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HEALTHCARELEADER

Sri Pothamsetty, MD, Founder Orlando GastroenterologyA plea for prevention of a disease that is the second leading cause of cancer deaths

Orlando Preparing for Second Medical City

Dr. Sri Pothamsetty is an Orlando gastroenterologist who received his medi-cal degree from Osmania Medical Col-lege NTR UHS and his residency and fellowship training in Gastroenterology at John H. Stroger Hospital in Chicago. He is Board-Certified and a member of the American College of Gastroenterology as well as the American Gastroenterological Association. He has been in practice for more than 15 years.

His passion for safe, comfortable and high-quality endoscopy led to the estab-

lishment of the endoscopy center at The Millenia Surgery Center, where he serves as the medical director. He has also been appointed as assistant professor at UCF College of Medicine.

Dr. Pothamsetty is affiliated with both Florida Hospital and Orlando Health sys-tems.

In 2015, he was awarded the Out-standing Physician Award by Surgery Partners. He is a member of the speaker bureaus for AstraZeneca, Inc. and Aller-gan Pharmaceuticals, and is a principal

investigator for Universal Clinical Re-search and Technology, Inc., as well as a member of the Board of Directors of the Orange County Medical Society.

Causes close to his heart include working with CAPI to raise funding for the OneOrlando Fund to benefit victims of the Pulse tragedy. His practice supports multiple charities including A Gift for Teaching (providing school supplies for children in Orlando), Community Based Care of Central Florida (benefiting foster care children in Orlando), Aman Vedika

By PL JETER

An architect’s idea to build a self-contained medi-cal city in Central Florida began as a training project for her design team working out of her Lake Nona of-fice headquarters.

The concept gained surprising traction and es-calated quickly to the announcement of PONTE HEALTH’s plan to break ground for site work and foundations for downtown Orlando’s first Vertical Medical City next summer.

At 540 feet tall, upon approval by the FAA, the proposed three-tower complex covers about 2 million square feet and represents the tallest project in the metro area, extending 100 feet higher than SunTrust’s tower. It also marks downtown Orlando’s first LEED platinum project.

“The conceptual design-team exercise … to pro-vide stepped care, from preventive to critical … wasn’t meant to be developed,” said Tabitha Ponte, AIA, founder and lead architect at PONTE HEALTH in Orlando, whose brainstorming mission resulted in the creation of what she hopes will provide seniors with a cohesive living experience, a higher quality of life and easier access to medical care. “(The work) kept going until we surpassed probably 420 hours collectively. By that point, we started getting a lot of attention.”

Ponte had been disturbed by the lack of suitable options for Central Florida’s aging population.

“In this culture, we isolate our elders into retire-ment homes with poor conditions,” she said. “We disrupt their circadian rhythms because they can’t go outside nearly enough.

(CONTINUED ON PAGE 4)

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Last year, Central Florida-based Shepherd’s Hope provided 19,674 free patient visits and medical services to the region’s uninsured; 17 percent (3,360) of whom were children. That total number was up 13 percent from the previous year, in part due to the influx of an estimated 200,000 Puerto Rican Americans who evacuated to Central Florida following hurricane Maria and needed access to a variety of services, including healthcare.

The growing capacity demands on Florida’s largest free and charitable clinic are immense. Helping Shepherd’s Hope provide access to high quality, compas-sionate medical care in 2017 were 2,800 licensed medical and general volunteers, three community hospital systems, and 100 diagnostic/secondary providers. Adalberto Torres, Jr., MD, is one of these volunteers.

Torres is a pediatrician certified by the American Board of Pediatrics to prac-tice pediatric critical care, and a Fellow of both the American Academy of Pediatrics and the American College of Critical Care Medicine. He currently serves as chief of critical care at Nemours Children’s Hospital and medical director of the hospital’s Clini-cal Logistics Center and Respiratory Care Department.

He earned his MD in 1986 from the University Of Illinois College Of Medicine. He also holds an undergraduate degree from Loyola University Chicago and a Master of Science from the Medical Col-lege of Wisconsin. Today, he helps educate the doctors of tomorrow as professor of pe-diatrics at the UCF College of Medicine.

Torres joined Nemours in January 2012. He was a key player in developing the policies and procedures for both the pediatric ICU and critical care transport program at Nemours Children’s Hospital, and assisted in recruiting many of the phy-sicians who were practicing there when the hospital opened its doors.

In 2017, Torres received the Don Quijote Professional of the Year award from the Hispanic Chamber of Commerce of Metro Orlando. The 20th annual award recognized community recipients for their vision, courage and impact on Central Florida – qualities exemplified by the clas-sic literary character of Don Quijote.

Torres describes his work with the sick children at Nemours as incredibly fulfilling. But, he says being able to offer hope and healing to the patients at Shep-herd’s Hope who can’t pay him back is one of the most rewarding parts of his job. Here, he shares his thoughts and experi-ences serving as a medical volunteer.

Q: Why did you choose to volunteer at Shepherd’s Hope?

I believe you need to do more than

just live and work in a community, you need to give something back to it.

For physicians, we all went into med-icine to help people. But, that purpose can get lost in the day-to-day business of healthcare, from documentation and elec-tronic medical records to dealing with in-surance companies. Helping patients who would not otherwise have access to medi-cal care reaffirms the feeling that you’re doing something good.

Q: Talk about the volunteer work you do with Shepherd’s Hope.

I started volunteering in 2014 when Nemours first partnered with Shepherd’s Hope to provide annual back-to-school physicals. Then, in the summer of 2016, I expanded my involvement to provide a pediatric clinic twice a month, seeing kids with both acute and chronic problems at the Dr. Diebel, Jr. Memorial Shepherd’s Hope Health Center in east Orlando. The patients are so grateful to be able to see a physician and make sure their kids are okay. You can’t help but feel good about the time that you spend there.

In addition, I am honored to join the organization’s board of directors this year, serving alongside an outstanding group of community leaders who are committed to furthering the mission of Shepherd’s Hope.

Q: Is there a memorable patient encounter that is especially

meaningful to you? It was the first day of my first regu-

lar pediatric clinic at the Diebel Center. A family brought in their son with severe abdominal pain. I was certain he had ap-pendicitis and immediately referred him to the hospital for surgery. If Shepherd’s Hope had not been there for the family that day, this young man’s outcome would have been much worse because of a delay in access to care.

There are also kids who come back to see me on a regular basis. One is a young man with ADHD. His mom is a home-less single parent whose biggest concern is that her son succeeds in school. Because of the treatment and medication he receives through Shepherd’s Hope, we have eased this mom’s anxiety and her son is doing better in school. It is very rewarding know-ing we are helping him reach his potential.

Q: What would you tell other physicians who may be interested in volunteering at Shepherd’s Hope?

First, I would say it’s very easy to get started as a medical volunteer with Shep-herd’s Hope, without a lot of hurdles to jump through. They streamline the process with online forms and handle the work of obtaining sovereign immunity from the State of Florida.

Once you start volunteering, there is a lot of support. The staff is wonderful. And, there are college kids with an interest

in medicine who serve as volunteer scribes to help alleviate a lot of the paperwork and keep the patients moving through the clinic.

I’ve heard other volunteer physicians describe the experience this way. You show up after putting in a long day at the office or the hospital. You make the drive in rush hour traffic to get to the clinic. But, when you walk through the doors and see that first patient, you realize the impact you’re making and that makes it all worthwhile.

Q: When you’re not working or volunteering with Shepherd’s Hope, what do you enjoy doing?

My wife and I are RV enthusiasts. We just bought our fifth recreational ve-hicle and will be driving it to Illinois this summer to visit our grandkids. I also have tickets to attend the four-day Bonnaroo Music Festival with my daughter in June. I’m a big fan of live music, and this will definitely be a bucket list experience.

The number of uninsured and under-insured patients who seek medical care from Shepherd’s Hope increases with every passing year. And, each year, some have to be turned away because there are not enough volunteer medical professionals like Dr. Torres.

To learn more about how to be-come a Shepherd’s Hope volunteer, con-tact Volunteer Program Manager Abby Seelinger at (407) 876-6699, ext. 233, or abby.seelinger@shepherdshope.org, or visit www.shepherdshope.org/volunteers.

PHYSICIANSPOTLIGHT

Award-winning Pediatrician Provides Hope and Healing to Orlando’s UninsuredAdalberto Torres, Jr., MD, has treated hundreds of children since volunteering for Shepherd’s Hope

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(sponsor education for needy children in India) and Sankara Eye Foundation (free eye surgery for those unable to afford it).

In our “In Other Words” forum this month, Pothamsetty speaks to the im-portance of encouraging patients, friends and family members to participate in colorectal screening.

IN OTHER WORDS by Sri Pothamsetty, MDMake a Difference: Prevent Colorectal Cancer

March has again been designated as National Colorectal Cancer Awareness Month. This annual reminder remains important. Colorectal cancer is the sec-ond leading cause of cancer death in the United States. Lifetime risk of developing colon cancer is around 1 in 20. Nearly 150,000 cases of colorectal cancer will be diagnosed in 2018. Over 50,000 deaths from colorectal cancer are expected to occur this year. Half of these deaths

could be prevented by screening. Mor-tality rates from colorectal cancer have declined during the past two decades, reflecting declining incidence rates and improvements in early detection and treatment.

It has been well established that most colorectal cancers and deaths from colorectal cancers can be prevented through screening. Screening is the pro-cess by which neoplastic and pre-neo-plastic lesions (adenomatous polyps) are detected, and then removed, in asymp-tomatic persons. Colonoscopy remains the gold standard for colorectal cancer screening.

Colorectal cancer has several fea-tures that make it ideal for screening. First, it is both a common and serious (fatal if not detected early) condition. Second, it arises from a known precur-sor lesion, an adenomatous polyp, that is easily identifiable and removable at colonoscopy. Third, screening and pre-vention tests, including colonoscopy are easily available.

Unfortunately, current screening rates are not adequate to prevent this potentially devastating cancer. Just over 50 percent of those eligible have received colorectal cancer screening. Even physi-cians and their families are not uniformly screened. Multiple barriers still exist that prevent everyone from getting a screen-ing test that can potentially save their life.

A very important barrier has tra-ditionally been (horror of horrors!) the bowel prep!!! Fortunately, since we intro-duced low-volume preps such as Suprep in our practice, this has become less of a problem. Cultural taboos still persist, but as public acceptance has become wide-spread over the years, this is not much of an issue anymore. Cost of the colonos-copy, which has been the biggest impedi-ment over the years, has become much less of a problem since Medicare and most insurers have started covering this procedure at little or no out-of-pocket cost to the patient. Especially when done in a surgery center, as we do with most of our patients, the costs to patients are

minimal, if any. Discomfort and pain as-sociated with colonoscopy has become a thing of the past with widespread use of Monitored Anesthesia Care, which we provide to every one of our patients.

On a national and local level, mul-tiple efforts are underway to expand colorectal cancer screening. The Ameri-can College of Gastroenterology, the National Colorectal Cancer Roundtable and numerous other organizations are spearheading multiple programs to this end. Television programs, radio spots, celebrity endorsements, print articles and local lectures contribute to expanded screening.

However, increasing colorectal can-cer awareness by itself is not going to make up the screening gap. Physician encouragement of screening must be-come a daily component of our patient care. A recent CDC report revealed that the main reason individuals failed to get screened for colorectal cancer is that their doctors did not tell them they should get a test. We need to ask the patient, what is it that will make him or her take the next step and get scheduled for a screening test. Of course, we all know that telling a patient to get a colonoscopy scheduled is not going to elicit smiles!

We must lead by example and en-sure that each of us, as well as our family members get age-appropriate screen-ing. Recommendation and example of a trusted physician can be powerful mo-tivators for our patients to get screened. We should not let up on our efforts, until screening becomes universal. Doctors are on the front lines of this battle and are crucial to raising screening rates. It is our responsibility to make a difference in the lives of our patients and their families, and prevent colorectal cancer to the best of our abilities.

