Steven E. Weinberger, MD, has been promoted to executive vice president and CEO of the American College of Physicians, effective July 19. The selection was made after a national search and based on recommendations from a search committee appointed by the ACP Board of Regents.
Weinberger will administer ACP's activities in medical education and publishing, membership services, business development, and public policy. He succeeds John Tooker, MD, who announced his intention to step down last October. Tooker will serve as ACP?s associate executive vice president for one year to help the leadership transition.
A career administrator and board-certified internist and pulmonologist, Weinberger served as ACP's deputy executive vice president since 2009 and as senior vice president for medical education and publishing since 2004.
Before joining ACP, Weinberger was faculty associate dean for medical education and a professor of medicine at Harvard Medical School.
He also served as executive vice chair of the department of medicine at Beth Israel Deaconess Medical Center in Boston and executive director of the Carl J. Shapiro Institution for Education and Research, an organization affiliated with both Harvard Medical School and Beth Israel Deaconess Medical Center.
ACP is the largest medical specialty organization and the second-largest physician group in the United States. Its members include 129,000 internists, related subspecialists, and medical students.
Connecticut Tuesday announced that it has reached a settlement with Health Net and its affiliates over the failure last year to secure the private medical records of 1.5 million policyholders and for the insurers' delay in reporting the breach.
Connecticut Attorney General Richard Blumenthal said the settlement imposes a $250,000 fine on the company for HIPAA and HITECH violations, and requires the insurers to adopt rigorous security and notification measures.
The settlement involves Health Net of the Northeast, Inc., Health Net of Connecticut Inc., and parent companies UnitedHealth Group Inc. and Oxford Health Plans.
Blumenthal said the insurers cooperated with the settlement, accepted responsibility for breach, and agreed to a remedial action plan.
The May 14, 2009 loss or theft of a portable computer disk drive at the company's Shelton, CT office impacted about 446,000 Connecticut policy and 1 million other policy holders across the nation. The breached data included personal health records, bank account numbers, and social security numbers. Health Net waited until Nov. 30 to provide notice of the breach.
The information included 27.7 million scanned pages of more than 120 different types of documents, including insurance claim forms, membership forms, appeals, grievances, correspondence, and medical records.
Health Net had maintained that the disk drive had been misplaced, but Blumenthal said a consultant hired by Health Net concluded that it had been stolen.
"This settlement is sadly historic — involving an unparalleled healthcare privacy breach and an unprecedented state enforcement of HIPAA," Blumenthal said in a statement. "These missing medical records included some of the most personal, intimate patient information — exposing individuals to grave embarrassment and emotional distress, as well as financial harm and identity theft," he said.
Health Net issued the following statement: "Protecting the privacy of our members is extremely important to us. As the Connecticut Attorney General stated, Health Net has worked closely and cooperatively with his office and state regulators to enhance our security systems and controls through additional associate training and education, as well as state-of-the-art security programs. All of these improvements will result in Health Net being in the forefront of securing member health information. As stated in the agreement with the Attorney General, to date Health Net has no evidence that there has been any misuse of the data."
Health Net has offered to pay for two years of credit monitoring services for any impacted members who elect the service.
University of Florida officials in Gainesville have notified 2,047 people that their Social Security or Medicaid identification numbers were included on address labels affixed to letters inviting them to participate in a research study.
The letters were sent through the US Postal Service on May 24, and the information also was shared with a telephone survey company. The problem was discovered June 6. Using Social Security numbers and other individual identifying numbers for non-essential purposes is against university policy, UF said in a media release.
The company, Burlington, VT-based Macro International Inc., said it will purge and destroy the information and sign legal documents indicating the task has been completed. The Gainesville-based printer that produced the mailing labels, Renaissance Printing, said it has already done so, UF said.
"We were dismayed to learn of this breach and deeply regret any concern this may cause these individuals," said Susan Blair, UF's chief privacy officer. "We have taken steps to address this problem and are continuing to evaluate our processes and procedures."
