Grand Rounds February


Jacobson Receives Inaugural Crystal Leaf Award

At the end of 2009, the Nashville Health Care Council recognized Harry R. Jacobson, MD, vice chancellor for Health Affairs Emeritus at Vanderbilt University Medical Center with the inaugural Nashville Health Care Council Crystal Leaf Award. The award recognizes Jacobson’s significant role in fostering healthcare industry innovation and entrepreneurialism in Nashville. Under Jacobson’s leadership, VUMC received numerous honors and was recognized as one of the “Top Hospitals in the U.S.” Jacobson also directed the development of the Monroe Carrell, Jr. Children’s Hospital at Vanderbilt, known as a one of the nation’s leading children’s hospital.
 
Displaying the city’s entrepreneurial spirit, he has played leadership roles in numerous healthcare companies, including founding Renal Care Group, and most recently the Tri-Star Technology Fund LLC, one of only six TNInvestco venture capital firms named by the state.
 
He joined the Vanderbilt Medical School faculty in 1985 as professor of medicine and director of the Division of Nephrology. He became vice chancellor for Health Affairs in 1997, retiring in 2009. Prior to his time at Vanderbilt, he served in the U.S. Army as chief of Nephrology and a faculty member at the University of Texas Southwestern Medical School. He received his medical degree from the University of Illinois and is board certified in both Internal Medicine and Nephrology. Jacobson has published more than 100 research articles, reviews and book chapters, and co-edited the book The Principles and Practice of Nephrology.
 
Jacobson is a former chairman of the Nashville Health Care Council and the Middle Tennessee Council of the Boy Scouts of America Boards of Directors. He is also active in national professional organizations, including the Association of American Physicians, the Society of Medical Administrators and the Institute of Medicine of the National Academy of Sciences. 
 

Baptist Sports Medicine Unveils New Software Program

Recently, Baptist Sports Medicine (BSM), a division of Saint Thomas Health Services, announced the implementation of the Dartfish software program to several of their clinic locations. The software program is a cutting-edge tool that is used to aid identification and measurement of abnormal movement patterns often associated with injury in patients and athletes. By using the Dartfish software, BSM therapists are able to perform walking and running analysis as well as putting more objective measures to sports specific movements used during research projects and evaluations.
 
“Over the past 10 years, research has shown certain movements patterns are associated with poor athletic performance and ultimately increase potential for injury,” said Trent Nessler, managing director of Outpatient Rehabilitation, which is comprised of Baptist Sports Medicine and Life Therapies. “In traditional therapy settings, objectively assessing these movements and showing objective improvements has not been possible. However, unlike traditional evaluations, with the use of this revolutionary technology, we are able to assess those movements and predict how a patient’s body is going to respond to certain athletic or day-to-day activities.” 
 
While it will primarily be used in orthopedic and sports medicine patient cases, the Dartfish software program has applications that can be used across the continuum from neurological rehabilitation to those suffering from gait disturbances, those at risk for falls and those with general weaknesses associated with multiple sclerosis.
 

Study Highlights Patient Preference for Kristalose®

Cumberland Pharmaceuticals Inc. (Nasdaq:CPIX) announced at the end of 2009 that new top-line results for a patient preference study evaluating Kristalose® (lactulose) for Oral Solution, a prescription laxative packaged as a crystalline powder, compared to similar products in liquid forms.
 
Kristalose is the only prescription-strength laxative available in pre-measured powder packets. Over a 14-day period, 50 patients with a recent diagnosis of chronic constipation were administered both Kristalose and liquid lactulose in a crossover study. Patient preference was measured through survey responses collected at the end of the study.
 
"Patients think that Kristalose tastes better and is more convenient than other options, which means that they are more likely to take the medication as directed," noted one investigator for the study, Charles F. Barish, MD, president of Wake Research Associates in Raleigh, NC and Clinical Assistant Professor of Medicine at the University of North Carolina School of Medicine. "It makes sense to prescribe medications that encourage patient compliance with the treatment protocol."
 
