October 7, 2015 | | JFAS | Contact Us

News From ACFAS

Board Nominees Announced
After careful review of applicants to serve on the ACFAS Board of Directors, the Nominating Committee recommends these four Fellows for three positions in the upcoming electronic election:
  • Christopher L. Reeves, DPM, FACFAS (Incumbent)
  • Randal L. Wraalstad, DPM, FACFAS (Incumbent)
  • Paul D. Dayton, DPM, FACFAS
  • Thanh L. Dinh, DPM, FACFAS
Two three-year terms and one one-year term will be filled by election. Candidate profiles and position statements will be posted on Nov. 16 at The ballot order and appearance are prescribed in the bylaws. Eligible voters may cast one, two or three votes on their ballot. Regular member classes eligible to vote are Fellows, Associates, Emeritus and Life Members. Individuals who intend to nominate by petition must notify ACFAS by Oct. 22, and petitions are due no later than Nov.14.

Online voting will be used from Nov. 29 to Dec. 29. All eligible voters will receive an email with special ID information and a link to the election website no later than Nov. 27. After logging in, members will first see the candidate biographies and position statements, followed by the actual ballot. Eligible voters without an email address will receive paper instructions on how to log in to the election website and vote. There will be no paper ballots.

The 2015 Nominating Committee included Thomas S. Roukis, DPM, PhD, FACFAS, Chair; Michael J. Cornelison, DPM, FACFAS; Richard Derner, DPM, FACFAS; John T. Marcoux, DPM, FACFAS; L. Jolene Moyer, DPM, FACFAS; Harry P. Schneider, DPM, FACFAS; and Julie A. Wieger, DPM, FACFAS.
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Fall FootNotes Ready for Download
New to the ACFAS Marketing Toolbox, the latest edition of the FootNotes patient newsletter. Download the customizable PDF to promote your practice and connect with your patients and community. Fall FootNotes includes the following timely articles:
  • Remember the Importance of Diabetic Foot Care
  • Prepare Your Feet for Autumn Hikes
  • Avoid Injuries When Playing Indoor Sports
Be sure to supplement this issue of FootNotes with Dos and Don’ts of Diabetic Feet, a newly released PowerPoint presentation also available for free in the Marketing Toolbox. Combine these two tools in advance of National Diabetes Month in November to educate your patients on diabetic foot health, all while highlighting your practice.

Visit often—more free products and resources are coming soon!
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Sign Up for Complications & Case-Based Presentations Seminar
Register now for ACFAS’ new advanced seminar, Taking a Scalpel to the Evidence, set for November 6–7 in Atlanta. Learn through case-based presentations and debate from experienced clinical and research faculty as they illustrate the decision dilemmas in common and complex foot and ankle surgery. Seminar includes 14 continuing education contact hours.

Space is limited—visit to reserve your spot today.
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Catch ACFAS On the Road
ACFAS is on tour again this fall and making stops at cities near you. Our regional program, ACFAS on the Road: Complex Forefoot Surgery with Advanced Solutions, combines cutting-edge content, hands-on lab instruction and the latest surgical techniques to teach you everything you need to know about treating forefoot deformities and injuries.

Each program begins on Friday evening with a presentation and case studies. Saturday features lectures from expert faculty and four sawbones labs. Four dates are scheduled between now and the end of the year, so visit to reserve your seat today.
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Foot and Ankle Surgery

Bone Risks Linked to Genetic Variants
A recent study looked to examine the role of rare genetic variants in bone mineral density and fracture risk. The researchers used the UK10K Project, a massive, whole-genome sequence-based resource of the general European population, to analyze data. They found variants associated with the density of bone near common sites of osteoporotic fractures. Other variants were found for the forearm, femoral neck and lumbar spine. The findings open a door to understanding the genetics behind the development of osteoporosis. “Ideally, genomic research will one day lead to more personalized interventions (precision medicine) that, in this case, will reduce bone loss and prevent fractures in older adults," said co-author Douglas Kiel.

From the article of the same title
NIH News (09/28/15)
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More Calcium Does Not Reduce Fracture Risks or Boost Bone Health
Two studies published in the British Medical Journal indicate that increased calcium intake does not reduce the risk of fractures or boost bone health. The studies found that while people who consumed more calcium had higher bone mineral density, the increases were too small to have a significant effect on overall bone health. A major contributing factor to the myth of calcium's effects is "companies with vested interests," according to lead researched Dr. Mark Bolland. In an analysis published earlier this year, Bolland urged academic researchers, advocacy organizations and health associations to cut ties with the dairy and supplement industries to prevent the public from receiving mixed messages about the purported benefits of calcium. The danger, says Dr. Heather McKay of the Vancouver Coastal Health Research Center, is that consumers could decide calcium is the solution to their bone problems instead of proven treatments such as exercise and building muscle strength. “I think as a culture, unfortunately, we would rather take something than do something,” said McKay.

