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Bringing Neonatology 24/7 to Brandon RegionalHCA hospital begins unique collaboration with All Children’s Specialty Physicians

BRANDON—Brandon Regional, an HCA Florida West Division hospital, recently partnered with All Children’s Specialty Physicians to staff its 22-bed NICU round-the-clock on “a rare win-win-win” achievement for patients ... 4

From CNO to CEOLifePoint nurses are rising through the ranks to top leadership postsWhen Cherie Sibley was a teenager, she spent a great deal of time in the hospital with her terminally ill grandfather ... 6

By LyNNE JETER

Tampa Mayor Bob Buckhorn is making it a point to greet every single visitor to the University of South Florida (USF) Health’s Pharmacy of the Fu-ture – Pharmacy Plus, a national prototype combining digital health, advanced technology and personalized medicine. To that end, he’s cloning himself. Well, sort of. Very soon, Buckhorn will represent the city in ho-lographic form to welcome everyone to the futuristic pharmacy at the USF Health Morsani Center for Ad-vanced Healthcare in Tampa, which opened to the public in October.

“We’re going to integrate technology in a way I’ve never seen in the pharma industry,” said Kevin Sneed, PharmD, who originated the concept of USF Health

National Pharmacy Prototype DebutsUSF Health’s Pharmacy of the Future combines digital health, advanced technology and personalized medicine

(CONTINUED ON PAGE 10)

By LyNNE JETER

WINTER PARK – As Floridians morph into holiday mode, a very im-portant meeting will take place concerning a critical aspect of futuristic medi-cine Dec. 4-5 at The Alfond Inn in Winter Park.

The Southeastern Telehealth Resource Center (SETRC), Florida State University (FSU) College of Medicine, and the Florida Partnership for Tele-Health will host the inaugural annual Florida TeleHealth Summit – Transforming the Delivery of Healthcare – for healthcare providers, hospital and health system ad-ministrators, policy makers, elected local and state offi cials, university admin-istrators, IT experts, and telehealth industry leaders.

Advancing TeleHealth in FloridaSoutheastern Telehealth Resource Center to host fi rst annual Florida TeleHealth Summit Dec. 4-5 in Winter Park


To promote your business or practice in this high profi le spot, contact Jay Joshi at Tampa Bay Medical News.

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By JEFF WEBB

TAMPA - Jayendra Choksi soon will complete his term as both the fi rst psychi-atrist and the fi rst Indian to serve as chief of staff at St. Joseph’s Hospital. For a phy-sician who contends his medical specialty is “the most diffi cult,” Choksi sure makes it look easy to his colleagues at the Bay-Care Health System facility.

“He’s been a real joy to work with,” said Mark Vaaler, MD, the vice president of physician services at St. Joseph’s who has worked with Choksi since he joined the hospital in 2002. As a top administra-tor, Vaaler said he has been very thankful for Choksi’s perspective as a psychiatrist.

“He’s been a godsend,” said Vaaler. “He looks at both sides of every story. An unpleasant part of the job is sometimes having to bring physicians in for disciplin-ary-type issues. They appear in front of a committee and answer questions and give their side of the story. In the past, with-out a psychiatrist on the committee, you analyze the person, look at their motives, listen to what they’re saying and some-times make guesstimates and value judg-ments. …. But with Dr. Choksi there, you look at him and ask ‘What can you tell us and what do you think about what you just heard?’ He brings a psychiatric and psychological perspective that none of us have. We rely on him,” said Vaaler. “It can work to the benefi t of everyone in-volved, including the physician who is on the hot seat. Dr. Choksi may say ‘I don’t think he’s being forthright.’ Or he might say ‘This guy is trying really hard and wants to do the right thing.’ It’s benefi cial to all parties.”

Additionally, Valler, said, as chief of staff Choksi “has brought behavioral health issues more to the forefront. ... His perspective points out to all of (our staff) how important those issues are and lessens the stigma.”

Choksi affi liated with St. Joseph’s when he came to Tampa in 1990. Martha Prede, the manager of medical staff ser-

vices, has worked there for 22 years. Dur-ing that time, Prede said she, too, has been impressed with how Choksi uses his talent as a psychiatrist to create a better work-place. “He defi nitely has a different take on things. You look at what people are saying and you sort of dissect that and see what they really mean. I think that really does help you make good leadership deci-sions,” said Prede. “When he was chief of psychiatry he did an excellent job of run-ning that department. He was very inno-vative and he spearheaded a lot of outside

education programs,” she said.Choksi’s election as chief of staff was

a milestone Prede appreciated. “Being the fi rst psychiatrist and the fi rst Indian – that’s a real accomplishment and some-thing to be proud of,” she said. “At a lot of hospitals the person who is chief of staff is someone who is seen at the hospital all day every day. But with psychiatry you are sort of sequestered and you don’t interact with (the other caregivers) as much. You really have to be a strong person (like Choksi) to make an impression,” said Prede.

At the same time, she said, “We have a lot of fun and it’s a wonderful place to work. Dr. Choksi is very social and he has a great sense of humor. We have a very diverse staff and you have to consider di-versity when you do anything. He’s very cognizant of that. I can’t say enough good things about him.”

