Tampa Bay Medical News March 2015

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PHYSICIAN SPOTLIGHT

Thomas Trinchetto, MD

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To promote your business or practice in this high profile spot, contact James Howard at Tampa Bay Medical News.

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Providing a Helping Hand Florida’s free and charitable clinics receive $4.5 million in state funding ... 4

By the Numbers: The Latest Stats on CancerDeath rates down, more work awaits ... 9

By JULIE PARKER

CLEARWATER—A 62-year-old woman retired early from Pinellas County Schools as a result of being an insulin-dependent diabetic with additional chronic health issues. Automatically deducted each month from her $1,822 monthly pension is a $700 COBRA insurance premium that doesn’t cover deductibles, co-pays, or medi-cations. During a particularly diffi cult fi nancial time covering meager living expenses on $1,122 a month, the woman abandoned medical care and insulin for two months.

“By the time she presented at the Clearwater Free Clinic, she was in a crisis, re-quiring care, medications, diabetic supplies and management,” said Jeannie Shapiro, executive director of the Clearwater Free Clinic in Clearwater. “We have patients like her present to us every day. They’re fi nding it diffi cult to transition into the ACA. About 80 percent of patients come to us with chronic diseases that need constant moni-toring and medication therapy.”

Healing the UnderservedClearwater Free Clinic provides

signifi cant medical services to community

By JULIE PARKER

By the time state lawmakers meet March 3 for the 2015 opening legislative session, legislation bringing Florida to the forefront of telemedicine may very well need only the polishing of a few details. Or will it? Both bills lack one important element: parity for telemedicine reimbursement.

State Sen. Aaron Bean (R-Jackson-ville), a staunch supporter of telemedicine, indicated earlier this year that a proposed telemedicine bill will likely pass this session.

Bean, chairman of the Senate Health Policy com-mittee, said last year’s 26-page bill was too complex for bipartisan support.

The much shorter 2015 draft of Senate Bill 478 should facili-tate the practice of remote medicine, Bean said.

The Florida TeleHealth Workgroup, initiated by the Southeastern TeleHealth Resource Center (SETRC), held a summit in

Orlando last Decem-ber, with improved telemedicine policy at the top of the agenda.

Last month, the work-groups met throughout

Florida to provide insight and direction regarding the

advancement of telehealth and to encourage collaboration among existing telehealth networks and programs.

“Once improved telemedicine legisla-

Facilitating the Practice of TelemedicineLegislature, FMA support legislative action to reimburse telemedicine for same rate as in-clinic visit and other benefi ts

Schools as a result of being an insulin-dependent diabetic with additional chronic health issues. Automatically deducted each month from her $1,822 monthly pension is a $700 COBRA insurance premium that doesn’t cover deductibles, co-pays, or medi-cations. During a particularly diffi cult fi nancial time covering meager living expenses on $1,122 a month, the woman abandoned medical care and insulin for two months.

quiring care, medications, diabetic supplies and management,” said Jeannie Shapiro, executive director of the Clearwater Free Clinic in Clearwater. “We have patients like her present to us every day. They’re fi nding it diffi cult to transition into the ACA. About 80 percent of patients come to us with chronic diseases that need constant moni-toring and medication therapy.”

Healing the Underserved

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By JEFF WEBB

SARASOTA - Thomas Trinchetto chuckles when someone comments on his Italian surname by saying “Oh, I know a Trinchetto.” Politely, he tells them “No, you don’t there was only one,” and the lin-eage is very short.

“My grandfather was an orphan in a town near Naples (Italy). He was named after one of the Italian sailing vessels around 1900. He had only one son (my father), and he had only three sons,” of which Trinchetto is one. “Now it’s just us and our children” who have the name Trinchetto, he said.

Trinchetto translates into English as “mast,” and his family’s emigration story could be a metaphor for the sturdy appa-ratus on which America was built.

“My dad was a carpenter’s appren-tice in Italy who arrived in this country in 1937 at age 15 with his mother and two younger sisters,” said Trinchetto. “My grandfather had come to the U.S. several years earlier to get a job and establish a home before sending for his family.”

“The ship my father came over on was the SS Leo and the passenger list identified him as ‘laborer, age 15,’” Trin-chetto said. “The day after arriving in New York City, speaking no English and having no idea how to navigate the city, he was sent by my grandfather to start a job on the docks in New Jersey. My grand-father just handed him a piece of paper with an address on it and sent him out the door. He eventually became a mechanic and worked on the docks for the rest of his working career,” he said. “His name was Salvatore and my mother was Teresa, a seamstress born in the U.S.”

“When he came here he had to start work and help support the family. All the opportunities he might have had (in Italy) came to an end then because he had to go to work. He sacrificed everything else to take care of his father and mother, and later his own family. It was a very tradi-tional, old-world role,” Trinchetto said.

The Trinchetto family settled in a four-story brownstone that his grand-father bought in Brooklyn. “He and my grandmother lived on the ground floor, and each of his three children and their families lived on one of the upper floors. I lived there until age 3, when we moved to Long Island,” Trinchetto recalled. “Back then, Brooklyn was a place they wanted to get away from. This was all part of the typical immigrant’s dream – work hard so your children would have the oppor-tunity to have a better life than they did,” Trinchetto said. His dad rose at 4:30 every morning to be at work as a Longshoreman in Brooklyn by 6, and did not return home until 8 at night. “I was always very aware and appreciative of what he sacrificed for

his family,” said Trinchetto. Trinchetto thrived academically as

a high school student, earning a score of 800 on his SATs, so he had his choice of universities. He chose John Hopkins University in Baltimore for a somewhat whimsical reason. “I gathered applications from everywhere, but I applied to only six. My high school guidance counselor asked me why. I told him I really hated writ-ing autobiographical essays. I mean, I’m 17 years old and they want an autobio-graphical essay? What was I going to say? ‘I was born. I grew up. I went to school. And now I’m going to college. That’s it!’ Trinchetto laughed. “So, I applied to the six good schools that did not require those essays. John Hopkins was one.”

It took him a couple of years to settle on a pre-med curriculum, Trinchetto said, because during that time he was under-going a social transformation. “I was very shy and introverted until I graduated high school, then consciously reinvented myself in college. I became very social – dorm president, pledge class president, frater-nity social chairman, then frat president. I wanted a fresh start,” he said.

After graduating in 1973 with a de-gree in Natural Sciences at John Hop-kins, Trinchetto returned to his roots to earn his MD at the State University of New York College of Medicine in Brook-lyn. But when it came time to complete his internship, residency and fellowship in internal medicine, he traveled south again on Interstate 95 to John Hopkins in Baltimore.

Trinchetto spent the next 12 years working as an emergency physician at hospitals in Maryland. “I found internal medicine moved slowly. But I was drawn to the action of emergency medicine. I much preferred being in the ICU where I see a person who is really sick and I have

to think fast on my feet. Whether this per-son lives or dies may depend on what I do and how fast I do it. I really liked that challenge,” Trinchetto said. “It’s acute intervention. You can see results and move on to the next patient.”

Trinchetto’s desire to “move on” next involved geography and lifestyle. In the early 1990s he and his fiance Cheri moved “as far south as we could” to the Florida Keys. “I had always been fasci-nated by the tropics … and I couldn’t stand the bad weather up north any more,” said Trinchetto, who enjoys boat-ing and fishing.

It was a major shift. “I had always heard the three biggest challenges or stressors in a person’s life were moving, getting married and changing jobs. So, I decided to do all three at once! I said ‘We’re all in. We’ll buy this house, build an addition on it, get married, start a new job and just get through all the stress at once!’” he said.

The couple moved with their two chil-dren, Salvatore and Samantha, to the Gulf Coast in 2001 and, after working in Englewood and St. Petersburg for a while, landed in 2006 at Doctors Hos-pital of Sarasota, where he now is Chief Medical Officer, and Cheri is vice presi-dent of Quality and Patient Safety.

