September 2, 2015 | | JFAS | Contact Us

News From ACFAS

Deadline Extended for Board Nomination Applications
The deadline for submitting applications to serve on the ACFAS Board of Directors has been extended to Sunday, September 13. If you are an ACFAS Fellow and believe you are qualified to serve on the board, submit your application now at or email it to Executive Director Chris Mahaffey.

Questions regarding eligibility criteria should be directed to Nominating Committee Chair Thomas Roukis, DPM, Ph.D., FACFAS via email or (608) 775-9673.

The Nominating Committee will announce recommended candidates to the membership no later than October 15, 2015. Candidate information and ballots will be emailed to all voting members no later than November 29, 2015. Electronic voting ends on December 29, 2015. New officers and directors take office during the ACFAS 2015 Annual Scientific Conference, February 11–14, 2016 in Austin, Texas.
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Austin, TX: A Jewel in the Violet Crown
Did you know that in the late 1800s, Austin, Texas was known as the City of the Violet Crown because of the distinct purple hue that often colored the hills at sunset? Come February, the Violet Crown will glow even more brilliantly thanks to ACFAS 2016. Set for February 11–14, this conference is expected to be bigger and better than ever with the stellar sessions, workshops and special events you’ve come to count on each year plus the superior educational opportunities you deserve.

Keep checking for the latest updates and get ready for a conference experience guaranteed to outshine all others!
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ICD-10 Tip of the Week
To avoid costly claim denials in your ICD-10 transition, remember to make note of the date of services. The date of service determines which code set you will use, not the billing date.

Claims for dates of service on and after Oct. 1, 2015, must be coded in ICD-10. If service was rendered prior to Oct. 1, 2015, the claim must be coded in ICD-9. For claims that span the transition date, refer to CMS for guidance.
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ACFAS e-Learning: Your Source for CME
Need a few CME hours to meet your requirements for continued licensure or privileging? Visit ACFAS’ e-Learning portal for a rich resource of opportunities to earn continuing education contact hours. Watch any of our monthly Clinical Sessions, successfully complete an exam, return it to ACFAS and you’re good to go!

You can also download our Surgical Techniques videos or purchase them on DVD. ACFAS releases free monthly podcasts as well to bring you up to speed on timely topics affecting the profession.

Why wait to earn CME when our e-Learning portal makes it easy and convenient for you to do so any time of the year? Visit today!
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Six Survey Participants Win Big
To thank those who participated in ACFAS’ Member Needs and Practice Economics Survey, the College randomly selected six participants to receive either an Apple Watch, complimentary registration to ACFAS 2016 or complimentary 2016 membership dues.

The six winners were:
  • Henry G. Bryant, III, DPM, FACFAS
  • Danielle N. Butto, DPM (Resident)
  • Tara L. Fussell, DPM, AACFAS
  • Philip E. Holmes, DPM, FACFAS
  • Jamie G. Hopkins, DPM, FACFAS
  • Kathryn A. Schramm, DPM, FACFAS
ACFAS thanks all survey participants for taking the time to share their thoughts. Your feedback will be used wisely over the next three years.
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Foot and Ankle Surgery

Complex Interventions for Preventing Diabetic Foot Ulceration
Ulceration of the feet can lead to amputation and is a major problem for people with diabetes mellitus. A recent study evaluated the effectiveness of complex interventions in preventing diabetic foot ulceration in patients. Researchers defined a complex intervention as "an integrated care approach, combining two or more prevention strategies on at least two different levels of care: the patient, the healthcare provider and/or the structure of healthcare." Six randomized controlled trials were found to meet the criteria for inclusion in the review. Three of the studies compared education-centered complex interventions with usual care or written instructions; little evidence of benefit was found. The other three studies compared the effect of more comprehensive complex interventions with usual care. One study found a significant cost reduction, another found a reduction of amputations and foot ulcers and the final study noted improvements in patient self-care. The researchers concluded no high-quality research evidence exists that evaluates complex interventions for preventing diabetic foot ulcers.