Comments or questions? Dr. Pothamsetty can be reached at sripothamsetty@gmail.com. For more information pertaining to colorectal cancer prevention and other digestive health issues, please visit the Orlando Gastroenterology website at supergastro.com

Srikiran Pothamsetty, MD, continued from page 1HEALTHCARELEADER

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“We can do better for them.”Leadership at the City of Orlando was

positive and supportive, along with local economic developers and healthcare exec-utives. The project received an unexpected major boost from a major health system. The healthcare system, whose identity Ponte declined to disclose, demonstrated interest in leasing the smallest tower in the complex. The property being negotiated for the project is a part of the Orlando metro core, the downtown business district.

“That was the most significant piece … I knew then we had a winning develop-ment,” said Ponte, who sought input from

a wide variety of professionals and experts. As a result, the tallest tower is reserved for physicians and medical offices, while the mid-size tower will house patient-focused assisted living, memory care and hospice care.

An indoor urban farm, on-site fitness center and pool are among the tri-plex’s planned amenities.

“Medical experts of all kinds are lend-ing suggestions,” said Ponte. For example, “a neuroscientist will be part of making better environments for degenerative neu-romuscular conditions.”

The latest updates by the development

team include the selection of the general contractor to carry out the vertical con-struction, company yet to be disclosed, and the disclosure of a partnership with The Local Chef -Chef Michael Sterner, who was once executive chef for Florida Hospi-tal. Chef Michael Sterner will help design the facilities as well as develop and lead the operations of the farm-to-table concept for the tri-plex.

The high-rise development will focus on integrating the most advanced technol-ogy into the building design.

“Big data is a big issue for this project,” she said. “We’re thinking along the lines of

artificial intelligence … GPS, internal social media, internal scanning and biometrics.”

The technology development team, led by Jonathan Mendez of M2O Tech-nologies of Lake Nona, will lead the new implementation of various software and hardware devices, including wearables, to facilitate the operations of the facility, track waste for lean adjustments in operations, improve processes and predict trends.

The proposed timeline calls for occu-pancy early 2024.

“It will literally be a true, self-con-tained medical city,” said Ponte.

Orlando Preparing for Second Medical City, continued from page 1

5 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

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More volunteer doctors and nurses needed now more than ever to help � ll the immense

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Shepherd’s Hope, the largest free and charitable clinic in Florida, is seeking Orthopedic Specialists to provide volunteer care for our orthopedic patients on Tuesday’s from 6pm to 9pm

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ORTHOPEDIC PHYSICIANS

Help those in need of hope and healing in our community by joining the over 2300 clinical and non-clinical volunteers at Shepherd’s Hope. 

For volunteer information contact Abby Seelinger, Manager of Volunteer Programs (407) 876-6699, ext. 233 | abby.seelinger@shepherdshope.org

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By NINA TALLEy, MEdSPEAkS

When you think of video games, you

don’t necessarily think of health and well-ness. Sure the WiiFit had its time in the sun, but much like all those Xbox Ki-nect games none of us ever bothered to play, it now gathers dust under our col-lective beds. And yet video games, as well as the technologies that fuel them, have still made a steady and increasing impact on the healthcare industry. New devices like the VimedixAR ultrasound simulator are primed to fundamentally alter how we train our physicians by utilizing Aug-mented Reality. Even here at home, we’ve seen the great work being done by the team at UCF Restores, utilizing Virtual Reality to implement behavioral therapy to patients with PTSD.

Video game and simulation technolo-gies have been applied to almost all fields of medical care, and when applied prop-erly and thoughtfully, are coming back with overwhelmingly positive results. Here is just a short list of some the things video games have recently been proven capable of:

• Improving postoperative pain management in patients

• Helping those with schizophrenia reduce the power of their hallucinations

• Improving triage decision making in physicians

• Improving emotion recognition and social reciprocity in children with autism

• Literally growing brain matter in older adultsIt was this type of promising evidence,

paired with Central Florida’s position as a hotbed for both the video game and healthcare industries, that lead to the cre-ation of MeGa Health Jam. A healthcare focused game jam, breaking down the barriers between our health, gaming, and simulation industries, to create meaning-ful solutions to some of healthcare’s most pervasive issues.

"This (event) is not just about creat-ing games. It's about applying gaming theory and technologies such as AR/VR/Simulation/3D Printing to the healthcare industry,” said Kelli Murray, CEO of Med-Speaks and one of the lead organizers of MeGa Health Jam. “The potential of le-veraging gaming tech and this type of both technical and creative expertise is a wide-open opportunity in health and medicine; particularly in areas like patient engage-ment, rehabilitation, and education.”

Does all of this sound great, but you

have no clue what a game jam is? Don’t worry, you’re not alone. Similar to a hackathon, game jams are usually free-form style events, consisting of pitches that bring together individuals as teams, and then rapid-paced development of video games around a specific theme or prob-lem. But can a game jam mold itself to the rigid standards of evidence-based science? Signs point to yes. Kunal Patel, founder of Indienomicon and co-organizer of MeGa Health Jam, has seen great success with game jams in a similarly rigid field, aero-dynamics and space travel.

IndieGalactic Space Jam, organized by Indienomicon, has been leveraging Florida’s abundant talent pool of Space Coast engineers & scientists together with Orlando’s booming gaming and enter-tainment industry for 3 years. They’ve brought in over 600 participants who have put in around 6,500 man hours, resulting in 80+ unique space themed projects. What’s more, their big-name sponsors like NASA and SpaceX are getting a chance to explore the effects of burgeoning tech-nologies applied to their data with very little cost sunk into R&D.

“Some people may call it R&D and others may call it playing around, but one thing is for certain we're going to open minds and find creative new ways to help physicians, patients and the industry as a whole,” says Patel. “Gaming has been the driver of cutting edge technology the last several decades. We had word processors and spreadsheets in the 80s, but it was gaming that consistently drove our need for faster desktops, laptops, phones, tab-lets, and more. Bringing that same tech-nology into the healthcare space can only help us create solutions with more impact faster than before.”

“We should keep in mind that the number one thing a game team needs to be successful is an engaging user experi-ence that is both memorable and appeal-ing,” adds Murray. “Healthcare is shifting directly into that lane. We need to activate patients in their care, reduce costs, and create differentiators in the market. To get there, the industry needs digital engage-ment strategies.”

MeGa Health Jam will be making its impact April 12th-15th at the GuideWell Innovation Center in Lake Nona, FL. There are 6 challenge categories: Children’s Health, Behavioral & Disability, Aging Well, Engagement & Adherence, Security & Privacy, and Community/Social Re-sponsibility. Organizers expect a turnout of

around 200 developers, and estimate that 25 individual projects will be created.

“What we're doing is taking these two highly specialized industries of healthcare and gaming, that are often living in totally separate worlds, and finding new innova-tions from their intersection,” says Patel.

“Which is why this event is really about cross-industry ideation and the lifting of the veil on how these industries can dynamically work together,” contin-ued Murray. “With Central Florida's rich talent pool of leading healthcare organi-zations combined with the students and graduates coming from entertainment, arts, and media universities and programs, we know that Orlando is the best place to make it happen.”For more information, please go to www.megahealthjam.com.

HEALTH INNOVATORS

Ready Player One? ... Florida’s First Health & Medical Game Jam

Disclosure: Readers, please take note that the companies featured in the Health Innovators section have not paid for or bartered for these acknowledgements. All companies are selected based on merit, intrigue, and their potential to move healthcare forward towards the Quadruple Aim. In a noisy and biased market, we believe this to be a valuable distinction.

SourceS

5 "Playing Super Mario 64 increases hippocampal grey matter in ... - PLOS." 6 Dec. 2017, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0187779. Accessed 28 Feb. 2018.

4 "Virtual Reality Enabled Training for Social Adaptation ... - Springer Link." 17 Jun. 2016, https://link.springer.com/chapter/10.1007/978-3-319-41165-1_9. Accessed 28 Feb. 2018.

3 "Efficacy of educational video game versus traditional ... - The BMJ." http://www.bmj.com/content/bmj/359/bmj.j5416.full.pdf. Accessed 28 Feb. 2018.

2 "Schizophrenia patients calmed by video game - BBC News - BBC.com." 12 Feb. 2018, http://www.bbc.com/news/health-43003378. Accessed 28 Feb. 2018.

1 "Development, Usability, and Efficacy of a Serious Game ... - NCBI - NIH." 10 May. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443914/. Accessed 28 Feb. 2018.

David Sawyer is the founder of TSOLife (The Story Of Life), a company based in Tampa that focuses on preserving legacy and passing down life stories for future generations. David, after the passing of his grandmother, realized he never had the opportunity to capture her life stories. That’s why he created an online platform and story recording application so that one day, no grandchild will have to wonder who their grandparent was. Strategic partners and investor opportunities available. Learn more at: www.get.tsolife.com/info

FEATURED INNOVATORS:

Based in Gainesville, BLUEWAVE is a medtech company based out of the Innovation Hub at the University of Florida. The device - a water free, detergent free, and chemical free plasma infusion - disinfects and deodorizes items that are virtually impossible to clean and kill 99.9% of bacteria (such as MRSA and E. coli), viruses, and fungi. Strategic partner and investment opportunities available. Learn more at: www.bluewave.tech

Based in Orlando, the JourneyLabs digital engagement platform creates simple, easy-to-use, tailored outreach experiences via mobile phone. Although use cases are plentiful, think of it as a GPS for patients with custom prompts for self-care, education, and a help now line. Investment opportunities are available. Learn more at: www.journeylabs.io

Based in Tampa, Verapy utilizes virtual reality (VR) technology to empower patients to participate in their physical therapy treatment. This immersive exercise game experience allows patients to perform rehab at home, which also minimizes barriers in traveling to or affording unnecessary clinic visits. Investment and Advisor opportunities are available. Learn more at: www.verapytherapy.com

Based in Miami, Room2Care is an end-to-end network of private caregiver homes that provide a significantly lower cost alternative to institutional assisted living. Seniors and caregivers are matched as “roommates” using algorithms much like the AirBnB lodging model. Strategic partner opportunities available. Learn more at: www.room2care.com

UPCOMING EVENTS

MedSpeaksTM showcases the most exciting experts, events and innovations in Central Florida by bringing together the state’s largest community network of Health Innovators. We have converged over 1,400 healthcare professionals including clinicians, entrepreneurs, and technologists to discuss and promote the problems facing healthcare today and the innovations reshaping the future. www.medspeaks.com

SynapseFLMARCH 28-29, 2018 | TAMPA, FLsynapsefl.com

HealthCon APRIL 8-11, 2018 | ORLANDO, FLhealthcon.com

MeGa Health JamAPRIL 12-16, 2018 | ORLANDO, FL megahealthjam.com

HIMSS 2018MARCH 5-9, 2018 | LAS VEGAS, NVhimssconference.org/

8 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

By LARRy JONES

The Integrated Independent Physi-cians Network was formed in 2015 to align independent physician practices in a uni-fied network to provide a vehicle for solo and small practices to compete in the ever-changing healthcare market, and provide a cost effective delivery system for central Florida patients.

Today the IP Network has over 1,000 Independent Physicians in eight counties and growing, and has also developed an ancillary network of providers, resulting in a complete independent healthcare delivery system. The result offers patients healthcare services without additional costs, called facility fees, charged by any healthcare faculty owned by a hospital system. These facility fees not only cost the healthcare system significant extra dollars, but also cost patients higher copays and out-of-pocket costs. This results in higher premiums for all payers and employers.

