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PROVIDER FOCUSFEBRUARY 20145 UnityPoint Clinics Earn National Recognition UnityPoint Clinic has been awarded recognition for the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home 2011 Program at five Des Moines-area clinics:Family Medicine – Ankeny (1105 N. Ankeny Blvd.)Family Medicine – Ankeny at Prairie Trail (2515 SW State Street)Family Medicine – Merle Hay (4020 Merle Hay Rd., Des Moines)Family Medicine – Norwalk (801 Colonial Circle) Family Medicine – Waukee (30 East Hickman Road) UnityPoint Clinic is transforming its primary care practices to a medical home model to improve patient-centered, coordinated care for the patients and communities it serves. The NCQA Patient-Centered Medical Home 2011 standards emphasize the use of systematic care management that supports access, communication and patient involvement.“The NCQA Patient-Centered Medical Home is a model of 21st century primary care that combines access, teamwork and technology to deliver quality care and improve health,” said NCQA President Margaret E. O’Kane. “NCQA’s PCMH 2011 Recognition shows that UnityPoint Clinic has tools, systems and resources to provide their patients with the right care at the right time.”“A medical home emphasizes the importance of an ongoing patient-provider relationship to ensure an individual’s health is managed appropriately over time,” remarked Dr. Patricia Newland, physician lead of the medical home implementation team for UnityPoint Clinic. “The provider leads a team of nurses, medical assistants and other staff who are collectively responsible for providing or coordinating the care, education and support that patients need to be successful.”UnityPoint Clinic has added care coordinators to their medical home team to help empower patients to be active participants in their health care. A care coordinator is a registered nurse who provides additional education on medication, nutrition, exercise and other topics important to a patient, assists them with goal setting and coaches them to develop a plan to achieve their goals.Patient-Centered Medical Home data shows promising results in improving care quality and lowering costs by increasing access to more efficient, coordinated and responsive care.According to Linda Wendt, RN, director of quality and administrative lead of the medical home initiative for UnityPoint Clinic, improving primary care leads to much more than better health. “Patients comment that the overall experience is better because they feel more included in their care, and providers find that sense of partnership very rewarding.”New ProvidersBlank Children’sPlease join in welcoming Dr. Lisa Hardisty, pediatric hospitalist, to Blank Children’s Hospital! Dr. Hardisty joins us after 3 years of service as a pediatrician at Boys Town National Research Hospital in Nebraska. She attended medical school at the University of Iowa and completed her pediatric residency at the University of Iowa Children’s Hospital.Dr. Hardisty joins the Blank Children’s hospitalist team with Drs. Brown, Dajud, Line, Moberg and Norris. The general phone number is 515-241-5926. Iowa RadiologyDr. Ben Stradling has recently joined Iowa Radiology. Dr. Stradling is originally from Mesa, Arizona. He brings experience gained most recently at Associated Radiologists and other private radiology groups in the surrounding Mesa area. He attended undergraduate school at Northern Arizona University in Flagstaff, Arizona. From there, Dr. Stradling moved to the mid-west where he completed medical school at Chicago College of Osteopathic Medicine at Midwestern University in Downers Grove, IL. After medical school, he pursued his residency and fellowship training in Vascular and Interventional Radiology at the University of Illinois College of Medicine at Peoria/OSF St. Francis Medical Center in Peoria. When not at work, Dr. Stradling loves spending time with his wife and sons. He also enjoys long distance running and cycling. His passion for running has allowed him to complete the Boston marathon twice. Dr. Lisa Hardisty Dr. Benjamin StradlingH&P RequirementsAs a reminder, all patients undergoing surgical or other invasive procedures (i.e. radiology, endoscopy, etc.) must have a History and Physical on file prior to the start of their procedure. This is a requirement of all accrediting agencies. If the H&P is not done in the outpatient area of the hospital on the day of surgery, or if the patient is not a current inpatient, there must be an addendum to the pre-operative history and physical. The pre-op H&P may be done outside of the hospital but must be done within the 30 days prior to surgery. The addendum is also a template in Epic under “Notes”. Open a new note and type “sur addendum” in the “Insert Smart Text” box. Choose “Addendum to H&P with Informed Consent”. The addendum can then be signed or any changes to the H&P can be noted at that time then signed.The Clinical Informaticists are available to assist you with this if you have questions. You can reach them at through the hospital Operator. IQ4 UpdatesPatient Portal UpdateMyUnityPoint, our system patient portal, continues to grow and mature. Outlined below are a few updates that providers and employees should be aware of when engaging with our patients. Patient use of MyUnityPoint is growing rapidly. Currently, there are more than 22,000 registered users and 150-200 registration requests are being received daily. Significant acceleration of patient adoption is anticipated in 2014 as the organization prepares to meet meaningful use requirements.UnityPoint Health is switching to Epic’s MyChart patient portal product from Jardogs’ FollowMyHealth (FMH) product over next 18 months. As a result, there will be two different portals in many of our regions for a period of time. Both portals will need to be supported to ensure our success in meeting meaningful use guidelines.All hospitals live with Epic will switch to