“We’ve worked together at the same facilities almost from the day we met,” Trinchetto said. “Cheri is an RN and over the years has held a variety of positions, up to and including chief nursing officer. She’s very well-educated. … She’s trained in so many things and can fill so many roles, it’s amazing. She’s better at what she does than I am at what I do.”

And Trinchetto really likes what’s he’s doing now. “I love this position! I did not know I was going to like it this much when I started. I was pretty burned out after 34 years in the ER, and I was at that stage in my life where working nights, weekends, and missing social events with friends and family happened a lot,” he said.

“I love where I live and I love this hos-pital. It’s the best place I’ve ever worked. I’m so happy doing what I’m doing and I feel like I can make a difference. It’s a new challenge and I had not had a new chal-lenge in a long time,” he said. “This ad-ministrative team is wonderful. Our CEO is great guy and there is a very pleasant work environment.”

Trinchetto, 63, said he has no plans to retire. “As long as I’m having fun and can do a good job to the satisfaction of my CEO and the team here, I’ll probably go until I’m 70,” he said. “I’ve still got a few years left and I don’t noticeably hobble when I walk!”

PhysicianSpotlight

Thomas Trinchetto, MDChief Medical Officer, Doctors Hospital of Sarasota

Those words apply to so much of this month’s edition of Medical News. The focus is on maximiz-ing outcomes … from the push to narrow down cancer types to bet-ter understand how to target an individual’s treatment … to the re-alization that healthcare marketing requires a different approach from ‘one size fits all’ when it comes to al-locating tight budgets to the great-est effect.

They also aptly describe Medi-cal News. With publications in 11 markets, primarily in the Southeast, Medical News has grown to be an invaluable source of clinical and business information impacting the healthcare industry. Our read-ership is pretty evenly split in each market between clinicians and the executives leading health systems, practices, entrepreneurial business ventures, industry associations, and allied consulting firms cover-ing legal, financial, technology and other industry concerns.

Someone recently asked me about our model of covering both business and clinical news. The rea-son, as all of you know, is simple. In today’s healthcare landscape, the two are inextricably connected. Physicians and researchers must work with an eye toward achiev-ing the best outcomes in the most efficient, cost effective manner. Similarly, administrators recog-nize reimbursement is increasingly tied to patient outcomes, quality and safety. And, of course, it’s all wrapped in a maze of regulatory compliance issues that impact all sides of the equation.

In total, our readership deliv-ers the key decision-makers that address quality, improve patient outcomes, educate the next gen-eration of clinicians, advance the science, create disruptive tech-nologies, provide solutions, and otherwise transform the healthcare industry. If these are the people you wish to reach, I’d love to discuss sales and partnership opportunities to help you deliver your message in a highly effective, targeted manner.

James [email protected]

FromthePublisherHighly targeted and intensely personal.


By JULIE PARKER

For the first time in Florida’s history, state lawmakers have allocated $4.5 mil-lion in grants to free and charitable clinics and networks across the state that provide primary and specialty care services to uninsured and low-income, underserved residents.

The grants, administered by the Florida Association of Free and Charita-ble Clinics (FAFCC) by contract with the Florida Department of Health, will allow 69 of the state’s 77 free and charitable clinics to fund a variety of needs -- the acquisition of medical and dental equip-ment, electronic health records systems, expansion of volunteer recruitment and retention, and strategic planning for in-come diversification.

“Free and charitable clinics provide a much needed safety net for uninsured resi-dents who otherwise might not be able to afford expensive medical and dental treat-ment and who are ineligible for subsidized coverage through the health insurance marketplace,” said Mark Cruise, a 24-year industry veteran who joined the St. Petersburg-based FAFCC as executive di-rector last July. “Our new grant program makes it possible for these organizations to build capacity (and) reach even more people who need services.”

One hundred percent of the grant money passes through the organization to FAFCC members.

The five largest grant recipients statewide are Grace Medical Home in Orlando ($177,037), Florida Interna-tional University Mobile Health Center in Miami ($158,040), Shepherd’s Hope in Orlando ($157,000), Caridad Center in Boynton Beach ($150,000), and Lake-land Volunteers in Medicine in Lakeland ($145,930).

The Tampa metro area’s three larg-est free and charitable clinics garnered a total of $286,949 in grants. The St. Pe-tersburg Free Clinic in St. Petersburg, Florida’s oldest free clinic established in 1970, received $98,349; Clearwater Free Clinic in Clearwater, a spinoff of the St. Petersburg Free Clinic, received $98,200; and the Judeo Christian Health Clinic in Tampa received $90,400.

“The grant recipients have ear-marked funds for organization capacity building types of initiatives,” said Cruise. “We’re very excited about the impact they’re making in enabling clinics to build a strong foundation for the long term.”

Senate President Andy Gardner, a

Republican from Orlando, championed the FAFCC appropriation, along with integral support of Republican Gov. Rick Scott, said Cruise.

“State Senator Gardner was by no means alone in advocating for funding, but he was certainly a vocal advocate and will continue to be a staunch supporter of the state’s free and charitable clinics,” he said. “We’re very proud of so many legis-lators – Republicans and Democrats alike in both chambers – who came together and recognized the need to support our sector in this challenging healthcare envi-ronment. It’s the kind of partnership be-tween the state and our sector that makes sense fiscally and for the health of our vul-nerable neighbors in need. We’re hopeful the appropriation continues this year, and we’re working hard to inform legislators about how the money is being used this year, the difference it’s making, and clari-fying why the appropriation should be continued.”

Concerning the controversy over whether to expand healthcare coverage for Floridians, Cruise firmly believes all citizens should have access to coverage and care.

“The best way to achieve that goal is via a broad, bipartisan solution everyone can salute,” he said. “For our part, we’ll continue to work very hard to care for the people left behind. In Florida, that’s a lot of people! That said, we’re also not under any illusion that the expansion of Medic-aid will result in universal coverage, espe-cially in Florida.”

Cruise has been in constant contact with state association colleagues across the country about trending news concerning free and charitable clinics.

“Some folks outside our industry have concluded that free and charitable clinics will continue to close in the years to come,” he said. “That isn’t true. When I’ve asked about closures, none of my col-leagues has noticed a trend in that direc-tion. The ones across the country that have closed have simply garnered a lot of attention. (None in Florida have closed.) In contrast, they’ve noticed an uptick … every single one. The demand for free and charitable clinics isn’t going away. In fact, we have eight clinics statewide that are planning to open this year. That tells you a little bit about the need our private sector provides.”

Providing a Helping Hand Florida’s free and charitable clinics receive $4.5 million in state funding

FAFCC MEMBER/FISCAL AGENT CITY GRANTBarnabas Health Services Barnabas Center, Inc. Fernandina Beach $83,675

Brandon Outreach Clinic Brandon Outreach Clinic, Inc. Brandon $45,600

Caridad Center Caridad Center, Inc Boynton Beach $150,000

Caring for Miami Mobile Health Unit Caring for Miami, Inc. Palmetto Bay $40,812

Catholic Charities Free Clinics Catholic Charities of Central Florida, Inc. Orlando $58,000

Center for Family Health Eldermed, Inc. Tampa $30,735

Clearwater Free Clinic Clearwater Free Clinic, Inc. Clearwater $98,200

Community Dental Clinic Community Dental Clinic, Inc. Clearwater $37,400

Community Health Center of West Palm Beach West Palm Beach $59,450Community Health Center of West Palm Beach, Inc.