Being chief of staff “opened up a whole new world to me,” said Choksi. “Being a psychiatrist helped me handle a lot of things in a very politically correct, psychological way. My approach is mild, but direct. I am able to read between the lines and see both sides. Being a psychia-trist helped me understand the physicians on one side and the administration on the other,” and his training has been useful in helping him build consensus with both the staff and the hospital’s directors, he said. “It has been a great and enriching experi-

ence.”Choksi’s leadership tenure came at

a time when “medical practice has been changing so drastically from the stand-points of increasing hospitalists, hospital mergers, Obamacare, electronic medical records, ACO, clinically integrated net-works etc.,” he said. “My chief of staff po-sition has been busy and challenging, but very fulfi lling,” he said.

Choksi also has been active in many other professional organizations, notably as a charter board member and vice chair of the 1,200-plus physicians network Bay-care Physician Partners, and as president of the Tampa Psychiatric Society.

Not to be overlooked is that Choksi founded and built a private practice that, since 1990, has thrived in what he calls “the most diffi cult branch of medicine.” He explains that assertion this way: “We do not have any labs or X-rays or MRIs, etc. (to help diagnose problems). It is a very subjective branch, so everything a patient and family member says is so important and has so many facets,” he said. “Peo-ple will pull your leg or not tell the whole truth. You have to really read between the lines to make a proper diagnosis and treat-ment plan. … There is a lot of trial and error. That makes it challenging.”

The realization of that challenge is what drew Choksi to psychiatry when

PhysicianSpotlight

Jayendra Choksi, MDPsychiatrist, chief of staff, St. Joseph’s Hospital, Tampa


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By LyNNE JETER

BRANDON—Brandon Regional, an HCA Florida West Division hospital, recently partnered with All Children’s Specialty Physicians to staff its 22-bed NICU round-the-clock on “a rare win-win-win” achievement for patients, obste-tricians and both organizations, said the HCA hospital CEO Bland Eng.

The level of care pro-vided to newborn and high-risk expectant mothers will be heightened as practice neonatologists and maternal-fetal medicine physicians join the hospital medical staff, expanding the specialized care to meet Level III neonatal care, the highest licensed level for neonatal service in Florida.

“It’s an outstanding opportunity for all of us,” said Eng.

St. Petersburg-based All Children’s Specialty Physicians group, a not-for-profit practice plan at All Children’s Hospital, has a roster of nearly 200 phy-sicians spanning 25 pediatric medical and

surgical specialties. “We obviously have a desire to grow

the pediatric realm, and we’d been chatting with the group about various specialties and ways to work together to better serve our patients,” explained Eng, who had recently reviewed neonatology and maternal-fetal medicine services provided at the hospital.

All Children’s Specialty Physicians group placed a “simply outstanding” pro-posal with the 398-bed acute care facility in Brandon “to have a staff neonatologist in-house 24/7,” said Eng. “That’s wonderful for us! When a delivery occurs or a neonate is in distress, it can happen anytime. We’re excited that parents will have access to the

expertise of All Kids’ pediatric subspecialists much closer to home.”

This latest development not only strengthens the Level II and Level III neonatal care that has been available at Brandon Regional, but also augments the service offered in Brandon’s Pediatric ER and Pediatric Intensive Care Unit (PICU).

Overall, hospital partner-ships with practice groups have increased through physician practice acquisitions or unique

collaboration opportunities between parties that might have been viewed not too long ago as “odd bedfellows.”

“With HCA, we have many partner-ships with other hospitals,” said Eng. “At my last hospital, I had a partnership with Miami Children’s Hospital,” which has nearly 700 attending physicians and more than 130 pediatric subspecialists. “We’re always looking at what we believe is the best success in business: to partner in the delivery of the best possible patient care.”

Paul Colombani, MD, presides over All Children’s Specialty Physicians, which uses a collaborative medical director-led model. An example of the practice’s ad-vanced level of expertise: All nurses on staff at All Children’s Hospital Specialty Physi-cians are trained on the placement of PICC (peripheral inserted central catheters) lines in the neonatal unit.

“We offer a more involved, family-cen-tered care and team approach,” explained Francisco Ojeda, MD, a neonatologist with the pediatric specialty group. “Parents are involved in the care and the decision mak-ing, and are with the physician when the physician rounds on their baby.”

Telehealth will also play a major role in NICU education to enhance the delivery of care.

“At All Children’s Hospital, we feel it’s our responsibility and commitment to the community to provide the best care for our youngest patients with complex condi-tions,” said Jonathan Ellen, MD, president and physician-in-chief at All Children’s Hospital and professor of pediatrics and vice dean of All Children’s Hospital at the Johns Hopkins University School of Medicine. “The NICU at All Children’s Hospital in St. Petersburg is nationally rec-ognized and meets the America Academy of Pediatrics Level IV standards. The ad-dition of our neonatology and maternal-fetal medicine team at Brandon Regional Hospital, and all our affiliate sites, allows us to provide that exceptional care closer to home for babies in the Tampa Bay area.”

New moms have already given Eng high praise concerning the new relationship.

“We’ve gotten great feedback,” he said. “Our patients and medical staff are very excited about this development. All Children’s is unquestionably one of the na-tional leaders in pediatric care.”