There will always be a need and place for hospital-based care, but why should pa-tients spend more than necessary for care, whether it is paid by their insurance or out-of-pocket costs? One example is that in 2016 there were 9 million emergency room visits in Florida, and it is estimated that 71 percent of those ER visits could have been provided by a primary care physician or urgent care center resulting in hundreds of millions of dollars in savings to the sys-

tem and patients. Independent urgent care centers charge significantly lower fees than hospital-owned urgent care or free standing hospital owned ER facilities.

One of the most significant impacts em-ployers can have on their healthcare costs is to educate their employees and families to access care with independent physicians and independent ancillary providers. IHP man-ages and owns IPAs, MSOs, and ACOs throughout Florida. IHP’s only mission is to preserve and protect the independent practice of medicine. Nothing happens in healthcare until a physician treats a patient, writes a prescription, or admits a patient to a healthcare facility, yet the imbalance of where our 3.6 trillion U.S. healthcare dollars go results in only 8 percent of those dollars going to physicians today.

The shift to value-based outcomes in the delivery of patient care and reimburse-ment is changing the landscape of healthcare with all stakeholders. Hospital systems con-tinue to position themselves to acquire and build delivery systems and ancillary facilities well beyond the walls of the hospital. This strategy by large hospital systems is driving up healthcare costs, premiums, and out of pocket costs to consumers and patients, and many times results in a referral gateway to hospital ERs. Patients often don’t even real-ize the difference in cost until they receive a bill for significantly more than expected.

Clinically Integrated Networks (CINs) have been developed in central Florida by both Florida Hospital and Orlando Health, along with the Integrated Independent Physicians Network’s CIN. These narrow networks all provide complete healthcare delivery systems for patients, however, the

IP Network represents independent physi-cians and ancillary providers, eliminating higher facility fees and costs.

Recently, Disney chose to contract di-rectly with the two hospital CINs for their self-insured HMO plan, eliminating many in-dependent physicians, both primary care and specialists, causing their employees to change physicians and convert to hospital-owned physicians for care. Disney’s decision to direct contract with the hospitals may come back to haunt them over time, resulting in even higher costs to them and their employees.

Independent physicians continue to fend off hospital forces that eliminate their access to patient care, trying to control their payer- physician relationships and con-tracting, and moving patients seeing inde-pendent physicians to their hospital-owned practices. The patient is usually unaware of this strategy and finds themselves paying higher out-of-pocket costs for care.

Unfortunately, when a patient ends up in a hospital ER or is admitted, they usually have no choice in which physicians provide their care. One solution is to work through their primary care physician and hospital-ist to access the physicians of their choice. Patients need to be more educated and in control of this process by asking for their doctors when in an acute care position. We have experienced numerous incidences where our patients are redirected to hospi-tal-owned physicians.

If the large self-insured employers in central Florida like Disney are convinced by the hospital CINs to sign these direct to employer contracts, costs will only increase, and access to care will be limited to hospi-tal-owned physicians.

Employers are continually seeing dou-ble digit rate increases in the fully-insured area, and self-insured employers continue to experience higher claims costs for their employees and families. Independent phy-sicians and independent ancillaries are the solution to these continued rising costs.

Family of four premium costs are ap-proaching $2,000 per month, and that can only represent 60 percent of total costs. It is es-timated that up to 40 percent of costs are paid out-of-pocket by patients today. A significant saving to patients can be made if services are provided by an independent provider.

It would seem that employers and con-sumers would wake up and understand that healthcare costs can be reined in if transpar-ency in pricing and quality are more evident. Our legislators need to continue to explore alternative delivery methods, just like we do in all other segments of our economy.

Buyer beware, consumer be educated, employer continue to educate. Central Florida has one of the finest healthcare de-livery systems in the U.S. Let’s just use our resources appropriately.

Larry Jones, is the Executive Direc-tor of the Integrated Independent Physicians Network and Chief Execu-tive Officer of Independent Health-care Partners (IHP), a Maitland-based healthcare company. He can be reached at ljones@hpofflorida.com

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9 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

By WENdy SELLERS, MHR, MHA, SHRM-SCP, SPHR

Q: Can I ban my employees from bringing a gun into our workplace?

As of today, under the “Preservation and Protection of the Right to Keep and Bear Arms in Motor Vehicles Act of 2008”, Florida law allows people a right to carry a concealed weapon in a vehicle on com-pany property. This is often referred to as the Parking Lot Law (790.251). People can-not be required to waive his or her right to possess and securely keep firearms and ammunition locked within his or her motor vehicle by virtue of becoming a customer, employee, or invitee of any employer or business establishment within the state, un-less specifically required by state or federal law. There are of course many exception to this “Parking Lots Law”. For example guns are not allowed on school property or property of any correctional institution, as well as a few other exceptions. For more information, review the Florida Statutes, Chapter 790 “Weapons and Firearms”.

However, employees can be banned from carrying a gun into the workplace. This covers employees, independent con-tractors, volunteers and interns, to name a few. It is advised that you are clear with your weapons and firearms policy, provide spe-cific details in writing and require employees to sign that they acknowledge your policy. Often this policy is included in an employee handbook. This may be a policy you may want to resist and remind people of yearly.

Q: I am having trouble hiring the right person for the job? What am I doing wrong?

Having the right employees in the right roles for the right amount of time simply cannot be downplayed. It does seem like a pretty easy concept, right? Then why do so many companies get it wrong?

During the hiring process, one major reason companies inadvertently hire the wrong people is because it is not clear on what skills or attributes they are looking for. Creating basic job descriptions for every role in the company will save time, money and painful experiences for all in-volved. Another major reason that compa-nies inadvertently hire the wrong person is that there is a lack the time allocated to management to find and screen appropri-ately qualified candidates as well as a lack of time to conduct effective interviews. Often the manager tasked with filling the

position is stressed, carrying a heavy work load and feels rushed to fill the position with any warm body. Any manager put in this position may hire the person who may just be “good enough” and end up with him/her not being able or willing to meet company expectations. In order to avoid hiring the wrong candidate, time must be allotted to hiring managers so that they can take an appropriate amount of time to find the right types of candidates, ask the right questions, get the right people involved in asking those questions and to finally give realistic job previews to the top candidates. Supply and demand drives the availability of qualified candidates there-fore every position will take a different amount of time to properly fill. For some positions, this may take 12 hours over 2 weeks; for other positions this may take 10 hours a week over 2 months.

For more HR advice, enjoy our Whitepaper “5 Ways to Destroy Your Business.” It is a tongue in cheek way of pleading with leaders to do the exact opposite in order to create a sustainable, profitable organization. This Whitepa-per can be found on the resource page of www.blackrainpartners.com

Q: I need to motivate my staff. Their engagement level seems to have fallen to the way side along with their productivity level. What advice do you have?

Did you know that companies with engaged staff have higher profit? Unfor-tunately, approximately 70% of the work-force is actively disengaged. Supervisors have the greatest influence over their em-ployees engagement level. The best way to motivate your staff is to focus on their strengths, not their weaknesses. Too often, we focus on the negative yet no matter how much you hammer your employees, their weakness will not magically turn into strengths overnight. Training and development may help. Coaching may help. Or perhaps you simply are expect-ing a magician to appear instead of real-izing that the skill you need must be found somewhere else. Work with your employ-ees to determine their strengths and clarify their roles around their strengths. Then empower them to take ownership of their role. Guess what comes with empower-ment? Accountability! Accountability is not micro management. It is being clear with expectations and deadlines, setting check in and follow up procedures, of-fering assistance and being clear with

consequences of not meeting deadlines including failing to satisfy the vendor or patient. A lack of patient satisfaction can lead to revenue loss which can lead to job loss. But on the other hand, does meeting deadlines and achieving excellence in cus-tomer or patient satisfaction lead to reve-nue increase for the employee? Find a way to reward them (it is not always money).

The best supervisors know their peo-ple well. They know them as human beings who have lives outside of work. They un-derstand their individual needs and traits, personal motivations, career goals and their strengths and weaknesses. Take note that engaging your employees takes time. Listening is important. Asking for their opinions and actually implementing some ideas is vital. An engaged employee needs to feel that their opinion and experience is valued. Continuous feedback is necessary as the once a year performance review is no longer effective and has not been for a while. So take this opportunity to schedule a 30 minute coffee session with each of your employees to really get to know them. Then schedule a follow up meeting to dis-cuss performance: your performance (what can I do better?) and theirs (what are your challenges?). You may be surprised what you will learn. Good luck!

Q: I hear other companies talk about Vison, Mission and Values. Aren’t these just motivational posters for a wall?

Unfortunately, this is what they tend to become: dust builders. Ask yourself

this question “how can I lead my team to achieve my vision if they do not know what it is?”. A true leader has a vision and hires, trains and develops people to fulfill that vi-sion with a deadline in mind. The vision could be as simple as “Making our com-munity the healthiest place to live through empathetic medical care”; or as optimistic as “To become the leading holistic health-care practice in the USA by 2030”.

So what are the difference between Vision and Mission? A vision statement for a company focuses on the potential inherent in the company’s future, or what they intend to be. The vision statement is simply a description of the “what,” mean-ing, what the company intends to be-come. The mission statement is simply a description of the “HOW,” meaning, how the company intends to achieve its vision starting now. Values are beliefs; what you stand for; what your company stands for. Values should be used in the hiring pro-cess and during performance and behav-ior conversations. Customers should know your vision, mission and values so they can help support you. Remember that a goal without a plan is just a wish. A goal with plan is a vision! A communicated vision keeps the team on track to achieving it!

Wendy Sellers “The HR Lady” is the COO of BlackRain Partners, a business consulting company. She has a Master in Health Care Administration, a Mas-ter in Human Resources, SHRM-SCP and SPHR certifications and is also a licensed Florida 2-15 life and health agent which she uses solely to advise and educate BlackRain’s clients.www.blackrainpartners.com

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By COREy BURkE

Cryos International is the world’s largest sperm bank and first free standing, independent egg bank in the U.S. and is regarded as an industry leader in the cryo-preservation of human donor sperm and eggs. Cryopreservation has turned out to be the perfect way for women to not be con-fined to their biological clocks, and Cryos International is fully prepared to offer this procedure to women who want it.

Women are no longer enforced to be the homemakers and caretakers that are pressured to start families at such young ages like in the 1960’s, but instead rising to the top of corporate ladders and pursuing long professional careers. Now that women are taking on top careers and higher and longer-term educations, beginning a family has begun to be pushed to later in life, and for some women putting off having chil-dren results in fertility issues and many not being able to have children of their own. Women began to become restricted to their ticking biological clocks, but now they have another choice, fertility preservation.

Until recently, fertility preservation was not available to women, but only available to men. Unlike men, women are born with all the eggs they will ever have, and at birth they have approxi-mately 600,000 in their ovaries, but these eggs are lost at the tune of about 600 per month until they are completely gone at menopause. By age 36, almost half of all women’s eggs are aneuploid, meaning they have extra or missing chromosomes, and in most cases these aneuploid eggs will not produce a viable pregnancy. Knowing that the biological clock is ticking, it is im-portant for women to know that they have the opportunity to preserve their precious eggs as well. Cryos International is one of the only sperm and egg banks in the U.S. to be equipped with an in-house embry-ology laboratory along with state-of-the-art facilities, including an office surgery center. Patients will be able to have their egg retrieval done at the same location to provide optimal convenience.

In the Cryos embryology lab, the vitri-fication of the retrieved eggs will take place. Vitrification is the process of removing cellu-lar fluids from the egg, replacing them with cryoprotectants like DMSO and ethylene glycol, and rapidly cooling them to -196°C in liquid nitrogen. Vitrification differs from freezing in that freezing involves the forma-tion of ice crystals which damage cell mem-branes killing the cell. Vitrification involves cooling at a rate of – 10,000° C/minute, a rate so rapid that ice crystals cannot form. In 2012 the American Society for Reproductive Medicine (ASRM) declared the procedure standard of care. Vitrification survival rates reached nearly 100 percent and pregnancies using vitrified eggs equaled those of fresh eggs. Vitrification has greatly slowed the ticking of

the biological clock and empowered women to have control of both their professional life as well as their family life.

