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PHYSICIAN SPOTLIGHT

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‘Now or Never’UCF Board of Trustees Approves Public-Private Partnership for Academic Hospital in Lake Nona

BY REBECCA SEIDLER

With the growing population of boomers, and the increased hospital readmission rates, Medicare is on a rampage to reduce those 30-day patient readmissions. Medicare has developed the Hospital Readmis-sion Reduction Program (HRRP). This program penalizes the hos-pital and reduces payments from Medicare if the hospital is listed as an “affected hospital.” No one is safe. Yes, the main focus is on our hospitals, but it takes physicians, home health care, therapy, HHA etc. to keep our patients

home and reduce readmissions. As the old saying goes, “It takes a City,” and everyone plays a part in keeping our patients home

and healthy after a hospital stay. Physicians are on the front line.

Hospitals are putting measures in place to help reduce those Medicare readmissions. These include, reducing medical complications during the hos-pital stay, clarifying discharge instruc-tions to patients and care givers, and

most importantly, coordinating with post-acute care providers. Hospitals are

looking to the physicians to help them re-duce the readmission rates. Once the patient

Atul Madan, MD, MBAHis attention to educational excellence and detail helped him garner a spot at the highly competitive medical school in India, the All India Institute of Medical Sciences ... 4

HEALTHCARELEADER

LNRCC Introduces New Director of Community DevelopmentAllow us to introduce you to Nancy Hoehn … 7

It’s Time for Physicians to Stand Tall!Yep, it’s all about patient empowerment and the democratization of health ... 9

MACRA - A Change in Payment Methodology

(MACRA) has been touted as the most significant change in Medicare reimbursement for physicians since the introduction of the Medicare program in 1965 ... 8

BY P.L. JETER

At their Oct. 24 meeting, the University of Central Florida (UCF) Board of Trustees approved a public-private partnership with Hospital Corporation of America (NYSE: HCA) to establish an academic hospital at the UCF Health Sciences Campus at Lake Nona.

At the meeting, University of Central

Florida College of Medicine (UCF-COM) Dean Deborah German, MD, told the UCF Board of Trustees it’s “now or never” to develop the academic teaching hospital. Otherwise, the opportunity “would likely be lost forever,” according to UCF-COM notes to the Board.

Here’s why all the haste: On Aug. 1, both Florida Hospital and HCA filed Letters

of Intention (LOIs) indicating their intent to build an acute care hospital in Orange County. The Florida Agency for Health Care Administration (AHCA) has indicated only one new acute care adult hospital cer-tificate of need (CON) will be approved to serve the growing Lake Nona area.

“The proposed academic hospital will (CONTINUED ON PAGE 4)

(CONTINUED ON PAGE 10)

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BY P.L. JETER

It seemed a cinch that Michael Jablonski would follow his father and brother into the family urology practice, established in 1970.

“When I was 15, my dad called me in the middle of the week and asked if I wanted to watch him transplant a kidney,” recalled Jablonski. “It was amazing to see somebody else’s kidney come out of a cooler … and watch it start making urine in somebody else. He let me go with him to tell the family that the patient had done well. Having a father who loves doctoring that much certainly rubs off .”

Jablonski was doing rotations in his third year of medical school when he dis-covered the allure of orthopedics. During his fi rst orthopedic rotation, he worked with “Doctor Pete” Indelicato, longtime team doctor for the Florida Gators. “I went on the fi eld and the training room and loved the experience,” said Jablonski.

During their residencies at the Univer-sity of Florida (UF), Jablonski and his wife also cared for their infant son, Chris. “I don’t know how we did it. We’d be on call every third day,” he said. “I’d be on call; she’d be up all night with our son and then

work all day. Then she’d be on call the next night. On the third night, we might see each other. You just kind of get through it.”

After wrapping up eight years at UF, starting with undergraduate studies, Jablonski accepted an orthopedics fellow-ship with the famed James Andrews, MD, of Birmingham, Ala.

“We saw patients two days a week, did surgery two days a week, some 25 to 30 operations each day, and do research on the fi fth day,” he said. “Then, he’d fl y to Alabama or Auburn football games on Saturday, and the Washington Redskins on Sunday. And start all over again on Monday.”

