In April of this year the Centers for Medicare andMedicaid Services (CMS) released the names of thefirst twenty seven Accountable Care Organizations(ACO’s) selected to participate in CMS’ Shared SavingsProgram. Our own Accountable Care Coalition ofNorthwest Florida established by Health First Network,Inc. was one of three Florida ACO’s to be included inthat twenty seven. Health First Network is partneringwith Collaborative Health Systems (CHS), a wholly –owned subsidiary of Universal American, establishedspecifically for the Shared Savings Program and ACOdevelopment. In fact CHS supported the developmentof sixteen of the ACO’s that were approved by CMS.That brought the total number of ACO’s to sixty fiveincluding the thirty two groups participating in thePioneer ACO Model as well as six organizationsparticipating in the Physician Group Practice TransitionDemonstration.

The Shared Savings Program and otherAccountable Care Organization initiatives are madepossible by the Affordable Care Act healthcare law of2010. It required CMS to establish this program tofacilitate care coordination, improve patient safety, carefor at risk populations and enhance preventive healthservices and patient experience. Ultimately it isdesigned to improve beneficiary outcomes at reducedcost. It will allow physicians who voluntarily agree towork together to coordinate care for patients and whomeet certain quality standards, to share in any savingsthey achieve for the Medicare program. The success ofthe organization will be gauged by thirty three qualitymeasures.

CMS will automatically assign Medicare patients tothe ACO and to their traditional physician who isparticipating in the ACO. Medicare will continue to payindividual physicians for specific items and services likeit currently does under the Medicare Fee-For-Servicepayment systems. Patients may continue to see anydoctor who treats patients with Original Medicare,regardless of whether their doctor is participating in anACO, and they continue to have the ability to choose.The participating physician is required to notifybeneficiaries that they are participating in an ACO, and

is eligible for additional Medicare payments. Thebeneficiary may then choose to receive services fromthe physician or from someone else. The beneficiarymust also be notified by the physician that thebeneficiary’s claims data may be shared with the ACOat the ACO’s request and must be given theopportunity to decline the data sharing arrangements.

Care coordination will play a significant role in thesuccess of any ACO and the Accountable CareCoalition of Northwest Florida will implement a CareCoordination Program. The outpatient CareCoordination Team will be the backbone of thisprogram and may include a variety of caregiversincluding Registered Nurses and Social Workers. It willbe assigned to patients based on their clinical andsocial needs and it will perform ongoing assessments,facilitating follow up care in conjunction with thepatients Primary Care Provider. Other care coordinationactivities will include medication reconciliation andcompliance monitoring; assessing home safety andmobility; assistance with activities of daily living (ADL)needs; patient and caregiver education on diseaseprocesses; identifying and coordinating DurableMedical Equipment (DME) and Home Health needs ;coordinating transportation needs and schedulingfollow up appointments. CHS will play a vital role in anadministrative capacity for the ACO. It will provideenhanced care coordination services such astelephonic in home nursing support, improvedtechnology solutions and administrative services.

CMS should have by now selected other ACO’ssince the target was to have had one hundred and fiftyby July of this year. It is believed that the first twentyseven ACO’s will provide care to nearly three hundredand seventy five thousand beneficiaries in eighteenstates, include more than ten thousand physicians, tenhospitals and thirteen physician-driven organizationslocated in both urban and rural areas. It is one part ofthe Accountable Care Act that has bi-partisan supportand will survive despite whatever else may happen withthe law. Commercial and Medicaid payers are alreadytrying to adapt the model to their populations.

Quality and Outcomesbased Payment System

Dr. George A.W. Smith

www.escambiacms.org

SEptEmbEr/OctObEr 2012VOlUmE 42, NO. 5

BULLETINUpcoming

Events

Tuesday October 9, 2012General Membership Meeting

[1.5 AMA PRA Category 1 CreditTM]

Speaker: Patricia Green, M.D. |Topic: “Breast MRI”

Speaker: Bruce Horten, M.D. |Topic: “Breast Cancer Analysis”

Wednesday, November 7, 2012General Membership MeetingIn Conjunction with StrategicHealth Intelligence Summit

Topic: “Meaningful Use”

Saturday January 19, 2013ECMS Annual Inaugural Ball

President-Elect:Wendy Osban, DOPaul’s on the Bay

RSVP: 478-0706info@escambiacms.org

Dr. George A.W. Smith

Founded in 1873

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 1

E.C.M.S. BulletinThe Bulletin is a publication for and by the members ofthe Escambia County Medical Society. The Bulletinpublishes six times a year: Jan/Feb, Mar/Apr, May/Jun,Jul/Aug, Sept/Oct, Nov/Dec. We will consider forpublication articles relating to medical science, photos,book reviews, memorials, medical/legal articles, andpractice management.

