REFLECTIONS AND RESOLUTIONS

INPATIENT REHAB: CONVENIENCE AND EXCELLENCE RIGHT HERE

Sending patients downstate for brain and spinal cord injury

rehabilita-tion is a practice physiatrist Julie Gronek, MD, would like her colleagues to reconsider.

The practice, while well intentioned, is one that may cause unnecessary hardship for the patient and the family who supports that patient’s continued rehabilitation at home, said Dr. Gronek, a partner with Neu-romuscular & Rehabilitation Associates of Northern Michigan. “For those patients undergoing brain and spinal cord rehabilitation, physicians should know that all services – internal medicine, radiology, surgical – come to the patient. That’s not always the case downstate, where patients are often transported elsewhere for x-rays or lab tests,” she said. “All acute services are right here, making it very convenient for the patient and the patient’s family.”

Munson Medical Center’s 12-bed Inpatient Rehab unit is run by an at-tending physician, with each rotation lasting a month at a time. Gronek and her six colleagues round three to four days a week, with two full-time midlevels rounding every day.

As we start a new year, it’s a great time to reflect on what we learned and accomplished in 2013.

We welcomed 21 new physicians to Munson Medical Center (see related article on pg. 4 and insert). These physicians will be great additions to our already outstanding medical staff. We continue to work with physicians and understand how processes, for example transition of care, have great impact, not only on patient care but also on office processes.

Practices participated in a series of Kaizen wayfinding events at Munson Medical Center to help improve signage so that patients can find their way around the hospital.

Government regulations, insurance requirements, and hospital processes and policies continued to evolve, and we kept you up-to-date on these changes through our newsletters, mailings, workshops, and one-on-one. 2013 saw the continuation of education geared towards getting practices ready for ICD-10 implementation. On-site HIPAA training for

practices continues to be a success with more than 700 providers and staff learning best practices for protecting patients’ privacy since the program began in 2011. And in looking forward to 2014, one of our New Year’s resolutions is to spend more one-on-one time with physicians and their staff so as to better understand your challenges and how Munson can be a stronger partner. Although every practice is unique; there are also many things held in common and we can all learn from each other. More to come on this resolution in my February column.

Best wishes to you and yours! Andrea is available at (231) 935-3391 or aludka@mhc. net.

REFLECTIONS AND RESOLUTIONS

Andrea Ludka

Dr. Julie Gronek answers a patient’s question.

“We want our patients functioning at the highest level of care they can get. What we don’t want is for families to take two weeks off and have to live in Grand Rapids. The family training can happen here.”

INPATIENT REHAB: CONVENIENCE AND EXCELLENCE RIGHT HERE

Continued from page 1

Although the rounding schedule exceeds Medicare guidelines, Dr. Gronek believes that this level of coverage, combined with visits by other specialists, allows the group to take a higher acuity patient. “In Munson’s Inpatient Rehab unit, accompanying medical issues are resolved, because our specialists follow these patients as needed,” she said. “If a patient’s medical problems are unstable, the physicians can come every day.”

Since inpatient rehab is a transition unit for those hoping to go home, Dr. Gronek and her partners work closely with the patient’s family to incorporate everyone’s goals.

“We want our patients function-ing at the highest level of care they can get,” she said. “What we don’t want is for families to take two weeks off and have to live in Grand Rapids. The family training can happen here.” One common misperception Dr. Gronek would like to dispel is that the unit is always full.

“There is an occasional waitlist, maybe two or three times a year,” she said. “But a bed will generally open up within a few days.”

Dr. Gronek said while the processes for treatment and discharge tend to be smooth, admissions can be slightly more complex because insurance approval for inpatient rehabilitation is on a case-by-case basis on weekdays only.

In response to these strict guidelines, Dr. Gronek and her group have become “very organized…we have three full-time people whose job it is to get these cases approved,” she said. “We very rarely get a denial.”

When it comes to the handoff, the group has a full-time discharge planner who sets up all follow-up appointments and issues the hospital summary, which outlines therapies, home care directives, and prescriptions.

“What we want our colleagues to understand is that we are very well-equipped to handle highly acute patients,” Dr. Gronek said. “Most don’t realize the acuity of patients we handle, and we want them to know the very best care is right here in their home hospital.”

“All the nursing staff and Dr. Gronek are super, and I have received great care. The therapists are top notch. Hard work is part of the rehab program, but I had to do that so I could go home,” said Inpatient Rehab patient Jim Cabot of Eastlake.