Years later, Jablonski dialed Andrews about a complex case involving a 21-year-old cook with a shoulder problem. “I sent the patient to see Dr. Andrews and it turned out he didn’t have insurance, so Dr. Andrews did the surgery to correct his shoulder – for free,” he recalled. “Three months later, Dr. Andrews called me out of the blue. He was sitting at home wonder-ing how that young patient was doing and wanted an update. He’s just a great man.”

The youngest of four children, Jablonski and his siblings live within 15 to 20 minutes of each other. With a physi-

cian father who practiced medicine in Orlando from 1970 to 2013 and mother who’s a trained nurse, it’s little surprise the whole family is centered around medicine, and that his siblings married fellow practi-tioners. His older sister, Sharon, earned a master’s degree in nursing before attend-ing law school. His other sister, Susan, was trained as a nurse, and married Nick Capone, MD, an anesthesiologist. His urologist brother is married to a physician; Jablonski’s wife is an internist.

“It’s helpful having a family that un-derstands how stressful our work can be,” he said. “When patients have outcomes that aren’t as good as you’d like, everyone can commiserate.”

His son, Chris, now 20, is in his sec-ond year at UF and on track to become an orthopedic surgeon. “Our 17-year-old daughter, Nicole, talks about study-ing medicine. She’s still fi guring out what she’d like to do,” said Jablonski.

A team doctor for the Orlando Magic and now University of Central Florida, Jablonski also volunteers to provide care for a special type of very high-level athletes: Orlando Ballet performers who are “unfor-tunately very poorly funded,” he said.

“What they put their bodies through

is as rigorous as any football, basketball or hockey players,” he said. “They don’t have a season; it’s year-round. When they’re not dancing, they’re teaching or rehearsing.”

At Jewett Orthopaedic Clinic, Jablon-ski is on his third year as president of the practice. “We’ve done some amazing things and we’re growing the right way,” he said. “A couple of years ago, West Orange Or-thopaedics joined us. We formed a group called OrthoSouth, which combined our group with other large orthopedic groups.”

Jablonski prizes his long-term re-lationships with patients. “To have the ability to fi x their problems, walk them through rehabilitation, and get them back on the playing fi eld is incredible,” he said. “Sometimes, it takes a full year. For a col-lege athlete, that’s a long time. We de-velop a tremendous bond.”

When he’s not practicing medicine, Jablonski, 6-foot-3, plays in a YMCA bas-ketball league, golfs on a regular basis, and spearfishes with his brother. “Our dad would go fi shing quite a bit,” he said, “so we try to stay outdoors as much as possible.”

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Michael J. Jablonski, MDPresident, Jewett Orthopaedic Clinic

SPONSORED BYPHYSICIANSPOTLIGHT

BY P.L. JETER

Michael J. Jablonski, MDPresident, Jewett Orthopaedic Clinic

PHYSICIAN

Jewett Orthopaedic Clinic, ORLANDO

Florida Orthopaedic Institute, TAMPA BAY

Tallahassee Orthopaedic Clinic,TALLAHASSEE

The Orthopaedic Institute,GAINESVILLE

ORTHOSOUTH MEMBER PRACTICES


BY P.L. JETER

Growing up in New Delhi, India “the only thing my parents wanted from me and my brother were accolades in education,” recalled Atul Madan, MD, MBA. His at-tention to educational excellence and de-tail helped him garner a spot at the highly competitive medical school in India, the All India Institute of Medical Sciences (AIIMS).

Madan completed his internal medi-cine residency at AIIMS before coming to the U.S., where he repeated his internal medicine, chief residency and cardiology training at the State University of New York (SUNY)-Downstate Medical Center in Brooklyn, NY. Finally, he completed his in-

terventional cardiology training at Brigham & Women’s Hospital, Harvard Medical School in Boston, Mass. “At Brigham, I was fortunate to work with the pioneers in the fi eld of cardiology, like Dr. Eugene Braunwald and late Dr. Donald Baim.”

“I was always passionate to go to busi-ness school,” said Madan, who went on to get his Master of Business Administration (MBA) from Troy State University while working in the Florida Panhandle.

