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NEWS FROM VACEP AND VIRGINIA NEWS FROM AROUND THE INDUSTRY



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NEWS FROM VACEP AND VIRGINIA

A note from the President
We have been inundated with information about Ebola of late. Through all this information, three key concepts stand out and are worth reinforcing:
    1. Awareness - the importance of being aware of this disease, and of the history that a patient has recently traveled to West Africa, had exposure to others who have recently traveled to West Africa, or have had contact with a patient with suspected / confirmed Ebola. Communication is a key piece of this. Make sure you know how the ED teams with whom you work will notify you of this information - and it wouldn't hurt to ask the questions yourselves, particularly for patients who present with viral symptoms.

    2. Preparedness - if you do identify the patient with possible Ebola, it is critical that you know the processes you and the ED team will use to care for that patient. What PPE will you use? Do you know how to put it on and take it off? Better yet, have you practiced putting it on and taking it off? What decontamination steps will you take?

    3. Notification - if you have a patient with suspected or possible Ebola, you should contact your local health department (find it, here). After hours, if you cannot reach your local health department, you can reach the 24 hr Virginia Department of Health answering service at 866-531-3068 (this number is for health providers only, not the public).
Now is the time to collaborate with your ED teams and ensure you are ready. I am optimistic that this will be something that very few Virginia ED providers will have to encounter - but if it happens, the above concepts will help our docs to be prepared, and to be safe.

As always, thank you for you do to provide care in Virginia!

Jake O'Shea, M.D., FACEP President, Virginia College of Emergency Physicians
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Virginia emergency physician endures a ZPIC audit
A well-known Virginia emergency physician Group endured a ZPIC audit of a few charts two years ago. A ZPIC and RACs are post payment audits initiated by CMS. They are managed by private companies contracted and paid, based on monies recovered from these audits.

The EM Group had just completed several appeals processes, after many dollars, meetings and months of work, demonstrating the archaic, hostile and ambiguous nature of government reimbursement recapture. The EM Group owns their own billing/coding service, so everything is done in-house. Their Physician President even got trained as a Certified Medical Coder to allow oversight. For a period of time, the EM Group, short on coders, hired an ACEP expert in billing/coding to bill some charts for the Group. The Group even had a nationally recognized coder audit some of the Group’s charts.

Click here to read more.
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Mark Your Calendar: VACEP Winter Annual Meeting

Mark Your Calendar: VACEP Winter Annual Meeting
Feb. 6-9, 2015
The Omni Homestead
Hot Springs, Virginia

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Ebola and US readiness are topics for discussion at Emergency Physicians Conference in Chicago, Oct. 27-30
ACEP
Now that the Ebola virus has crossed America’s borders, emergency physician experts will be in Chicago to discuss it and answer questions about preparedness and clinical response. Drs. David Pigott, Alexander Isakov and Swaminatha Mahadevan will share their research knowledge and experience dealing with Ebola in three related sessions at the ACEP 2014 Scientific Assembly at McCormick Place Convention Center from Oct. 27 to 30. A special feature at ACEP14 will be simulated mass casualty and critical care exercises in the “InnovatED” emergency department of the future.
View full course catalog for ACEP14, here.

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Join us in Chicago... VACEP/UVA jointly sponsored reception, Oct. 27

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McDade Research Award applications for 2015 due Jan. 10, 2015
This McDade award is bestowed for exemplary and outstanding research in the field of emergency medical care. Recipients will be honored at the annual meeting of the College of Emergency Physicians.
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VACEP’s Nomination’s Committee is soliciting emergency medicine physicians
interested in serving on the VACEP Board of Directors.
If you want to share your leadership skills to help direct VACEP’s activities and actions
please send an email to Bob Ramsey by Nov. 10.