Fertility preservation has become known as Social Egg freezing and com-panies like Apple and Facebook now offer social freezing to their female employees, showing their encouragement for women to hold professional and long-term careers. Parties even began to pop up in cities like New York and Los Angeles to promote the benefits of fertility preservation. In 2016 the Department of Defense announced they would cover the cost of sperm and egg freezing for active duty military members. The new era of women being able to take control of their fertility is coming to life.

So how does the process of fertility pres-ervation work? Women begin by contacting an egg bank, reproductive endocrinologist (REI), primary care physician, or attend a so-cial egg freezing event. The next step is usu-ally a consultation with a physician or other medical professional to explain the procedure and the risks and benefits associated with it. Cryos has highly experienced physicians that provide all the information patients need and want to know about the procedure. If they elect to proceed they are scheduled for an exam with an REI who will access their fertility status using a blood test to determine the anti-mullerian hormone(AMH) level and ultrasound to perform an antral follicle count. AMH does not predict a specific number of eggs, but higher values indicate a higher number of eggs remaining in the ovaries. Once the preliminary testing is complete, the patient is often put on oral birth control to regulate her menstrual cycle.

Once they reach the appropriate stage they begin taking injectable go-nadotropins for approximately 8-12 days. These medications help the ovary to ma-ture more eggs than would normally ma-ture in a cycle. Depending on the age and ovarian reserve of a woman the number that mature can range from 5 to 50 eggs. While the patient is taking the medica-tions, she is monitored at the REI’s office every 2-3 days to track the development of the eggs through estradiol levels and vagi-nal ultrasounds. Once the follicles (ovar-ian structure that contains the egg) reach a

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By RON FRECHETTE, THE CyBER GUy

Last month we discussed the impor-tance of implementing good cybersecurity health practices in 2018. We provided a cyber-health checklist which I’m hopeful most of our readers are working towards completing. Based on what cybersecurity experts are predicting we will see from cyber criminals in 2018, I strongly encour-age revisiting last month’s lesson. We will be writing more about the latest security threats in the months ahead to keep you ahead of the game.

Our objective this month is to provide a visual perspective of what our online presence looks like in cyberspace. In the IT security industry, we refer to a person or company’s online presence as a digital footprint.

There are billions of digital foot-prints in cyberspace. Each time you hit the send button on a digital device, your IP address launches packets of data into cyberspace. These data packets travel at lightning speed to other digital footprints that you have selected to send. This could be an email, paying a bill online, sending a client an agreement, or conducting some on-line banking.

The digital footprints we interact with depend on our personal and professional affiliations. They vary widely in size de-pending on a person or company’s inter-net presence. For instance, the IRS and

Amazon have extremely large digital foot-prints, whereas a local business would be much smaller.

Let’s analyze the components of a digital footprint.

The circle represents our security perimeter. This is where we put security controls in place to reduce the risk of our sensitive information from being compro-mised. The lines around the circle repre-sent data attempting to enter and exit our environment. The lock inside the circle represents the area where our sensitive information resides. This could be credit card data, PII (Personal Identifiable In-formation like DOB, SSN, wills, banking info, etc.), PHI (protected health informa-tion) and/or Client Data.

Q: Who is trying to steal my data and how do they do it?

There are millions of cybercriminals across the world who come to work every day with the sole purpose of stealing infor-mation online that they can sell on the Dark Web for monetary gain. Over the years they have littered cyberspace with countless types of worms, bugs, viruses, ransomware, brute force hackers, trojans… you name it. There are over 500k new malware vari-ants being launched into cyberspace daily. Unfortunately, as more and more people discover the internet, the problem will only continue to increase. The digital age is forcing us begin adopting a “defense in depth” mindset as we become more depen-

dent on technology to live our lives. There are 4 threat vectors around the

security perimeter of every digital footprint that cybercriminals try to exploit.

1. People – Spouses, children, and/or business colleagues having or not having the awareness that these vulnerabilities exist, how they behave when they are confronted by a phishing email and how they respond. Are they a defense or liability? Knowledge is power.

2. Processes – Having formal policies and procedures in place with detailed guidelines and having been properly educated on the threats of cyber-attacks.

3. Facilities - This has to do with physical controls. Do you have locks in areas of your home or business where sensitive information can be accessed? If you have servers in house, are they under lock and key with 24-hour camera surveillance?

4. Technologies – Ensuring that the networks and applications you utilize have been properly vetted and can guarantee an acceptable level of security. This applies to your digital footprint

and the digital footprints of others that

you interact with on a routine basis. Never feel shy about evangelizing what you learn about good cybersecurity hygiene with friends, family and business colleagues. It will enhance the security of everyone you interact with in cyberspace.

Cybersecurity experts are predicting 2018 will be more of the same that we saw in 2017 only with much more sophistica-tion and perseverance. As new technology advances such as machine learning and artificial intelligence, so will the tactics of the bad guys.

Over the next few months, we will begin to break down each of these threat vectors and share ways you can begin to identify the security vulnerabilities that exist within digital footprints. We will arm you with the tools and knowledge to iden-tify where those gaps are and provide guid-ance to install the proper security controls.

So, stay tuned and we look forward to continuing on in our journey to help our readers remain a step ahead of the cyber thugs and stay safe in cyberspace.

Ron Frechette, Co-Founder & Managing Partner of GoldSky Security is a cyberse-curity and healthcare entrepreneur who over the last several years dedicated his career to helping enterprise companies reduce the risks of cyber-attacks. Ron left the enterprise security world in 2015 and co-founded GoldSky Security, LLC. Ron’s vision is to build cybersecu-

rity firms across the US that exist to help small-midsize businesses implement affordable cybersecurity solutions. Ron can be reached at ron.frechette@goldskysecurity.comQuestions? Send me a tweet @GoldskyRon.

Securing Our Digital Footprints

Timing of Reproduction is at Hand, continued from page 10certain size, the patient is given a “trigger” of hCG or Lupron to induce ovulation 36 hours following the trigger.

Approximately 34-35 hours later the eggs are surgically removed using an ultra-sound guided needle that passes through the vaginal wall into the ovary. The needle passes into the follicles and aspirates the fluid containing the egg from them into a test tube. The tube is then given to the em-bryology laboratory which searches the fluid for the egg. The eggs are then incubated for a short time before the cumulus cells are removed and the maturity of the eggs evaluated. Only metaphase II (MII) eggs are considered viable for use in IVF and all others are discarded. The mature MII eggs are then vitrified and stored until the patient is ready to use them. At Cryos, a storage center is held on site for direct storage and regular monitoring. During this procedure, the patient will be under mild anesthesia so no severe pain will be felt. Women who have come to Cryos International for their treat-ment have mostly claimed to feel only a bit of cramping after the quick surgery is com-plete. The doctors and physicians at Cryos strive to make the procedure as painless and as comfortable for women as possible.

As with any surgical procedure there are risks. The decision to do social egg freezing should be well thought out and researched and should be viewed as an in-surance policy that may never be needed. Those interested in social freezing should understand that not all facilities are cre-

ated equally when it comes to freezing eggs. The facility that is chosen should preform egg freezing routinely and have a solid history of good results, such as that of Cryos International which has a full medical team of experts that have com-pleted numerous successful procedures. Many clinics offer egg freezing as well,

even though they may only preform a few procedures per year and may not be fully competent in the process.

Visit Cryos International’s state of the art facility located in Orlando near UCF for any of your sperm or egg needs. Social egg freezing is offered to the public in ad-dition to their donor products. If you are

interested in fertility preservation/social egg freezing, contact the experts at Cryos.

Corey Burke is the Tissue Bank Director at Cryos Interna-tional Sperm and Egg Bank in Orlando, one of the industry leaders in reproductive technology. Cryos offers fertility preservation to the general public. For further details please call 407-203-1175

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Florida Hospital Medical Group and the medical team at Cancer Institute of Florida have added an-other award-winning cancer special-ist with the arrival of Martin Dietrich, MD, PhD in early 2018. Dr. Dietrich is a board-certified medical oncolo-gist with fellowship training in hema-tology/oncology and a background in molecular genetics research.

Dr. Dietrich sees patients with many types of malignancies but will have a special focus on research, prevention and advanced treat-ments for breast cancer at the Can-cer Institute of Florida.

A noted clinician and researcher, Dr. Dietrich is especially proud of his numerous scientific publications that have contributed "snippets" to the puzzle of clinical and scientific prob-lems. He has had the opportunity to conduct groundbreaking medi-cal oncology research with multiple, prestigious organizations including the German Cancer Research Cen-ter in Heidelberg, MD Anderson Cancer Center in Houston and the University of Texas Southwestern Medical Center in Dallas.

Dr. Dietrich arrives in Cen-tral Florida from Pembroke Pines,

where he was a clinical assistant professor at Florida International University's Herbert Wertheim Col-lege of Medicine and a member of the thoracic oncology team at Me-morial Healthcare. Prior to his work there, he undertook his hematol-ogy/oncology fellowship, internal medicine residency and PhD stud-ies in molecular genetics all at the University of Texas Southwestern. He earned his medical degree with distinction from Germany's Univer-sity of Heidelberg. A marathon run-ner and world traveler, Dr. Dietrich is fluent in English and German with professional proficiency in Spanish. "We are honored to bring Dr. Diet-rich to our practice and look forward to his continued advancements in breast cancer treatment and re-search," said Tarek M. Mekhail, a leading physician at Cancer Insti-tute of Florida. "He is an outstand-ing physician with a true passion for helping patients along every step of their healthcare journey."

Cancer Institute of Florida Welcomes Martin Dietrich, MD, PhD

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity

CMS is pleased to announce a new funding opportunity for the develop-ment, improvement, updating, and expansion of quality measures for use in the Quality Payment Program. CMS will be partnering directly with clinicians, patients, and other stakeholders to pro-vide up to $30 million of funding and technical assistance in development of quality measures over three years.

Cooperative agreements provide a unique opportunity for CMS to partner with external entities, such as clinical specialty societies, clinical professional organizations, patient advocacy orga-nizations, educational institutions, in-dependent research organizations, and health systems, in developing, improv-ing, updating, and expanding quality measures for the Quality Payment Pro-gram. By giving external entities needed resources to help guide their measure-development efforts though this fund-ing opportunity, CMS can leverage the unique perspectives and expertise of these external entities, such as clinician and patient perspectives, to advance the Quality Payment Program measure portfolio. The cooperative agreements will allow CMS to collaborate with stakeholders to address essential top-ics such as: clinician engagement, bur-den minimization, consumer-informed decisions, critical measure gaps, quality measure alignment, consumer-informed decisions, clinician engagement, and efficient data collection that minimizes health care provider burden.

The priority measures developed, improved, updated or expanded un-der the cooperative agreements will be aligned with the CMS Quality Measure Development Plan. The CMS Quality Measure Development Plan provides a strategy for filling clinician and spe-cialty area measure gaps and for rec-ommendations to close these gaps in order to support the Quality Payment Program, and identifies the following initial priority areas for measure de-velopment: Clinical Care, Safety, Care Coordination, Patient and Caregiver Experience, Population Health and Prevention, and Affordable Care. The gap areas include, but not limited to: Orthopedic Surgery, Pathology, Radiol-ogy, Mental Health and substance use conditions, Oncology, Palliative Care, and Emergency Medicine.

More broadly than the CMS Qual-ity Measure Development Plan, which is specific for the Quality Payment Program, CMS measures work is guid-ed by the Meaningful Measurement framework which identifies the highest priorities for quality measurement and improvement. The Meaningful Measure Areas serve as the connectors between CMS goals under development and in-dividual measures/initiatives that dem-onstrate how high quality outcomes for

our Medicare, Medicaid, and CHIP ben-eficiaries are being achieved. They are concrete quality topics which reflect core issues that are most vital to high quality care and better patient outcomes.

