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September 29, 2021 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

News From ACFAS


Renew to Reboot
October is the official kickoff of our annual membership renewal and a great time to refresh your memory about all the meaningful benefits that come with being an ACFAS member - like our robust education and professional development offerings, practice growth and management tools and our top-rated Annual Scientific Conference.

Planning for the 2022 Annual Scientific Conference in Austin is already underway and promises to be another exciting learning, social event and a "time to reboot!" But you need to renew to reboot! You can renew online or via mail or fax. Please reach out to the Membership Department at membership@acfas.org or visit the Member Center at acfas.org if you have any questions about your membership benefits.
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Catch the Next Surgical Management of the Active Patient
Register today to join us for our Surgical Management of the Active Patient course coming up November 6-7.

This two-day, interactive course is led by a faculty of skilled arthroscopy surgeons giving you the opportunity to learn and practice established and cutting-edge techniques in surgery for the foot and ankle as well as the latest techniques in management of the active patient. Highlights include Achilles tendon pathology, 1st MPJ pathology, jones fracture management and more! As an ACFAS course, the faculty to attendee ratio is purposely kept low to facilitate open interaction with the faculty.

Learn more about this course and register today at acfas.org/skills.
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Make Fall the Season for Foot Health with FootNotes
Head into fall with the newest issue of FootNotes! Give your patients more seasonal tips to keep their feet and ankles healthy as the weather cools down. This edition includes:
  • Ways to keep kids in the game for fall sports, how to treat any injuries including checking on old ones, proper footwear and checking fields before any games to make for a long, successful sports season.
  • Heading back to school without pain for kids and how to keep their feet in the best shape as they head into a new school year.
  • Making fall hikes as safe as possible including prep tips, how to spot injuries and things to bring with on each hike.
This issue of FootNotes can be used to help maximize your reach with patient education and marketing your practice however you want! Add your practice information to the customizable second page and keep copies in your office, post it to your practice website and share it on your social media accounts.

Visit acfas.org/Marketing to download the newest issue and access more free tools to help up your practice marketing game today.
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Foot and Ankle Surgery


Evaluation and Validation of the Dutch European Foot and Ankle Society (EFAS) Score
A study sought to probe and validate the measurement properties of the Dutch version of the European Foot and Ankle Society (EFAS) score. Subscales of the Dutch EFAS score were assessed in 547 patients with various foot and ankle diagnoses. Floor and ceiling effect, reliability and construct validity were assessed. The internal consistency of the EFAS score was acceptable while repeatability was designated poor, with intraclass correlation coefficients between 0.32 and 0.39. Construct validity was not adequate with confirmation of 67 percent of the hypothesized correlations. The Dutch EFAS score thus failed to possess sufficient measurement properties for use in patients with varying foot and ankle problems.

From the article of the same title
Journal of Foot & Ankle Surgery (09/19/21) Palmen, Leonieke N.; Kosse, Nienke M.; van Hooff, Miranda L.; et al.
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Impact of Early Weightbearing After Ankle Arthroscopy and Bone Marrow Stimulation for Osteochondral Lesions of the Talus
A study was held to retrospectively review patients with osteochondral lesion of the talus undergoing ankle arthroscopy with concomitant bone marrow stimulation (BMS) between 2015 and 2018 to ascertain outcomes based on postoperative weightbearing status. A total of 69 patients met the inclusion criteria for this study, with 51 placed into a nonweightbearing (NWB) group and 18 into a weightbearing-as-tolerated (WBAT) group. The mean lesion size was 9.48 × 9.21 mm for the NWB group and 9.36 × 9.72 mm for the WBAT group. The pain visual analog scale scores improved from 4.40 to 0.67 for the WBAT group and from 6.33 to 2.55 for the NWB group, with the difference in final values achieving statistical significance. Postoperative range of motion between the cohort had no significantly difference, and there were four repeat operations within the NWB cohort.