Bringing Neonatology 24/7 to Brandon RegionalHCA hospital begins unique collaboration with All Children’s Specialty Physicians

Helping Parents through Unimaginable Pain

A decade ago, Laurie Van Damme, a labor and delivery nurse at Brandon Regional Hospital, was tending a family whose pregnancy ended in the death of a son, Adam Allred, when she thought about the hospital’s need for bereavement services. Knowing the heartache burdened by families whose preg-nancies don’t end well – more than 1 million babies die annually from miscarriage and stillbirth in the United States – Van Damme created a first-of-its-kind, award-winning bereavement program and software using bereavement pho-tography and video slideshows that can be duplicated in any hospital.

Van Damme’s experience inspired Adam’s Garden, a pregnancy and infant loss remembrance courtyard created at the northeast corner of the campus, where remembrance ceremo-nies now take place for those families.

“After having to release the Allred family from the hospital with virtually no memories of Adam and no way to help ease their pain, I was left com-pletely devastated,” said Van Damme. “The bereavement program started as a simple way to help families that expe-rienced loss at Brandon Regional, and has grown from there into more than I could’ve imagined.”

Now the perinatal bereavement program coordinator for Brandon Regional, Van Damme spearheaded the 8th Annual Pregnancy and Infant Loss Remembrance Ceremony on Oct. 15 that included remarks by Adam’s brother and a song performed by the Mulrennan Middle School band that Michael Vail, school director of bands and orchestra, commissioned in mem-ory of the daughter he lost.

The remembrance ceremony at-tracted nearly 600 people for the can-dlelight vigil and a video montage of infants lost at birth. Parents wore white in unity to represent the innocence of each young life remembered.

“I can only measure the success of our program by the gratitude expressed by our families,” Van Damme said. “The growing number of people that come out to our Remembrance Ceremony each year is a testament to the validity of what we do and also to the impor-tance of remembering. It can be painful to remember, but there’s a sweetness in the mention of their child’s name, in the opportunity to see their precious baby’s name or photo in a video, and certainly in seeing their names written amongst the hundreds of others in the garden. I believe there’s healing in re-membrance.”

Laurie Van Damme

Bland Eng


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COMMUNIT Y is our middle name.

By LyNNE JETER

When Cherie Sibley was a teenager, she spent a great deal of time in the hospi-tal with her terminally ill grandfather.

“I always appreciated the nurses, the great job they did, and the difference they made with my grandfa-ther’s care and well-be-ing,” said Sibley, CEO since May 2013 of Life-Point’s 79-bed Clark Re-gional Medical Center in Winchester, Ky.

Sibley, whose back-ground is surgical ser-vices nursing, is one of many CEOs who has risen through the nursing ranks, a move that makes sense in the new patient-centered health para-digm.

“I speak the clinical language, under-stand the industry changes, and can pro-actively head off many issues at the pass,” she said. “Being able to understand qual-ity, patient safety, and the financial opera-tions of the industry is a strength clinical leaders possess.”

The HR AspectPam Belcher, vice president of human

resources and talent management for

Brentwood, Tenn.-based LifePoint Hospitals, called the nursing-to-CEO path “possibly an emerging trend.” At the time of the interview, 11 percent of 47 LifePoint CEOs have CNO expe-rience; 18 percent of the company’s COOs were promoted from CNO positions. (At press time, the company has approximately 50 CEOs.)

“We’re certainly seeing more can-didates with nursing experience wanting to get into that executive hospital leader-ship role,” she said, adding how industry changes have also impacted the progres-sion. “We saw a shift in nursing from sim-ply a caregiver role that involved primarily caring for patients at bedside – turning and bathing them, for example – to that of a well-educated clinician with high expec-tations. The depth and breadth of their knowledge is amazing! As we changed the model of our hospitals to focus on how we were caring for patients, we put a greater responsibility on our lead clinician, which is mainly the CNO role. In addition, we began to ask them to manage the largest part of the facility – people, processes, equipment, and inventory – so their job

has expanded significantly as healthcare has evolved.”

Steady Pace to CEO RoleSibley, a native of Bear Creek, a rural

community in northwest Alabama, began her career immediately following high school. She earned an associate’s degree from the local community college and a nursing degree from the University of North Alabama while working at Lake-land Community Hospital in Haleyville, Ala. She had served as a nurse for more than 10 years when LifePoint acquired the hospital in 2002.

“As part of their evaluation process to assess talent, LifePoint talked to us about our roles and aspirations, while also shar-ing their succession planning and career development programs,” she said. “When I met with my leaders, rising to CEO was a goal. As part of my leadership develop-ment, they afforded me the opportunity to advance my education and then to pro-mote me when a position became avail-able.”

Sibley knew she needed business education before crossing over to the fi-nancial fold. After LifePoint relocated her to Selma, Ala., where she served as CNO of Vaughan Regional Medical Center, she earned an MBA with an emphasis in

healthcare administration from nearby South University.

Sibley moved into the COO role at Vaughan Regional, and then to the same role at a larger hospital, the 250-bed Dan-ville Regional Medical Center in Dan-ville, Va. During her time there, Sibley successfully recruited nearly two dozen physicians to the hospital, significantly im-proved physician satisfaction, and helped implement the Duke Quality Oversight program. In 2008, LifePoint Hospitals awarded her the honorable Fleetwood Award for extraordinary leadership.