Vision for the Bulletin:• Appeal to the family of medicine in Escambia and SantaRosa County and to the world beyond.• Collaborate with the Alliance to bring together Escambiaand Santa Rosa County medical families. To know the needsof the community and promote the healthcare needs.• A powerful instrument to attract and induct members toorganized medicine. Views and opinions expressed in the Bulletin are those of theauthors and are not necessarily those of the directors, staff oradvertisers.

Ad placementContact Erica Huffman at 478-0706

Ad rates1/8 page: $100 • 1/4 page: $150 • 1/2 page: $300

ContentsPage 3 - 5 - Membership

Page 6 & 7 - Accurate Medical

Records: Your Primary Line of Defense

Page 8 - Correcting Errors in the

Electronic Medical Record

Page 9 - Keeping Your Practice Going

During a Technology Outage

Page 10 & 11 - Hospital News

Editors:Christopher Burton, MD

Erica Huffman, Executive Director

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 2

Membership 3ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Ismeth Abbas, M.D.Baptist Medical Group- Hospitalists1000 W. Moreno StreetPensacola, FL 32501Phone: 850-469-7406Fax: 850-437-8283Specialty: Internal Medicine

Amy Armstrong M.D.Baptist Medical Group1000 W. Moreno StreetPensacola, FL 32501Phone: 850-437-8600Fax: 850-437-8601Specialty: Internal Medicine

Elias Banuelos M.D.Gulf Coast Physician Partners5992 Berry hill Road 300Milton, FL 32570Phone: 850-623-9787Fax: 850-626-7512Specialty: Family Medicine

Vishnu Behari, M.D. Gulf Coast Primary Care1921 East Nine Mile RoadPensacola, FL 32514Phone: 850-479-4791Fax: 850-494-2260Specialty:

Leo Carney, D.O.Naval Hospital Pensacola6000 W. Highway 98Pensacola, Fl 32512Phone: 850-505-6380Fax: 850-505-6501Specialty: Family Medicine

Amy Doyle M.D.Baptist Medical Group1000 W. Moreno StreetPensacola, FL 32501Phone: 850-469-7406Fax: 850-437-8283Specialty: Internal Medicine/InfectiousDisease

Sherif Ibrahim, M.D.Baptist Medical Group1717 N. “E” Street Ste. 231Pensacola, Fl. 32501Phone: 850-469-7975Fax: 850-469-2113Specialty: Hematology Oncology

Adrian Jefferson M.D.Baptist Medical Group Hospitalists1000 West Moreno St.Pensacola, Fl. 32501Phone: 850-469-7406Fax: 850-437-8283Specialty: Internal Medicine

Teri Lord M.D.Baptist Medical Group1000 W. Moreno StreetPensacola, FL. 32501Phone: 850-437-8600Fax: 850-437-8601Specialty: Internal Medicine/ Pediatrics

Megumi Maguchi, M.D.Baptist Medical Group801 W. Avery StreetPensacola, Fl. 32501Phone: 850-437-8650Fax: 850-437-8659Specialties: Family Practice, Geriatrics

Monica Montoya, M.D.Baptist Medical Group3810 Highway 90Pace, Fl 32571Phone: 850-994-1011Specialty: Family Practice

Monica Nall, M.D.Baptist Medical Group3874 Highway 90Pace, FL 32571Phone: 850-995-4244Fax: 850-995-9188Specialty: Family Practice

Brett Reichwage M.D.Baptist Medical Group1717 North E Street Ste 422Pensacola, FL 32501Phone: 850-469-0642Fax: 850-434-8879Specialty: Neurosurgery

Neil Sandhu, M.D.Gulf Coast Dermatology3089 Gulf Breeze ParkwayGulf Breeze, Fl 32563Phone: 850-233-3376Fax: 850-522-8354Specialty: Dermatology