From the article of the same title
Globe and Mail (09/29/15) Weeks, Carly
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Risk of Infection After Intraarticular Steroid Injection at the Time of Ankle Arthroscopy in a Medicare Population
Researchers recently sought to create a national database evaluating the association between intraoperative corticosteroid injection at the time of ankle arthroscopy and postoperative infection rates in Medicare patients. The study looked at 9,786 patients who underwent ankle arthroscopy. Patients were split into two groups: 459 were assigned to ankle arthroscopy with concomitant local steroid injection, and 9,327 were placed in a control group who underwent ankle arthroscopy without intraoperative local steroid injection. No significant differences between the groups were noted for variables such as gender, age group, smoking and average Charlson Comorbity Index. The infection rate for the injection group was 3.9 percent compared with 1.8 percent for the control group. Researchers concluded that the injection group was associated with significantly increased rates of postoperative infection.

From the article of the same title
Arthroscopy (09/29/15) Werner, Brian C.; Cancienne, Jourdan M.; Burrus, M. Tyrrell; et al.
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Practice Management

Do Not Neglect Employee Well-Being in the Quest for Patient Satisfaction
New research from Gallup shows that hospitals often look to increase patient satisfaction while disregarding employee morale. The study analyzed five categories: employees' feeling of purpose, their financial security, their overall health, social relationships and sense of community. Less than 10 percent of respondents strive in all five measures. This is not entirely the hospital's fault, the study said; healthcare workers tend to neglect their own well-being and leave themselves susceptible to burnout. This is why organizations must step forward to care for their employees, especially since research shows that workers with high well-being are more resilient in the face of stress. Healthcare providers have multiple ways they can improve employee morale, including healthier food options and creating a sense of motivation and community.

From the article of the same title
Fierce Healthcare (09/29/2015) Budryk, Zack
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ICD-10 Is Up and Running: How to Survive
Some practices are not prepared for ICD-10, but yours may be ready–and there still may be problems in the coming weeks. Tammie Olson, a billing expert at the Management Resource Group, provides some tips to help keep your head above water:
  • Stay up to date with all announcements from your payers. They will send notifications pertaining to issues they experience.
  • Review all claims before submitting to make sure you have the right codes for the date of service. Anything prior to Oct. 1, 2015 must be coded with ICD-9.
  • Separate your denials for diagnosis coding from the rest of your denials. This helps track the amount of lost revenue due to ICD-10 denials.
  • Learn and get comfortable with the ICD-10 code book. The codes will likely be updated every few years, so focusing on 50 or so often-used codes may be a risk.
  • Submit your claims in smaller batches. If you have issues with ICD-10, they will be easier to work with than if you submit a week's worth of claims once a week.
  • Call experts and get help. You need not do this alone. Third-party companies are prepared to assist with ICD-10 transitions.
From the article of the same title
Physicians Practice (10/01/15) Hurt, Avery
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ICD-10: What You Should Know
ICD-10 has arrived, and you must be aware of many changes to avoid the pitfalls associated with poor preparation. Here are some tips to make the transition as smooth as possible:
  • ICD-10 means more detail in documentation. Detailed documentation is essential for many reasons, from organization to communication. In addition, it allows physicians to compare international data with that of different regions of the country.
  • Sources are expecting some cash flow issues. The transition will not be smooth for everyone, and cash flow issues will arise as some organizations remain stuck using ICD-9 systems. This will only be temporary, but keep money in the bank at the end of the third quarter as a precaution.
  • Transition will require strict oversight. Training of staff is crucial, and all documents must be updated to reflect the coding changes.
  • Full transition will likely take a few years. CMS will reportedly not be very strict in the first year of implementation, so healthcare providers should use the time to acclimate themselves and find what strategies work for them.
From the article of the same title
Healio (09/30/2015)
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Health Policy and Reimbursement

Gaps in Payer ICD-10 Readiness Could Affect Provider Reimbursement
A provider organization could do everything right in preparing for ICD-10, but problems with insurers could still mean they will not receive the benefits of optimal payments. According to John Elion, MD, founder of ChartWise, a vendor of clinical document improvement software, this could represent a wrinkle in ICD-10. A physician could perform a surgery and code everything correctly, but if the payer's lists covering various criteria is not updated from ICD-9, things could get tricky. Elion is uncertain whether physicians will get paid under ICD-10 or ICD-9 rules. That will not be answered until sufficient ICD-10 claims start being processed. There is yet another gap that could arise–some ICD-9 codes do not have an equivalent ICD-10 PCS procedural code. This could affect reimbursement, so Elion says that physicians must remain patient and do their research to determine the best course of action.