The letters were generated as part of a research study conducted through the UF College of Medicine's Department of Epidemiology and Health Policy Research. They were sent to parents or guardians of adolescent girls listed in a statewide database to seek their participation in a telephone survey about human papillomavirus, or HPV, vaccination. The study included a control group of unvaccinated girls ages 9 to 17 and those ages 11 to 17 who had received the vaccine.
The numbers — which were included on the address label so the telephone survey company could identify participants by their number only — were supposed to have been generated randomly. Instead, 647 were Social Security numbers and the remainder were Medicaid numbers, in both cases preceded by an alphabetical character with the hyphens omitted.
UF officials told the Florida Agency for Health Care Administration and the federal Office of Civil Rights. Information about the breach and has posted a notice on the university's home page and the privacy office's website.
Rising operating costs, managing finances amid Medicare reimbursement shifts, and installing electronic health records are the top three challenges for medical practice managers, according to Medical Practice Today: What Members Have to Say, an annual survey from the Medical Group Management Association.
"It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued congressional irresponsibility in not permanently addressing the flawed sustainable growth rate formula," said William F. Jessee, MD, president/CEO of Englewood, CO-based MGMA.
Medicare reimbursement rate uncertainty ranked No. 5 in 2008 and 2009.
The online survey of 1,798 people -- conducted from Feb. 12 to March 5 -- also found that "managing teamwork and group dynamics among physicians," an organizational governance issue MGMA introduced to the list this year, debuted at No. 8. "Implementing a patient-centered medical home model of care" made the biggest leap from last year's list -- from No. 22 to No. 12.
"Practices are clearly balancing the very serious issue of keeping their practices afloat amid unprecedented financial uncertainty with the more delicate practice management issues such as managing group dynamics and overseeing their organizations' strategic direction," Jessee said.
MGMA found that when compared with independent medical practices, hospitals and health system respondents were more concerned with:
Modifying physician compensation methodology
Recruiting physicians
Dealing with rising operating costs
Implementing a patient-centered medical home model of care
However, hospitals and health system respondents were less likely than independent medical practices to be challenged by "maintaining physician compensation levels" and "negotiating contracts with payers."
For a second year, MGMA also asked participants how the recession is affecting their medical groups and how they are responding. The participants said their practices have:
While these same issues ranked as the top five issues in 2009, the percentage of respondents who saw an increase in uninsured patients or postponed capital expenditures dropped this year. Among the ranking of the recession's effects, "staff salary freeze" accounted for the biggest jump in rank, moving up from No. 12 to No. 6.
Direct FDA jurisdiction over how CT scanners are used -- including radiation dose requirements -- would be a logistical nightmare because of the numbers and types of scanners in operation, and the variety of imaging services they provide, the American College of Radiology and the Society of Computed Body Tomography and Magnetic Resonance said Tuesday in a joint statement.
Instead, ACR/SCBTMR said that concerns surrounding imaging equipment could be addressed if the federal government required healthcare providers that use imaging equipment to adopt ACR safety standards.
ACR/SCBTMR were responding to a perspective piece published in the June 23 issue of New England Journal of Medicine which suggested that direct FDA oversight of CT scanners and other devices that deliver radiation is needed to control patient exposure brought on by the overuse of imaging equipment by inadequately trained medical staff.
The author, Rebecca Smith-Bindman, MD, a professor of radiology at UC San Francisco's Helen Diller Family Comprehensive Cancer Center, wrote that she and her colleagues had determined that the risk of cancer from a single CT scan could be as high as 1 in 80.
"Yet no professional or governmental organization is responsible for collecting, monitoring, or reporting patients' CT-dose information," Smith-Bindman wrote in NEJM. "The FDA approves CT scanners, but because it has no authority to oversee the way CT tests are used in clinical practice, it collects only limited data on routine doses. Radiologists and other medical specialists determine how CT tests are performed. Studies have consistently shown that physicians know little about radiation doses or cancer risks from medical imaging."