Mohamed Sultan M.D.Santa Rosa Medical Group5992 Berryhill RoadMilton, FL 32570Phone: 850-626-5324Fax: 850-626-5124Specialty: Neurology

Christine Tenniswood, M.D.Santa Rosa Medical Group4225 Woodbine Rd, Ste. APace, Fl. 32571Phone: 850-994-6575Fax: 850-994-5643Specialties: Family Medicine

Huaiyu Tan, M.D.Baptist Medical Group1717 North E Street Ste. 530Pensacola, Fl. 32501Phone: 850-916-8700Fax: 850-916-8709Specialties: PhysicalMedicine/Rehabilitation

New Students/ResidentsRichard Sims, FSU College of MedicineChad Brady, FSU College of Medicine

Changes or UpdatesClarence Louis, M.D.P: 850-497-2738Specialty: Neorology

Mark Ates M.D.Santa Rosa Medical Group4225 Woodbine Road Ste APace, FL 32571Phone: 850-994-6575Fax: 850-994-5643Specialty: Family MedicineRetired

RetiredMichael Fry, M.D.Gastroenterology Associates, PA1717 North “E” Street Ste. 308Pensacola, Fl. 32501Phone: 850-436-4563Specialty: Internal Medicine/Gastroenterology

Always Remembered Never ForgottenNorman Holmon, M.D.• All medical records have been given to theEscambia Community Clinic

New Members

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 3

4 MembershipESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Christopher Burton, M.D.

Congrats to Dr.Christopher Burton forcompleting the 2012Florida MedicalAssociation PhysicianLeadership Academy.

Wendy Osban, DO

(Above) Wendy Osban, DO served on the 2012Reference Committee #2 for the FMA AnnualMeeting.

ECMS would also like to announce that Dr.Wendy Osban will be joining the 2013 FloridaMedical Association Physician LeadershipAcademy.

Rick Sims, M3 FSU COM

(Above) Rick Sims (M3, FSU COM) presents hisresearch at the 2012 FMA Annual Meeting. Part ofRick’s trip was sponsored by the Escambia & SantaRosa County Medical Society.

Laura Davis, M4 FSU COM“I am honored to be a recipientof the 2012 ECMSScholarship. This will be atremendous help in covering thecost of tuition for the upcomingacademic year. As part of mymedical education, I considerwhat I have learned aboutorganized medicine to be keyin my development as aphysician. I am excited aboutworking with my local medicalsociety, as well as the FMAand AMA, as I continue myeducation and remain anactive voice in organized

medicine as a physician.” ~ Laura Davis

(Above) Laura Davis(M4, FSU COM)Accepts the 2012ECMS Scholarshipfor $5000.

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 4

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTYMembership 5

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Women in Medicine BrunchSeptember 30,2012

Fish House

2012 Women in Medicine Attendees: Wendy Osban, DO; Elise Gordon, MD; Julie Hoffman,MD; Hilary Hulstrand, MD; Donna Jacobi, MD; Jennifer Miley, MD; Paula Montgomery,MD; Naomi Salz, FSU COM; Karen Snow, MD; Bach-Uyen Le Thi, MD; Janet Lewis, MD;Brenda Jacobsen, DO; Nell Potter, MD; Susan Laenger, MD; Jennifer Driskle, MD; AndreaHackel, MD; Mary Mehta, MD; Jennifer Murray, MD; Katheryn Bond, MD; Tina Tarantola,MD; Abeer Abutaleb, MD; Heba El Goweni, MD; Cynthia Worrell-White, MD; Jill Prafke,MD; Michelle Brandhorst, MD.

Sponsors: Baptist Health Care & Virginia College

Michelle Sims, Erica Huffman, ChristineHurd

Jennifer Miley, MD; Mary Mehta, MD;Tina Tarantola, MD; Julia Hoffman, MD

Jennifer Driskle, MD; Katheryn Bond,MD; Wendy Osban, DO; CynthiaWorrell-White, MD

Left to right

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 5

6 Practice ManagementESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Every medical malpractice suit can be won or lost based onthe quality and content of the medical records.

A suit without merit can be lost because the medicalrecord was vague, incomplete, or altered. Conversely, apotentially damaging suit can be won because the medicalrecord was precise, thorough, and accurate—and events werewell documented.

The Doctors Company is adamant about the critical needfor every physician to maintain meticulous records. If you arefaced with a malpractice claim, your record keeping will helpus provide the best possible defense.

