairment in Elderly
Researchers from the University of Southern Denmark have released a study that shows surgery and anesthesia in older adults does not negatively affect cognitive abilities. By analyzing more than 8,500 middle-aged and elderly Danish twins, the researchers were able to conclude that previous research indicating harm in elderly surgery was off-base. Postoperative cognitive dysfunction is normal in older patients for up to a few weeks, but there appears to be no long-term negative effects. Findings showed that twins who underwent major surgery had slightly lower scores when compared to counterparts who did not, but the difference was not statistically significant.

From the article of the same title (03/01/16) Lees, Kathleen
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Daniel C. Jupiter, PhD

Gregory P. Still, DPM, FACFAS

Jakob C. Thorud, DPM, MS, AACFAS

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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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