“One reason why CNOs can be so successful is the respect and trust obtained through nursing,” emphasized Sibley. “Nursing is the top trusted profession – over clergy and doctors! We always un-derstand the patient perspective because we’ve cared for them firsthand. And that trust spills over into other leadership posi-tions.”

Ahead of the CurveSusan Peach broke gender and age

barriers at Rockdale Medical Center in Conyers, Ga., when at the age of 38, she became the state’s youngest and first fe-male hospital CEO. She also rose through the ranks of CNO to other C-suite roles.

From CNO to CEOLifePoint nurses are rising through the ranks to top leadership posts

Cherie Sibley

Pam Belcher



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Meeting the nation’s highest quality care goals

For free 24/7 health information or physician referral, please call 1-855-245-8330. 6001 Webb Road, off of Hillsborough Ave. TampaCommunityHospital.com

COMMUNIT Y is our middle name.

By CINDy SANDERS

Parallon Business Solutions, an HCA subsidiary offering a range of business and operational solutions, recently launched StaRN: Specialty Training Apprentice-ship for Registered Nurses — a unique educational opportunity to meet a critical need for specialty nurses in Florida.

“We have an inter-esting phenomena going on right now in nursing,” said Tony Pentangelo, executive vice president of managed services for the Franklin-based Paral-lon Workforce Solutions business unit. “It’s very competitive for critical care nurses in particular.”

In the Florida market, he added, a sig-nificant number of new nursing graduates were licensed and had passed their boards. However, a shortage of positions for be-ginning nurses left many of these gradu-ates unemployed or under-employed. “We had licensed nurses working as waitresses,” Pentangelo said.

On the flip side, he noted, hospitals were competing against each other for spe-cialty care nurses or bringing in contract

nurses to try to meet demand. “The hos-pitals won’t take newly licensed nurses for critical care,” Pentangelo said, adding that almost never happens. “The intensity and the acuity of the patients are just too high. Typically, they want at least two years ex-perience.”

The need at one end and surplus on the other had created a frustrating ‘catch 22’ for both area hospitals and young nurses. “We think this helps bridge that gap a little bit,” Pentangelo said of StaRN.

The intensive, 13-week program for nursing graduates combines classroom in-struction, a robust simulation experience and hands-on clinical training done in con-junction with a regional academic partner. Upon completion, the nursing graduates are equipped with the knowledge and skill set typically found in more experienced staff nurses.

The first half of the program is pent in the classroom and simulation labs where Pentangelo said the nurses get hands-on experience in a very controlled environ-ment. The last half of the program is spent in a clinical preceptorship. “It really helps them understand how to apply the knowl-edge in a patient scenario,” Pentangelo noted.

Prospective candidates interview with

the hospitals so they are pre-identified for the units in need. The hospitals then pay a placement fee that covers the cost of the StaRN program. In exchange, the participating nurses make a two-year com-mitment to work at the sponsor hospital. Training during the course can be tailored to meet the specific needs of the sponsor hospital.

While there is an out-of-pocket cost to the hospitals, Pentangelo said it doesn’t compare to the expense of bringing in contract nurses year-round, particularly if a hospital is paying signing bonuses, hous-ing allowances, and travel stipends. “We estimate that if a facility can replace a con-tract labor FTE (full-time equivalent), the savings is upward of $100,000 per (StaRN) nurse.”

Another benefit is the young nurses typically already have ties to the com-munity unlike travel nurses that have no real reason to stay beyond their contract period. “These local nurses want to stay in the town. They’re committed to the town. They know the hospital,” Pentangelo stressed. Hiring locally also enhances the hospital’s hometown relations by reinvest-ing in the community.

“When hospitals can’t find specialty-trained nurses, they are forced to use

costly alternative measures such as hiring temporary contract labor, which does not address the core problem: the shortage of experienced, specialty-trained nurses,” said Pentangelo. “StaRN offers a way for-ward that provides short- and long-term benefits to hospitals and nurses, alike.”

The first StaRN program launched this past June with a class of 52. Since then, several more classes have successfully graduated. Another 13 classes are sched-uled in both the eastern and western part of Florida for 2015. Pentangelo said Paral-lon is already in the process of expanding the program to other states with plans to roll StaRN out nationally in the future.

Parallon’s StaRN Program Answers Critical Nursing Need

Tony Pentangelo

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“Early on, I re-ceived some grief from my board and a few local business leaders who were concerned whether I could make hard busi-ness decisions because I was a compassionate, empathetic nurse,” said Peach. “Some also wondered if I under-stood enough about business and finance to lead an organization as CEO. The first challenge wasn’t difficult to overcome be-cause I’ve made many hard choices and hard decisions with respect and compas-sion. On the business side, it’s all about results. You can talk a good game, but you have to produce good results. I’ve been very fortunate … achieving wonderful fi-nancial results every time.”

Peach chuckled when recalling the steep financial learning curve needed in her first CNO role.

“I’d never done a budget,” admitted Peach, who earned a nursing degree from Clayton College. “When the CFO, back in the paper days, handed me a stack of spreadsheets, he said, ‘Here, I need this by Friday.’ I went home to my dad, a con-troller with Coca-Cola, and said, ‘You’re going to have to help me. I don’t have any clue how to do this.’ He looked me right in the eye and said, ‘I’ll help you one time, and then you best learn how to do it on your own.’ He was very strict. At that point, I decided to get my MBA so I’d know as much about business as I did about nursing and healthcare.”