Through these cooperative agree-ments, CMS aims to provide the nec-essary support to help external entities expand the Quality Payment Program quality measure portfolio with a focus on clinical and patient perspectives and minimizing burden for clinicians. Focus-ing on patient perspectives will ensure measures focus on what is important to patients and drive the improvement of patient outcomes. To accomplish this, the cooperative agreements prioritize the development of: outcome mea-sures, including patient reported out-come and functional status measures; patient experience measures; care co-ordination measures; and measures of appropriate use of services, including measures of overuse.

For more information, search for the Medicare Access and CHIP Re-authorization Act of 2015 (MACRA) Funding Opportunity: Measure Devel-opment for the Quality Payment Pro-gram on Grants.gov or visit our web-site, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html.

14 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

During the sixth annual Lake Nona Impact Forum Tavistock Development Company announced the creation of an innovative wellness, performance and medically integrated fitness facility in part-nership with Signet, LLC. and its subsidiary Integrated Wellness Partners (IWP).

Situated within Lake Nona, the world's most sophisticated well-ness community as noted by the Global Wellness Institute, the new 110,000+-square-foot center will be lo-cated across the street from Lake Nona Medical City in the second phase of development of the Lake Nona Town Center, Lake Nona's premier entertain-ment, dining and shopping district.

The new wellness campus will be one of the most comprehensive in the region, offering a broad array of health and wellbeing programs and services for the entire community, for Lake Nona residents, families, employees, recreational fitness and sports enthu-siasts, as well as elite athletes. Mem-berships will be available, though rates have not yet been established.

The facility will take a personal-ized approach to each member. The staffing model, intake process and the technology provided to each member is a tailored plan, which is updated in real time and based on the member results.

"The creation of this world-class facility in Lake Nona is yet another ex-ample of how we are building out one of the most unique and comprehensive wellness communities in the country," said Gloria Caulfield, executive director of the Lake Nona Institute. "This best-in-class collaboration with Signet and IWP will create an incredible regional as-set, offering world-class programs and services across the entire spectrum of health and wellbeing. No matter where you are on your personal wellbeing jour-ney, this new campus will offer some-thing to help get you to that next step."

Jim Ellis, managing director of IWP, describes the Lake Nona Wellness Center as the next evolution in health

and wellness-with a community-based, scientific and medically integrated ap-proach to combat deteriorating health and skyrocketing costs of health care.

"The only solution to overcoming the national health care crisis is pre-vention, that comes ultimately through lifestyle change," said Ellis. "The over-whelming evidence shows that we need to deliver impactful solutions that create community environments where, increasingly, the default choices for individuals, families and employees are healthy choices. The Lake Nona Wellness Center delivers on the vision and promise made by Tavistock to the entire Lake Nona community to offer its membership a healthy, happy life-

GrandRounds

Dr. Jessica Narváez-Lugo, a board-certified doctor in Gastroenterology, obtained her medical degree in 2003 from Ponce Health Sciences University in Puerto Rico.

SheShe completed her fellowship in Gastroenterology at the University of Puerto Rico School of Medicine and its affiliated hospitals.

Dr. Narváez-Lugo is passionate about diagnosing and treating all gastrointestinal disorders but has special interest on Abdominal Pain, Anemias, Gastrointestinal Bleeding, Constipation, Diarrhea, Diverticulosis, SwallowingSwallowing Disorders, Gallbladder Disorders, Gastroesophageal Reflux Disease (GERD), Liver Diseases such as Hepatitis C (HCV), Inflammatory Bowel Disease (IBD, such as Ulcerative Colitis and Crohn's Disease), Irritable Bowel Syndrome, and Peptic Ulcer Disease.

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BASHER ATIQUZZAMAN, MD “DR. ATIQ”GASTROENTEROLOGIST

Affectionately known to his patients and staff simply as Dr. Atiq, Basher M. Atiquzzaman, MD, brings an exceptional level of expertise to the treatment of diseases and disorders that affect the stomach, colon, intestines, liver, pancreas, and esophagus. With more than 20 years of clinical experience, and advanced endoscopy training, his skilled hands, precise techniques and compassionate approach are preferred by many for therapeutic and diagnostic endoscopies and colonoscopies. Providing full service gastroenterology and hepatology medical services, Dr. Atiq performs endoscopy procedures at the Endo-Surgical Center of Florida.

DR. SAM ATALLAH, MD FASCRS, FACSCOLON AND RECTAL SURGEON | DIRECTOR OF RESEARCH & CLINICAL TRIALS | WWW.DRATALLAH.COM

Dr. Atallah is among the most well known colorectal surgeons in the world. He moved to Orlando in 2007 after completing training at Houston’s Texas Medical Center with Surgical Oncology training at MD Anderson Cancer Center where his training had earned him double-board certifi cation in General Surgery and Colorectal Surgery. Two years to the day after completing fellowship training in colon & rectal surgery, Dr. Atallah performed the world’s fi rst TAMIS operation in Winter Park, FL on June 30, 2009. This created a new approach to treating rectal cancers and polyps, that is now being practiced in more than 50 countries. He is one of the leaders in advanced technology for rectal cancer surgery and has developed the technique of stereotactic navigation for transanal total mesorectal excision (taTME) — an important step forward in the evolution of computer-assisted surgery.

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The Blood & Marrow Transplant Center is pleased to welcome Juan Carlos Varela, MD, PhD. Dr. Varela is board certified in hematology.

"We're very excited to have Dr. Varela join the Blood & Mar-row Transplant Center," said medi-cal director, Steven C. Goldstein, MD. "His clinical interests in novel immune therapies for hematologi-cal malignancies and bone marrow transplantation, as well as treat-ments for leukemia, lymphoma and multiple myeloma will be of great benefit to Orlando and our patients from around the world."

Dr. Varela obtained his MD,PhD from the Medical University of South Carolina in 2010. He received his residency training in internal medi-cine in the Osler medical training program at the Johns Hopkins Hos-pital. Subsequently, he completed his fellowship training in hematol-ogy at the Johns Hopkins Hospital and the Sidney Kimmel Compre-hensive Cancer Center. Dr. Varela

is an award-winning researcher and physician, having been honored as a Calebresi Scholar and an Abney Scholar at the Medical University of South Carolina in recognition of clinical excellence.

Dr. Varela is a member of the American Society for Blood and Marrow Transplantation and the American Society of Hematology. He is the principal investigator for numerous national clinical trials.

Dr. Varela's areas of specialty include:

• Clinical Trials in Cellular Ther-apy

• Immunotherapy• Autologous and Allogeneic

Blood and Marrow Transplantation• Acute and Chronic Graft vs

Host Disease• Hematologic Malignancies

Florida Hospital Medical Group's Blood & Marrow Transplant Center welcomes Dr. Juan Carlos Varela.

Tavistock Announces New Wellness, Medically Integrated Fitness Facility in Lake Nona

15 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

style. This will then have a ripple effect on not only the Lake Nona community but many others for years to come as Lake Nona becomes a health and well-ness flagship model for the country and around the world."

The Lake Nona Wellness Center will offer a medically-based fitness cen-ter, sports performance training center, physician offices, community educa-tion spaces, and community-based programming, which extends well be-yond the walls of the brick and mortar facility. Its programming and features are designed to create and nurture an "ecosystem of wellness" that encom-passes individuals, families, businesses and institutions, all supported by the medically-integrated health and well-ness center platform, which serves as the hub for the model.

The facility will seamlessly in-tegrate state-of-the-art physical re-sources, experts in preventive health, wellness and medicine, as well as a commitment to advancing the under-standing of the science around health and wellness promotion, offering the Lake Nona community:

• Health and fitness opportunities for all ages and levels of fitness

• A Sport Performance Institute geared toward improving athletic per-formance for all ages and abilities

• Medical services and educational programming offered by clinical and wellness partners based in the facility, creating employee wellness program-ming, sports performance training, and other onsite activities that create a "bridge" to the facility

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Novlet Mattis has been named Chief Information Officer for Orlan-do Health. In this position, she is re-sponsible for establishing the vision and direction of the organization's Information Systems in concert with its global corporate strategy. She oversees the Information Technol-ogy division representing an annual spend in excess of $145 million. Ms. Mattis joined Orlando Health on January 11, 2018, reporting to Bernadette Spong, CPA, Chief Fi-nancial Officer.

"We are extremely pleased to have Novlet join the organization," said Mrs. Spong. "The healthcare environment continues to increase in complexity, especially in the area of information technology. Novlet's leadership experience and exper-tise in the IT field are key to Or-lando Health's expanding use and safety of electronic information."

Prior to joining Orlando Health, Ms. Mattis served as Vice President of Information Technology for As-cension Information Services in St. Louis, Missouri where she led a team that supported more than 125

hospitals across the United States and internationally. In that role, she provided executive leadership for IT cost reductions and operational optimization including applications rationalization, innovations to ad-vance clinical and business strate-gies, and supported a number of enterprise wide corporate func-tions.

She has also held leadership positions at Dell Global Services, Lucent Technologies and AT&T as well as serving as Vice President of IT and Chief Information Officer for Rex Healthcare in Raleigh, NC.

Ms. Mattis is a native of Ja-maica. She earned her Bachelor of Business Administration degree from Howard University in Washing-ton, DC, and an MBA from George Washington University. She holds the CHIME Certified Healthcare CIO (CHCIO) certification, is a con-ference speaker and writer.

Novlet Mattis Joins Orlando Health as Chief Information Officer

Tavistock Announces New Wellness ... continued

Orlando, FL (March 1, 2018) -Mi-chele Napier, vice president of revenue management and chief revenue officer for Orlando Health has been named one of the nation's top 15 female rev-enue cycle management (RCM) leaders to know in 2018. The honor, from indus-try publication Becker's Hospital Review, recognizes progressive revenue cycle thought leaders who are helping to re-shape the industry's financial systems.

"Michele's foresight and innova-tion in revenue cycle management is unparalleled," said Bernadette Spong, Orlando Health chief financial officer. "We are so pleased that she is being recognized for her leadership, experi-ence and expertise."

"I am honored and humbled to be included in this distinguished group of revenue cycle management officers," said Michele Napier. "Over the last few years, financial responsibility in the healthcare industry has been redefined for everyone involved; hospitals, prac-tices, insurers and patients. I consider it a privilege to be part of this dynamic field."

As chief revenue officer for Orlando Health, Ms. Napier oversees revenue management, managed care, and care management for eight hospitals, 600 physicians, and ancillary services. She graduated from Florida International University with a bachelor's degree in business administration and earned her master's in business administration from the University of Miami. She has worked in the healthcare industry for 30 years including hospital, physician, reimbursement, strategic pricing, and health plan operations. Her profession-al accomplishments include directing the managed care strategy and rev-enue cycle operations for a top insurer and leading a successful turnaround for a government HMO. Ms. Napier has experience in multiple markets in the

Midwest, Southeast and Northeast re-gions of the U.S. and Puerto Rico where she oversaw regional networks for two of the nation's largest insurers.

She is certified in managed care by the Healthcare Financial Manage-ment Association (HFMA) and is a fel-low, HFMA. She is a Board Member for the HFMA Florida, the past president of the Southwestern Ohio Chapter of HFMA and has served on national HFMA councils including the National Advisory Council for Revenue Cycle.

Orlando Health VP is Recognized as "RCM Leader to Know in 2018"

16 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

GrandRounds

Enzo Henney spent the first five months of his life separated from his mother, Sara, who was only able to touch her baby's tiny hands through the holes of an incubator.

But the mother and son received a special gift that helped strengthen their bond while being physically apart: pint-sized hearts.