General GuidelinesThe following general guidelines should be observed whencompleting a medical record:

• Ensure medical record entries are clear and readable. Ifpossible, dictate all long entries that require more thanbrief or routine annotations.

• Include a detailed and accurate medical history, physicalfindings, differential diagnoses, treatment plan, carerendered, advice given, and all other matters pertinent tothe patient’s medical course.

• Never squeeze words into a line or leave blank spaces.Draw diagonal lines through all blank spaces after an entry.

• Never erase, write over, try to ink out, or use whiteout onan entry. In case of error, draw a single line through theincorrect entry, and write the date, the time, and yourinitials in the margin.

• Never add anything unless you write a separately datedand signed note. The patient, a third-party payer, or aplaintiff ’s attorney may have obtained a copy of theoriginal records.

• Always indicate the date and time of an entry. Ensure eachpage includes the patient’s name and that each progressnote is accompanied by the date and time. Make certain allentries are initialed or signed.

• Avoid personal abbreviations, ditto marks, or initials. Useonly standard and accepted medical abbreviations.

• Do not use lengthy, self-serving entries. These may appeardefensive in nature when explaining a complication ormedical catastrophe.

• Do not use the patient’s record as a place to recordconfidential communications between you and yourprofessional liability insurance carrier or your attorney—orto criticize another caregiver.

• Always keep a record of when and by whom your medicalrecord is photocopied.

Using Specific LanguageAvoid imprecise language, generalizations, and the use ofstatements that are subjective rather than objective.

Examples include the following:• Imprecise: Doing OK.

Accurate: Less pain today. Ate full diet. • Subjective: Appears depressed.

Objective: Crying and worried about progress. • General: Wound OK.

Specific: Surgical incision healing. No sign of infection.

Rely on your senses. Describe your observations:• See: Color, abnormality, posture. • Smell: Breath, drainage, excretions. • Hear: Sounds of breathing, crepitation, bowel sounds. • Feel: Hot or cool, dry or moist, soft or firm.

Document patients’ verbatim statements:• Incorrect: Patient apparently fell.

Correct: Patient states that he “tried to get up, tripped,and hit head on the corner of the bed.”

Detailed documentation is most important in the followingsituations:• When absent from practice, include the name of the

physician you have signed out to and the date and timeyou signed out, pertinent observations, and follow-up ofany abnormal situation.

• Justification of your failure to comply with—or yourrejection of—a consultant’s advice.

• Your viewpoints and reasons for any disagreement onpatient care between you and a hospital utilization reviewcommittee, a preferred provider organization, or amanaged care receiver.

• Explanations of delayed responses to a nurse or house staffcalls, including dates and times.

• Responses to nurses’ pertinent observations of a patient.(Be sure to record follow-up in your progress notes.)

• A patient’s negative reaction to any treatment ormedication.

A Checklist Helps to Protect YouThe following entries should appear in the office or hospitalrecords of each patient:• Results of a patient’s physical examination, specificallynoting the absence of abnormality. • Patient history, a list of all medications with particular

Accurate Medical Records:

Your Primary Line of Defense

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 6

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTYPractice Management 7

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

emphasis on current medications, to include over-the-counter drugs and supplements and any allergies or drugsensitivities.

• Specific notation on the patient’s experience, if any, withdrug or alcohol abuse and family or emotional problems.

• Progress notes, entered after each office visit, about anychange in status. (If negative, your follow-up should beindicated.)

• Signed and witnessed consent forms for special proceduresor surgery.

• Patient response to medication or procedures. • Patient failure to follow advice or to keep appointments

and any refusal to cooperate. (Log missed appointmentsand follow-up telephone calls and letters.)

• All significant laboratory or x-ray reports and the dateswhen they were ordered and read.

• Copies or records of instructions of any kind (includingdiet) and directions given to the family.

• Records of consultations with other physicians and theirwritten or oral responses, with the dates and times.

• Thorough documentation of any patient’s grievance,including the date and time.

Patient Care Instructions• Always record your instructions in writing. • Review your instructions with the patient and the patient’s

family. • Ensure comprehension. Use a teach-back method to

ensure that the patient can accurately describe his or hertreatment plan. Record the patient’s response.

• Document language limitations and attempts made toovercome them through the use of translators, as well asany questionable comprehension. Note any literatureprovided to the patient and family.