Community Health Outreach Westjax Outreach, Inc. Jacksonville $58,000

Community Medical Care Center Community Medical Care Center of Leesburg, Inc. Leesburg $28,333

Community Smiles Dade County Dental Research Clinic, Inc. Miami $134,782

Crescent Community Clinic Crescent of Hernando, Inc. Spring Hill $44,000

Englewood Community Care Clinic Englewood Community Care Clinic, Inc. Englewood $43,100

Epilepsy Association of Central Florida Epilepsy Association of Central Florida, Inc. Orlando $82,800

FIU Mobile Health Center Florida International University Foundation, Inc. Miami $158,040

Flagler County Free Clinic Flagler County Free Clinic, Inc. Bunnell $66,145

Florida Baptist Mobile Dental Unit Florida Baptist State Convention, Inc. Jacksonville $48,440

Florida Waterman Community Primary Health Clinic Eustis $40,920Florida Hospital Waterman Foundation, Inc.

Good Health Clinic Good Health Clinic, Inc. Tavernier $52,915

Good News Care Center Miami Baptist Association, Inc. Miami $38,835

Good Samaritan Free Clinic Talbot House Ministries of Lakeland, Inc. Lakeland $92,180

Good Samaritan Free Clinic The Good Samaritan Free Clinic, Inc. Fort Pierce $39,350

Good Samaritan Health Centers Good Samaritan Health Centers, Inc. St. Augustine $62,731

Good Samaritan Health Clinic of Pasco Good Samaritan Health Clinic of Pasco, Inc. New Port Richey $57,110

Grace Medical Home Grace Medical Home, Inc. Orlando $177,037

Health and Hope Clinic Health and Hope Clinic, Inc. Pensacola $48,035

Helping Hands Clinic Helping Hands Clinic, Inc. Gainesville $38,500

HEP Free Dental Clinic Homeless Emergency Project, Inc. Clearwater $42,850

Hope Medical Clinic Hope Medical Clinic, Inc. Destin $50,598

Jesus Clinic The Jesus Clinic, Inc. Daytona Beach $46,060

Judeo Christian Health Clinic Judeo Christian Health Clinic, Inc. Tampa $90,400

Lake Wales Free Clinic Lake Wales Care Center, Inc. Lake Wales $39,226

Lakeland Volunteers in Medicine Lakeland Volunteers in Medicine, Inc. Lakeland $145,930

Lee County Volunteers in Medicine Lee County Volunteers in Medicine, Inc. Lehigh Acres $38,900

Light of the World Charities Light of the World Charities, Inc. Palm City $56,210

Light of the World Clinic Luz Del Mundo Light of the World, Inc. Oakland Park $45,000

Lotus Wellness Center Sundari Foundation, Inc. Miami $53,969

Miami Rescue Mission Clinic Miami Rescue Mission Clinic, Inc. Miami $50,580

Mission House Mission House, Inc. Jacksonville Beach $46,700

Mission Smiles Mission Tampa, Inc. Tampa $30,450

Muslim American Social Services Muslim American Social Services, Inc. Jacksonville $35,300

My Clinic Jupiter Jupiter Community Health Services, Inc. Jupiter $42,500

Open Door Health Center Open Door Health Center, Inc. Homestead $70,425

Palm Beach County Project Access Specialty Network Palm Springs $58,500Palm Beach County Medical Society Services, Inc.

Palm Springs Baptist Church Medical Mission Clinic Palm Beach $34,150Palm Springs Baptist Church, Inc. West

Samaritan’s Touch Care Center Samaritan’s Touch Care Center, Inc. Sebring $55,650

Senior Friendship Centers Senior Friendship Centers, Inc. Venice $95,225

Shepherd’s Hope Shepherd’s Hope, Inc. Orlando $157,000

Space Coast Volunteers in Medicine Indian River Volunteers in Medicine, Inc. Viera $45,000

St. Andrew Community Medical Center St. Andrew Community Medical Center, Inc. Panama City $70,315

St. John Bosco Clinic SSJ Health Foundation, Inc. Miami $68,130

St. Lucie County Health Access Network St. Lucie County Health Access Network, Inc. Fort Pierce $72,225

St. Petersburg Free Clinic St. Petersburg Free Clinic, Inc. St. Petersburg $98,349

SW Florida Free Pain Clinic Fort Myers First Church of the Nazarene, Inc. Fort Myers $49,300

The Haley Center First Baptist Church of Winter Haven, Inc. Winter Haven $44,408

The Heights Center Clinic The Heights Center, Inc. Fort Myers $38,955

The Way Free Medical Clinic The Way Free Medical Clinic, Inc. Green Cove Springs $51,400

Turning Points Community Coalition on Homelessness, Inc. Bradenton $61,100

University of Florida Mobile Outreach Clinic University of Florida Foundation, Inc. Gainesville $45,600

University of Miami Pediatric Mobile Clinic University of Miami, Inc. MIami $105,000

Virginia B. Andes Volunteer Community Clinic Port Charlotte $84,500St. Vincent de Paul Community Health Care, Inc.

Vision is Priceless Vision is Priceless Council, Inc. Jacksonville $71,221

Volunteers in Medicine Jacksonville VIM JAX, Inc. Jacksonville $105,860

We Care Jacksonville We Care Jacksonville, Inc. Jacksonville $77,600

We Care of Lake County We Care of Lake County, Inc. Tavares $51,800

We Care Physician Referral Network Alachua County Medical Society Foundation, Inc. Gainesville $73,800

Westside Samaritan’s Clinic Westside Samaritans Clinic, Inc. Gainesville $42,283

Willa Carson Health & Wellness Center Willa Carson Health & Wellness Center, Inc. Clearwater $42,406

$4,500,000

SAFETY NET


The Clearwater Free Clinic, a non-emergent medical clinic established in 1977 as a spinoff of the St. Petersburg Free Clinic, sprawls over 7,000 square feet. The staff of eight, a family practice nurse prac-titioner grant-funded by the Morton Plant Mease Foundation, and volunteer roster of 150 healthcare volunteers are near ca-pacity, offering medical services for “the gap people” of mid and upper Pinellas County four days a week, 10 hours a day (9 am to 6 pm).

Healthcare services include office visits, medications, lab work, x-rays, spe-cialty referrals, diabetic and nutritional counseling, and hospital-based procedures at no cost for those who don’t qualify for government assistance and cannot afford private medical care. The clinic has a wide range of clinical specialists and specialty services, which includes an active pediat-ric program.

In addition, approximately 70 com-munity medical and surgical specialists agree to see patients in their offices at no cost, with a referral from a clinic doctor.

“We originally opened one night a week for a few hours in a rented house provided by the city,” said Shapiro, who joined the clinic in 1998. “Last year, we

had approximately 13,000 patient visits and 34,000 courses of acute and chronic medications retailing over $1.3 million through pharmaceutical-assisted pro-grams. What’s more, we’re not seeing a slowdown. Every month, we have an av-erage of 70 new patient visits.”

The clinic’s $850,000 annual budget was recently augmented by a first-time grant from the Florida Association of Free and Charitable Clinics for $98,200. Its an-nual fundraiser, the very popular Martinis & Matisse event held every January, cov-ers one-fourth of the budget. On May 4, the clinic will host its second fundraiser for the year: a golf tournament at Belleview Biltmore Country Club in Belleair. Nearly $4 million of goods and services were do-nated to the clinic in 2014.

BayCare is a significant contributor for in-kind services at its nearby hospi-tals– Morton Plant, Mease Countryside, and Mease Dunedin. The nearest com-munity partner, Morton Plant Mease Health Care, provided nearly $2 million in donated healthcare services to clinic pa-tients in 2014.

“BayCare provides all our lab work, up to 50 radiology appointments monthly, a certain number of sleep studies, proce-

dures for endoscopies,” said Shapiro. “We’re very fortunate for their help.”

BayCare also contributes significantly to the metro area’s safety net initiatives. In 2013, the 11-hospital healthcare system contributed $110.9 million in traditional charity care and $11.3 million in unbilled community services.