From the article of the same title
Health Data Management (09/30/15) Goedert, Joseph
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House Lawmakers Urge for Delay and 'Refocus' of MU Stage 3
More than 100 House lawmakers signed a letter this week urging a delay for Stage 3 of the Meaningful Use program. The letter, addressed to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell and Office of Management and Budget Director Shaun Donovan, asks for a commitment "to refocus the program to better serve patients and the providers who care for them." In addition, the lawmakers believe Stage 3 should be delayed until a "rigorous" look at participation in Stage 2 has been conducted. Donovan and Burwell have also received letters from the American Medical Association and 41 medical societies imploring them to delay the next stage.

From the article of the same title
FierceEMR (09/29/2015) Dvorak, Katie
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Huge Healthcare Price Disparities Seen Within Cities, Communities, Study Shows
A study from the Health Care Cost Institute found discrepancies within many of the 41 areas of the country it observed, showing that some areas had both high inpatient and outpatient prices compared to other regions. This runs contrary to the long-held belief that some areas of the country have expensive costs while others are cheap. The institute determined that places like Boulder, Denver, Dallas, Milwaukee and Philadelphia all had high inpatient and outpatient costs. Other regions, such as Louisville, St. Louis, New Orleans and Tucson had low costs in both settings. Eric Barrette, the institute's director of research, said this happens because inpatient and outpatient care can be separate markets that do not compete with each other. Most evaluations of this spending level data are based in Medicare trends; this study is notable because it is one of the few that used private commercial insurance data.

From the article of the same title
Healthcare Finance News (09/30/15)
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Medicine, Drugs and Devices

Crowdfunding for Medical Devices Could Be a Passing Fad
Research and consulting firm GlobalData thinks crowdfunding for medical devices will not stay in fashion for long. The controversial practice, where companies finance their devices through online donations, has gained steam in recent months as startups push to enter the medical device market. The U.S. Food and Drug Administration (FDA) has not released any concrete guidelines pertaining to crowdfunded medical devices, although a regulatory crackdown could be coming soon. Some companies, such as California-based device manufacturer Cur, are anticipating FDA intervention by updating their terms of service to emphasize that contributors are financing a work in progress and not making a direct purchase. “The success of crowdfunded medical technology depends on whether many of these devices eventually achieve regulatory approval," said GlobalData analyst Shashank Settipalli. "Even though the hurdles of initial financing are overcome, medical devices need to follow the requisite pathways for market entry." Ultimately, crowdfunded medical devices may only find success as small, simple devices that are geared toward quick approval and treat a wider pool of patients.

From the article of the same title
HIT Consultant (09/30/15)
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Pitt Researchers Hope to Pioneer New 3-D Printing Treatment for Bone Breaks
A University of Pittsburgh scientist has created a formula that he hopes will be approved by federal regulators to replace the metal screws, pins and plates traditionally used to repair bone fractures. Abhijit Roy's concoction is a mix of water-based liquid and calcium phosphate powder that forms a putty, which can fill gaps in broken bones and safely dissolve as the bone heals. The project is part of a larger effort at Pitt to develop medical applications for 3D printing, which could revolutionize medicine due to its ability to quickly and efficiently create customized products. Roy's putty is made with ingredients already approved by the U.S. Food and Drug Administration, but he will need to prove to the agency that the magnesium in the putty is safe to insert into bodies. The hope is that the treatment will allow patients to walk sooner and avoid operations to remove stainless steel or titanium plates, while steering clear of infections.

From the article of the same title
Pittsburgh Post-Gazette (09/27/15) Boselovic, Len
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Thousands of Medical Devices Are Vulnerable to Hacking, Security Researchers Say
Security researchers this week presented findings at the DerbyCon security conference showing that thousands of medical devices are vulnerable to hacking. These devices include MRI scanners, X-ray machines and drug infusion pumps, all of which can be hacked and altered with fatal results. The risks are a result of medical equipment increasingly becoming connected to the Internet. "As these devices start to become connected, not only can your data gets stolen but there are potential adverse safety issues," researcher Scott Erven said. This, paired with poor password selection and management, can make any device susceptible to attack. The research was focused on GE Healthcare, but the authors claimed they could have picked any company. In addition, they found that devices are not just vulnerable to hacking online. Detailed information is available almost anywhere, including host names, equipment descriptions, physical locations of devices and physicians assigned to them. A criminal can access this information and launch a phishing attack through the organization's email accounts. Fortunately, no evidence showed the hackers had targeted the devices specifically because they looked like medical systems, but they are still being targeted.

From the article of the same title
Computerworld (09/30/15) Niccolai, James
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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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