Peach juggled raising a young family, managing a high-maintenance CNO role, while also earning an MBA from Geor-gia State University. “My husband, Jim,

and my angel of a mother, made it all pos-sible,” she said. “Jim and I have been mar-ried for 38 years and he’s always been so supportive of my career. My mother, bless her heart, never said no when I asked her to help with the kids.”

Since July 2012, Peach has been CEO of LifePoint’s HighPoint Health System, overseeing more than 300 licensed beds on four campuses. Before that, she served as a CNO at LifePoint’s Hospital Support Center, worked for Catholic Health Ini-tiatives as senior vice president of perfor-mance management, and served in various “O” roles. Now, the recipient of Sumner County’s Impact Award for two consecu-tive years, and LifePoint’s prestigious 2013 CEO of the Year Award, makes a point of devoting time to mentoring rising stars, generally working concurrently with four potential leaders.

“When I look back, I realize I was somewhat naïve to believe I could be the latest and greatest CEO at a young age,” joked the mother of two and grandmother of two. “The staff makes my job wonderful every day. I know my job is to get out of the way and make sure they have the tools and processes to do a good job.”

The Male CounterpartA couple of decades ago, if a man

dressed in scrubs walked into a hospital room, patients frequently assumed he was a doctor because the number of male nurses was so low. Nationwide, those gen-der numbers have improved. According to MinorityNurse.com, male RNs now com-prise roughly 9 percent of the total nursing population; 7.6 percent of LPNs are men.

“As in any industry, I have to prove myself,” said Mark C. Holyoak, CEO

of LifePoint’s 49-bed Castleview Hospital in Price, Utah. He previ-ously served in COO and CNO posts. “In this case, I had to prove my-self in the clinical arena that I was a competent, safe and compassion-ate nurse. In addition to those traits, I needed to demonstrate that I could lead others towards positive changes in the organization. From the nursing ranks, additional challenges were to gain financial acumen, to demonstrate a knowl-edge and understanding of the business.”

Even though the workforce is a gen-eration past being male-dominated, being male didn’t make it easier to rise to the top executive position, Holyoak noted.

“I don’t think it really made a differ-ence,” said Holyoak, a 15-year LifePoint employee. “Some of my counterparts may disagree, but I believe each one of us, re-gardless of gender, has the responsibility to prove ourselves and look for leadership growth opportunities. For me, I would hate not having the clinical knowledge, background and experience before mov-ing into this seat. I’m thankful I took this non-traditional road.”

Holyoak occasionally indulges in one of his favorite practices at Castleview: “I still throw my scrubs on periodically, walk the halls, and interact with patients. Being involved in patient care keeps me in con-tact with the hospital staff and seriously helps regenerate my battery!”

Full CircleBelcher, the HR executive who joined

LifePoint in 2006, has enjoyed watching

the collaborative leadership traits CNOs bring to the table.

“When I got here, and it came to the C-suite executives, the CNO was part of it, but the COO and CEO were the two stronger leaders in that group,” she noted. “It’s been fun for me to watch the CNO step up. We have some really good CFOs (without clinical experience) who ap-proached us a few years ago and said for their jobs to be easier, and for the hospi-tal to reach the organization’s goals, they needed to partner more often with CNOs. Once we began to see those collaborations happen, and the value it brought to both of those critical positions, we’ve encour-aged it, and have put programs in place,” such as the LifePoint Learning Academy’s Leadership Development & Training Pro-gram, a 4-day event designed to develop and enhance leadership competency. There’s also a component, Finance for the Non-Financial, to help clinicians un-derstand LifePoint’s specific financial ex-pectations.

“I’ve never had a conversation with a CEO who felt threatened by the rise of the nurse ranks to C-suite levels,” said Belcher. “Our organization appreciates and recognizes talent in a unique way.”

From CNO to CEO, continued from page 6

Susan Peach Mark C. Holyoak

he was in medical school in his native India. He is the youngest son of parents who pushed all four children to acquire the education they lacked. “They instilled the best values - hard work, respect, sac-rifice, honesty and caring for others,” said Choksi.

He completed a residency in India before coming to the U.S., where he had to repeat it at University Hospital in Stony Brook, N.Y. From there, he was the staff psychiatrist at a hospital in Erie, Pa., a four-year stint that “I still scratch my head about, but at least I learned to ski!” he laughed.

Leaving there and building a profes-sional and personal life in Tampa worked out “with God’s grace,” he said. Choksi’s wife of 38 years, Shaila, also had some-thing to do with it.

“I am so successful because she not only handles my office and related mat-ters,” but raised their two sons “with positive attitudes and values, including spiritual and religious aspects,” he said. One son is an oncologist in Pittsburgh and the other is almost a lawyer.

Despite his busy schedule, Choksi said he and his wife love to travel for pleasure, and he has taken humanitarian medical trips to Africa and India. He also “volunteers a lot of time in local Indian organizations every year,” he said.

Now that he’s in his 60s, does Choksi have plans to slow down? “I have slowed down. I used to work 80 hours a week and go to 10 hospitals. Now I only go to one hospital - St. Joseph’s,” he said.