Sewn by volunteers, sets of hearts are donated to mothers of babies be-ing treated at Florida Hospital for Chil-dren's neonatal intensive care unit. One heart is worn by the mom and the other by the baby for 24 hours to ensure their scent is embedded

in the material. After that, the hearts are swapped, allowing the mom and baby to sense a part of each other de-spite physical separation.

"I've used the hearts for over five months," Henney said. "It helps know-ing that even when I leave, he still senses me. Anything to stay connect-ed helps; it gives me piece of mind."

Every year, 380,000 babies in the United States come to the world weeks earlier than anticipated, which means their bodies are not ready for all the stimulation that's waiting for them in the world, according to March of Dimes.

Beth Suffer, one of the volunteer sewers, estimates they've donated 1,000 "hearts of love" to Florida Hospital for Children. The initiative began with at the pediatric cardiac unit to comfort babies going to sur-gery, but given the medical benefits, the hearts were taken to the NICU to help families cope with separation.

"Moms will smell the scent on the hearts as they are lactating and it has shown to help with milk pro-duction and bonding," said Summer Bernath, child life specialist at the NICU.

Volunteers sew hearts for moms, NICU babies to help build bonds during separation

Therigy, the pioneer and leader in developing cloud-based medication therapy management solutions, is start-ing 2018 strong by creating more value for new and existing TherigySTM cus-tomers through its bundle of product and system enhancements. These new solutions were developed to help spe-cialty pharmacies save time and money through a comprehensive suite of four patient-centered therapy management solutions: TherigyOnboard™, Therigy-Assure™, TherigyInsights™, and The-rigyEngage™.

This week, Therigy launched the fol-lowing new products and enhancements, which together will automate and make cumbersome onboarding processes more efficient; streamline the manage-ment of all patient populations within one total system; provide a new way to train and engage patients in the educa-tion, adherence, and compliance jour-ney; and help specialty pharmacies prove their value. They include the following:

TherigyOnboard Specialty pharmacy staff can now

make the onboarding and referral man-agement process easier and more effi-

cient with automated triggers. They can track re-authorizations, eliminate double entry, increase the accuracy and integ-rity of data, and improve communica-tion and reporting between stakehold-ers. TherigySTM integrates with leading dispensing systems.

TherigyAssureAs the core product of TherigySTM,

TherigyAssure helps pharmacies save time and money, meet accreditation standards, and consistently deliver high standards of care with the best possible outcomes for all patients. TherigyAssure makes this possible through complete, ready-to-use care plans and assess-ments based on the very latest clinical evidence and best practices across 23+ disease states, with 900+ assessments, supporting 400+ medications.

As an option now available within TherigyAssure, the new Specialty Gen-eral Meds module makes it possible for specialty pharmacies to easily manage all patient populations (any condition, any medication) in one system - includ-ing patients on orphan or pseudo spe-cialty drugs.

TherigyInsightsTherigyInsights has a portfolio of

reporting and data analytic solutions to help specialty pharmacies monitor onboarding, operations, and clinical performance. They can assess the ef-fectiveness and efficiency of staff, meet accreditation requirements, generate reports for payers and providers, and prove the value of their clinical pro-grams. They can access preconfigured reports or customize their own internal and external reports. There's no limit to how their data can be structured. This level of flexibility is particularly vital in supporting specialty pharmacies of all sizes and volumes.

TherigyEngageTherigyEngage is the gateway

to a world of mobile patient engage-ment and digital communication and education tools. With TherigyEngage, specialty pharmacies can meet URAC multi-lingual, multi-modal requirements and tap into new ways of helping pa-tients achieve the intended outcomes of their medication therapies. Specialty pharmacies can extend care beyond traditional channels and meet patients

where they are-on their mobile devices. With automated access to on-demand, patient-specific medication videos that complement TherigyAssure's clinical content patients can watch videos any-time in the media format of their choice, in English and in Spanish.

"As we progress into 2018, the complexities of specialty therapy man-agement continue to drive the industry's need for more innovation and efficiency. We believe these new products and en-hancements will reassure our customers that Therigy is listening and responding to their needs," explained Russel Al-linson, RPh, MS, Therigy's co-founder, chief executive officer. "These enhance-ments answer some of our customers' greatest challenges and demands. Each one of the enhancements addresses a separate part of the therapy manage-ment journey, however, they are inter-connected and add greater value when used together."

Specialty pharmacies can schedule a "test drive" or learn more about The-rigy's 2018 products and enhancements by contacting us by phone: 844.4THE-RIGY; email: supportcase@therigy.com or website at: http://www.therigy.com/.

Therigy® Introduces New Bundle of Patient-Centered Therapy Management Products

Central Florida Regional Hospital, an affiliate of HCA North Florida, will bring state-of-the-art emergency care to north-west Seminole County in Fall of 2018 with the opening of a freestanding emer-gency department at 4525 International Parkway, on a 28-acre site at the intersec-tion of International Parkway and Wilson Road. A groundbreaking ceremony took place Friday, March 2, at 1 p.m.

The 11,000-square-foot facility is expected to serve more than 7,500 resi-dents from northwest Seminole County and surrounding areas each year. The $11.6 million project will feature 12 pri-vate patient care rooms and will employ more than 40 full-time staff and emer-gency medicine physicians.

The new ER on International Parkway will operate as a full-service emergency de-partment providing 24/7 emergency care for both pediatric and adult patients. The new facility will offer comprehensive emer-gency services as well as laboratory and im-aging services.

"Central Florida Regional Hospital is committed to providing high-quality, convenient emergency care to the local community," said Wendy Brandon, Chief Executive Officer. "Minutes matter in an emergency and this facility will help provide faster, expert care to thousands of residents in northwest Seminole County as well as west Volusia and Lake Counties."

Central Florida Regional Hospital To Open Full-Service ER In Seminole County

17 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

GrandRounds

Accountable care organiza-tions are playing a pivotal role in the value-based ecosystem. Since their formation in 2012, MSSP ACOs have saved over $2 billion for mil-lions of assigned beneficiaries. More importantly, the quality of care has improved drastically as a direct result of the collaborative efforts by ACOs. The average quality scores of 2016 are higher than ever, attesting that ACOs are instrumental in advancing value-based care.

However, the overall results, as observed on ACO Compare, do not reflect on the varying performances of every ACO. As a matter of fact, just over 30 percent of the 432 par-ticipating ACOs were eligible for the $700 million shared savings in 2017. Undeniably, there is a striking con-trast between the top performers and the ones suffering losses. As we look closer at the numbers, we get a clearer picture.

• 42% of the ACOs founded in 2012-2013 generated more savings as compared to 18% of the 2016 starters.

• 68% of Track 2 and Track 3 ACOs earned shared savings in comparison with only 29% of Track 1 ACOs.

ACOs-whether new or old-need to analyze their performance across different quality metrics and align their resources to drive bet-ter clinical and financial outcomes. The challenge is at the beginning, when ACOs have little visibility of the opportunities they can tap and what holds them back in enhancing care outcomes. Analyzing their per-

formance to strategically move for-ward and succeed in the transition to value-based care is a high priority for ACOs today. The older ACOs have had ample time to learn, explore im-provement opportunities, and build new care management models.

To help ACOs learn more about their performances, Innovaccer Inc., a leading San-Francisco based healthcare data platform company, launched the revamped version of its flagship tool, ACO Compare 3.0. With information dashboards of the tool, ACOs can create an outcomes-driven strategy to enhance quality in care. The tool assembles extensively researched data from P.Y. 2012 to 2016 and provides an in-depth analy-sis of Medicare ACOs in the country.

"Being the champions of value-based care, ACOs want transparency in day-to-day operations by closely monitoring their performances and redesigning care that puts goals of the organization first," says Abhi-nav Shashank, CEO at Innovaccer. "The phenomenal response on our previous versions of ACO Compare is a testament to the importance of state-of-the-art analytics. This time with new data and added function-alities of our pioneering platform in the tool, we are certain that ACO Compare 3.0 will definitely be an as-set to ACOs. The modern context of healthcare can successfully lead the way to an efficient healthcare, which is why we are keeping this tool avail-able to everyone free-of-charge."

Access ACO Compare 3.0 here: www.innovaccer.com/aco

Innovaccer Launches ACO Compare 3.0, Its Flagship Tool to Compare and Analyze ACO Performance Trends

Florida Hospital is pleased to an-nounce multiple changes within its leadership team.

Doug Harcombe has been named CEO of Florida Hospital Cel-ebration Health, fol-lowing the retirement of Ken Bradley. Har-combe previously led

Florida Hospital Altamonte and also had executive oversight of Winter Park Memorial Hospital and Florida Hospi-tal East Orlando. He will also provide executive oversight to the leadership team at Florida Hospital Kissimmee.

Tim Cook, who serves as CEO of Florida Hospital Apopka and Florida Hospital Winter Garden, will also now serve as CEO of Florida Hospital Altamonte.

Dr. Alric Simmonds has been named Chief Medical Officer of Flor-ida Hospital East Or-lando, effective March 4. Simmons, who has been a member of

the General Surgery Residency core faculty at Florida Hospital since 2006, serves as the Associate Program Direc-tor and Site Director for all third- and fourth-year medical students from the

University of Central Florida College of Medicine and Florida State College of Medicine. In addition to academic and clinical medicine, Dr. Simmonds serves as Medical Director of the Sherman Outpatient Surgery Center and Chair-man of the Florida Hospital System Operating Room Governance.

Dr. Dennis deLeon will join Florida Hospi-tal Kissimmee as Chief Medical Officer on March 4. Dr. deLeon is a family physician with experience in pri-

mary-care and multi-specialty medical groups, as well as in health-plan and hospital administration. An authority in the field of hospital clinical ethics, he will also serve as physician leader for clinical ethics at Florida Hospital. During more than a decade as a fam-ily physician in California, Dr. deLeon taught residents in family medicine and bioethics, and helped build a consul-tative clinical ethics program at Loma Linda. He has also assisted health plans and hospitals, such as Adventist Health Glendale, with electronic health record implementation, utilization and case management. Most recently, Dr. deLeon served as associate chief medi-cal officer of three hospitals with CHI Franciscan Health in the Seattle/King County region.

Florida Hospital Announces New Leadership Positions

As physicians begin the sec-ond year of quality reporting under the Quality Payment Program (QPP), the American Medical Association is launching a series of podcasts on ReachMD to help physicians success-fully navigate the new regulations. Physicians can stay up to date with the latest developments in the Centers for Medicare & Medicaid Services' QPP by listening to the new series, "Inside Medicare's New Payment System."

Three new 15-minute podcasts are now available to download and listen on demand:

• AMA President Answers Top Questions About the Quality Payment Program: A board-certified family phy-sician and hospital administrator, AMA President David O. Barbe, MD, offers his insight into how the new regula-tions will affect physicians' practices.

• How Small Practices Can Com-ply with MIPS Quality Reporting Re-quirements: Richard Deem, the AMA's senior vice president of advocacy, ex-plains how the new regulations par-ticularly affect small practices and what

physicians in these practices must know to succeed.

• The Technical Assistance You'll Need for the Quality Payment Pro-grams Changes: To smooth the transi-tion to QPP, two experts discuss what technical assistance is available to help physicians navigate the new regulatory plan. Dr. Edward Sobel, medical direc-tor at Quality Insights, and Temaka Williams, a health information technol-ogy adviser at Telligen, offer a guide to available resources.

Transcripts are also available. Ad-ditional podcasts will be released soon, and the AMA website has additional resources to help physician practices be successful under QPP.

These new tools build on earlier, significant AMA efforts to ensure that physicians and their practices are pre-pared for MACRA: The MACRA web-page on the AMA's website has been a source of information on the changes facing physicians and their practices, and will continue to be a frequently updated source of information as the regulations are fine-tuned.