From the article of the same title
Orthopaedic Journal of Sports Medicine (09/13/21) Danilkowicz, Richard M.; Grimm, Nathan L.; Zhang, Gloria X.; et al.
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Repositional Subtalar Arthrodesis Combined With Supramalleolar Osteotomy for Late-Stage Varus Ankle Arthritis with Hindfoot Valgus
A study investigated the clinical and radiographic impact of repositional subtalar arthrodesis combined with supramalleolar osteotomy (SMO) for late-stage varus ankle arthritis with hindfoot valgus. Sixteen consecutive patients and 16 ankles with late-stage varus ankle arthritis of Takakura stage 3-b and hindfoot valgus were treated using repositional subtalar arthrodesis plus SMO and followed for at least two years. Post-surgery visual analog scale and Foot Function Index score were significantly improved. Mean talar tilt angle improved from 12.8 ± 2.8 degrees to 3.9 ± 3.1 degrees, while talus center migration and Meary angle also improved after surgery. Medial distal tibial angle, lateral talocalcaneal angle, hindfoot moment arm and talonavicular coverage angle underwent significant change after the procedures, while radiographic stage improved in 15 ankles (93.8 percent).

From the article of the same title
Foot & Ankle International (09/16/21) Park, Chul Hyun; Kim, Jaeyoung; Kim, Ji Beom; et al.
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Practice Management


Biden Administration Seeks to Expand Telehealth in Rural America
About 15 percent of the US population lives in rural areas, including some of the oldest and sickest patients nationwide. The Biden administration has allocated funds to bolster telemedicine to enhance their access to care. The Department of Health and Human Services said last month it was distributing almost $20 million to telehealth services in rural and underserved communities, including about $4 million to help bring acute, primary and behavioral healthcare directly to patients via telehealth, typically via video or phone, in 11 states. The money will be used to train doctors and nurses on conducting telehealth appointments, update technology in rural healthcare clinics and educate patients on taking advantage of virtual appointments when visiting in person is infeasible. Another $4.3 million will go toward assisting specialists at academic medical centers and provide training and support to primary care providers in rural and other underserved areas via "tele-mentoring."

From the article of the same title
New York Times (09/20/21) Walker, Mark
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Four Ways to Stop Ransomware From Destroying Your Practice
Practices can prevent the threat of crippling ransomware attacks in four ways. The first strategy is to train staff to identify possible ransomware links and engage a company that can test them with bogus links. Staff that fail should receive more training on what mistakes they made and how to avoid them. The second tip involves formulating an incident response plan that outlines what steps will be followed by whom if an attack happens, including who to contact in leadership and who to contact in information technology. Experts advise partnering with a third-party security firm before any breach that can help mitigate the damage, while all software must be reinstalled and all malicious code removed prior to resuming operations. The third measure is to guarantee the security of all medical devices by checking with every vendor to determine their vulnerability, risk mitigation procedures and whether there are any updates requiring installation. The fourth and final suggestion is to migrate to the cloud to ensure the availability of backups in the event of a ransomware attack.

From the article of the same title
Medical Economics (09/20/21) Shryock, Todd; Lutton, Logan
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Level-Up Your Digital Marketing Strategy with These Five Tips
Healthcare providers need to attain the right digital marketing expertise and growth strategy tuned to patients' preferences if they are to advance and remain profitable. This strategy must be consistent and professional, and it starts with grading the provider's online presence to get a sense of its effectiveness. The practice should then compare its Web presence with that of other similar practices in a particular community, especially the top ones. Gauging client feedback is critical, and practices can administer proactive patient surveys after every patient encounter to flag problems before they turn into poor online ratings. The next step is to set clear expansion goals to align with the digital marketing budget. The final step is to remedy the most pressing and critical problems first.

From the article of the same title
Physicians Practice (09/16/21) Miele, Shawn
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Health Policy and Reimbursement


CMS Extends Open Enrollment Period, Launches Initiatives to Expand Health Coverage
The US Centers for Medicare and Medicaid Services (CMS) is extending regular open enrollment by 30 days from November 1, 2021, to January 15, 2022, allowing consumers more time to review and pick health plans. The agency is also expanding services provided by federally-facilitated marketplace navigators, as well as relaunching its "Champions for Coverage" program. The program currently features over 1,000 local organizations that provide outreach and education about the Health Insurance Marketplace and how consumers can enroll in coverage through HealthCare.gov, Medicaid or the Children's Health Insurance Program. CMS said the goal of these initiatives is to make it easier for consumers to enroll in affordable health coverage and to reduce health disparities in various communities across the country.