Physician Spotlight, continued from page 3


Welcoming New PatientsRichard A. Cain, MD | Orthopedic Surgery

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Dr. Richard Cain specializes in orthopedic surgery and is a member of the St. Joseph’s Hospitals medical staff. He is a member of the American Academy of Orthopaedic Surgeons, the Arthroscopy Association of North America, the Florida Orthopaedic Society, the American Medical Association and the Florida Medical Association.

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“This will be the Florida’s fi rst focused statewide telehealth summit,” said SETRC director Rena Brewer, RN, MA. “We have folks from across the state contributing to this im-portant agenda. There’s a lot of telemedicine going on in Florida right now, despite the lack of tele-health supporting policy.”

In less than a year, Waycross, Ga.-based SETRC, which also serves Georgia, Ala-bama and South Carolina, has provided a platform for telehealth stakeholders from across the state to come together in three regional workgroups to improve collabora-tion, address barriers, and overall, advance telehealth in Florida. Healthcare industry advocates have lobbied state lawmakers to pass telehealth legislation that includes, among other points, reimbursement for telehealth at the same rate as an in-clinic visit. Bills introduced in the 2014 session didn’t gain suffi cient traction.

A priority agenda item for the summit, which will begin and end with policymak-ers, will include gearing up for compre-hensive telehealth legislation in the 2015 legislative session.

“Florida’s been chewing on it for a couple of years at the capitol,” said Brewer. “We’re hopeful 2015 is the year for mean-ingful telehealth policy for Florida.”

Healthcare ReformTelemedicine is the key to reforming

healthcare, emphasized Paula Guy, CEO of Global Partnership for TeleHealth and the Florida Partnership for TeleHealth.

“Access to care is becoming more of a problem and telemedicine is the answer, especially as fewer primary doctors are coming out of residency … and more new physicians are moving into specialties,” she explained. “Technology is allowing the physician to go to the patient instead of vice versa, and there are truly no limits with tele-medicine.”

Guy quashed a misperception about telemedicine by pointing out that “the right telemedicine can be extremely high quality, very effi cient and quite cost-effective.”

SETRC is also working with hospitals on readmission issues, an area in which tele-medicine can make a tremendous difference and also allay fi scal penalties.

“One of the leading reasons for re-admission is chronic disease,” said Guy. “When patients are sent home, it’s typically not with the kind of follow-up needed to keep them out of hospitals. Heart failure is a great example. Telemedicine allows the necessary follow-up and patient education opportunities for those who have been re-cently discharged. Patients can use simple technology to record heart rhythms and submit other patient biometrics.”

Agenda HighlightsMeeting agenda highlights slated for

the fi rst annual Florida TeleHealth Summit: David Christian, vice president of

government affairs for the Florida Chamber of Commerce, will moder-ate a Day 1 early morning session on Florida Tele-Health Policy.

Anne Burdick, MD, MPH, associate dean of telemedicine and clinical outreach for the Univer-sity of Miami Miller School of Medicine, will lead a discussion on TeleHealth: Enhanc-ing Healthcare for Floridians.

Mark Stavros, MD, FACEP, associate professor of clinical sciences and education director of emergency medicine for the FSU College of Medicine; Kim M. Landry, MD, FACEP, associate professor of the FSU College of Medicine and CEO of Excali-bur Telemedical Services Inc.; and Antonio Carlos de Cunha Marttos, MD, assistant

professor of surgery and director of Global e-Health for the University of Miami Miller School of Medicine, will serve on the pre-lunch Emergency Telehealth Panel.

Jay H. Sanders, MD, CEO of The Global Telemedicine Group and found-ing board member and president emeritus of the American Telemedicine Association (ATA), will present the luncheon keynote address. (Florida has approached the ATA about becoming its fi rst state chapter.)

Florida telehealth initiatives to be discussed cover ALS patients, behavioral health, cardiac patients, e-ICU, school-based teleheath, telegenetics, telestroke, and how telemedicine can increase effi ciencies and patient access.

Ken Peach, executive director of the Health Council of East Central Florida, will moderate discussion about strategies for moving telehealth forward in Florida.

Day 2 begins with a look at improv-ing access to care for rural patients with multiple sclerosis, featuring Paul Hoffman, MD, and Sean McCoy, PhD, both with VA Telehealth. McCoy recently reported the VA model allows for healthcare provid-ers to “practice anywhere in system,” and

discussed how 11 state consortiums in the Northeast have reciprocity for nursing licen-sure; a current congressional bill proposes licensure requirement for the state of resi-dency only.

Christopher Sullivan, PhD, of Image Research LLC, will moderate a discussion on health information exchanges (HIEs) concerning telemedicine and public health.

Deborah Randall, a health law attor-ney and telehealth consultant, will moderate a panel discussion on telehealth legal con-siderations. Also on the panel: healthcare attorneys Michael R. Lowe of Michael R. Lowe PA, and Lance Leider of The Health Law Firm.

Chris Pittman, MD, president-elect of the Florida Medical Association’s political action committee, will participate in a panel discussion on The Politics of Telehealth.

The summit will close with a summary discussion of the unlimited potential of tele-health in Florida.

“If you’re not doing telemedicine today, you will within a couple of years,” said Guy. “That’s why healthcare providers need to at-tend this conference. Telemedicine is chang-ing people’s lives for the better.”