AMA Launches Podcasts to Help Physicians Navigate the Quality Payment Program in 2018

18 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

GrandRounds

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The Johnson & Johnson Human Performance Institute announced it is expanding its footprint in the Lake Nona community in Orlando, Florida with the construction of its new global headquarters. The $18 million state-of-the-art campus, located in Lake Nona Medical City, will house the Hu-man Performance Institute's multidis-ciplinary training center and serve as the global hub for continuing research and development into science-based approaches to improve human energy capacity for performance, resilience and leadership. Construction will be completed by the end of the year.

The announcement comes as more than 250 health and wellness thought leaders from around the globe attend the annual Lake Nona Impact Forum, an invitation-only conference that brings the best and brightest minds in healthcare together for thoughtful and collaborative conversations about how to accelerate the impact of health innovation. The Forum has been sup-ported by Johnson & Johnson since its inception six years ago.

"At the Johnson & Johnson Hu-man Performance Institute, we are pas-sionate about our mission to enable

individuals to identify their purpose and sustain peak performance. With this investment, we are accelerating our ability to impact human wellbeing globally," said Lowinn Kibbey, Global Head of Johnson & Johnson Human Performance Institute. "In creating this world-class training environment, right in the heart of a vibrant community for medical care, research and education, the new facility will anchor our efforts to help individuals and organizations unleash their potential and their capac-ity for peak performance and wellbe-ing."

"Johnson and Johnson's deci-sion to invest to further expand their footprint in Lake Nona is a testament to our city's success in diversifying our economy and building infrastructure that drives Orlando's reputation as a desired location for corporate ex-pansion," said Orlando Mayor Buddy Dyer. "We welcome the company's new facility, as it will create quality em-ployment opportunities and provide a number of targeted and specialized services to our community."

This state-of-the art training and research facility in Lake Nona will serve as the global flagship for the Human

Performance Institute, will enable more workplace innovation concepts and will serve as an expression of Johnson & Johnson's human-centered design capabilities and commitment to wellcare. To complement the physical expansion, the Human Performance Institute is transforming the brand ex-pression across all key touch points, beginning with a relaunch of the com-pany's online portal at www.jjhpi.com to provide users with the latest practi-cal insights, case studies and research on expanding energy capacity and im-proving personal performance.

"I am especially proud of the ex-pansion of the Human Performance Institute's new facility in Orlando -the same city we have called home for more than 20 years," reflected Jack Groppel, Co-Founder of the Johnson & Johnson Human Performance Insti-tute. "There has never been a greater need -from those starting out in their careers to the upper reaches of the

boardroom -to develop vital energy-management skills. As our world grows more complex and frenetic, our re-search continues to prove that discov-ering and living your personal purpose brings energy, fulfillment and wellbe-ing to your life. Living a life of character brings energy, fulfillment and wellbe-ing to the lives of others as well."

For more than 30 years, the Hu-man Performance Institute has been a pioneer in proven, sustainable be-havior change science, working with professional athletes, military Special Forces and Fortune 500 CEOs in the field of high performance and energy management. Human Performance In-stitute programs are grounded in the sciences of performance psychology, exercise physiology and nutrition to deliver proven sustainable behavior change and help individuals become physically energized, emotionally con-nected, mentally focused and fully en-gaged for real results.

Johnson & Johnson Human Performance Institute Invests in $18 Million Facility in Lake Nona

19 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

Orlando Health Arnold Palmer Medical Center has named LaTasha Barnes, chief financial officer, and An-twan Williams, administrator, allied health & support services. Arnold Palm-er Medical Center consists of Arnold Palmer Hospital for Children and Winnie Palmer Hospital for Women & Babies. The organization has also promoted Theresa Ransome to director of network development at the corporate level.

"We are extremely pleased to have LaTasha and Antwan join the organiza-tion," said Sheila Bystrak, chief operat-ing officer for Winnie Palmer Hospital. "They are accomplished individuals who excel in their respective fields."

Ms. Barnes comes to Orlando Health with over 18 years of expe-rience, primarily in the healthcare industry, including more than seven years in both

public accounting and internal audit. She received her B.B.A. in Account-ing at Tennessee State University in Nashville, Tennessee. She is a certified public accountant, licensed in both Tennessee and Florida and a member of the National Association of Black Ac-countants. Ms. Barnes has served on the boards of Matthew Walker Com-prehensive Health Center (Nashville, TN) and JFK Medical Center Charter School (West Palm Beach, FL).

Originally from St. Petersburg, Florida, Mr. Williams joins Orlando Health from the Geisinger Health System in Danville, PA where he complet-

ed his administrative fellowship and served as director of operations, emer-gency medicine, providing leadership to seven emergency departments within a 12-hospital campus. He also served as interim administrator, ortho-pedics and anesthesia service lines, responsible for strategic, financial and operational leadership. Mr. Williams earned his B.S. in Business Manage-ment at Florida State University, and Masters in Health Administration at the University of Central Florida. He is a member of the National Association of Health Services Executives and co-author of "Walking on Air: Success Tips for the Young, Fly and Foolish".

"Their leadership experience and expertise will be instrumental in ensur-ing that Arnold Palmer Medical Cen-ter continues to provide extraordinary care to the women, parents, children and babies of our region," added Cary D'Ortona, chief operating officer of Ar-nold Palmer Hospital. "They will be inte-gral in helping to direct the operational and financial success of both hospitals."

Ms. Ransome, a 24-year employee with Or-lando Health, has been promoted to director of network development at the corporate level. In her new role she will

lead provider contracting for Orlando Health's clinically integrated network (CIN) and collaborate with the corpora-tion's human resources benefits team.

In her most recent role with the organization, Ms. Ransome served as manager of the Orlando Health Team Member Health Plan, where she was responsible for the dayto-day opera-tions of the provider network. She has served on numerous councils during her career at Orlando Health and has completed the Orlando Health Ad-vanced Leader Program.

"Throughout her career, Theresa has demonstrated her commitment to Orlando Health and to the care of team members and their families," says Jer-ry Senne, vice president, value-based care & population health. "In this new role, she will use her leadership skills and experience to help improve and streamline the care of all patients who receive care through our CIN."

Mr. Williams joined Orlando Health January 9. Ms. Ransome's pro-motion became effective January 26. Ms. Barnes joined the organization February 1.

GrandRoundsOrlando Health Welcomes New Leaders

GenCare Resources Home Health-care is among 50 statewide companies expected to see significant growth over the next several years. GenCare Resources was selected from more than 500 nominees for Florida Compa-nies to WatchSM, a statewide program managed by economic development group GrowFL, in association with the Edward Lowe Foundation.

GenCare's management team, competitive market position and strong community involvement were among several factors that put them in contention for the award.

"These stand-out companies are all led by entrepreneurs, and have demonstrated their capacity and intent to grow," said Dr. Tom O'Neal, execu-tive director of the Florida Economic Gardening Institute and associate vice president for the University of Central Florida's Office of Research and Com-mercialization. "They also all have critical intellectual property or a niche position that gives them a competitive edge in their markets," he said.

Joining GenCare on the Florida Companies to Watch list are 49 other Florida-based businesses.

"This is a strong group of com-panies that deserve this special rec-ognition given annually to the state's top second stage companies," said Dr. O'Neal. Second-stage companies are defined as those with six to 150 full-time employees and between $750,000 and $100 million in annual

revenue. There are many programs and incubators promoting start-up businesses; GrowFL is the only Florida program that focuses exclusively on second-stage companies.

Economic Impact of 50 Winning Companies 2017 Florida Companies to Watch Honorees • $391 million in total annual revenue in 2016 47 percent increase in total an-nual revenue in 2016 compared to 2015• 1,948 full-time equivalent employ-ees in 2016 48 percent increase in 2016 total employment compared to 2015• 693 net new jobs projected for 2017 • Increasing Impact From 2013 through 2016, these companies gen-erated more than $1 billion in revenue and added more than 1,300 employ-ees, reflecting a 137 percent increase in revenue and 219 percent increase in employment for the four-year period. That translates into a 30 percent annual growth rate for revenue and a 50 percent annual growth rate for employment. • These companies project continued growth in 2017, with a 53 percent rev-enue increase and 36 percent growth in employment compared to 2016. If their projections hold, these companies will have generated $1.6 billion in rev-enue and added more than 2,000 jobs over the last five years - a 262 percent increase in revenue and 333 percent in-crease in jobs since 2013.

Florida Companies On Growth "watch" List

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GrandRounds

A new study reveals that many pa-tients with breast cancer have miscon-ceptions and fears about radiation ther-apy, but their actual experiences with modern breast radiation therapy are better than they expected. In the study published early online in CANCER, a peer-reviewed journal of the American Cancer Society, most patients agreed that their initial negative impressions were unfounded.

Over the past 20 years, there have been significant advances in how radia-tion therapy for breast cancer is deliv-ered, allowing clinicians to spare critical organs, create an individual radiation plan for each patient, and deliver ra-diation in more convenient schedules. Nonetheless, many patients have fears and misconceptions about radiation therapy.

To get a better sense of patients' views concerning modern radiation therapy, a team led by Susan McClos-key, MD, MSHS, and Narek Shaverdian, MD, of the University of California Los Angeles, surveyed 502 patients who were treated for breast cancer between 2012 and 2016. Among the 327 pa-tients who responded to the survey, 83 percent underwent breast conservation therapy (defined as lumpectomy and ra-diation therapy).

"We wanted to look at the patients' perspective of the breast cancer radia-tion experience, to have tangible real-

world data to guide future patients and providers in their decision making," said Dr. Shaverdian.

Sixty-eight percent of surveyed pa-tients stated that they initially had little to no knowledge about radiation ther-apy; however, 47 percent reported that they had heard frightening stories about it. Only 2 percent of patients agreed that the negative stories they previously heard about radiation therapy were ac-tually true. Also, 83 percent reported that short-term radiation side effects-such as breast pain, work limitations, and family disruptions-were less than or as expected, and 84 percent of patients said this about long-term side effects.

The survey revealed that 93 percent of breast conservation patients and 81 percent of mastectomy patients agreed with the statement "If future patients knew the real truth about radiation ther-apy, they would be less scared about treatment."

"The word radiation itself sounds frightening and is associated with many negative news stories, but the implica-tions of this study are that, in actuality, radiation therapy for breast cancer is a much better treatment experience than perceived," said Dr. McCloskey. "We hope these real-world data from the voices of past patients can give future patients a better understanding of mod-ern breast radiation therapy when mak-ing treatment decisions."

Most Breast Cancer Patients' Experiences with Radiation Therapy Are Better than Expected

Florida Hospital Celebration Health Expands Cardiology Services

Residents and visitors who need emergency cardiac care in the Cele-bration area now have more options close to home.

Florida Hospital Celebration Health recently launched vascular surgery and interventional cardi-ology services with two newly ex-panded and remodeled cardiac catheterization labs, where physi-cians can use a thin, flexible tube to check and repair the blood flow in coronary arteries.

That means patients suffering from conditions such as heart at-tacks, congenital heart defects and disease affecting arteries or veins can be evaluated, diagnosed and treated in a single location. The catheterization labs started offering pacemaker services this week.

"There is immense growth in Central Florida, and with that comes the important need to provide ad-vanced, life-saving cardiac care close to our patients' homes," said Dr. Duane Davis, director of the Florida Hospital Cardiovascular Institute. "Our cardiac network will continue to grow along with our community."

Osceola County's population

is expected to skyrocket over the next decade. The University of Flor-ida's Bureau of Economic and Busi-ness Research estimated 288,200 residents in Osceola in 2015, and that's projected to climb nearly 24 percent to 358,700 by 2030. Sur-rounding Orange and Polk counties are also projected to experience no-table growth.

The Celebration expansion is the latest of Florida Hospital's growing cardiac services - a diagnostic cath lab opened at the new Florida Hos-pital Apopka in December, and be-fore that, a cath lab opened at Florida Hospital Kissimmee. These join the established services at Florida Hospi-tal Orlando, Altamonte, Winter Park and East Orlando campuses.