Enter Sunil M. Kakkar, MD, trained at the Texas Heart Institute and fellow AIIMS alum, who founded Cardiac Clinic in 1981. “Dr. Kakkar recruited me to Orlando in 2005 and since then our practice has grown, adding three more cardiologists to

the group,” recalled Madan. His wife, Alka Arora, MD, is a staff oncologist with the UF Health Cancer Center - Orlando Health. Their daughter, Vrinda, is a high school se-nior, and their son, Varun, a seventh grader.

In addition to his family, Madan is proud of his partners at Cardiac Clinic, who have worked hard to make it one of the area’s most valuable practices. The greatest quality, he counts, is the cohesive-ness of the practice. “The consistent high-quality patient care is our biggest asset,” he said. “We have never looked at num-bers or statistics. We always believe in the highest patient satisfaction.”

After moving to Orlando, Madan has been active in the local Indian commu-

nity. Since 2012, he has been an executive member of the Central Florida Association of Physicians from the Indian Subcontinent (CAPI). In 2015, he was treasurer of the 33rd annual American Association of Phy-sicians of Indian Origin’s (AAPI) national convention, held in Orlando. In 2016, he has served as the president of CAPI.

During his fi ve years as an offi ce bearer, he has worked hard to revamp the organization and give back to the com-munity. In addition, he has made remark-able progress in his ambitious “President’s to-do list for the year 2016.” (Please see The CAPI Conversation article in this edition.)

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provide the missing link for clinical services at Lake Nona Medical City, which currently has hospitals that serve only children and veterans,” German pointed out.

The development of a university teaching and research hospital has been on the agenda since 2006, when German helped establish the UCF-COM. An aca-demic hospital would serve as an essential lab, catalyst and resource for clinical and translational research and also support

population health and health outcomes re-search. It would allow the UCF-COM to easier recruit employed clinical faculty in procedural specialties.

In 2012, UCF purchased 25 acres of

land adjacent to the 50-acre COM campus as the site of the planned hospital. However, potential hospital partners warned that Lake Nona did not yet have enough rooftops to provide a market for the services. The fol-

lowing year, a housing boom hit the Lake Nona area, and in 2014, the City of Or-lando Economic Development Department produced a Growth Management Plan Projections Report, showing the region sur-rounding Lake Nona is expected to increase by 67 percent by 2040. Over the next fi ve years, Osceola County is projected to expe-rience greater growth than Orange County, for an overall growth rate of 16.6 percent.

In August, the UCF-COM dispatched Invitation to Negotiate (ITN) bids for a pub-lic-private partnership on the academic hos-pital. The Big 3 health systems in Central Florida submitted bids. On Sept. 1, the UCF Academic Health Board – German chairs UCF Academic Health Inc. (UCFAH) – unanimously selected the for-profi t HCA as its partner. Both parties have formed Cen-tral Florida Health Services LLC as the aca-demic hospital’s governing body.

Among the reasons for the Board’s favorable decision: HCA’s standing as the largest hospital operator in the U.S., with 48 HCA hospitals delivering care to one in four Floridians. The Board also liked HCA’s model of favoring affi liation with physicians rather than employing them. The current balance is approximately 35,000 affi liated physicians and 3,500 employed ones. Last year, HCA’s Florida hospitals spent roughly 8 percent of their net revenue on Medicaid and indigent patients. Also, HCA’s deep pockets provide the strength to fund the aca-demic hospital’s development and services and importantly also cover losses.

The proposed hospital partnership structure allows 50-50 representation on

In 2006, the COM admitted its inaugural class of medical students, all on full scholarships.

The COM obtained full LCME accredita-tion, perhaps in record time.

This August, the COM admitted its eighth class of MD students and also graduated its fourth class of MDs – 263 graduates.

Every MD class has surpassed the na-tional test averages, and outperformed the national average on the National Board of Medical Examiners, particularly concerning neurology, OB-GYN, pediatric, psychiatry, and surgery.

The COM has brought in nearly $100 mil-

lion in research funding.The college has also established rap-

idly-growing graduate medical education (GME), now with 126 residents, and a UCF-HCA GME Consortium with plans to have nearly 600 residency positions in HCA hos-pitals by 2021.