“Think about one chronically ill dia-betic that goes into the hospital and needs dialysis, or a patient who has a cardiac event that could’ve been avoided with preventive care, the cost can run into $300,000 to $500,000 per person,” said Shapiro. “By keeping these chronically ill patients healthy and functioning and working and contributing to the commu-nity is a win-win for everyone.”

Clearwater Free Clinic, which re-

ceives no regular government or United Way financial support, added behav-ioral health services last March, privately funded by community philanthropists and clinic supporters Kate Tiedeman and Ellen Cotton.

“We’re increasing services every year,” Shapiro noted. “We have a very generous community.”

None of the services provided by the clinic would be possible without a strong volunteer presence, Shapiro emphasized.

“Their importance is essential to our ability to deliver care,” she said. “Fortu-nately, as a result of working hard to make sure our volunteers have a meaningful experience, we continuously get applica-tions. It’s significant to note that many vol-unteers aren’t healthcare providers. There are lots of clerical opportunities. We’re al-ways welcoming to those who want to help us help those in need.”

Volunteers needed now at the Clear-water Free Clinic include primary care and specialty physicians, nurse practitio-ners and physician assistants, nurses, dieti-cians, social workers, receptionists, office personnel, counselors, health educators, fundraiser event volunteers, and computer and information services.

Healing the Underserved, continued from page 1

SAFETY NET

tion is approved and implemented, we’ll have elements in place to help facilitate its growth,” said SETRC director Rena Brewer, RN, MA. “The medical commu-nity is committed to the advancement of telehealth because of its great potential to reach more patients.”

Michael P. Smith, MA, MPA, de-velopment director of the Telemedicine Program for the Florida State University College of Medicine, and Ken Peach, executive director of the Health Coun-cil of East Central Florida, participated in a telemedicine press conference at the Florida Capitol that included Bean, Sen. Arthenia Joyner (D-Tampa), Rep. Travis Cummings (R-Clay County), and Rep. Mia Jones (D-Duval County), and gar-nered quite a bit of publicity.

“As Rep. Jones mentioned, after four years of effort, this may just be the year to get this legislation passed,” said Smith, noting that Miami Children’s Hospital, an early pioneer of telemedicine since 1973, Lee Memorial Health System, Flor-ida Chamber of Commerce and Baptist Health South, among others, provided compelling demonstrations of telemedi-cine’s potential for Florida.

The Florida Medical Association re-leased a position statement on telemedi-cine in its legislative agenda, “The FMA’s Prescription for a Healthy Florida,” sup-porting the use of new technologies to expand access to areas where too few phy-sicians or a second opinion by a specialist is quickly needed.

“Our goal is to expand the use of tele-

medicine while ensuring high standards and providing appropriate safeguards to protect patient safety and privacy,” said Jeff Scott, FMA director of legal and gov-ernmental affairs, noting four components the statewide association believes must be accomplished:

Definition of Telemedicine: Flor-ida must clearly define the practices of tele-health, telemonitoring and telemedicine. The definition of telemedicine must in-clude language that requires an established patient-physician relationship and also the requirement for patient-informed consent.

Physician Accountability: Physi-cians using telemedicine must be licensed in Florida. To ensure the safety of Flori-da’s patients, these physicians should meet uniform standards of care. The Florida Board of Medicine must have jurisdiction to credential and discipline these physi-cians practicing medicine on Florida pa-tients via telemedicine.

Continuing Medical Education (CME): All physicians practicing tele-medicine must comply with state laws and rules. The best way to maintain this knowledge in an ever-changing techno-logical landscape is for physicians to com-plete CME provided by their professional association.

Reimbursement: Lack of payment for telemedicine services is a significant barrier to widespread adoption of this innovative technology. Parity for face-to-face consults and telemedicine consults must apply in the private insurance market and Medicaid. The physician expends the

same amount of time, skill and diagnos-tic expertise when conducting a consult, whether face-to-face or via telemedicine.

“As with any new technology, there’s always potential for abuse,” Scott pointed out. “It’s important that insurance com-panies are prevented from using telemedi-cine physicians as ‘gatekeepers’ to deny care. In addition, health plans should by prohibited from using telemedicine to get around network adequacy requirements.”

Scott emphasized there are no reim-bursement issues in either bill.

Smith suggested the lack of reim-bursement “is a strategic move ... that will be addressed in subsequent years.”

The House counterpart (HB 545), in-troduced by Cummings and Jones, defines telehealth and telehealth provider, pro-vides for practice standards for telehealth providers; authorizes telehealth provid-ers to prescribe controlled substances via telehealth with exception; and provides for the maintenance and confidentiality of medical records.

Senate Bill 478 has an addition: “pro-hibits the use of telehealth or specified computer-controlled devices to prescribe optical devices.”

The Florida Senate Health Policy Committee unanimously voted in favor of Senate bill 478, which was amended and now more closely conforms to the House version.

“We supported the bill in the Senate Health Policy committee,” said Scott. “We’d like to do some fine tuning, and are working with the sponsors to accomplish this.”

Facilitating the Practice of Telemedicine, continued from page 1

For advertising opportunities, please contact

James Howard813-956-4428

[email protected]

Your Primary Source for

Professional Healthcare News

On Monday, May 4, the 2015 Clear-water Free Clinic Charity Golf Tour-nament will be held at the Belleview Biltmore Golf Club in Belleair, from 1 pm to 8:30 pm. For more informa-tion, call the clinic at (727) 447-3041.

SAVE-THE-DATE



By CINDy SANDERS

With better understanding of the human genome, physicians and research-ers have opened up exciting new lines of personalized medicine where providers de-liver radiation with pinpoint accuracy and tailor treatments to fit a patient’s unique needs. While a highly scientific, very tar-geted approach is often used to promote improved outcomes, it is rarely employed when it comes time to promote a facility or provider expertise to improve income.

If precision medicine has been shown to work, why not also utilize precision marketing?

A Call to ArmsIn his 2011 mani-

festo for transforming healthcare marketing, “Joe Public Doesn’t Care About Your Hos-pital,” author Chris Bevolo explored why the digital world had made it possible … and desirable … to change not only the message but also the manner in which it is delivered. His September 2014 follow-up, “Joe Public II: Embracing the New

Paradigm,” offered practical strategies for making the move from mass marketing campaigns to much more precise digital and content marketing options.

The norm, Bevolo pointed out, has been to take a shotgun approach via mass marketing. “It really was a call out to the industry to say, ‘This isn’t working … we

need to stop this,’” he said of his first book.Change doesn’t come easily, pointed

out Bevolo, executive vice president for healthcare marketing communications firm ReviveHealth. And just as the indus-try was beginning to get the hang of Face-book and Twitter, the digital landscape shifted again.

“Social media is still important, al-though we’re beginning to see the lim-its of what it can do from a marketing standpoint,” said Bevolo. “Instead of a few big players, you’re seeing more and more players emerge,” he continued of the segmentation of social media. “It’s an im-portant supportive tool, but I think there was a time when people thought it would totally revolutionize marketing.”

Instead, it is one device in the big-ger picture of digital marketing, which is revolutionizing the way providers and ad-ministrators reach their target audiences. Bevolo said ‘search’ should be a primary driver of how customers … also known as patients … find you and your message. Whether by purchasing prime real estate in popular search engines or effectively using tags, it’s certainly a competitive ad-vantage to be among the first few sites that pop up when someone looks for “urolo-gist, Saint Louis,” or “safest hospitals, Tampa area.”

Additionally, emerging technologies allow practices and health systems to re-ally drill down and target specific mes-sages to specific populations in a way that is timely and useful. “It has to be relevant, and it has to be relevant to what they need in the moment,” Bevolo stressed.

Content is KingBevolo said there is no question that

people are facing information overload, and he noted research has shown indi-viduals are hit by thousands of marketing messages daily but can only process about 100 of them.