The Florida Hospital Cardiovas-cular Institute is one of the largest and best-regarded cardiac facilities in the country, and Florida Hospital is the only health care provider in Cen-tral Florida that performs heart trans-plants. Every year, the Cardiovascu-lar Institute serves more than 70,000 cardiac patients, including 25,000 who seek emergency care and 2,000 who require cardiac surgery.

National Science Foundation Awards SegAna Phase 1 SBIR Grant

An Orlando-based company has been recognized by the federal gov-ernment as innovating in the field of cancer research.

The company has been grant-ed a Small Business Innovation Re-search (SBIR) Phase 1 grant valued at $225,000 from the National Science Foundation (NSF).

"It's a great honor to be one of the few selected to receive a Phase 1 SBIR Grant from the National Science Foundation," says Rodney Bosley, CEO and director of SegAna. "As we move forward in advancing the com-mercialization of SegAna's real-time cloud-based treatment guidance soft-ware for radiation cancer treatment, grants like these are vital."

The company was founded to bring technology developed at the University of Central Florida and the University of California Los Angeles together into a commercially avail-able simulated lung. The grant is a cooperative grant with UCLA's De-

partment of Radiation Oncology.Once fully developed, the tech-

nology will allow radiation oncologists to plan and deliver patient-specific, advanced treatments quickly and modified to suit the current tumor lo-cation and motion. More importantly, it only delivers radiation to the tumor and avoids normal tissues.

Specifically, SegAna's technology will be a software framework that pro-vides treatment guidance for radio-therapy. The software provides near real-time computing performance fa-cilitating clinical decision-making for adaptive radiotherapy.

"We've been able to show in our research how this technology will improve radiation treatment, the pa-tient's quality of life, and ultimately, reduce the number of times a patient is readmitted to the hospital," Bosley adds.

The grant has allowed the com-pany to hire three additional software engineers.

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21 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

GrandRounds

Lake Nona Institute Partners with Florida Hospital to Advance Health and Wellness Initiatives

The Lake Nona Institute, the non-profit organization of Tavistock Devel-opment Company that aims to inspire healthy, sustainable communities of the future, announced a partnership with Florida Hospital to further advance its health and wellness initiatives within Ta-vistock's innovative, best-selling Orlan-do community, Lake Nona. Lake Nona is home to one of the fastest-growing health and life sciences clusters in the nation and is recognized as a global model for the design of a comprehen-sive, healthy community according to the Global Wellness Institute.

The Lake Nona Institute is re-searching and analyzing information on human, physical, and environmen-tal elements in real-time to better un-derstand the interaction and effects of the built environment and lifestyle be-haviors on human wellbeing. Through the partnership, Florida Hospital will participate in several of Lake Nona's current health and wellness research initiatives, including:

• Lake Nona Impact Forum, an annual thought leadership forum that aims to unlock innovation, advance quality of life and move the needle on health care, globally

• Lake Nona Life Project, a ground-breaking, multi-generational study that focuses on better understanding com-munities and the factors that lead to better overall health

• WHIT, Lake Nona's Wellness Home built on Innovation and Technol-ogy, that serves as an incubator for de-velopment of forward-thinking home health technologies

"We are incredibly excited to col-laborate with Florida Hospital on our promising research projects, and look forward to the many collaborative op-portunities that will arise with our in-novative partners -all of whom have come to Lake Nona to push the limits

and make a lasting, positive impact so that we many all have a chance at a better, healthier tomorrow," said Glo-ria Caulfield, executive director of the Lake Nona Institute.

Known for its culture of innova-tion and collaboration, Lake Nona is globally recognized as a ‘living lab' with multiple onsite initiatives and or-ganizations whose common goal is to improve our overall health and wellbe-ing. Florida Hospital joins this notable group of innovators, including Cisco, Delos, GE, GuideWell Innovation, Johnson & Johnson Health & Wellness Solutions, Siemens, and Technogym.

Florida Hospital is known for its spirit of innovation and enthusiastic collaboration with many partners to improve the health of our community, and to transform the way that health care is delivered. Florida Hospital looks forward to adding its HelloWell platform to the health-care innova-tions on display at the WHIT house. In addition, Florida Hospital will be deeply involved with the Life Project, which aligns with the organization's focus on adopting healthy habits, the importance of preventive care and population health. Florida Hos-pital was pleased to participate in last year's forum and will do more in 2018.

"We are honored to join a pres-tigious group of partners who have committed to advance health and well-ness. Together with our resources and complementary initiatives, we believe we will change the future of health care, and create a healthier future for generations to come in this living lab Tavistock has built from scratch at Lake Nona," said Rick Wassel, vice presi-dent, Strategic Innovation & Partner-ing for the Florida Division of Adventist Health System, the parent company of Florida Hospital.

Orange County Medical Foundation Hosting CycleBar Event

Calling all cycling enthusiasts! The Orange County Medical Foundation announces a fun-filled afternoon of ex-ercise and charity, Sunday, April 22nd at 12:30 pm at CycleBar Winter Park.

Join your colleagues as we raise our heart rate and much needed funds to support the mission of the Orange County Medical Foundation.

The Foundation is the philanthrop-ic arm of the Orange County Medi-cal Society and is organized exclu-sively for charitable, educational and

scientific purposes. The Foundation Board works to create opportunities for OCMS members to be involved in charitable activities and support medi-cal education and health care related endeavors in Central Florida.

Space is limited and participation is open to the public. We would love to see many of our members and their families participate.

Registration is available at the fol-lowing link: https://winterpark.cycle-bar.com/classdetail/?apptid=5228540

A new Psychiatry Residency Pro-gram, based at Osceola Regional Medical Center and the Orlando VA Medical Center has received initial AC-GME accreditation and is seeking im-mediate applicants.

This program is part of the UCF College of Medicine-Hospital Corpora-tion of America North Florida Division Consortium seeking to add more than 600 residency slots to Florida by 2020. In the last three years, the consortium has added 20 graduate medical educa-tion programs that are currently train-ing about 250 physicians in Central and North Central Florida. The addition of the Psychiatry program will increase the number of programs to 21.

The Accreditation Council for Graduate Medicine Education (ACG-ME) approved the Psychiatry Residen-cy program for 6 residents per year of the four-year program, for a total of 24 residents. The program will be directed by Dr. Martin Klapheke, Assistant Dean and Professor of Psychiatry at the UCF College of Medicine.

UCF and HCA started the residen-cy programs to help address Florida's and the nation's physician shortage. Dr. Klapheke noted that a 2014 Florida workforce report showed that by 2025, Psychiatry will be the physician special-ty with the highest shortage -a deficit of about 2,000 psychiatrists statewide. "The faculty, staff and residents in this new UCF/HCA Residency have the op-portunity to make a major impact on mental health care in Central Florida by providing more services and more practitioners in the coming years," he

said. Osceola Regional Medical Cen-ter is a 396-bed tertiary hospital that is part of the HCA hospital group and includes 500 affiliated physicians. The hospital had more than 18,000 annual admissions and 86,000 Emergency Department visits in the last year. Of those, 446 direct hospital admissions and about 1,400 patients to the Emer-gency Department needed psychiatric care. Osceola Regional offers a range of mental health programs, including inpatient, partial hospitalization and in-tensive outpatient services

The new Orlando VA Medical Center is a state-of-the-art, 1.2 million square foot facility featuring a large multi-specialty outpatient clinic which includes a wide-range of adult psychia-try and counseling services and 130-in-patient beds that include psychiatry services. The VA also has a 60-bed domiciliary and a 120-bed outpatient living center with in-house psychiatric and counseling services, including ge-riatric psychiatry.

Residents will also rotate at Nemours Children's Hospital in Lake Nona to gain experience in Child and Adolescent Psychiatry.

The program will be participating in the NRMP Supplemental Offer and Acceptance Program (SOAP). Applica-tions following SOAP should be sub-mitted through Krystal D. Hernandez, GME Program Coordinator, Psychiatry Residency Program, Osceola Regional Medical Center, at krystal.hernandez@hcahealthcare.com. Qualified appli-cants will be selected for interviews.

UCF College of Medicine/HCA Consortium Announces New Psychiatry Residency Program

22 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

By LEENA kAMAT, Md March is National Colorectal Cancer

Awareness Month. Colorectal cancer is a cancer that starts in the colon or rectum. Among cancers that affect both men and women, colorectal cancer is the second leading cause of cancer death in the United States. Every year, about 140,000 Americans are diag-nosed with colorectal cancer and more than 50,000 die from it. However, this disease can be preventable.

Most colorectal cancers begin as a growth called a polyp on the inner lin-ing of the colon or rectum. Some types of polyps can change into cancer over the course of several years but not all polyps become cancer.

The risk for colon cancer increases with age and most often found in people 50 or older. Risk factors include personal history of colorectal polyps or cancer, personal history of inflammatory bowel disease, and family history of colorectal cancer. Manageable risk factors include obesity, physical inactivity, diet (high in red and processed meats), smoking, and heavy alcohol use.

This disease is highly preventable by getting screened beginning at age 50. Screening tests help prevent colorectal cancer by finding precancerous polyps so they can be removed. Screening also finds

this cancer early when treatment can be most effective. There are several screen-ing tests: colonoscopy, high sensitivity fecal occult blood testing, sigmoidscopy, or CT colonography (virtual colonos-copy). Screening is recommended for men and women beginning at age 50 and continuing until age 75.

Some people with colorectal polyps or cancer do have symptoms. This may include blood in the stool, abdominal pain, or unintentional weight loss.

So how do radiologist get involved in the diagnosis and treatment of colorectal cancer? When a patient is diagnosed with cancer...radiology directly impacts the

care. Cancer patients undergo a variety of different scans throughout the course of their treatment, including MRIs, CT and PET scans, and x-rays. A radiologist will review these scans and inform oncologists

if the current treatment is either helping or not beneficial to the patient. If the current treatment is not effective, a ra-diologist, along with an oncologist, will recommend a different course.

The radiologists from Radiology Specialists of Florida at Florida Hospi-

tal are very well trained and experienced. We have radiologists specifically trained in body imaging who use imaging tech-niques to diagnose abnormalities of the bowel and assist with staging of cancer. We keep up to date on the latest technol-ogy and information so that we can offer patients the best care.

The Florida Hospital Care Network delivers seamlessly connected healthcare services for all ages. For more information visit Somedaystartstoday.com.

Leena Kamat, MD, is a board certified diagnostic radiologist, sub-specialized in breast imaging for Radiology Special-ists of Florida at Florida Hospital. She earned her medical degree at the Uni-versity of Florida, College of Medicine and following graduation completed her residency at the University of South Florida and a fellowship in breast imag-ing at the Moffitt Cancer Center.

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Colorectal Cancer: What is It and How to Prevent It

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23 > MARCH 2018 o r l a n d o m e d i c a l n e w s . c o m

In Honor of

National Doctors’ DayWe extend our deep appreciation to our

VOLUNTEER PHYSICIANSfor the thousands of hours of service donated to the

men, women and children of Central Florida.

“Making Healthcare Available For Everyone In Our Community”Community Medicine Clinic at Florida Hospital, Dental Care Access Foundation,

Florida Department of Health-Orange, Grace Medical Home, Healing the Children, Shepherd’s Hope,

and SpecialCare are all members of the Primary Care Access Network (PCAN).

P C A N O R A N G E C O U N T Y . C O M | 4 0 7 - 8 3 6 - P C A N

FOR VOLUNTEER OPPORTUNITIES, CONTACT:Community Medicine Clinic at Florida Hospital 407-303-7298 | Dental Care Access Foundation 407-898-1525 | Florida Department of Health in Orange County 407-858-1400

Grace Medical Home 407-936-2785 | Healing the Children - 407-877-9311 | Shepherd’s Hope, Inc 407-876-6699 | SpecialCare, Inc. 407-836-2519

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