MyChart on March 3, 2014. The remaining hospitals will switch to MyChart as they go live with Epic. The flow of new hospital information to FMH will be terminated when a hospital switches to MyChart.Our clinics will switch from FMH to MyChart as they go live with Epic. The implementation of Epic in our clinics goes through 2Q 2015.Plans for public communications and a smooth transition of registered users from one portal to another are in development. Patients should still be encouraged to register for the FMH version of the portal prior to the transition.From the patient perspective, the MyUnityPoint name will remain consistent. In regions where two portals are active, steps will be taken to minimize confusion and help patients easily connect to the information sought.Scripting will be provided for provider/staff interactions with patients. On February 3, radiology results began flowing through MyUnityPoint. New inpatient radiology results will flow to the portal three days after the report has been completed. New ambulatory radiology results will become available to the patient two days after the report has been verified in Allscripts by the physician or advanced practitioner. New outpatient results, not associated to an ambulatory physician or provider using Allscripts, will be released in the same manner as inpatient results.Addendum items are released to the patient’s portal account in the same fashion as a results release. Patients enrolled with MyUnityPoint as of February 3rd will receive new radiology results on a go-forward basis. Patients enrolled after February 3rd will also have some access historical radiology results upon activation of their portal account.Also on February 3, inpatient (including ED) lab results began flowing to the portal.Inpatient results will follow the same protocol as outpatient lab results. They will become available to the patient two days after the report has been verified by the provider.If at any time there is a concern about results in the portal, staff and providers can contact the portal support team by phone and email. The support team is available Monday through Friday from 8 am to 6 pm at 877-224-4430 or myunitypointsupport@. After hours and critical calls can be placed to the general UnityPoint Help Desk at 800-681-2060.Radiology exam ordersWhen entering orders for Radiology exams, the Indication needs to be the diagnosis or symptom of the patient. Do not use R/O, screening, or Pre-op as a reason for an exam.Paging On-Call Providers through the IntranetHow to page an on-call provider:Go to the System Tab in the Intranet and choose ‘Intregrated Services’This screen will appear, then click on the link ‘IntelliWeb’-3810018478500Choose the ‘OnCall’ tab at the top and then you can search by department. You may choose by Department or Person.Then you may page the person on call by clicking the Pager icon and typing the information in the popup box.ICD-10Look for information coming soon regarding opportunities to learn about ICD-10. ICD-10 is the newest coding version that will be in use beginning this year. Orders and Order SetsThere have been several changes made to order sets recently. Please ensure you are reviewing and accepting the changes as they appear. Once you accept the change, the pop-up screen will not show again for that change.Infection Prevention NewsWe will present a series of short clinical scenarios over the next several months with the goal of improving understanding and use of isolation precautions. This month – possible respiratory viral infection; next month – MRSA. Please call us with any questions as we welcome your calls. You can reach the Infection Prevention Team at 205-4658.CASE 1:4-month old male presents with a 5 day history of upper respiratory infection. Initial symptoms started with cough and congestion but now increased fussiness and poor oral intake. Over past 24 hours he has only one wet diaper and is dehydrated. In the ED, noted to be in respiratory distress with significant retractions. Q: What isolation precautions should be utilized upon admission?A: DROPLET and CONTACT PrecautionsWHY: DROPLET precautions are in place for possible diagnosis of influenza, para-influenza, mycoplasma, pertussis and several other respiratory pathogens. CONTACT is required for possible RSV and metapneumovirus.CASE 2:A 31-year-old obese, diabetic male presents to the ED with a fairly benign past medical history. He complains of a 3 day history of abrupt onset of fever, chills, myalgias and cough. This morning he was short of breath and temp was 102.3 F. The Iowa Department of Public Health has just announced that influenza is considered “wide-spread” in Iowa. Q: What isolation precaution should be utilized upon admission?A: DROPLETWHY: DROPLET precautions are in place for possible diagnosis of influenza, para-influenza, mycoplasma, pertussis and other respiratory pathogens (CONTACT not required on admission for this patient as RSV and metapneumovirus are less common pathogens in adults than in children).The rapid influenza A/B test is negative. Q: Can precautions be discontinued?A: NOWHY: Rapid influenza screening test has a low sensitivity (30 – 50%) so a negative test during influenza season is of NO VALUE! The filmarray PCR panel influenza testing is 95% – 98% sensitive. Precautions can be discontinued if the filmarray PCR is negative and/or an alternative diagnosis is established. Save the Date2nd Annual Liver Disease ConferenceFriday, April 4, 2014Iowa Methodist Medical CenterEducation & Research Center1415 Woodland AvenueDes Moines, IA 503099 a.m. – 4:30 p.m. (lunch provided)Join us for a FREE conference to discuss ways to improve the liver healthof Iowans by updating health care providers on current guidelines formanaging the most common liver disorders.Registration and continental breakfast from 8:30 – 9:00 a.m.Registration required by March 28, 2014In Stitches ................
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