From the article of the same title
Cochrane Database of Systematic Reviews (08/15) Hoogeveen, RC; Dorresteijn, JA; Kriegsman, DM; et al.
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Long-Term Functional and Radiographic Outcomes in 243 Operated Ankle Fractures
Very few studies evaluate the long-term functional outcome of operatively treated ankle fractures. A recent study looked at 243 operated ankle fractures to analyze the long-term functional outcome and effect on the development of osteoarthritis. Significant differences were found between unimalleolar fractures and bimalleolar fractures for all outcomes, including American Academy of Orthopaedic Surgeons and American Orthopaedic Foot and Ankle Society scores, and dorsiflexion restriction, as did unimalleolar and trimalleolar. Fibular fractures with an additional posterior fragment were similar to isolated fibular fractures. No functional differences were found between bimalleolar and trimalleolar fractures. Isolated medial malleolar fractures achieved poor outcomes, and osteoarthritis primarily developed in trimalleolar fractures with a posterior fragment larger than five percent. The study showed that long-term functional outcome is strongly associated with presence of medial malleolar fractures, isolated or as part of bi- or trimalleolar fractures.

From the article of the same title
Journal of Foot and Ankle Research (08/25/2015) Verhage, S.M.; Schipper, I.B.; Hoogendoorn, J.M.
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Surgical Reconstruction of Metatarsal Type Preaxial Polydactyly Using an Amalgamating Osteotomy
Polydactyly of the foot is a common condition that often involves duplication of the metatarsal type preaxial polydactyly (MTPP). The MTPP is typically reconstructed by resection of the hypoplastic lateral ray, and the most commonly reported adverse result is residual hallux varus. Researchers have developed a novel technique for treating children with MTPP using an amalgamating osteotomy that retains the stable medial metatarsotarsal joint and eliminates residual hallux varus. Two children underwent an amalgamating osteotomy at the respective ages of 31 and 18 months. At follow-up, both patients displayed excellent functional results, and plain radiographs showed a well-aligned first ray with no abnormal growth or hallux varus. The amalgamating osteotomy is a viable surgical solution for children with MTPP.

From the article of the same title
Journal of Pediatric Orthopaedics (08/20/15) Boyle, Matthew J.; Hogue, Grant D.; Kasser, James R.
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Practice Management