Smith-Bindman wrote that while radiation doses are supposed to be "as low as reasonably achievable," there are no guidelines to indicate what constitute reasonable doses for most types of CT. In addition, she wrote, enforcement and training requirements vary from state to state, and CT technologists often don't receive consistent and comprehensive training.
In their response Tuesday, ACR/SCBTMR said they share Smith-Bindman's concerns about the overuse and improper use of CT scanners, but said her call to put medical imaging directly under FDA oversight would create "narrowly defined regulations (that) may not allow for the flexibility that physicians need to provide the best possible care to their patients."
ACR/SCBTMR said a more effective and immediate path toward addressing radiation doses would be for the federal government to require all imaging providers to meet existing, previously voluntary programs that the ACR has already put in place. Those programs include:
Computerized exam ordering systems based on ACR criteria that help doctors prescribe the best exam for a patient's given condition, inform them when an exam that does not use radiation may be more appropriate or when no scan may be warranted at all.
ACR facility accreditation, which requires facilities to maintain image quality, checks radiation dose used, and minimizes the likelihood of adverse events such as those highlighted in recent news reports, by requiring physicians to meet certain education/training standards, scanners to be surveyed regularly by a medical physicist to ensure proper function, and technologists operating scanners to be certified.
The ACR CT dose index registry, which allows providers to submit radiation dose data so that facilities may compare their CT dose indices against realistic national benchmarks and may re-examine their imaging protocols if necessary.
"Lawmakers and government agencies need to work with the provider community to help ensure that that the next steps to address the very important issues of medical radiation reduction and necessary utilization are the correct steps," ACR/SCBTM said in a media release. "Federally mandating participation in these existing programs can help ensure that medical imaging is safe, effective, and available without removing treatment decisions from doctor's hands, and without further stressing the American healthcare system."
St. Joseph's Women's Hospital in Tampa has broken ground on a $75 million expansion project. The 125,000 square foot building will house the St. Joseph's Children's Hospital's Neonatal ICU with 64 NICU private suites, the Shimberg Breast Center, and other specialty services for women and newborns.
The Shimberg Breast Center, with 24 private suites, will include diagnostic tools such as CT scanner, ultrasound, Dexa scan, digital mammography and state-of-the-art MRI. It is expected to be completed by Fall 2012.
In addition to all private suites, other amenities include: full in-suite accommodations for families of NICU and women's hospital patients; wireless communications and Internet access; all-digital diagnostic imaging services; and Biometric Palm Scanning technology for registering and admitting patients.
The Shimberg Breast Center was named after Tampa philanthropists Hinks and Elaine Shimberg, who were the primary donors for the expansion. Elaine Shimberg is a breast cancer survivor, and the grandmother of a baby born prematurely.
St. Joseph's Women's Hospital, part of 10-hospital BayCare Health System, is the only freestanding hospital in the Tampa Bay area for women and infants.
I've been writing lately about violence in the hospital, and how hospitals should adopt a proactive, preventative zero tolerance towards assaults against employees. We've seen the data. employees are four times more likely to be assaulted on the job than are employees in most other sectors of the economy.
I've gotten some good feedback on the topic, but one email left me rankled. A hospital worker-who shall remain anonymous—told me that he had been assaulted on the job, but received little help prosecuting the case either from the police or from the management at the hospital where the assault occurred. The injured employee had to use his free time to go to court to file charges on his own.
This is troubling.
Hospitals must support assaulted employees. One simple, powerful way to do that is to provide paid time off so that the employee can prosecute the case. Prosecuting criminal cases can mean several hours of sitting on hard wooden benches at your local criminal court, only to be told late in the day to return tomorrow, or next week.