UCF COLLEGE OF MEDICINE MILESTONESNow or Never, continued from page 1


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CAPI Prepares for Year-Ending GalaExecutive Committee Report: Great Strides in 2016

SPONSORED BYCAPI CONVERSATION

BY P.L. JETER

The Central Florida Association of Physicians from the Indian Subcontinent’s (CAPI) Dec. 3 Winter Gala will feature keynote speaker Seetha Raghavan, PhD, an associate professor in the Department of Mechanical and Aerospace Engineer-ing at the University of Central Florida (UCF), who will share her story of produc-ing a revolutionary, low-cost artificial limb through UCF-based Limbitless Solutions.

The Saturday evening event will take place at Rosen Centre Hotel in Orlando, beginning at 6 pm.

Limbitless Solutions began as a group of students collaborating to build a personalized 3-D printed bionic arm for a Central Florida child. They gave then 6-year-old Alex Pring the arm at no cost and decided to do more. The stu-dents turned the team of volunteers into a nonprofit organization, with a goal of expanding its reach while also harnessing community support to continue the work. Limbitless was recently showcased at the White House, along with other social in-novators.

The Winter Gala is one of two annual medical gatherings – the other is CAPI’s Spring Gala – for networking and ex-changing ideas, combined with traditional Indian food, music and dance. Both events

are limited to CAPI members, spouses and invited guests.

This year, the gala will begin with ex-hibits and hors d’oeuvres, followed by the President’s address and upcoming year’s agenda by the incoming president and the keynote speech. This will be followed by dinner, music and entertainment.

2016 CAPI Agenda Check-UpAtul Madan, MD, president of CAPI,

challenged members at the start of his term with a “Give back to the community in 2016” to-do list. Here’s the status of those items:• Build and strengthen bridgeswithhospitalpartners. CAPI has made in-roads with all three major health systems in the area. Strength-ening collaboration with Osceola Regional Medical Center, members went on a 3-day CME cruise to the

Bahamas in September. Orlando Health CEO David Strong will host a meet-and-greet event in November for CAPI members

• Workinclosecollaborationwithsister organizations. CAPI rou-tinely works with Orlando’s Indian American Chamber of Commerce (IACC) on fundraising events to help care for Central Florida’s indigent population. Quite a few CAPI mem-bers volunteer their time at Knights Clinic, run by the University of Central Florida College of Medi-cine (UCF-COM), and Shepherd’s Hope, a faith-based organization that provides access to healthcare for Or-lando’s uninsured. In addition, CAPI members raised $15,000 for the vic-tims of Pulse tragedy.

• Market CAPI’s leadership,strength and buying power tolocal businesses, hospital andcorporations. “We’re slowly and surely making progress getting the word out about the impact of In-dian doctors and dentists on Greater Orlando’s health system,” said Dr. Madan. “Some peers were surprised to learn that one in seven patient en-counters across the U.S. – and in Or-lando – is with an Indian healthcare professional.”

• Set up a Women’s Forum. To achieve this goal, CAPI works in col-laboration with Kanti Bhalani’s Doc-tors Goodwill Foundation, IACC and other local women organizations. “This is one area I haven’t found the right outlet,” said Dr. Madan. “This is a work in progress.”

• Revamp CAPI website: Earlier this year, the website was revitalized to make it more user-friendly with a digital format easily navigated on smartphones and tablets.

• Develop a mission statement with short-term objectives and long-term goals for the organization. “I brainstormed with 20 previous presi-dents and members of our executive committee to come up with a mean-ingful mission statement,” said Dr. Madan. “It took an extraordinary arduous one-and-half months and a great team effort to come up with a consensus statement.” (See Mission Statement below.)

“We at CAPI encourage all phy-sicians, dentists and area health sys-tems to come together or at least make a collective effort to give back to the community,” said Dr. Madan. “We shouldn’t wait for a tragedy to unite us. We should unite to avoid tragedies, and make ORLANDO STRONG!”

Please visit capimed.com for more details.

CAPI’S MISSION STATEMENT “A network of Central Florida medical and dental professionals pooling resources to make a difference in the lives of members and the community.”


PARTY 2GOBe the life of the party at the next birthday, of�ce meeting or team celebration with Yogurtland yogurt and fresh toppings

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Allow us to introduce you to Nancy Hoehn… Hoehn is delighted to have recently joined the Lake Nona Regional

Chamber of Commerce as Director of Community Development. Nancy brings 20+ years of experience to the Chamber in business develop-ment, public relations, event planning and leadership training.