There was no significant difference in adverse effects between patients who took Kristalose and those taking liquid lactulose. This multicenter, randomized, open label, crossover trial was conducted over 14 days. As with previous clinical trials, Cumberland Pharmaceuticals plans to submit the results of this study for publication. 
 

Skyline First in State to offer ‘GPS-Type Technology’ to Help Treat Brain Blood Clots

With just a few hours to get lifesaving treatment for a hemorrhagic stroke, many patients simply run out of time. For those who do survive, approximately half suffer permanent disability.
 
Recently, Skyline Medical Center became the first hospital in Tennessee to offer minimally invasive Stealth-guided endoscopic removal of blood clots in the brain. “It’s similar to the way GPS technology works,” said neurosurgeon Paul McCombs, MD. The computerized surgical guidance system allows him to safely navigate through the brain. Prior to surgery, pictures of the brain are loaded into a computer system, which is then accessed during surgery. A keyhole-sized surgical site is made through the surface of the brain and a catheter, the width of a drinking straw, is inserted to remove the blood causing the hemorrhagic stroke.
 
“This new technology allows less damage to normal healthy tissue, minimizes scarring, facilitates rehabilitation and has proven to reduce the length of hospital stay. It also lowers other risks of other complications such as pneumonia, blood clots and urinary tract infections,” MCombs noted. He added the neurological benefits from this lifesaving technology are still under investigation, but said the future looks very promising for patients who otherwise had limited treatment options.
 

Vanderbilt Pediatrics Researcher Finds Risk of Death Ten Times Higher in Children with H1N1

A Vanderbilt researcher, while working in his native country of Argentina, has found that children with H1N1 influenza die at a rate 10 times higher than those who suffer from seasonal flu. Fernando Polack, MD, the Cesar Milstein associate professor of Pediatrics in the Department of Pediatrics at Vanderbilt, describes the serious impact of the H1N1 influenza virus on children in an article titled Pediatric Hospitalizations Associated with H1N1 Influenza in Argentina, published in the December 23, 2009, issue of the New England Journal of Medicine. The overall death rate with H1N1 was 1.1 per 100,000 children, compared to .1 per 100,000 for seasonal flu in 2007.
 
“One thing that was striking was the tremendous impact on hospital logistics. Routine surgeries were cancelled; mass infection control practices were put in place; wards doubled -- particularly in ICU’s, with everyone working over capacity. It was pretty rough,” Polack said of the peak of the outbreak last summer.
 
Kathryn Edwards, MD, Sarah H. Sell Chair in Pediatrics and director of the Vanderbilt Vaccine Research Program (VVRP), was a coauthor on the article. Edwards says the H1N1 outbreak showcases opportunities which can result from observing opposing seasonal illness peaks from the northern to the southern hemispheres. The hope is that scientists can learn to respond more quickly to a developing pandemic.
 

Let’s Give Them Something to Talk About!

Awards, Honors, Recognitions

The Tennessee Department of Health Immunization Program was awarded the 2009 Bull’s Eye Award for Innovation and Excellence in Immunization from the Association of Immunization Managers. AIM has recognized the state’s success at using the Tennessee Web Immunization System, or TWIS, to register medical providers to receive important information and efficiently order H1N1 flu vaccine in preparation to respond to the H1N1 pandemic.
 
At the end of December, Leadership Health Care named Deloitte Director Lisa Nix as its 2009 Volunteer of the Year. Nix, who serves on the Deloitte & Touche Life Sciences & Health Care M&A Transaction Services team, has been instrumental in the development and growth of LHC since the group’s beginnings in 2002. She is a member of the organization’s board of directors and its strategic development committee and has lent her healthcare financial expertise to LHC in planning programmatic content for its 2009 Delegation to Wall Street, as well as its other unique programs and signature events specially-designed for emerging industry leaders.
 