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VACEP voices opinion on changes to TDO & ECO
In a letter to the VDBDS Commissioner VACEP President Jeremiah O’Shea voiced opposition to extending an ECO to 24 hours and CSB personnel from petitioning the magistrate independently form the treating physician for a medical reason.
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Ebola Update #2
Commonwealth of Virginia, Department of Health
Marissa J. Levine, M.D., MPH, FAAFP, writes: First and foremost, thank you for your dedication and commitment to providing safe and effective care to patients in Virginia, including those who may have Ebola in their differential diagnosis. My colleagues and I appreciate the challenges that a person with suspected Ebola virus disease (EVD) presents in all healthcare venues. I am writing to be sure you are aware of the latest hospital personal protective equipment (PPE) guidance for the management of patients with EVD. I also want to clearly communicate that this revised CDC guidance is only relevant to hospital care. PPE guidance already issued for other health care venues (EMS, outpatient) is still in effect, although under review.
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A 1st of its kind summit on lessons learned, best practices and innovative strategies for delivering Value Based Care in the Emergency Department — March 13, 2015
While the Emergency Department accounts for only 4 percent of overall healthcare expenditures, the ED has a major impact on total costs with more than 50 percent of all admissions coming through the Emergency Department. Healthcare reform has accelerated the shift from fee-for-service medicine toward value-based reimbursement and population health management. Hospitals and healthcare providers face the daunting challenge of developing new strategies for delivering better, faster and less expensive healthcare.
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UPCOMING EVENTS
Event Date More Information
ACEP Council Meeting
Oct. 25-26 More Information
ACEP14
Oct. 26-29 More Information
VACEP/UVA Reception during ACEP14
Oct. 27 More Information
Pennsylvania Chapter, ACEP, EM Oral Board Review Course
Nov. 3 More Information
International Trauma Life Support, International Trauma Conference
Nov. 4-7 More Information
The Virginia EMS Symposium
Nov. 5-9 More Information
International Trauma Life Support Combined Provider Re-Certification, EMS Symposium
Nov. 6 More Information
OMD Training
Nov. 6-7 More Information
VACEP Board of Directors Meeting
Dec. 12 10 a.m.-3 p.m., VACEP Office
VACEP White Coats on Call
Jan. 27, 2015 Richmond, Virginia
VACEP Hot Topics
Feb. 6-9, 2015 Omni Homestead Resort