Being involved with various civic and non-profi t organizations, Hoehn has served on boards, worked with members, developed and guided teams and is currently serving in the elected position of District 84 Direc-tor for Toastmasters International. In this position she directs a leadership team of more than 70 volunteers to guide the management of more than 200 clubs in Central and Northern Florida, ensuring that clubs are meet-ing quality standards to provide the best service to the members. Hoehn earned her master’s degree from Webster University and has achieved the highest educational award in Toastmasters - Distinguished Toastmaster.

“My attraction to the Lake Nona area is because of the strong com-munity relationships and the compassionate nature of the community as a whole. Lake Nona being the home of Nemours – caring for children, the new VA Hospital – caring for Veterans, and UCF College of Medi-cine – training our next generation of medical professionals with the lat-est high-tech skills, to name just a few, I fi nd this to be the most exciting

place in Florida!” said Hoehn.She recently worked with the

East Orlando Chamber of Com-merce and became very involved in the Lake Nona community through that relationship. She knew that she was passionate about this active and fast-growing community, so when the op-portunity opened the door to work with the Lake Nona Regional Chamber, there was no question that this is the right place to be.

Hoehn is looking forward to meeting the business owners, promot-ing the development in Lake Nona and serving the members. She is excited to start working the Board at the Chamber to develop new ben-efi ts and opportunities for our members.

You can reach Hoehn by email at [email protected] or her cell is 321-436-8043. She would love to meet you and talk about the exciting new developments that are coming to enhance membership and your involvement with the community.

Nancy’s heart is in Lake Nona! Is yours?

fast-growing community, so when the op-portunity opened the door to work with the

LNRCC Introduces New Director of Community Development

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Lake Nona Regional Chamber of Commerce Events

NOV 12 - Taste of Nona 2016, 6:00 pm-9:00 pm at Marriott Courtyard Lake Nona Town Center.This year’s Taste will feature 21 fantastic restaurants, dessert makers, and catering services! Each vendor will be bringing a sampling of some of their most celebrated offerings, and all of this is included in every ticket purchased for the Taste. LNRCC members can get $5 discount on tickets. Speak with a Board Member to get a discount code to apply to tickets purchased online. Tickets are $40 at the door. Signup Form: http://goo.gl/ forms/NRS78zGRN2cYHafg2. Sponsored by LNRCC

NOV 9Breakfast Connections, 8:00 am-9:30 am at Canvas Restaurant & Market (Lakehouse)

NOV 18Business Luncheon, 11:30am -1:30pm at Village Walk at Lake Nona. Sponsored by Village Walk

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the Governing Board and reserved rights for UCFAH’s representatives on 17 speci-fi ed major decisions. The 100-bed hospital includes emergency services and eight Labor & Delivery beds. An 80-bed hospital was also proposed as a secondary option.

According to the hospital pro-forma, the capital investment is projected at $150,000,000 with HCA owning 80 percent and UCF owning the balance. At the end of the fi rst full year of operations, the hospital is projected to break even, with an estimated operating revenue of $71,242,000 and net income of $10.2 million. The return on in-vestment suggests 12.9 percent.

On Oct. 12, the complete CON, along with 350 letters of community support, was fi led on behalf of the hospital partnership. AHCA plans to issue its initial decision on the CON application Dec. 2, and it may take until Jan. 9, 2017, to become fi nal, if uncontested.

If HCA develops a free-standing emer-gency department in advance of the hospi-tal, HCA will initially sublease a portion of the 25.2 acres at fair market value, accord-ing to October 24 meeting materials.

German told the Orlando Sentinel re-cently that if UCF can attract fl y-in patients for medical care, “what UCF and the Medi-cal City can do for all of Central Florida in the medical area would be like what Disney did in the area of attractions.”

Now or Never, continued from page 4


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BY LARRY JONES

The Medicare Access and Chip Re-authorization Act of 2015 (MACRA) has been touted as the most significant change in Medicare reimbursement for physicians since the introduction of the Medicare program in 1965. Not only will this reim-bursement change impact physician reim-bursement for Medicare beneficiaries, it will establish a transformation change in the private sector as well.