The Health Ethics Trust® recently named BlueCross BlueShield of Tennessee a winner in two categories at its 2009 Healthcare Compliance Best Practices Forum. BlueCross was among seven organizations honored at the forum held in Washington, DC. BCBST was specifically recognized for the redesign of its compliance training program, which is responsible for the yearly training of more than 5,000 employees. Additionally, the company was acknowledged for its practice of researching compliance inquiries — both internal and external — to assess program effectiveness.
 
Beverly Little received special recognition during Centerstone’s December 2009 Board of Directors meeting in Nashville. She has been part of Centerstone’s leadership for nearly 20 years, serving on the Board of Directors for Highland Rim Mental Health Center from 1990-1997 and the Board of Directors for Centerstone from 1997-2009. Centerstone CEO Bob Vero and Centerstone Board of Directors Chair Joan Sivley presented Little with a plaque in appreciation of the leadership and vision she provided during her tenure as a board member.
 

Recent Certifications & Accreditations:

The Metabolic Surgery Center at Baptist Hospital has been recertified as a Blue Distinction Center for Bariatric Surgery by the BlueCross BlueShield Association. The designation is awarded to medical facilities that have demonstrated their commitment to quality care, resulting in better overall outcomes for bariatric patients. Each facility meets stringent clinical criteria, developed in collaboration with expert physician panels and national medical societies, including the American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation, and is subject to periodic reevaluation as criteria continue to evolve. Blue Distinction Centers for Bariatric Surgery provide a full range of bariatric surgery care services, including inpatient care, post-operative care, outpatient follow-up care and patient education. Baptist Hospital was first certified as one of more than 200 Blue Distinction Centers for Bariatric Surgery across the country in April 2008. It is also recognized as a Center of Excellence by the American Society for Metabolic and Bariatric Surgery, Cigna and United Resource Networks.  
 
Middle Tennessee Medical Center recently announced its Bariatric Center has been named an American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Surgery Center of Excellence®. This designation recognizes surgical programs with a demonstrated track record of favorable outcomes in bariatric surgery. In addition, the Bariatric Center’s surgeons, Drs. Wayne Westmoreland and George Eckles, have been designated as ASMBS Bariatric Center of Excellence Surgeons. To qualify for designation as an ASMBS Bariatric Surgery Center of Excellence, the MTMC Bariatric Center participated in an evaluation process designed to document its comprehensive program and meet the established program requirements for providing safe bariatric surgical care with excellent short- and long-term outcomes. The evaluation not only documents process, including equipment, supplies, training of surgeons and staff and the availability of consultant services, but also emphasizes results.
 

SCRI Adds Cardiologist to Lead Electrophysiology Research Efforts

The Sarah Cannon Research Institute (SCRI) has named R. Christopher Jones, MD, director of electrophysiology (EP) research. He joins Director of Cardiovascular Research Steven V. Manoukian, MD, FACC, FSCAI in SCRI’s cardiovascular research initiative. Jones will lead SCRI’s newly formed EP Consortium.
 
Jones joined Centennial Heart Cardiovascular Consultants in 2006 after practicing at Saint Thomas Cardiology Consultants. A member of the American College of Cardiology, American College of Physicians and Heart Rhythm Society, Jones is board certified in internal medicine, cardiovascular disease and cardiac electrophysiology.
 
After receiving undergraduate and graduate degrees in nuclear engineering from the University of Tennessee in Knoxville, Jones earned his medical degree from Vanderbilt University School of Medicine in Nashville. He completed his internship and residency at Johns Hopkins Hospital in Baltimore and later completed a fellowship in cardiovascular disease at The Cleveland Clinic Foundation. Jones furthered his cardiology training by completing an electrophysiology fellowship at St. Vincent Hospital in Indianapolis.
 

Mewbourne Joins Sumner Wound Care Medical Staff

Sumner Wound Care, Sumner Regional Medical Center’s (SRMC) outpatient wound treatment center, recently added surgeon Brandon Mewbourne, MD, to its medical practice. Mewbourne joins an existing staff team that includes medical director and Certified Wound Specialist® Paige Reichert, MD, Certified Wound Specialist® Scott Faulkner, MD, and Graham Frazier, DPM.  
 