Advancing TeleHealth in Florida, continued from page 1

Rena Brewer

Paula Guy

The Southeastern Telehealth Resource Center (SETRC) is one of 14 regional and national HRSA-funded TeleHealth Resource Centers. The non-profi t Georgia Partner-ship for TeleHealth Inc. operates Atlanta-based SETRC, which serves as a resource to organizations, networks, and practitioners interested in providing, supporting and promoting telehealth services for the rural and underserved in Alabama, Florida, Georgia and South Carolina. Its primary mission: to increase the use of telehealth ser-vices throughout the region, especially to underserved populations.

For more information, visit www.setrc.us or contact SETRC director Rena Brewer, RN, MA, via [email protected] or (229) 291-0494.

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Pharmacy Plus. “Some of it is so brand new, we haven’t had the opportunity to use it the way I intend to. The technological ap-plication to medicine is the most exciting component.”

The 1,500-square-foot fa-cility was created as a national model for pharmacy education and care to improve the way patients tap into the expertise of pharmacists and advanced tech-nologies to better manage their health. The new pharmacy flow features eight to 10 components not commonly found in a phar-macy, such as the RX Medic robot, which safely and rapidly counts pills and dispenses most medications, freeing up pharma-cists to become more engaged in patient care.

“We typically picture pharmacists dis-pensing medication on a tray, using a spat-ula to count by five,” said Sneed, founding dean of the USF Health College of Phar-macy. “It’s not the job of the pharmacist to count pills and pour them into a bottle. We want to have less emphasis on that, and much more emphasis on providing pharmacists with opportunities to interact more frequently with healthcare providers and patients, and gather more pertinent, real-time information to improve health outcomes.”

A personalized medicine room with

access to pharmacogenomics screening and counseling serves as a private setting to discuss confidential, meaningful genetic information to help patients determine the best drug treatments for their diseases or conditions. Videoconferencing and tele-health capabilities are provided via the pa-tient education room, while an integrated medical records system connects phar-macists with other healthcare providers on the patient’s medical team to expedite seamless patient-centered care.

“It’s our full intention to tailor medi-cation therapy to what’s occurring in a patient’s DNA,” said Sneed, who recently met with Stephen B. Liggett, MD, director

of the USF Center for Personal-ized Medicine and Genomics since its inception in 2012, to strategize about detailed ways to implement DNA profiles to tailor patients’ medical care on the pharmacy level. “In the past, a physician might give 10 patients the same medication at the same starting dose. In test-ing, we might find out that two patients don’t metabolize the medication the same as other pa-tients. One consequence of those two patients may be an adverse reaction; another, the medica-tion isn’t providing any benefit for them. We’ll use that data to tailor drug therapy. The part we have to look at now is reviewing

and reporting our findings to the patient and provider in a usable manner.”

USF Health’s Pharmacy of the Fu-ture also provides a diverse range of mo-bile device apps with tools to help patients manage their medications and track their health. Onsite pharmacists and phar-macists-in-training will help consumers integrate the digital apps and mobile tech-nologies into their clinical care and daily health routines.

“For example, we’re working with diabetic patients to record readings on a cell phone to send to the pharmacy,” said Sneed. “We’re monitoring those readings to determine how to better communicate with those patients. Maybe a pharmacist doesn’t need to call; instead, a nurse or physician might contact the patient in particular circumstances. The answer may not be to increase the dosage of medica-tion. Perhaps the patient’s diet needs to be altered, or fitness level changed. We might need to see a patient’s home envi-ronment to better determine changes that will benefit patients’ health, which could be accomplished by video conferencing, and save in-office visits for patients who need more intervention to achieve a better health outcome.”

USF Health pharmacy students will rotate through the onsite pharmacy as part of their supervised hands-on training. Once student demand is met, spots might open for pharmacy students rotating from outside USF Health, noted Sneed.

“It’s uncommon for a College of Pharmacy to own a pharmacy, as we do,” said Sneed. “I’ve been contacted by other schools of pharmacy around the country wanting to hear more about our concept. I’m excited about having our students learn a different way and immerse into mainstream pharmacy.”

Because the pharmaceutical indus-try is undergoing a massive shakeup, the timing was ripe for the Pharmacy of the Future at USF Health, which accepts no financial incentives from pharmaceutical companies, Sneed emphasized.

“About 70 percent of the most com-monly prescribed medications on the market have gone generic,” noted Sneed. “That’s a great thing for the patient, but it begins to present a new challenge for phy-sicians. Three decades ago, there weren’t

that many medications to choose from. Then we went through an era where a lot of new medications flooded the mar-ket. The physician was guided into which medications to choose, either by insurance companies or in some cases, influence from pharmaceutical sales reps. Now, ac-cess to all medications is changing. We need to be smarter about which medica-tion to give a patient.”

Sneed joined USF as a visiting pro-fessor in 1999, played a vital role in the development of the USF College of Medi-cine’s interdisciplinary programs in 2007, and was named founding dean of the USF College of Pharmacy in 2009. He spear-headed the development of USF Health’s new four-year Doctor of Pharmacy de-gree program, a comprehensive curricu-lum with an added emphasis on geriatrics, pharmacogenetics, leadership develop-ment, informatics, and clinical research with USF faculty.

Next up: USF Health plans to initi-ate an entrepreneur academy for its phar-macy students, in conjunction with the USF Center for Entrepreneurship.