Pay for performance reimbursement based on outcomes and cost reduction is not a new

concept. Accountable Care Orga-nizations began in 2012 with CMS, and today there are 402 Medicare ACOs man-aging almost 8M Medicare beneficiaries. Private insurers have established Col-laborative Accountable Care and Ac-countable Provider Organizations called “value-based arrangements.” Both models are based on managing a defined patient population, and sharing the savings cre-ated by better outcomes and costs.

MACRA was signed into law on April 26, 2016 and was initially intended to re-place the sustainable growth rate (SGR) formula, a flawed reimbursement meth-odology that was implemented to reduce CPT code reimbursement for physicians 27 percent between 2005 and 2011. The SGR reductions were never implemented

due to Congress repealing the reductions each year. However, the pressures to reign in the spiraling cost of the Medicare pro-gram continued.

MACRA has two payment tracks under its Quality Payment Program (QPP). The MIPS track and the APM track. In the advanced alternative pay-ment model (APMs) can earn bonuses an-

nually of 5 percent. These are risk models that require significant structure, large numbers of physicians, and organization.

The Merit-Based Incentive Payment System (MIPS) consolidates three Medi-care physician quality reporting programs (Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use of EHRs).

The majority of physicians will par-ticipate in the Merit-based Incentive Payment System (MIPS). In this track, physicians can earn plus or minus 4 per-cent of reimbursement in 2019, 5 percent in 2020, 7 percent in 2021 and 9 percent in 2022. Recently, CMS has indicated a delay in the implementation of the pro-gram allowing physicians to choose three different options. CMS has indicated that a final interpretation of the rules will be issued this fall.

Medicare’s own projections show the vast majority of physicians in groups of less than 10 suffering penalties. That includes 87 percent of solo practitioners who can expect their reimbursement to fall, and 70 percent of physicians in groups of two to

nine, Medicare data show.Data shows 55 percent of physicians

in groups of 25 to 99 can expect to see their reimbursement rise, with 81 percent of physicians in groups of more than 100 anticipated to get a reimbursement boost from MACRA. Just a snapshot of the de-tails surrounding the new legislation.

Most physicians are unaware of the details surrounding MACRA; however, all physicians are attuned to new finan-cial pressures coming their way.

While the details may seem over-whelming to most physicians and their staff, there is no reason to panic. Many programs are available to help physicians embrace value-based reimbursement for their Medicare, Medicaid, and private insurance patients.

The Patient Centered Medical Home (PCMH) certification and Patient Centered Specialty Practice (PCSP) certi-fication for practices, offered by the UCF Regional Extension Center in collabora-tion with the IP Network, an independent physician network of 1100 physicians in

central Florida, will assist physicians in po-sitioning their practices for “value-based accountable care” programs.

It’s about physicians understanding what quality measures must be monitored on patients, ensuring they collect that data on each patient, and provide coordinated care through the process, engaging the pa-tient and care giver in all decisions. Many tools are now available for physicians that educate and engage patients through the acute and post-acute process.

Responsible accountable patient care should mean providing the right care, at the right place, at the right time, for the most affordable cost.

Independent physicians have united together in the Central Florida area under the IP Network to provide quality patient care for their patients, and address the pressures of MACRA and other collab-orative care models.

Contributed by Larry Jones, CEO of HPOF Holdings, LLC, and Executive Director of the Integrated Independent Physicians Network, LLC. [email protected]

MACRA - A Change in Payment Methodology


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It’s Time for Physicians to Stand Tall!

BY JOHN NOSTA

Yep, it’s all about patient empowerment and the democratization of health. But as we empower the patient, there’s someone sitting on the sidelines. It’s the physician.

Defined these days by burnout, misery and a burning desire to leave the profes-sion, today’s physician is yesterday’s icon of accomplishment. And to further the sad story is the advancements of other health-care professionals such as the nurse and pharmacists who claim more and more re-sponsibility. Then there’s the looming as-pect of artificial intelligence that threatens to replace today’s physician with a smarter and more efficient electronic model. Just ask a physician if he or she would like their child to go to medical school…

And while this all may be true, to one degree or another, something else is in the air. Over the outcries of patients, advocacy groups, caregivers and the common folks is the timing for a clarion call of physician em-powerment. Remember, we love physicians. We trust in them to provide valuable insights to care and life. And the simple reality is that these life savers are driven by intellect and compassion that sadly is drowned out by other valid voices that just may be more “timely” or loud. We just need to get the physician away from the torturous EHR and provide them with a real seat at the table. Be-cause healthcare reform and evolution must engage the clinician as a primary stakeholder and not just part of the problem or a disen-franchised remnant of yesterday’s model.