Your employee has already been victimized. Don't pile on. Give that employee the time he needs to be in court to see justice done, and pay his salary for the time he's away. If possible, have a representative from the hospital at the injured employee's side. Even better, involve your hospital's legal counsel to help the injured employee navigate through the criminal justice system. This sends a powerful message to employees that you care about them, and that you take their safety seriously
If an employee tells you he or she has been assaulted, investigate the case, and vigorously pursue prosecution when appropriate. It doesn't matter if it's a verbal threat, spitting, or a more physical assault. The message must be sent that violence against healthcare professionals will not be tolerated. If you do not do this, then you are sending the message that assault is "part of the job." You owe it not just to your employees but to all healthcare employees who put their safety on the line to treat potentially violent patients.
In some instances police are reluctant to prosecute. Maybe they have good reasons, or maybe they don't. You owe it to your employees to monitor the disposition of the case. You represent a hospital, one of the largest and most influential employers in your town. Use your status to ensure that your employee's complaint gets fair consideration.
If you or your injured employee isn't satisfied with the police response, take your case to the local news media if you think it is serious enough. I'm not sure what the HIPAA minefields are in this area. Even when privacy issues exist, there are ways around them. Don't make "bad publicity" for the hospital your primary concern. The public will demand action. .
I had a conversation recently with a friend who is an emergency room employee about hospital violence. He rolled up his sleeve to show me a years-old bite scar on his forearm—a memento from a drug-addled patient who'd slipped his restraints and taken a chunk out of my friend. As if the fear and violence of the assault itself were not traumatic enough, he had to undergo blood tests to ensure that he had not contracted hepatitis.
The board of directors at Mercy Hospital in Miami has voted to sell the 473-bed acute-care facility to Hospital Corporation of America. Financial terms for the sale of Miami-Dade County's only Catholic hospital were not disclosed.
"This is a wonderful opportunity to allow Mercy to be part of a larger presence in South Florida, while the mission of service to our patients continues," said Manuel P. Anton, III, MD, president/CEO of Mercy Hospital, in a joint statement today with HCA announcing the sale.
"Although Mercy now will be part of HCA, it will continue to operate in a manner consistent with the designation as a Catholic hospital, such that the Archbishop of Miami will be able to endorse it as a Catholic Hospital, adhering to the principles of faith with which it has served the community since its founding. Our top priority as always is the care of patients. This will be a seamless process for patients, their families, our associates and physicians." Anton said.
Mercy Hospital has served the Miami and Coral Gables area for nearly 60 years.
Michael G. Joseph, HCA East Florida Division President, said the acquisition of Mercy Hospital would complement the hospital chain's existing presence in South Florida. "With facilities in Aventura and Kendall, the addition of Mercy in Miami creates a corridor of care that enables us to better serve the community," Joseph said. "We have long admired Mercy's proud history of quality, compassionate care, and look forward to welcoming it into the HCA network of hospitals."
Mercy Hospital will retain its name and will continue to serve as a Catholic acute care hospital, owned and operated by HCA. The deal is expected to close as soon as possible.
Nashville-based HCA operates more than 160 hospitals, including 12 hospitals in its East Florida Division, and more than 100 surgery centers in 20 states and the United Kingdom. Established in 1950, Mercy is staffed by more than 700 physicians representing 27 medical specialties. Its Centers of Excellence include: The Heart Center at Mercy Hospital, the Miami Cancer Center at Mercy Hospital, the Orthopedic Institute at Mercy Hospital, and the Minimally Invasive Surgical Institute at Mercy Hospital.
Primary care physicians saw a 2.8% increase in their median compensation in 2009, according to a Medical Group Management Association study released today.
The Physician Compensation and Production Survey: 2010 Report Based on 2009 Data found that while most specialists continued to receive higher overall compensation than their primary care counterparts, some specialists reported flat or falling compensation.
"Despite a convergence of economic factors, employers' and payers' increased commitment to preserve the ability of primary care physicians to do their important work has allowed their compensation to keep pace with inflation," said William F. Jessee, MD, president and CEO of MGMA. "However, the continued threat of cuts to Medicare payments and its impact on private insurance reimbursement to all physicians impedes practices' ability to deliver quality care to an ever-expanding patient population."