“How do you become one of the 100

out of 3,000 or 6,000?” he asked. “The key is relevancy.”

Bevolo continued, “That’s the chal-lenge for any marketer, but it’s particu-larly challenging for hospitals. What they have to offer is not relevant to the vast ma-jority of people at any given time.”

Expecting consumers to hone in on messages that don’t apply to them isn’t realistic, he said. “If you’re not in need of a doctor at this moment, you don’t care about awards, service lines or how great a hospital’s doctors are,” he pointed out. “Yet, we try to do broad marketing. Not only is it silly, it’s a waste of money and time … and you don’t have time to waste, and you don’t have money to waste.”

When patient volume is down, Bevolo said the gut reaction is to believe it’s be-cause not enough people know about you and your wonderful services. The prevail-ing sentiment is that if you just get a mes-sage out there about how good you are, then people will a) hear it, b) care about it, and c) will take action on it. “All three are false, by and large,” he said.

Bevolo continued, “That’s the funda-mental breakdown in logic … that telling people how great you are will get people through your doors. I don’t care how good the billboard is, it’s not going to make me run in and have my gall bladder taken out if I don’t need it removed.”

With limited resources, why pay to broadcast to a million people when only 30,000 need your message, he questioned. However, Bevolo was quick to add, tar-geting the 30,000 doesn’t mean you are giving up on the other 970,000. Instead, he continued, you just have to rethink the messages.

“You’re missing a lot if you don’t focus on people who do not need services today,” he said. “There’s an opportu-nity to connect with those people around something that is relevant to them.”

Bevolo suggested using digital op-

Personalized MessagingA marketing manifesto

Okay … you are understandably proud of achieving or exceeding impor-tant quality, safety and outcomes bench-marks. Those awards do say something about your skill set and are important to specific segments of the population. While a seven-year-old with a broken arm might not care about your top-ranked cardiology program, you can bet it makes a difference to a 55-year-old in need of bypass surgery.

Healthcare marketing expert Chris Bev-olo said sharing information about awards as a secondary sales tool is appropriate in several promotional marketing outlets.

Continuing with the cardiology award theme, the first good option would be to include that information in direct market-

ing pieces where you have pre-identified individuals with heart disease.

Sharing accolades through your web-site is also appropriate. “If I’ve gotten to your cardiology section, I’m probably inter-ested,” Bevolo pointed out.

A third option is to take advantage of digital searches. Bevolo said it is a smart use of technology to target people through keywords like “top cardiologist.” Locally, you might buy the phrase so your ad would pop up when people in your geographic region initiated a search for a cardiologist. Writing meaningful content about cardiol-ogy topics and using tags at the end of your content could also help you pop up on national searches.

And for those wondering about Bevolo’s accolades, there are plenty. The nationally recognized futurist is a frequent speaker on healthcare market-ing and strategy. In addition to his “Joe Public” books, he has authored two other books and numerous articles. In 1995, Bevolo founded Minneapolis-based In-terval to serve clients across the health-care spectrum. Last year, Nashville-based ReviveHealth, which O’Dwyer’s ranks as one of the nation’s top 15 healthcare marketing firms, acquired his company. Bevolo serves as executive vice president of consumer marketing for ReviveHealth and continues in his mission to transform healthcare marketing.

But When Can We Tell People About Our Awards?

Chris Bevolo

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By JULIE PARKER

America’s free and charity clinics are undergoing a transfor-mation, and not necessarily in a good way.

According to a 2014 re-port by the National Association of Free and Charitable Clinics (NAFCC), patient demand has spiked 40 percent while donations have dropped 20 percent.

“As soon as there was the perception of universal health-care, the likelihood of receiving donations goes down,” Colin McRae, JD, told the Wall Street Journal in December.

For the last two fiscal reports ending June 30, Orlando-based Shepherd’s Hope, one of the na-tion’s most successful free clinic networks, experienced a 22 percent in-crease in patient volume, seeing 16,973 patients in 2012-13, and nearly 21,000 patients in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fiscal year.

“It’s a concoction of the most toxic kind without the resources to resolve it,” said Marni Stahlman, CEO of Shepherd’s Hope, noting a May 2013 report by the Congressional Budget Office showed that even though the healthcare law is ex-pected to reduce the number of uninsured by 25 million in 2023, 31 million Ameri-cans will remain uninsured. “The role of the free clinic is more critical than ever.”

Medicaid expansion, or the lack of it, lies at the heart of the problem.

In Medical News’ coverage area, Ar-kansas and Kentucky are among 28 states that have expanded Medicaid.

Alabama, Florida, Georgia, Loui-siana, Mississippi, Missouri, North and South Carolina, Tennessee, Texas, and Virginia are among 18 states that haven’t expanded Medicaid and aren’t likely to, with the exception of Tennessee, one of four states anticipated to possibly expand in 2016.

David W. Strong, who will leave the University of North Carolina (UNC) Health Care system next month to take over as CEO of the expansive Orlando Health network in Florida, pointed out an aspect of Medicaid expansion that doesn’t get much press.

“It’s important to note the bulk of every state’s Medicaid program is already funded by the federal government,” said Strong. “All states are relying on signifi-cant federal funds now. Unfortunately, by not expanding Medicaid, Florida and North Carolina are among the biggest losers in the country because of the popu-lation base. Ultimately, we all bear the burden for the lack of expansion because

people will continue to seek care in our emergency departments and facilities.”

Much national attention has been placed on Florida, the nation’s fourth most populated state with 18 million residents and the highest percentage of 65 and older adults. The sunshine state ranks 41st on the list of highest volume of uninsured residents nationwide.

“What you have is a really bad sand-wich. Without resources, insurance, or ac-cess to healthcare, many Floridians who’ve been captured in the healthcare cover-age (Medicaid) expansion gap find them-selves without anything,” said Stahlman. “There’s also a gap on the high end.”

According to a 2014 Modern Health-care report, the nation’s busiest emergency room is Florida Hospital, with 206,800 visits to emergency departments at Flor-ida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Winter Park Memorial Hospital.

Orlando Health’s Orlando Regional Medical Center accounted for the nation’s fifth busiest ER, including emergency de-partments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne Hospital, South Semi-nole Hospital and the Winnie Palmer Hospital for Women & Babies.

“Florida is at a particular disadvan-tage because we have one of the highest uninsured rates in the nation, and a com-paratively smaller percentage of residents on employer healthcare plans to absorb the cost,” said Florida Hospital CEO Lars Houmann. “Federal, state and local fund-ing sources cover some but not all costs. And so the burden is passed on to insured patients and their employers in what’s commonly called the cost shift … a hid-den tax applied to premiums, co-pays and deductibles.”

University of Florida econo-mists predict $4.7 billion in Med-icaid dollars will be sent to other states in 2016, including nearly $400 million to Ohio, where Re-publican Gov. John Kasich has reduced the state’s budget by $404 million over two years by expanding coverage.

Despite previous opposition to the idea, recently reelected Flor-ida Gov. Rick Scott announced more than two years ago that he supports a legislature-approved, three-year Medicaid expansion. However, Scott, a Republican, hasn’t marked it priority.

Even with gubernatorial sup-port, Tampa General CEO Jim Burkhart said Medicaid expan-sion won’t be an easy sell to state lawmakers.

“It’s going to be a pretty heavy lift because there are lots of people who think they know a different way, or don’t think we should do it at all, or only believe we should do it for people that don’t match up with what the federal government says

you have to have in your criteria for the money to be made available,” he said. “At least discussion is ongoing. We’re hopeful it’ll continue and lead to something con-crete.”

Mississippi Gov. Phil Bryant, a Re-publican, has firmly said no, thanks. “For us to enter into an expansion program would be a fool’s errand,” in case Obam-acare is repealed or altered in a way that forces states to foot the bill,” he told the Associated Press. “We’d have no way to continue the coverage.”