“We’re in the midst of early discus-sions concerning components of such a program with the College of Business,” said Sneed. “We want to encourage pharmacy graduates who are entrepre-neurial by nature to consider establishing their own independent pharmacies. We want our pharmacy graduates to be well-rounded when they leave USF Health.”

National Pharmacy Prototype Debuts, continued from page 1

Another First In a partnership that per-

haps represents the first pairing of students and faculty from a law school and an academic health center, USF and Stetson Univer-sity College of Law are joining forces to help Florida veterans navigate supportive clinical ser-vices, collaborative student train-ing and joint research.

“Our goal is to serve Florida’s veteran population by helping them secure benefits they’ve rightfully earned from the Department of Veterans Af-fairs, while also providing an inte-grated, interdisciplinary learning opportunity for our law students as they gain practical, legal ex-perience working directly with clients and professionals in other disciplines,” said Christoper M. Pietruszkiewicz, dean of Stetson law school, a staunch supporter of veterans programs who re-cently expanded the law school’s Veterans Law Institute and Veter-ans Advocacy Clinic.

Kevin Sneed, PharmD


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GrandRoundsFlorida Hospital Association Recognizes BayCare President & CEO

BayCare president and CEO, Steve Mason, was recognized at the Florida Hospital Association’s Cel-ebration of Achievement in Quality and Service Awards. Mason received the Ralph Glatfelter Spirit of Advocacy Award for his efforts advocating on be-half of Florida’s hospitals and patients.

Mason, an active member of the FHA Board of Trustees, served as the chair in 2010. During his involvement, he has contributed significantly to the state-wide effort to secure coverage for unin-sured Floridians. Additionally, Mason’s contributions were recognized in 2012 at the national level when the American Hospital Association named him Florida’s Grassroots Champion.

The FHA’s Celebration of Achieve-ment in Quality and Service Awards hon-ored 12 caregivers and hospitals. The event pays tribute to caregivers and in-novation in the areas of patient safety, employee and community engagement.

IMPOWER Doctors Receive Waiver from Florida Board of Medicine to Prescribe Controlled Substances via Telepsychiatry

Three Florida licensed medical doc-tors on staff at IMPOWER, a leading non-profit mental health & child well-being organization in Central Florida, have been granted a waiver from the Florida Board of Medicine regarding Rule 64B8.90.141(4) Florida Administrative Code which prohibits the prescribing of

controlled substances through the use of telemedicine. M. Branch, M.D., J. Reed, M.D. and N. Kirmani, M.D. are the only mental health practitioners in the state to receive the waiver therefore making IMPOWER the only current Florida pro-vider of telepsychiatry that can prescribe controlled substances for psychiatric care.

Statistics indicate that 1 in every 4 adults, and 1 in 5 youth ages 13 to 18 experiences a mental health illness every year. The most successful medications for these diagnoses and others are primarily stimulants which are non-narcotic con-trolled substances that were impacted by Rule 64B8.90.141(4) F.A.C.

In Florida and the country are facing a shortage of psychiatrists, particularly child and adolescent psychiatrists…. which is creating an accessibility crisis, says Anna Baznik, IMPOWER President & CEO. To fully address the mental health needs of the community, this shortage must be ad-dressed and treatment and medication management accessible, especially for clients who reside in rural areas, Baznik added.

The use of telepsychiatry is widely accepted and endorsed in other states further stated Baznik. The program of-fers mental health and psychiatric care through a real-time, live, face-to-face, HIPPA compliant, secured video plat-form via the internet and successfully ad-dresses these barriers to care. To date, the alternative virtual care option has resulted in increased patient access to services, more consistent patient services, reduction in time/costs/transportation for patients, reduction in stigma of seeing a psychiatrist and reduced absences from school/personal time.

Currently, an approximate 4,000 cli-ents are receiving mental health services

and 1,900 clients are receiving psychiat-ric services from IMPOWER in Orange, Osceola, Seminole, Brevard, Volusia and Polk Counties.

In September, Dr. Branch, Dr. Reed, Dr. Kirmani and IMPOWER petitioned the Florida Board of Medicine for a waiver from Rule 64B8.90.141(4) Florida Admin-istrative Code. On October 10, 2014, Anna Baznik and Dr. Branch (IMPOWER’s Medical Director) appeared with their counsel, Anthony Iannacio, Esquire of Bush Graziano Rice & Platter, P.A., before the Florida Board of Medicine to present their Petition.

The Board granted the parties a one-year wavier from Rule 64B8.90.141(4) Flor-ida Administrative Code and requested Ms. Baznik and Dr. Branch return in De-cember of 2015 to report on the success of IMPOWER’s tele-medication manage-ment program, as well as to seek a per-manent waiver from the Rule.

MedMal Direct Insurance Ranked on 2014 Florida Fast 100 List

Jacksonville-based MedMal Direct Insurance Company (MedMal Direct) was recognized as one of Florida's fastest growing companies and was named to the 2014 Florida Fast 100 List as the 19th fastest growing company in the State of Florida.

MedMal Direct debuted on the 2014 Florida Fast 100 List after realizing more than 344 percent revenue growth be-tween 2011 and 2013. The list recognizes the 100 fastest growing companies in Florida each year and is compiled using data obtained by research directors of the four Florida Business Journal markets including Jacksonville, Orlando, South Florida and Tampa Bay.

Steve Mason

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