In addition to having a surgeon on the Wound Care staff team, SRMC is the only hospital in Middle Tennessee to have two Certified Wound Specialists® on its medical staff, and is one of only two hospitals in the Middle Tennessee area with hyperbaric oxygen chambers.
 
“As a surgeon, caring for wounds has always been a part of my practice,” said Mewbourne. “Since joining the Wound Care Center, however, I have learned new strategies for treating difficult wounds that will benefit my own patients as well as those of referring physicians."
 
Mewbourne completed medical school at the University of Alabama, Birmingham, and completed both his internship and residency at Baylor University Medical Center in Dallas.
 

Hawthorne Joins LBMC Healthcare Practice

Lattimore Black Morgan & Cain, PC (LBMC) recently added healthcare consultant, Caryn Conklin Hawthorne to its Knoxville office. She will serve healthcare clients across the state of Tennessee. Hawthorne, a Certified Public Accountant (CPA), has joined the accounting firm as the practice leader of financial consulting for the healthcare consulting division. She brings over 28 years experience in healthcare including 16 years as chief financial officer to two hospital systems. While serving as CFO she worked with a variety of organizations ranging from small, rural hospitals to stand-alone community hospitals to large health systems that include physician practices.
 
In her new role Hawthorne will provide consulting services in the following areas: healthcare operational and financial strategy, planning and implementation; financial feasibility and analysis; revenue cycle solutions; high performance management services; mergers/acquisitions and valuations; and hospital and physician integration strategy and implementation. Hawthorne completed her bachelor’s degree in accounting at the University of Tennessee at Chattanooga and her MBA at the University of Tennessee in Knoxville. She is an active member of Executive Women’s Association and Healthcare Financial Management Association as well as TSCPA and AICPA.
 

Centerstone Research Institute Promotes Four Employees

Centerstone Research Institute (CRI), a not-for-profit organization of Centerstone, has announced the promotions of four employees:
  • Frank Stevens, PhD, to Vice President of Clinical Informatics,
  • Paul Robbins, MA, to Director of Clinical Application Development,
  • Kathryn Bowen, PhD, to Director of Evaluation, and
  • Christina VanRegenmorter, MSSW, to Communications and Policy Coordinator.
 As Vice President of Clinical Informatics, Stevens will oversee the management and analysis of clinical information at Centerstone, as well as the integration of the organization’s Electronic Health Record system with clinical workflow. In his new role, Robbins will be responsible for gathering information from users and workgroups on required functionality of clinical records, as well as designing, developing and implementing these functionality changes, and providing support and training
 
As Director of Evaluation, Bowen directs all aspects of evaluation for multiple federally-funded grant projects, supervises all program evaluators and evaluation associates, and actively participates in the development of new projects and research opportunities. As Communications and Policy Coordinator, VanRegenmorter is responsible for federal policy analysis and advocacy.  She previously served as Technical Writer at CRI, where she created materials to disseminate CRI research findings, and also contributed to manuscript development and grant writing. 
 

LifePoint Hospitals Apponts Koford President of Strateic Growth & Development

In late December, LifePoint Hospitals® (NASDAQ: LPNT) announced the appointment of Joné L. Koford to the position of president of Strategic Growth and Development. In her new role, Koford will oversee LifePoint’s efforts to acquire additional hospitals and lead in-market growth and development initiatives for the Company’s facilities nationwide.
 
Koford joined LifePoint in 2001 as vice president of Development. Most recently, she has served as president of Strategic Growth and Quality Initiatives, overseeing hospital strategic planning, capital asset management, the physician resource initiative and in-market development, as well as clinical operations and quality initiatives. From 2001 to 2007, she served as division president for the American Division, overseeing 10 hospitals. 
 