So, have docs given up? Have they re-signed to the complexities of a system that seems out to get them? I don’t think so. But, in my experience, it seems that movements like digital health have created this assump-tion that the empowered patient will own

care and the physician is, at best a passive participant. So, maybe the democratization of health is really a two-party system where both patient and physician work together to optimize care. Individual control has shifted to collaboration and that’s a win-win. But to-day’s dynamic make it seem like a win-lose, with the physician as a tragic victim to in-novation. But dear doctor, if you don’t act up, that might just happen. So, next time frustration takes hold, remember that you’re really in charge and play such a central role to care. But you might have to bend to grow stronger in today’s world defined by expo-nential change. So, keep this in mind…

• Recognize change.• Embrace technology

as your empowerment.• Get involved and be part

of the solution.• Place an optimistic foot forward.• Advocate for the exciting future

of techno-empowered physicians.• Stand up and be heard!

And while this revolt may be better de-fined as a movement or empowerment, it is worded this way to help drive action. There’s no better and more honorable job than to be a physician. So, physician, heal thyself!

John Nosta is a leading thinker in the convergence of technology, medicine and innovation. He is a Google Health Advisor, faculty member of Singularity University / Exponential Medicine, a frequent contributor to Forbes and CES, and ranks in the top 10 of the #HIT Top 100 list. Earlier in his career, John was a research associate at Harvard Medical School. He is now the president of NostaLab, a digital health consultancy dedicated to the empowerment of innovation via communications.

BY BETH RUDLOFF

Not many of us over the age of 21 say, “I can’t wait ‘til I am older!” After tour-ing the WHIT house and hearing from the speakers at the Florida Health Innovators’ (www.healthinnovators.info) meetup, we can feel much better about our gray hairs and advancing years. There is quite a bit to look forward to because of the hard work being done in medical technology.

The home of the future, as far as health, is definitely the WHIT house at Lake Nona (http://www.meetwhit.com/). This home is a place to implement and try out new health technology from initial pro-totypes to the commercial available. For ex-ample, Phillips has developed lighting that simulates natural light circadian rhythms. Phillips uses this technology in light bulbs around the home and alarm lights by the bed for waking up and calming down more naturally. These light bulbs and alarm lights are now commercially available. There are also appliances developed to grow plants and micro greens hydroponically in a small space, ultraviolet lights that destroy bacte-ria in the bathroom, as well as the use of cleaner building materials like cork floors and wall paint low in VOCs.

Even with technology in our homes

to keep us healthy as we age, many of us still worry about our mental capacity while growing older from dementia. We don’t want to be a danger by leaving the stove on, or forgetting to take our meds. Technology is also being developed in this area to help us age in place instead of being institution-alized. Augmented cognition is an effective term for this intervention, where we are helped to do the things that keep us healthy and monitor our routines to catch problems early. Senscio (http://www.sensciosystems.com/) has developed systems that passively collect data and then use the data to habitu-ate the best health habits. It also can pick up on subtle changes to notify caregivers that action needs to be taken before it becomes a crisis. Dr. David Metcalf, director of the Mixed Emerging Technology Integration Lab at UCF’s Institute for Simulation and Training discussed the work being done to develop avatars that look like us and can provide health support and information at home in a conversational way with socio-emotional programming.

With these and many more innova-tions in play...bring on aging! We are ready!

Beth Rudloff is a Health Innovators Healthcare Executive in Residence and COO Emeritus of UF Health Cancer Center - Orlando Health

MedSpeaks ™ is an engagement focused organization created to showcase the most exciting events, experts, and healthcare developments within our region. Our strength isin our community network of Health Innovators as well as our platform for promoting/facilitating medical events and expertise. Our engagement model has enabled us to converge over 1,300 healthcare professionals, clinicians, entrepreneurs, and technology enthusiasts to fuse ideas on the problems and solutions facing healthcare.