4 Social Media Trends Your Practice May Have Missed
Physician practices in 2015 must focus on brand management more than ever. Social media is a critical tool to this end, and experts have selected four trends that will help your practice make a name in the digital age:
  • It does not take much time to reap benefits. More than 84 percent of marketers increase their traffic in as little as six hours per week. More than 66 percent gained new business leads. Almost 50 percent reduced their marketing expenses. Social media brand management is not a full-time job.
  • Giving patients a forum to post complaints can be good for business. Customer service is especially important if you have an online presence. Creating a complaints forum can be beneficial because a good response can carry equal or more weight than positive consumer engagement, according to a recent PricewaterhouseCoopers report.
  • Standing out is not as hard as you think. Many practices use social media; few do it well. Focus on distinguishing yourself and putting out a good social product. Focus on providing value and gaining respect.
  • "Friending" patients is not necessarily off-limits. It is generally considered unprofessional to engage in direct social networking discourse with patients, but new guidelines from the American College of Obstetricians and Gynecologists suggest that this should not be the case. "If the physician or healthcare provider trusts the relationships enough...we didn't feel like it was appropriate to really try to outlaw that," the guidelines stated.
From the article of the same title
Fierce Practice Management (08/25/15) Beaulieu-Volk, Debra
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Adjusting Your EHR to an ICD-10 Environment
The Oct. 1 2015 deadline for ICD-10 is fast approaching. Here are some tips from Ron Sterling, president of Silver Spring, Md.-based Sterling Solutions, for practices that want to thrive in the ICD-10 world:
  • Ensure staff are trained to make ICD-10 changes. Your staff must be fully trained prior to the deadline. They will be in an ICD-9 world one day and suddenly will occupy an ICD-10 world; this sudden change can only be withstood by proper and thorough training in advance.
  • Work closely with your electronic health record (EHR) vendor. Apply any recent software updates to your EHR after Oct. 1, and make sure your EHR is completely ICD-10 compatible. Keep up with your EHR vendors for advice.
  • Set up treatment plans within the EHR. Create more specific treatment plans within the EHR. Since ICD-10 has more codes, a higher level of detail is necessary to keep a patient healthy.
  • Work with other providers. Practices should plan ahead with other providers to get an idea of what their plans are after Oct. 1. This is important for prescriptions or referrals, as well as surgery dates. Planning ahead will prevent patients from experiencing critical delays pertaining to medicine and surgery.
  • Recode claims for ICD-10. Claims edits may be necessary if your EHR and practice management system are integrated. Assume that anything in process on Sept. 30 could require recoding to ICD-10.
From the article of the same title
Physicians Practice (08/24/15) Cryts, Aine
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Is a New Era of Patient Engagement Upon Us?
Established in 2005, the Electronic Medical Record Adoption Model (EMRAM) helps institutions work to complete eight stages (0-7) of technological improvement. Stage 7 means that an institution has achieved an environment where paper charts are no longer used. Getting to Stage 7 is not easy, but the EMRAM shows that in 2011, the number of acute care hospitals achieving Stage 5 or 6 increased by more than 80 percent while the number of hospitals occupying Stages 0, 1, 2 or 3 decreased. The Scottsdale Institute is a not-for-profit membership organization that supports its members in their journey to clinical integration through information technology. Thanks to the success of places like the Cleveland Clinic, the Scottsdale Institute has become a major player in the race to reach EMRAM Stage 7. The institute even created the SI Patient/Consumer Engagement Adoption Model, an assessment tool to help healthcare systems measure the effectiveness of engaging patients based on EMRAM. "Studies have shown that clinical outcomes and health improve, and costs are reduced, when patients are actively involved in managing their own health and well-being," the Scottsdale Institute reported recently. "Healthcare-provider organizations have lacked any clear consensus on practical steps to achieve that goal...only time will tell, but there's no doubt that this model is a step in the right direction."

From the article of the same title
Healthcare Informatics (08/19/15) Leventhal, Rajiv
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Health Policy and Reimbursement

Federal Appeals Court Affirms FTC's Power to Regulate Cybersecurity
A federal appeals court Aug. 24 affirmed the Federal Trade Commission's (FTC) power to regulate cybersecurity, which could have far-reaching effects on the healthcare industry. The lawsuit against Wyndham Worldwide Corp. alleges that Wyndham engaged in unfair cybersecurity practices that exposed consumer data to unnecessary risk and that the hotel chain's privacy policy was deceptive. The lawsuit came to trial following three hackings of Wyndham's computer systems in 2008 and 2009, with more than $10.6 million in fraudulent charges. A panel of judges stated that FTC has the authority to regulate cybersecurity under a law that prohibits deceptive acts affecting commerce. The news arrives as the healthcare industry experiences breaches with greater frequency than ever. Anthem and Premera Blue Cross are two examples of large companies that have suffered significant hacks. FTC does not get involved in too many healthcare breach cases, but Lisa Clark, a partner at Duane Morris in Philadelphia, says that this could change. "It seems that this decision really validates FTC in terms of its recent enforcement actions," Clark said. "It's been very active in this area, and I think this just means for healthcare providers, on top of HIPAA, they just have to be that much more vigilant."

From the article of the same title
Modern Healthcare (08/24/15) Schencker, Lisa
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House GOP Adds Healthcare Tax Bill to Fall Agenda
House GOP leaders will look to repeal some of the most controversial taxes under the Affordable Care Act later in the year. "We’re going to continue to focus on ObamaCare implementation, but we're also looking at a number of the tax provisions that need to be repealed," Rep. Kevin Brady said in an interview. Various provisions will be examined, including the repeal of the "Cadillac" tax on high-cost health plans. Brady said that other proposed changes will surround the tax treatment for health savings accounts and flexible spending accounts. President Barack Obama's administration has already expressed disdain toward the repeal of the Cadillac tax, despite some bipartisan support.