OB/GYN, invasive cardiology, and hematology/oncology were among the specialties that reported flat or declining incomes. Physicians in OB/GYN posted a 1.1% decline in total median compensation in 2009, while invasive cardiologists posted a 0.2% decrease. Physicians in hematology/oncology—who have experienced declining revenues in their practices as a result of reduced reimbursement for administering drugs—reported that their compensation has increased 2.2% since 2005.
In marked contrast, dermatologists posted the largest compensation gains, a 12.2% median increase. MGMA attributed the steady compensation gains of dermatologists over the last several years to their elective procedures not covered by insurance and for which dermatologists can collect the full fee at the time of service. An increase in demand for dermatology services may also have driven up their compensation. Ophthalmologists reported a 7.7% increase in 2009 as laser refractive surgery and other non-covered services became increasingly popular.
MGMA's Physician Compensation and Production Survey Report provides data on nearly 60,000 physicians and non-physician providers in more than 110 specialties.
UCSF Children's Hospital has been given $100 million to help fund the construction of its new home at the UCSF Mission Bay campus near downtown San Francisco, the hospital announced today.
The gift is a private donation from Marc Benioff, founder, chairman and CEO of salesforce.com, a San Francisco-based sales and customer services applications provider. It is the largest gift ever granted to the UCSF Children's Hospital.
With the gift, the hospital is being renamed UCSF Benioff Children's Hospital. The new name will apply to the hospital at UCSF's Parnassus Heights campus and to the future UCSF Benioff Children's Hospital at Mission Bay, part of a 289-bed integrated hospital complex for children, women, and cancer patients. Construction of the new hospital begins this year.
"In business, we say that people overestimate what you can do in a year and underestimate what you can do in a decade. This is true in philanthropy as well," Marc Benioff said. "We will give exclusively to UCSF Benioff Children's Hospital, which has the research base for the next generation of discoveries, a commitment to advance health worldwide, and a focus on every child, regardless of resources. This is where we believe our time and resources will make the most impact in the next decade and beyond."
The $100 million gift is one of the largest private donations ever made to a children's hospital in the United States and is the fourth largest philanthropic gift in UCSF's history.
"The Benioffs' extraordinary generosity will have a direct impact on the many thousands of young patients cared for at UCSF Benioff Children's Hospital each year," said Mark Laret, CEO of UCSF Medical Center and UCSF Benioff Children's Hospital. "UCSF and the Benioffs share a commitment to performing at the very highest level, and we look forward to realizing our joint vision of creating the world's most advanced children's hospital at Mission Bay."
The gift completes the $125 million matching gift to the Campaign for UCSF Medical Center made in March 2009 by The Atlantic Philanthropies and its founder Charles F. Feeney. The match comes in two years ahead of schedule and brings the total raised for the $600 million capital campaign to $320 million.
UCSF is also launching an interactive website that will invite visitors to help shape the future of the new Mission Bay hospital. The UCSF Benioff Children's Hospital Ideas site will offer an open forum for submitting suggestions about the new facility, including innovations in care and patient amenities.
When it is completed in 2014, the 183-bed UCSF Benioff Children's Hospital at Mission Bay will offer urgent/emergency care, pediatric primary care and specialty outpatient services; and, with 45 more beds than the existing hospital and an on-site helipad.
The proximity of the hospital site to UCSF's 42.5-acre biomedical research campus will speed the application of laboratory discoveries to the treatment of pediatric patients in the Bay Area and beyond, Laret said.
The Mission Bay children's hospital has been designed specifically for children and their families. Innovative equipment, child-friendly décor, and rooms and resources that engage the whole family will be large enough to enable parents to stay with their children around the clock. The new hospital will also have thousands of square feet of rehabilitation, play therapy, and outdoor garden areas.
The entire hospital complex also has been sustainably designed and will be certified LEED Gold by the U.S. Green Building Council's Leadership in Energy and Environmental Design.