Koford has many years of industry experience. Prior to joining LifePoint, Koford was with Altius Health Plans in Salt Lake City, Utah. She also served as regional vice president for both Columbia/HCA and HealthTrust in Nashville. She holds a master’s degree in science and health administration from the University of Colorado and is a graduate of Weber State University, where she serves on the National Advisory Council.
 

Gullett Sanford Robinson & Martin Launches Weekly Healthcare Legislative Newsletter

The law firm of Gullett Sanford Robinson & Martin PLLC (GSRM) recently announced the launch of a newsletter that will highlight Tennessee legislative activities of interest to the healthcare industry. The newsletter is titled GSRM: Healthcare from the Hill and will be distributed on a weekly basis to clients and friends of the firm. 
 
Each week's newsletter will list healthcare-related bills introduced the previous week or scheduled to be heard in a committee or by the House or Senate. The goal of the newsletter is to provide valuable insight on the current trends in state regulation and assist in identifying issues with legislation that has the potential to affect companies in the healthcare industry. 
 
The inaugural newsletter was distributed in late December with a list of healthcare bills introduced in 2009 but tabled until this year. Subsequent newsletters will be distributed at the throughout the legislative session beginning last month continuing weekly through the end of the session. The newsletter is produced by Matt Scanlan, an attorney with GSRM who practices in the firm’s government relations section.
 

New Goggles Light the Night for LifeFlight

Vanderbilt LifeFlight is now using technology once reserved for military operations or secret spy missions. With the ability to enhance light 10,000 times, the air ambulance service's new night vision goggles essentially turn night into day.
 
“You can see a lit cigarette 10 miles away,” said Wilson Matthews, RN, EMT, chief flight nurse for LifeFlight's base in Lebanon, Tenn., who is part of the night vision transition. “You go from seeing nothing to seeing the texture of tree leaves.”
 
Matthews said night vision will be most useful when making scene landings because pilots and nurses will be able to see the trees, power lines, rising terrain and other hazards on the ground.
 
Because military demand had dropped, this is the first time that the goggles are available to civilian aviation operations. Three of LifeFlight's four bases are already using night vision, and the final base should be trained early this year. 
 
Matthews cautioned that night vision will not allow LifeFlight to make flights that were deemed too risky in the past, but it will greatly enhance the safety of their current capabilities.
 
“LifeFlight will still have to say no when the weather is bad or we can't land safely, but night vision is a huge step forward for us. We can be more confident in our landings and put more focus on great patient care,” he said.
 

Cogent Selected by BroMenn Regional Medical Center to Provide Hospitalist Services

Cogent Healthcare recently announced a new hospital medicine affiliation with BroMenn Regional Medical Center, a 221-bed full-service, not-for-profit hospital located in Normal, Ill. 
 
BroMenn Regional Medical Center is part of BroMenn Healthcare System, which serves an eight-county area in Central Illinois. The medical center has provided hospitalist services since 2004. In January 2010, the BroMenn System merged with Chicago-based Advocate Health Care, the largest healthcare system in Illinois. BroMenn has a solid vision of being the best regional integrated healthcare system serving Central Illinois. 
 

CHS Announced Execution of Affiliation Agreement with Spokane, Wash.-Based Multi-Specialty Clinic

Community Health Systems, Inc. (NYSE: CYH) announced in late December that a subsidiary had closed an affiliation agreement with Rockwood Clinic, P.S., a multi-specialty clinic with 32 locations across the Inland northwest region of the State of Washington.
 
Rockwood Clinic employs more than 1,100 employees, including 220 physicians and mid-level providers, offering care in more than 30 medical specialties. The affiliation agreement will lay the groundwork for a new, fully integrated healthcare delivery system that will include hospital services; primary care and specialty medicine physician practices; ambulatory surgery centers; urgent care facilities; outpatient physical therapy centers and outpatient imaging. Two Community Health Systems, Inc. affiliated hospitals, Deaconess Medical Center in Spokane and Valley Hospital and Medical Center in Spokane Valley, will serve as cornerstones for the new system.