NEWS FROM AROUND THE INDUSTRY


ACEP President-elect — A short video on Ebola
The president-elect of the American College of Emergency Physicians, Dr. Michael Gerardi talks about the Ebola situation in the United States, what ACEP is doing and what the organization is asking for from lawmakers in terms of additional resources. Watch the video, here.
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Why are healthcare workers getting infected with Ebola? We were not prepared
By Joan Spitrey
With the current infections of two direct caregivers, questions have surfaced regarding the preparedness of our hospitals and healthcare staff in the United States. As of this article, there have been no reports of the mode of transmission and/or contamination of the two healthcare workers. When Pham was diagnosed, the CDC was quick to blame the nurse for not following protocols. That was followed by the statement that the protocols were being evaluated. This raised the question that if the protocol was sufficient and the nurse was "to blame for her infection," why the sudden need to change the protocols?
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CDC announces faster test for enterovirus D68
The Hill
Federal health officials announced on Oct. 14 that they've developed a faster lab test to diagnose the rare enterovirus D68 amid a large outbreak of the virus. The Centers for Disease Control and Prevention said the test would come in handy as the agency moves through a backlog of roughly 1,000 specimens submitted since mid-September. The new lab test will reduce what would normally take several weeks to get results to a few days. A handful of children have died while infected with the virus.
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More children receiving medical care in the emergency room
HealthDay News via Healthcare Professionals Network
More children are going to the emergency department for health care, according to a research letter published in the Oct. 15 issue of the Journal of the American Medical Association. Children's visits to the emergency department in California hospitals increased 11 percent between 2005 and 2010. At the start of the study, 2.5 million children were seen in the emergency department. By 2010, 2.8 million children visited the emergency department each year.
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Study shows complications of dermatology cases in ED
By Lynn Hetzler
More than 75 percent of all dermatology complaints seen in emergency departments are acute rather than chronic, according to research results presented at the 23rd European Academy of Dermatology and Venereology Congress. Priyanka Vedak from Massachusetts General Hospital in Boston and her colleagues conducted the study in hopes of evaluating the dermatologic diagnoses in the emergency department there, and to assess the use of dermatology consultations.
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UCLA study offers hope on emergency room crowding
Los Angeles Times
A new UCLA study has found that while people enrolled in low-cost, government-run health plans visit emergency rooms at high rates soon after becoming insured, the number falls dramatically within a year. That's good news, said study author and UCLA professor Dr. Gerald Kominski, because patients' long-neglected health problems are being "addressed during the first year, and because of that there's a drop-off."
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Study: Approximately 14 million major medical conditions in US due to smoking
Medical News Today
Approximately 14 million major medical conditions attributable to smoking are suffered by American adults, according to the estimates of a new study. This figure is significantly larger than figures that have been previously reported. The findings of the study, published in JAMA Internal Medicine, suggest that the disease burden of cigarette smoking in the US "remains immense," write the authors.
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New app helping med students diagnosis quickly in ER
By Stephanie McKenzie
There is a new app that is making emergency medicine a lot easier for residents and interns on the floor. The Basics of Emergency Medicine app by the Emergency Medicine Residents' Association is currently only available on iPhones, but it is already proving to be an invaluable tool to emergency medicine interns and residents across the country. The Basics of EM app is meant to give residents and interns access to a quick, easy clinical guide to dealing with up to 20 of the most common complaints seen in the ER. Young medical students are already finding it to be their "go-to" tool for nearly everything they do at work.
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What role do emergency rooms play in the healthcare system?
Medical Daily
While many people hope that increasing insurance coverage through the Affordable Care Act will lead to a decrease in emergency room visits, access to Medicaid may actually be linked to an increased use of emergency services among adults. And what about children? An analysis of emergency room visits by children, teens, and young adults in California found that rates increased across the uninsured as well as the insured, no matter their group. "Shifts in insurance (from private and no insurance to Medicaid) during the recession likely influenced the trends during this time," wrote the authors in their conclusion.
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Equity of care: Hospitals tackle health disparities
Healthcare Finance News
This infographic from the American Hospital Association's Hospitals in Pursuit of Excellence details findings from their 2013 Diversity and Disparities Survey. The survey highlights both the advancements and additional work needed in eliminating healthcare disparities.
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Spike in ER use short-lived after Medicaid expansion
MedPage Today
While the Medicaid expansion may lead to a dramatic rise in emergency room use and hospitalizations for previously uninsured people, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to an analysis from the UCLA Center for Health Policy Research released Wednesday. Researchers reviewed 2 years of claims data from nearly 200,000 Californians, including a group who had enrolled in public programs well in advance of the expansion of Medi-Cal,the state's version of Medicaid, in January.
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4 ways cameras are changing healthcare
Forbes
When discussing innovation in healthcare technology, much of the terminology is exotic-sounding and futuristic. Recent examples include: functional MRIs to detect lies, active cancellation of tremor to stabilize food utensils for Parkinson's patients and virtual assistant apps for people with cognitive disabilities. But it's important to remember that a lot of progress can be and is made by applying older technologies in new, transformative ways. Take, for example, the camera. Here are four new and exciting ways that cameras will impact the clinical landscape in the years ahead.
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States seek solutions to hospital violence
FierceHealthcare
State legislatures aim to reduce a prevalent problem in the healthcare sector: violence against workers. A resolution in the Georgia legislature this year created a panel to study assaults on hospital staff and make recommendations for future action, according to the Gainesville Times.
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Predicting geriatric falls following an episode of emergency department care: A systematic review
Academic Emergency Medicine
This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk.
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New test reduces trial-and-error process for mental health drugs
By Rachael Mattice
Picking up a prescription from the pharmacy always includes general warnings. When it comes to more complex medications that are used to treat mental health disorders — such as antidepressants or antipsychotics — a patient can expect a printout of warning labels with possible adverse effects that are dangerous and symptomatically worse than the condition being initially treated. Substantial advances have been made in the field of genomic medicine since the decoding of the human genome in 2001. One such advance is known as pharmacogenetic testing.
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Thyroid storm-induced multi-organ failure in the setting of gestational trophoblastic disease
Journal of Emergency Medicine
Thyroid storm is a potentially life-threatening complication of gestational trophoblastic disease (GTD), with varying clinical severity. It should be considered in patients with GTD, abnormal vital signs, and clinical signs of hyperthyroidism.
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High blood sugar may worsen spinal cord injury
HealthNewsDigest
Scientists have discovered yet another reason to curb sugar consumption: high levels of it in the blood may make recovery after spinal cord injury harder. Controlling blood sugar levels in patients with spinal cord injury could potentially help doctors prevent additional neurological deterioration. In mice models of high blood sugar (hyperglycemia) and in a retrospective analysis of human patients, researchers found a link between hyperglycemia and poorer outcomes after spinal cord injury.
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Emergency room visits linked to synthetic pot up significantly in recent years
HealthDay News via Healthcare Professionals Network
The number of visits to U.S. emergency departments linked to synthetic pot — also known as "K2" or "Spice" — have more than doubled in recent years, according to an Oct. 16 report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). "Synthetic cannabinoids are a growing public health risk — made even more dangerous by the widespread misconception that they are safe and legal," SAMHSA Administrator Pamela Hyde said in an administration news release.
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VACEP eNews
CONTACT VACEP:
2924 Emerywood Parkway, Suite 202, Richmond, VA 23294
804.297.3171

Bob Ramsey, CAE, VACEP Executive Director

Colby Horton, MultiView Vice President of Publishing, 469.420.2601
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Jessica Taylor, MultiView Senior Medical Editor, 202.684.7169  
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