• Retain a copy of instructions given to the patient andfamily.

• Note patient failure to comply with instructions and yourefforts to inform the patient of the risks of noncompliance.

Instructions to Include (When Applicable)• Specific wound care. • The amount of incisional bleeding to be expected. • Limitations of activity, position, or exercise. • Dietary restrictions. • Specific instructions for medications, including possible

side effects and when to resume preoperative medications. • Anticipated postoperative pain and time frames for

analgesia.

ConclusionAs a company built by doctors for doctors, we are fiercelycommitted to helping you minimize risk. Your medicalrecords are a vital part of your defense in the event of a claim.Using these guidelines is crucial to your protection anddefense.

About the AuthorThis article, published in 2003, was updated in 2008 by Governor EmeritusMark Gorney, MD, FACS, Paula A. Jenkins, Senior Vice President of Claims,Laura A. Dixon, BS, JD, RN, CPHRM, Director, Department of Patient Safety,Western Region, and Susan Shepard, MSN, MA, RN, Director, Patient SafetyEducation.

The guidelines suggested here are not rules, do not constitute legaladvice, and do not ensure a successful outcome. The ultimatedecision regarding the appropriateness of any treatment must bemade by each health care provider in light of all circumstancesprevailing in the individual situation and in accordance with the lawsof the jurisdiction in which the care is rendered.

Accurate Medical Records: Continued

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 7

8 Medical/LegalESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Correcting Errors in the ElectronicMedical Record

Despite all of the benefits that electronic health records (EHR)offer, there remain opportunities for incorrect data entry due toproblems with system design and or user error. Errors caused bysystem problems (e.g., a confusing screen design, etc.) can beprevented by working with your vendor to reset user preferencesas needed. In order to preserve data quality and protect patientsafety, it is essential to set an office policy to funnel all errors tonecessary staff and physicians in a timely manner. The case studybelow illustrates why establishing a sound system is veryimportant.

Suppose that a physician orders a pregnancy test ona patient before administering a variety of drugs knownto cause birth defects in the fetus. An incorrect result isrecorded in the patient’s record, but subsequentlydiscovered. the patient might well have beguntreatment prior to the correction of the lab report. Insuch a situation, it would be important to the physicianto be able to prove that the initial (incorrect) report onwhich he relied, existed. It is also important that acorrected report be brought to the immediate attentionof the physician.

In the case of electronic records, the problem is that thecorrection of the lab report may potentially eliminate informationthat the physician relied on for a period of time. Also, thecorrection might be made without the physician ever being awarethat a reporting error was made. State laws vary on how medicalrecords can be amended. Generally the law frowns on erasingrelevant information so that it cannot be recovered. That’s whyopaque correction fluid should not be used in correcting paperrecords, and why incorrect entries in the written medical record belined out and rewritten rather than obscured.

The possibility exists that over-writing the initial EHR, eventhough the information is incorrect, could be construed asimproper alteration of the historical medical record. In general,states merely require that electronic records be maintained “to thesame standards” as paper copies. Also, the amended EHR shouldbe flagged to indicate that it has been corrected, and somemechanism be put in place to retain and easily access copies ofthe original, if incorrect, data. A comment field in the amendedreport may suffice. In general, a narrative entry in the medicalrecord statement indicating that an error has been made, and is

being corrected, is the best procedure. When a lab or diagnosticreport is involved, the facility director or pathologist shouldassume the responsibility for insuring that such an entry is made.Both the original error and the correction should be welldocumented for future reference. Personal contact between thelaboratory/diagnostic facility and the involved physician is alwaysdesirable, and should occur whenever an erroneous report mustbe corrected. Keep in mind that the report may be critical andtime may be of the essence. Most importantly, whenever an errorin lab/diagnostic test reporting is made, it is essential for thelaboratory/facility to retrace the handling of the specimens, filmsetc., and determine how erroneous results were released. Thefacility should then institute appropriate policy and procedurechanges to prevent recurrence of such errors.

In summary, correcting errors in EHr systems should followthe same basic principles as correcting paper copies. thesespecific considerations apply:

• Work with your vendor toconfirm that your HER systemallows error correction andwhether or not the vendor hasestablished a process.• The system must have theability to track corrections orchanges once the original entryhas been entered orauthenticated.• When correcting or making achange to an entry, the originalentry should be viewable, thecurrent date and time shouldbe entered, the person makingthe change should beidentified, and the reasonshould be noted.• In situations where there is ahard copy printed from theelectronic record, the hardcopy must also be corrected.