From the article of the same title
The Hill (08/24/15) Ferris, Sarah
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Stage 2 Meaningful Use an Ongoing Challenge
Stage 2 meaningful use has raised objections from critics who feel the requirements are too strenuous, but many eligible hospitals and providers now appear to be on track to attest by the conclusion of 2015. Meaningful Use is a set of criteria for the use of EHR systems to improve patient care by healthcare providers. Beginning in 2012, incentives were established along with penalties for failure to achieve standards by 2015. Hospitals and providers have waited to attest, either because they want to stretch the deadline for as long as possible or because the requirements are overly bureaucratic. "At times, it's kind of like trying to change a tire on a moving vehicle," says Thomas Thrower, chief information officer for the Austin Diagnostic Clinic. Thrower's organization is one of many in the final stages of preparing for attestation after spending copious amounts of time updating software and modifying workflows. While the Austin Diagnostic Clinic will attest this year, there are still questions about the necessity of such a complex overhaul of previously established systems. However, Thrower notes that most hospitals and providers are committed to the Stage 2 attestation process despite this.

From the article of the same title
Healthcare IT News (08/21/15) Noteboom, Michelle Ronan
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Medicine, Drugs and Devices

Disease-Modifying Drugs May Help RA Patients Achieve Drug-Free Remission
A new Swedish study has found that early treatment with disease-modifying antirheumatic drugs (DMARDs) can help patients with rheumatoid arthritis (RA) achieve remission. Patients are often treating with nonsteroidal anti-inflammatory drugs (NSAIDs), but DMARDs appear to be significantly more effective. Of 1,007 patients, 155 achieved sustained remission after the treatment. The key was early treatment. The study noted that "patients who are diagnosed and treated within a three-month window do best—before their joints have been damaged by their disease." In some cases, DMARD therapy is not effective, and patients must undergo a regimen of biological therapy to control their RA.

From the article of the same title
Healthline (08/24/2015) Boynes-Shuck, Ashley
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How mHealth Tools Advance Nationwide Telemedicine Adoption
The American Telemedicine Association (ATA) is holding the 2015 ATA Fall Forum in Washington, DC later this year. ATA president Reed Tuckson recently discussed what he hopes to see happen at the forum, at a time when telehealth continues to advance and gain traction nationwide. According to Tuckson, the ATA Fall Forum is "an opportunity for people to get a hands-on feel for where the field is today, what’s going on in the field and the implications of this as we go forward." The twice-a-year event will also discuss how mobile healthcare is being adopted rapidly across the country. "I think most of us would be overjoyed by the opportunity that this now brings for health to become much more central into the daily life of the consumer," Tuckson said. "Health is being brought much more central into the milieu of the many other different apps and patient-centric individual tools that this revolution is bringing."

From the article of the same title
mHealth Intelligence (08/25/15) Gruessner, Vera
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Vaccine Style Treatment for Rheumatoid Arthritis on the Way?
Researchers from the University of Queensland in Australia have designed a vaccine-style treatment that could soon treat patients with rheumatoid arthritis (RA). The treatment, which the researchers called immunotherapy, is designed for patients who have high-risk RA genes and specific RA antibodies. According to the study, there is a need for this treatment because current therapies only slow the progress of RA as opposed to actually treating it. The treatment works by teaching the patient's immune system to ignore a naturally occurring peptide. It is prepared by taking a sample of blood and extracting a particular type of immune cell called dendritic cells, which are then challenged with the peptide and an immune system modulator before being injected back into the patient. The method is currently not viable because of cost and efficiency, but study author Ranjeny Thomas says the future looks promising.

From the article of the same title
HCPLive (08/24/15) Lutz, Rachel
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

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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