While states continue to determine the best solution, ER visits are piling up. The average admission cost of an ER visit is roughly $4,600 versus the average cost of a visit to the free clinic valued at $77, said Stahlman, referring to 21,000 visits anticipated this fiscal year.

“Do the math on 21,000 visits last year, each valued at $77 ($1.6 million) versus $4,600 ($96.6 million),” she said. “The role of the free clinic is more critical than ever.”

What’s Happening to our Safety Net?Changes, challenges of free clinics and covering the uninsured

Dr. Kathryn Crampton performs free back-to-school phycical.

SAFETY NET


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By KRISTEN SCOTT

Think hard about your practice’s web site. Is it performing well, or have you ex-perienced a slump in your business, and your bottom line? Consider the following questions:

• Is your website not HIPAA compli-ant?

• Was it designed before 2013?• Does it not respond to, and function

on, all devices and browsers correctly?• Do you rank after the first page on

Google search?If you have answered yes to any of

these questions, it’s past time your website was redesigned. Your website is an im-portant asset in today’s economy, but the technology has never been so confusing. So many businesses know that they need an update, but end up settling for new lay-outs of websites built with the same level of technology. Like a brick and mortar facility, it requires maintenance and care. Taking your practice to the next level today means carefully scouting out a web design company and doing your research. One of the largest considerations for most practices is the price, but that should not be your deciding factor. Remember, just as in the medical field, you often get what you pay for.

If you are considering making the leap onto the Internet, the price tag can be daunting, and the services offered con-

fusing. We all know a presence on the internet is a valuable asset and an in-vestment so careful consideration is required. Where should you start? Here are some quick tips on how to choose your future web design company:

StaffingEvery office is staffed by

individuals with different special-ties – you have an office manager, your MD, your PA, nurses and assistants… all with specialized tasks, all carefully chosen to work well together. No one person can be a specialist in everything, so only con-sider purchasing from a company who has a team at your disposal. The right company for you will include specialists in graphic design, coding, content development and SEO (search engine optimization). If you want your website to attract your custom-ers, you need to make sure that your site is both informational and inviting. A web design team can handle multiple angles at once, while providing personalized experi-ence. This will lead to a better web experi-ence for not only you, but your current and prospective patients as well.

PortfolioMedical websites have very unique

design and security requirements, so the right web design company for you will not only have a strong portfolio in the medi-

cal field, but also the knowledge to assist you with finding the right server for your HIPAA compliance needs. Take the time to look through their portfolio for designs that appeal to you, as well as testing a sampling of their websites to ensure that they are able to be navigated on all de-vices. I know your time is at a premium so the easiest way to do this is to shrink the browser window size on your computer to see how the website responds to change. A website that adapts to your window size (without shrinking to an unreadable font size) is called a responsive website, and these are typically preferred by users to the extremely ‘simple’ mobile websites of the early 21st century. Having a website that is completely responsive on all devices and browsers means that you won’t miss out on prospective clients simply because they aren’t on a desktop computer.

SEOThe medical

field is highly com-petitive - so it is impor-

tant that your potential web design firm operates up to Google’s standard. All the SEO work in the world may

not be able to make up for a poorly designed website. In the

long run, spending a little more up front may save you thousands. When asking for a proposal from a firm, make certain to have them outline what is included as a part of their SEO work and don’t forget to ask if it includes content development by a professional copywriter. This is an extremely crucial part of the process as (in Google’s world) content is king and over 90 percent of search engine traffic never goes past the first page on Google search.

Company policiesRegardless of your practice’s beliefs, it

is always important to place high value on integrity and the honesty of the vendors you wish to contract. Look for a company that willingly provides references in your field, has a history of standing behind their work, and is always easy to reach. If it takes you weeks to get in touch with some-one for a proposal, then odds are good it will not be any easier to reach them when you have made a payment. Oftentimes, it is worth paying a little extra for a com-pany that fulfills these requirements, and if you take the time to contact the com-panies they provide as references, you will often be able to find out the truth about a company’s work. Ask not only about their attitude and the experience, but whether the price changed after the work started, if the site was completed on time, and if they have ever had issues with reach-ing the company. This will help ensure a great (and timely) web design experience for your practice.

Just as I spent time researching doc-tors and reading reviews when I needed knee surgery, you need to do the same for your website. In the end, you need to weigh the benefits against the cost, and often that means paying a little extra for the best you can find.

You have 5-7 seconds to make that first impression online and impress your prospective clients… So take a good look at your current website and ask yourself - Have you?

Kristen Scott is Google & Inbound Certified and works as a Strategy Consultant with the highly creative marketing & web design firm Designzillas. She is a specialist in marketing needs for the medical professional and excels in helping businesses interact with their customers. She can be reached at [email protected]

Team Web Design: More Bang for Your Buck


By CINDy SANDERS

As the ‘official sponsor of birthdays,’ the American Cancer Society (ACS) found a reason to rejoice in their latest report – Cancer Facts & Figures 2015. Since hitting a peak in 1991, cancer deaths have fallen 22 percent over two decades in the United States, which means more than 1.5 million deaths have been avoided … and more birthdays celebrated.

An ACS infographic showed 3.3 mil-lion cancer survivors in the United States in 1973. Today, there are more than 14.5 mil-lion cancer survivors, and that number is projected to jump to 18.9 million by 2024.

Each year, the ACS compiles the most recent data on cancer incidence, mortal-ity and survival using data from a variety of sources including the National Cancer Institute, National Center for Health Statis-tics and the Centers for Disease Control and Prevention. The most recent five-year data (2007-2011) showed the overall cancer in-cidence rate held steady in women and de-clined by 1.8 percent per year in men. The decrease in men was attributed to rapid de-clines in colorectal cancer (3.6 percent per year), lung cancer (3 percent per year) and prostate cancer (2.1 percent per year).

During the same time period, the av-erage annual decline in cancer death rates was 1.8 percent in men and 1.4 percent in women. Lung cancer, while still the dead-liest form of the disease, has declined 36 percent between 1990 and 2011 among men. Women have also seen double digit declines attributable to reduced tobacco use. On another happy note, breast can-cer death rates for women are down more 35 percent from peak rates, and prostate and colorectal cancer deaths are down by nearly half (47 percent).

Despite the good news, though, ACS of-ficials also noted there is much more work to be done. “The continu-ing drops we’re seeing in cancer mortality are reason to celebrate, but not stop,” stated John R. Seffrin, PhD, chief executive officer for ACS, when the report was released in Jan-uary. He added cancer was still responsible for nearly one in four deaths in the United States in 2011. Furthermore, Seffrin noted the country’s second leading cause of death overall is actually the top cause of death among adults ages 40 to 79.

Looking to this year, the ACS has projected 1.658 million new cancer cases will be diagnosed in 2015, and 589,430 Americans will lose their battle with the disease. Of the new cases, the estimate is that men will account for about 848,000 diagnoses across all sites and women 810,000. Prostate, lung and colorectal

cancers will account for about half of all cases in men with prostate cancer account-ing for around 25 percent of all new di-agnoses. Among women, it is anticipated the three most common diagnoses in 2015 will be breast, lung and colorectal cancers. Of those, breast cancer is expected to ac-count for 29 percent of all new cancers for women this year.

Of the 589,430 estimated deaths in 2015, the gender breakdown is 312,150 men and 277,280 women. The most com-mon causes of cancer death are lung, prostate, colorectal and breast cancer with these four accounting for almost half of all cancer deaths. More than a quarter of all cancer deaths (27 percent) will be attribut-able to lung cancer.