From the article of the same title
Healthcare Finance News (09/20/21) Lagasse, Jeff
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Most of $9.2 Billion in Questionable Medicare Payments Went to 20 Insurers, Investigators Say
Medicare insurers drew $9.2 billion in federal payments in one year through controversial billing practices, according to findings by the Office of Inspector General of the US Department of Health and Human Services. The report, which found that 20 companies benefited disproportionately and together accounted for more than 50 percent of the total, are the latest sign of growing scrutiny of Medicare Advantage insurers. The report focuses on certain procedures used by insurers to document health conditions, which helps determine how much they are paid. The investigators said the findings raise concerns that insurers might be gaming the process to improperly boost federal payments.

From the article of the same title
Wall Street Journal (09/23/21) Mathews, Anna Wilde
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Medicine, Drugs and Devices


Americans Struggling With High Cost of Prescription Drugs
A West Health/Gallup survey found 15.5 million younger American adults and 2.3 million seniors could not pay for at least one doctor-prescribed medication in their household. Twice as many younger adults could not fill needed prescriptions in the previous three months versus seniors, and findings according to age were similar for foregoing pills to reduce costs. Even adults with chronic ailments including diabetes, chronic obstructive pulmonary disease and immune-compromised conditions reported difficulty covering prescriptions at a rate that is nearly double that of Americans overall. "Prescription drugs don't work if you cannot afford them," said Gallup senior researcher Dan Witters. "All ages, race and ethnic groups, political parties and income levels are reporting that they are struggling to afford medications."

From the article of the same title
HealthDay News (09/20/21)
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Biosimilar Drugs Gain Ground in US, but Concerns Linger About When Patients Can Switch
Slow US uptake of biosimilar drugs is partly due to issues raised by patients and doctors that switching to them may worsen their health. Biologic drugs have in recent years become a preferred treatment for autoimmune conditions like Crohn's disease and rheumatoid arthritis, cancer, diabetes and other ailments. Medical experts hope that as biosimilars become more popular they will increasingly reduce drug spending. A NORC poll of 602 physicians who prescribe biologics found more than 66 percent thought biosimilars are just as safe and effective as their biologic counterparts, yet they were generally less confident about switching patients from a brand-name biologic to a biosimilar. It can be difficult to find a treatment regimen that works for patients with complex chronic conditions, and physicians and patients often do not want such a regimen disrupted once reached. "We haven't seen enough studies about patients going from the biologic to the biosimilar and bouncing back and forth," said the American College of Rheumatology's Marcus Snow.

From the article of the same title
STAT (09/21/2021) Andrews, Michelle
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CDC Announces $2.1 Billion Investment into Infection Control, Surveillance Across Healthcare Settings
The US Centers for Disease Control and Prevention (CDC) announced plans for a $2.1 billion investment into public health infrastructure for infection prevention across healthcare facilities. The agency will be issuing $1.25 billion of the funds over a three-year period to 64 different state, local and territorial health departments, with initial awards totaling $885 million to be doled out this October. Healthcare-associated infections increased in 2020 due to a “perfect storm” of COVID-19 stressors on providers, agency leaders and researchers revealed earlier this month. The increases, as much as 47 percent year over year for central line-associated bloodstream infections and 44.8 percent for ventilator-associated events, reversed multiple years of progress against these healthcare-associated infections.

From the article of the same title
Fierce Healthcare (09/20/21) Muoio, Dave
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Toward a Smarter Electronic Health Record
A system developed by researchers at the Massachusetts Institute of Technology (MIT) and Beth Israel Deaconess Medical Center aims to improve the electronic health record by combining machine learning and human-computer interaction. The MedKnowts system automatically displays customized, patient-specific medical records, offers autocomplete for clinical terms and auto-populates fields with patient information, among other things. Said MIT's Luke Murray, "[Doctors] will look through a medications page and only focus on the medications that are relevant to the current conditions. We are helping to do that process automatically and hopefully move some things out of the doctor's head so they have more time to think about the complex part, which is determining what is wrong with the patient and coming up with a treatment plan." Hospital scribes at Beth Israel Deaconess gave MedKnowts an average usability rating of 83.75 out of 100.

From the article of the same title
MIT News (09/23/21) Zewe, Adam
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, 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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