Aging... A Reason to be Excited?

DOCTODOOR provides seamless connection between doctors and patients through the patient journey. Automate patient monitoring, track patient progress, intervene when necessary via tele-visits or messaging. Learn more: doctodoor.comSENSCIO, IBIS, monitors self-management behaviors and collects data from multiple in-home devices and interprets them through artificial intelligence to proactively alert members of the care team to provide timely interventions. Learn more: sensciosystems.com

FEATURED INNOVATIONS

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Unlocking the Potential of Mental & Behavioral Health TechNov. 15, Orlando www.healthinnovators.info

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leaves the hospital, the patient’s care falls on the physicians.

So how can our physicians help keep their Medicare patients home, healthy and safe?

• Provide interpreters for patients with limited English proficiency.

• The hospitals and physicians must work together and provide communication to

the patients to make sure they schedule a follow up visit within 7 days of discharge.

• Make sure patients have a strong home healthcare program including nursing, social workers, physical, occupational and speech therapy.

• The physicians and hospitals both have to play a part in making sure their patients have a smooth transition when discharged, and are being discharged to a safe home.When patients come home they are

usually weak from lying in a hospital bed. It is more difficult for patients to be mobile throughout their home after a hospital stay. Steps in the home can be challenging, if not impossible for a discharged patient to ma-nipulate. If a patient comes home in a wheel-chair, the physicians and hospitals should be concerned about making sure the patient can be mobile throughout their home. Are the doorways wide enough? Is there enough space in each room for the patient to turn the wheelchair? Are there ramps by the front door or garage for easy access into the home? Is the patient able to safely transfer into their shower? Are there cabinets under sinks to prevent a wheelchair bound person from reaching the sink faucet? If someone comes home with limited ROM (range of motion) of their upper extremities or lower extremi-ties, from a total hip, total shoulder or total knee replacement, how can they reach items in high cabinets, or clothing on closet rods without falling? If someone comes home with COPD, is their home set up to help them conserve energy and reduce dyspnea, there-fore reducing fall risks and reducing hospital readmissions? They may need hand rails in their hallways, grab bars in their bathroom or kitchen area. They may need a lift chair to help them stand. Discharging patients to a safe and accessible home is imperative to

reducing hospital readmission rates. Most times the home environment

is overlooked by everyone, including the hospitals, physicians etc., and preventable falls will occur post a hospital discharge. If measures were put in place to check the home and/or have the caregivers fill out a home safety checklist that could be reviewed by qualified personnel in home safety, this would greatly reduce falls, and reduce hos-pital readmissions.

Physicians who oversee the patient’s transitional/home care can request a home safety report from the home health-care nurses and/or occupational/physical therapists. This is a discussion that is neces-sary amongst hospitals, doctors and home health care agencies to implement home safety into the HRRP.

Why is it important for Hospitals and Physi-cians to be Concerned with Safe Homes for Their Patients? The number one reason is to re-duce falls post a hospital discharge. Falls in the home are too common when a patient comes home from a hospital stay, especially a long stay. These fall risks need to be re-duced in the home. Patients require time to heal. They need rest, maybe medication, and a stress-free environment to come home to. This is one of the crucial factors to reduc-ing hospital readmission rates.

Making that transition from a hospital stay to home requires many occurrences, and many medical and non-medical disciplines to help our Medicare patients reduce falls, stay healthy in their homes and most importantly, reduce hospital readmission rates.

Rebecca Seidler , COTA, CAPS, is president and owner of Aging In Place Safely, LLC. She is a home revision expert for safety and accessibility. Aging In Place Safely provides accessible home remodeling creating functional homes that are beautiful and easy to live in for everyone. Her company offers solutions to common and unsafe obstacles in the home. To learn more contact Rebecca email [email protected] or view our website at aginginplacesafelyconsulting.com

Hospitals, Physicians Concerned, continued from page 1

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CORRECTIONS: Colon and rectal Clinic of Orlando’s fax # was incorrectly published in the 2016-17 SCMS Physician Directory. The correct fax # is 407-425-4358

In last month’s issue, we incorrectly identified the chairman of the 2015 AAPI National Convention as Dr. Mohan Saoji. The chairman was Amish Parikh, MD.


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