While death rates have declined, the report noted mortality improvements aren’t equal from coast-to-coast. In fact, cancer death rates vary by state and region with the Southeast being on the lower end of improvement scale (15 percent decline in overall cancer mortality) and the North-east on the higher end (between 25-30 percent decline). The variation has been attributed to a number of reasons includ-ing risk factor patterns (such as the number of smokers), distribution of poverty, and access to healthcare.

Risk AwarenessA recent survey by the American Insti-

tute for Cancer Research found there is an ‘alarmingly low’ awareness of key cancer risk factors, and many Americans put fear before facts. The Cancer Risk Awareness Survey, released on Feb. 4 in conjunction with World Cancer Day, found Americans worry about factors over which they have little or no control … such as genetic risks or food additives … with less than half recognizing the correlation between an in-creased risk of cancer and alcohol, obesity, lack of physical activity and poor diet.

The findings of the biennial survey give providers and other health experts an idea of whether or not cancer messaging is being heard by the American public. This year’s results were decidedly mixed.

Only 42 percent surveyed were aware a diet low in vegetables and fruit increases cancer risk. This number has trended downward since 2009, when it stood at 52 percent.

Only 43 percent knew alcohol in-creases cancer risk, an increase of five per-centage points since the 2013 survey.

And only about 1 in 3 Americans (35 percent) realized diets high in red meat have been convincingly linked to colon cancer. This figure has not changed since the survey was last conducted in 2013.

Awareness that carrying excess body fat is a cancer risk factor is rising. In this latest survey, 52 percent realized obesity and overweight impact cancer risk, a rise

of 4 percentage points.Awareness that being inactive in-

creases cancer risk jumped 6 percentage points, from 36 percent in 2013 to 42 per-cent in 2015.

There was a high recognition of sev-eral known risk factors for cancer includ-ing 94 percent of those surveyed correctly identifying tobacco use and 84 percent cit-ing excessive sun exposure as risks.

However, a significant number of those surveyed also worried about risks for which research has yet to provide a defini-tive answer. Pesticide residue on produce (74 percent), food additives (62 percent), genetically modified foods (56 percent), stress (55 percent), and hormones in beef (55 percent) were all cited as concerns.

By the Numbers: The Latest Stats on CancerDeath rates down, more work awaits

Dr. John Seffrin

President Obama’s Precision Medicine InitiativeAfter first introducing the topic during the State of the Union Address, President

Barack Obama held an event at the White House at the end of January to unveil details about the Precision Medicine Initiative, a major research push to pinpoint the best, most precise treatment options for individual patients considering genetic profile, environment and lifestyle.

In a fact sheet created for the program, White House officials stated, “The Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge and therapies to select which treatments will work best for which patients.”

While the move away from ‘one-size-fits-all’ medicine is not limited to cancer research, oncology is at the centerpiece of the initiative and a recipient of significant funding. If passed, President Obama’s 2016 budget includes a $215 million investment in the program including $130 million to the National Institutes of Health to develop a voluntary national research cohort of a million or more volunteers to propel the science forward and to create a model for responsible data sharing. Additionally, $70 million is specifically earmarked for the National Cancer Institute to scale up efforts to identify genomic drivers to various cancers, and a major objective of the initiative is to create ‘more and better treatments for cancer.’

In response to the Jan. 30 announcement, American Association for Cancer Research CEO Margaret Foti, PD, MD (hc), said, “We live in an extraordinary time when the scientific opportunities and our ability to translate this new knowledge into ways to both save and improve the quality of life of patients are simply astounding. This is why we are so excited about today’s event at the White House and specifically about President Obama’s major investment in the enormous potential of precision medicine, which is in the very early stages of transforming healthcare.”

Similarly, the Pancreatic Cancer Action Network voiced their appreciation and support for the initiative. “The Pancreatic Cancer Action Network applauds President Obama for his new Precision Medicine Initiative and for making an important investment to advance cancer research and arm the scientific and medical community with the cutting edge tools and resources needed to fight cancer,” said Julie Fleshman, president and CEO of PanCAN. “This is especially welcome news for patients fighting pancreatic cancer who face a five-year survival rate of just 7 percent.”

With personalized medicine for pancreatic cancer still in the early stages, she added, “We recognize, as President Obama highlighted, that the “one-size-fits-all” approach does not work for pancreatic cancer and recently launched Know Your Tumor, a personalized medicine service available through our patient services program. In addition to providing molecular profiling that may help a patient’s oncologist determine the best treatment options, we will collect tumor information from thousands of pancreatic cancer patients to assist with future research and development of new therapies and diagnostics for pancreatic cancer.”

Dr. Margaret Foti


World’s Largest Precision Cancer Research Collaboration Adds Four New Members

A novel research partnership an-chored by two of North America’s lead-ing cancer centers, Moffitt Cancer Center and The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James), have announced the addition of four nationally recognized cancer centers, bringing its membership to six and extending the national oncology network from coast to coast.

The new members of the Oncology Research Information Exchange Net-work (ORIEN) include:• City of Hope• University of Virginia Cancer Center (UVA)• University of Colorado Cancer Center• University of New Mexico Cancer

Center (UNMCC)The addition of the new ORIEN

members is expected to exponentially increase the number of patients consent-ing to donate their tissue and clinical data – including corresponding genomic data – for research to understand cancer at the molecular level, with the goal of develop-ing more targeted cancer treatments.

Additional nationally designated cancer centers are in the process of join-ing ORIEN, where partners share de-identified data to accelerate the devel-opment of targeted treatments, allowing researchers and clinicians to more quick-ly match eligible patients to clinical trials and conduct larger and richer analyses.

ORIEN personifies “big data” – ex-tensive databases with cancer patient information (medical history, cancer tis-sue, DNA) that can be used for basic research and clinical trials – that puts cancer genomics on the leading edge of precision medicine.

ORIEN is expanding just as the na-tional spotlight is focused on the promise of precision medicine. President Obama revealed his plan to invest in precision medicine during his State of the Union speech, and on Jan. 30 unveiled the $215 million initiative.

City of Hope and the UVA, CU and UNM cancer centers will adopt Total Can-cer Care®, the protocol created by Moffitt

in 2006 and now in use at the OSUCCC-James. The protocol creates a standard system for tracking patient molecular, clinical and epidemiological data. Con-sented patients are followed throughout their lifetime and agree to be contacted for future studies, playing an active role in the study of their cancer and improving care for future generations.

M2Gen®, a subsidiary of Moffitt, serves as ORIEN’s operational and com-

mercial provider for support, bringing expertise in data management and infor-matics. ORIEN’s approach to clinical trial matching presents a significant oppor-tunity for pharmaceutical companies to modernize trial recruitment and facilitate adaptive clinical trial design.

Through M2Gen, industry research-ers are able to match their targeted drugs to participating patients within ORIEN

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SOUTHCOMMChief Executive Officer Paul Bonaiuto

President Chris FerrellChief Financial Officer Ed TearmanExecutive Vice President Of Digital

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And Analysis Carla SimonVice President Of Human Resources Ed Wood

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Creative Director Heather Piercetions such as blogs, channels, websites and apps to share messages about prevention, healthier living and other topical content. A young mother might not care that you are the top joint replacement hospital in the area, but she might really want to learn how to make quick, healthy lunches for her children. A retiree who isn’t inter-ested in how many babies you delivered last year could be eager to learn about fall prevention measures.

“That’s how you resonate with Joe

Public … because you are the arbiter of health,” Bevolo shared.

He said to think of consumers en-tering the system through a large funnel. Whereas hospitals and practices have typically tried to get to potential patients, who reside near the bottom of the funnel (right before they become your patient), the idea is to target them farther up the funnel. “Those people will need care one day; and if you are the resource they turn to when they are healthy, you’ll be the one

they turn to when they do need services.”Of course, Bevolo noted that is often

easier said than done. Delivering edu-cational information in a non-sales way requires flipping a mental switch. “The reason it’s so hard is because it is a 180 de-gree shift from how it’s always been done and how physicians and operational lead-ers think it should be done,” he said. “It’s not just about marketers changing their approach … it’s about changing a whole industry.”