• The process should permitthe author of the error toidentify, and time/date stamp,whether it is an error.• The process should offer theability to suppress viewing ofthe actual error but ensure thata flag exists to notify otherusers of the newly correctederror.• The location of the errorshould also point to acorrection. The correction maybe in a different location fromthe error if there is narrativedata entered, but there must bea mechanism to reflect thecorrection.• Develop a practice policy toensure that your facilitycorrects and reports errors in aconsistent and timely manner.

By Georgette Samaritan, RN, Senior Risk Management Consultant

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 8

Medical/Legal 9ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Power Out. No Internet. No EMR. Help!Keeping Your Practice Going During a Technology Outage

If you are familiar with the psychologist Abraham Maslow, and his famous“hierarchy of needs,” then you will know he clearly wasn’t born in the age of theInternet. According to Maslow, “needs” are listed in order of importance —beginning with essentials such as food, water and safety; then escalating toneeds such as security, love, prestige; and ending with the elusive concept hecalled “self-actualization.” Today it seems the list would be: Internet, cell phone,food, water, safety, security, love, prestige and self-actualization.

This, of course, is a bit of a jest but have you considered what your practicewould do if you lost access to technology? Do you have a plan for just a day ortwo of downtime? What about a longer-term plan? Does your practice have anycontingency plan?

Performing more than 200 HIPAA audits, I have noticed an alarming trend:Most practices don’t have any contingency plan in place at all. Did you knowthat this is a required standard of the HIPAA Security Rule as stated in citation164.308(a)(7)(i), and failure to have a contingency plan could result in fines — orworse, total loss of your practice.

Developing a contingency planThe purpose of this article is to focus on the minor disaster that tends to be

much more frequent — loss of access to technology — and to discuss yourresponse options.

The first thing you need to do is isolate the problem. What caused theoutage? Is it the Internet service provider? Obviously this will bring down anyweb-based EMR. Is it your local server that houses the EMR onsite? Do youhave a contact list of entities to call – IT vendor, EMR vendor, Internet serviceprovider, etc.? tip: When calling your IT provider or EMR support be sure to mention you are“completely down” as this usually will expedite the process. Remember the oldadage, “The squeaky wheel always gets greased first.”

Secondly, you need to have a plan in place that allows you to function and

continue to see patients when no technology is available. On the clinical sideyou can revert back to paper for charge capturing, patient visit recording,prescriptions, etc. Do you have super bills, prescription pads, etc., handy forsuch an emergency?

What about patient histories? The move to an “all electronic” world meansthese charts may not even exist at your practice anymore. In some cases, it’spossible to access the server (assuming it is onsite) using a very powerful UPS(uninterrupted power supply) that can power the server and a printer. Thiswould give you the ability to print from within your practice managementsystem in a pinch. tip: An entry-level UPS should last about 30 minutes, but can differ based onload.

Another suggestion is to keep a copy of the EMR and patient database on asecure local laptop with a long battery life.

What if your Internet is down for a few days and your EMR is housed on theweb?

One thing to consider would be to use aircards, which are offered byvarious cell phone vendors and are fairly inexpensive. In some cases a cellphone with Internet access can even be used as an “ad hoc” modem pluggedinto a PC to get you online. Cell phones also can be used to access the Internetand, therefore, the EMR.

Secondly, you should consider getting a backup Internet line. For example, ifyou currently use a T1 to access the Internet, purchase an inexpensive DSL orcable line as a backup.bottom line: You should have a contingency plan in place for minor events, aswell as major catastrophes. A contingency plan is not only a HIPAA SecurityRule requirement, but a wise business decision.

Brian Tuttle is an IT Manager & Sr. Compliance Consultant with InGaugeHealthcare Solutions and InHealth Company. He may be contacted at:brian.tuttle@ingaugehsi.magmutual.com.

By Brian L Tuttle, CHPIT, CHP, CHA

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 9

10 In The CommunityESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Sacred Heart NewsNew Senior Leaders Announced for Sacred Heart Health System

Susan L. Davis, RN, EdD, FACHE, has been named thepermanent President and Chief Executive Officer of SacredHeart Health System. She serves as Ascension Health’sMarket Leader for New York, Connecticut, North Floridaand the Gulf Coast. Susan also retains her role as CEO ofSt. Vincent’s Health Services in Bridgeport, Conn.

Kerry Eaton, MSN, RN, will join Sacred Heart HealthSystem as the new Chief Operating Officer October 1.Kerry was most recently Senior Vice President and ChiefOperating Officer at St. Vincent’s Medical Center inBridgeport, Conn..

Henry Stovall is the new President of Sacred HeartHospital, Pensacola. Most recently he was the Senior VicePresident for Special Projects at Sacred Heart, providingleadership and guidance in forming a joint venture withLHP Hospital Group to acquire Bay Medical Center inPanama City.

Buddy Elmore, who has served as Chief Financial Officerfor the Health System for the past six years, recently wasnamed the new President of Sacred Heart Medical Group.Buddy has a wealth of experience in developing physician-hospital organizations and overseeing physician practices andcommunity clinics.

Assistance With Health InsuranceEnrollment for Kids.

Sacred Heart has received a grant to provide one-on-oneassistance to parents, grandparents and guardians inunderstanding their options and enrolling in the FloridaKidCare program. A community-health worker will beavailable to help families in Escambia, Santa Rosa, Okaloosa,Walton, Gulf and Franklin Counties. For more information,please e-mail InsureKidsNow@shhpens.org or call 1-800-874-1026.

Hospital News

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 10

In The Community 11ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

Baptist Health CareWelcomes New Chief Development Officer Brian Matson

Brian Matson has been named senior vice president and chiefdevelopment officer for Baptist Health Care. Matson brings awealth of knowledge and experience in strategic planning andbusiness development. He joins Baptist from Sacred Heart HealthSystem (SHHS) in Pensacola, where he served as vice president ofoperations transformation.

Andrews Institute Welcomes New SpecialistsThe Andrews Institute for Orthopaedics & Sports Medicine and

Baptist Medical Group are proud to welcome the following physicians:Juliet DeCampos, M.D., orthopaedic surgeon. Huaiyu Tan, M.D., Ph.D., interventional pain medicine physician.Brett Reichwage, M.D., neurosurgeon. To learn more about these physicians, please visit

TheAndrewsInstitute.com or call 850.916.8700.

Baptist Health Care Launches New Employee &Employer Health Program, Healthy Lives™

Healthy Lives™ is a comprehensive initiative to engage Baptistteam members and their families in their own health caremanagement. By delivering customized programs, including health

screenings and coaching, Baptist aims to help their workforce livehealthier and keep health care costs low. Baptist is also providingthis integrated employee-health program to employers on the GulfCoast. Interested employers can call 1.855.469.6903 or e-mailhealthylives@bhcpns.org.

Andrews Institute Orthopaedic PhysiciansOffer Student-Athlete Injury Clinic on Saturdays

Student-athletes concerned about an injury now have access tofree injury evaluations by an orthopaedic physician on Saturdays atthe Andrews Institute. The “Student-Athlete Injury Clinic” isavailable to athletes ages 5 and up, each Saturday morning from 8-10 a.m., Aug. 25-Nov.10. No appointment necessary. Learn more atTheAndrewsInstitute.com.

Baptist Health Care Foundation Invites You to the36th Annual Foundation Fashion Show Nov. 1st

Physicians and their families are invited to support thecommunity by taking part in this red carpet extravaganza at NewWorld Landing set for Nov. 1. Doors open at 5:30 p.m. and allproceeds from sponsorships and ticket sales will support the BaptistHealth Care Foundation and the mission to improve quality of life inour community. Get details, become a sponsor and purchase ticketsby visiting BaptistHealthCareFoundation.org.

The Fisher Brown HealthCare Practice team

provides All Lines of Insurance & offers

Risk Management advice for all aspects

of the HealthCare Industry.

Our Commitment is to reduce your Long Term Cost of Risk

Rob RemigNorthwest Florida Business Consultant

850-444-7606

Hospital News Continued

ECMS.Sept.Oct._ECMS Bulletin 10/1/12 3:45 PM Page 11

8880 University Pkwy., Suite BPensacola, FL 32514Ph: 850-478-0706 Fx: 850-474-9783Email: info@escambiacms.orgExecutive Director: Erica Huffman

PRSRT STDU.S. POSTAGE

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