Personalized Messaging, continued from page 6

GrandRoundsSouth American Surgeons Shadow Dr. Caesar Santiago at St. Joseph’s Hospital

Five surgeons from South America observed Dr. Caesar Santiago perform robotic colorectal surgery at St. Joseph’s Hospital in February. The doctors, who reside in Bra-zil, Panama, Columbia and Chile will apply the skills they learned from Dr. Santiago and use them to build a robotic colorectal surgery program in their native countries.

The surgeons said there’s nothing like observing the robotic operation in person because it gives you the opportunity to really see the technique of the physician in ways you just can’t get from watching a video.

St. Joseph’s Hospital is one of 10 Colorectal Epicenters in America, which means it has a host surgeon who has completed 100 cases, offers teachable, reproducible and effective surgical techniques as well as a willingness to work toward being the most highly rated Epicenter in the nation.

Only a small percent of surgeons are trained in the latest colorectal robotic techniques, but Dr. Santiago said these advancements are important to him because they help his patients feel better, faster.

Dr. Santiago offers physicians an opportunity to observe his surgeries once a week. He also conducted live surgery via teleconference to more than 300 physicians attend-ing the Clinical Robotic Surgery Association’s 5th Worldwide Congress in Washington, DC. He also travels the globe, speaking about colorectal robotic surgery.

With four robots and more than two dozen robotic surgeons on staff, St. Joseph’s Hospital’s Advanced Center for Robotic Surgery is one of the nation’s most compre-hensive robotic programs.



GrandRoundscancer center members based on their molecular profile, promoting greater clinical trial precision and flexibility. Ulti-mately, researchers are better equipped to identify potential candidates for their drug trials, leading to better outcomes. ORIEN also creates the ability to accel-erate and improve efficiencies of clinical trials and the drug approval process, in-cluding post-market surveillance.

Moffitt Cancer Center Receives $50K Grant from Pfizer and the Avon Foundation

Moffitt Cancer Center has been cho-sen as one of 23 grant recipients for the Avon-Pfizer Metastatic Breast Cancer Grants Program: Identify-Amplify-Unify. Moffitt’s Breast Program is the only insti-tution in Florida that not only promotes targeted therapy, but also conducts the level of genomic translational research that holds promise for breast patients with advanced disease.

The program, run by Pfizer Inc. and the Avon Foundation for Women, grant-ed a total of $1 million to 23 organiza-tions nationwide to support and educate more than 5,000 metastatic breast can-cer patients, their caregivers and their communities. The program was created in June 2014 to support advocacy, aca-demic and other nonprofit organizations that provide information and services to help people with metastatic breast can-cer navigate the medical and emotional challenges associated with their disease.

To date, the majority of public atten-tion on and funding for breast cancer has centered on early-stage disease – such as screening strategies and survivor-ship – not on late-stage diagnosis. As a result, the Avon-Pfizer Metastatic Grants Program was established to address the gaps in support available to women and men living with metastatic disease, and to create new services for metastatic patients so they do not have to face this disease alone said Marc Hurlbert, execu-tive director of the Avon Foundation for Women Breast Cancer Crusade.

Moffitt’s breast program is dedicated to caring for the whole person, offering a wide range of support and wellness ser-vices addressing the social, emotional and financial consequences of the dis-ease and treatment. Moffitt’s team mem-bers are committed to reaching as many patients with metastatic breast cancer as possible and addressing cancer dispari-ties for vulnerable populations.

The treatment of metastatic breast cancer requires intervention on many lev-els. Chemotherapy and targeted therapy is just a small part component in treating the breast cancer patient with advanced disease. Patients will need physical, emo-tional and strong social support. Often, the very fine balance of work, family, friends and life is disrupted by their diagnosis of advanced disease explained Roohi Ismail-Khan, M.D., medical oncologist specializ-ing in breast cancer at Moffitt.

Moffitt will use the grant to implement a local metastatic breast cancer support

group, a web-based group for remote pa-tients, peer-to-peer support and mentor-ing, support for families affected by meta-static breast cancer and weekend retreats for patients in a wellness and healing set-ting, among other initiatives.

Doctors Hospital Board of Trustees Appoints New Board Chair

Doctors Hospital re-cently named Myron F. Rob-inson as the new Board of Trustees Chairperson.

Mr. Robinson has served on the Doc-tors Hospital Board since 2012. His back-ground includes more than 35 years of service as President and CEO of various Urban League affiliates across the coun-try. He was also a Marketing and Senior Sales Executive for AT&T and Southern New England Telephone Company.

SMH Moves Forward with Residency Program

Sarasota Memorial Health Care Sys-tem is moving ahead with plans to de-velop an Internal Medicine Residency Program for newly graduated doctors.

Sarasota Memorial already provides education to third- and fourth-year Flor-ida State University medical students. The Internal Medicine Residency Pro-gram would take that training one step further, creating Sarasota’s first residency program for new physicians graduating from medical schools.

It would also complete Sarasota Me-morial's evolution to a nationally recog-

nized "teaching hospital," said Sarasota Memorial Chief Medical Operations Of-ficer Steve Taylor, MD.

Sarasota Memorial is finalizing an affiliation agreement with Florida State University, with initial plans to fill as many as 10 new residency slots by July 2017. It will take several million dollars and at least two years to establish the curricu-lum, infrastructure and medical staff fac-ulty needed to win final approval from the Accreditation Council for Graduate Medical Education (ACGME) to start a residency program.

Once approved by the ACGME, the program will allow residents to undergo three years of training in Internal Medicine at Sarasota Memorial, with inpatient and outpatient rotations in cardiology, pulm-onology, infectious disease, gastroenter-ology, critical care and elective subspe-cialties. The residents also will have op-portunities to gain experience in a range of outpatient settings through Sarasota Memorial’s First Physicians Group net-work and Community Medical Clinic.

Hospital Board Approves SMH Trauma Center Bid

The Sarasota County Public Hospi-tal Board has voted to support Sarasota Memorial Health Care System’s bid to become a Level II Trauma Center.

The unanimous decision by the Hos-pital Board commits the finances, re-sources and personnel necessary to sup-port the new trauma program. Expand-ing Sarasota Memorial’s scope of servic-es to treat trauma patients is in keeping with the public health system’s safety-net

mission, and with just one trauma center slot remaining in the tri-county region, the Board agreed that it would be ben-eficial for the community to be served by a not-for-profit trauma provider.

Pivotal to Sarasota Memorial's deci-sion is a recent ruling by the state Depart-ment of Health, which allocated a second trauma center to Florida’s Trauma Service Area 13 (Sarasota, Manatee and DeSoto counties). Currently, most people injured in this region are transported to Blake Medical Center in Bradenton, or to a Lev-el I trauma center in another region if a higher level of care is needed.

Sarasota Memorial is working closely with Tampa General Hospital, using its physician, nursing and administrative ex-pertise to develop policies, education and training related to its trauma program. TGH has the only Level I Trauma Center in the region and is the only Level I trauma provider in Florida verified by the Ameri-can College of Surgeons, the highest level of recognition a trauma center can receive.

Start-up costs include $3.6 million the Board approved today to upgrade an operating room and two existing trauma resuscitation rooms in the ER, as well as purchase additional equipment, furniture and supplies to support a Level II trauma program. Sarasota Memorial also hired three fellowship-trained trauma surgeons and is finalizing agreements with local subspecialists and remaining members of its trauma team in the coming weeks.

2629 McCormick Dr. , Sui te 101 | ClEARWATER, FL 337592629 McCormick Dr., Suite 101 | Clearwater, FL 33759

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Myron Robinson

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Tampa Bay Medical News March 2015