To refer a patient to Munson’s Inpatient Rehab or for more information, please contact Diane Glowicki, Rehab Manager and Admissions Coordinator, at (231) 935-7341 or dglowicki@mhc.net.

“What we want our colleagues to understand is that we are very well-equipped to handle highly acute patients. Most don’t realize the acuity of patients we handle, and we want them to know the very best care is right here in their home hospital.”

- Julie Gronek, MD; Neuromuscular & Rehabilitation Associates

“All the nursing staff and Dr. Gronek are super, and I have received great care. The therapists are top notch. Hard work is part of the rehab program, but I had to do that so I could go home.”

- Jim Cabot, Inpatient Rehab patient

Dr. Julie Gronek and physical therapist Chrystie Pearson help a patient stand.

For inpatient rehab facility (IRF) treatment, the patient must:

• Be sufficiently medically stable to actively participate in a rehabilitation program. • Have an acute or chronic

(chronically stable or slowly progressive) condition. The complexity of the patient’s nursing, medical management, and rehabilitation needs requires an inpatient stay and an interdisciplinary team approach to care. • Require multiple therapy

disciplines including physical therapy, occupational therapy, speech-language pathology, and orthotics/ prosthetics. One of the therapy disciplines must be physical or occupational therapy, though in most cases both will be needed. • Demonstrate the potential to actively participate in a minimum of three hours of therapy daily.

• Demonstrate the potential to learn and carry-over new skills.

To refer a patient to Munson’s Inpatient Rehab, please contact Diane Glowicki, Rehab Manager and Admissions Coordinator, at (231) 935-7341 or dglowicki@mhc.net.

November December January February March April May June July August September OCTOBER 2014

ICD-10 Countdown Clock

242 Days Remaining

ICD-10 COUNTDOWN

ICD-10 CHECKLIST

Should be completed: Vendor assessment Technology inventory Education strategy Physicians: ICD-10 Awareness Education (available via HealthStream) Staff: begin education FY14 Budget

Up next:

Conduct internal and external testing Business process modifications Technology modifications

Physicians: ICD-10 HealthStream (specialty-specific) Attend Workshop #3: Feb. 4 & 5, 2014

Physicians: Feb. 14, 2014 Friday Medical Conference, “Healthcare Reform – Connecting the Dots with ICD-10” presented by Diane K. Donley, MD

HealthStream Link for Physician

ICD-10 Education

In an effort to make it easy for physicians to access ICD-10 education, Munson is providing free ICD-10 education to Munson’s Medical Staff through Munson’s HealthStream learning website at https://www.healthstream.com/hlc/ munsonhealthcare.

The ICD-10 Physician Advisory Group assigned awareness modules that were due December 31, 2013. Physicians who have not completed them should do so as soon as possible. These courses provide CME credit, are self-paced, and can be accessed from any device with an Internet connection. Physicians will receive specialty-specific modules via HealthStream in the next few months.

Additional ICD-10 preparation resources are available online at munsonhealthcare.org/icd10.

If you have any questions, please contact Cheryl Wheeler, ICD-10 Education Coordinator, at (231) 935-6040 or cwheeler@mhc.net.

Improving access to information for patients and clinicians – as well as meeting some of the regulatory requirements for Meaningful Use Stage 2 – is the goal of iPATH (Improving Patient Access to Health), which goes live January 28. iPATH is being rolled out at Munson Medical Center, Kalkaska Memorial Health Center, Mercy Hospital Cadillac, Mercy Hospital Grayling, and Paul Oliver Memorial Hospital so there is a standardized discharge process across all five Munson Healthcare hospitals.

Physicians and practices will see changes to three patient reports following iPATH implementation: Hospital Summary (formerly Discharge Summary), Hospital Course, and Patient Instructions. Practices should have received a mailing outlining these changes as well as examples of the revised reports. You will continue to receive these patient reports via your current report distribution method; iPATH will not change that. As with the launch of any new software, there are apt to be some bumps along the road. If you notice any issues, would like additional training, or have any suggestions, after iPATH goes live on Jan. 28, please call the Help Desk at 935-6053.

Thank you for your patience as we work to improve the patient discharge process. For more information on iPATH, go to munsonhealthcare.org/ipath2014.

iPATH Goes Live January 28

FUTURE ICD-10 WORKSHOPS

All workshops will be held in the Lake Rooms at the

Park Place Hotel.

WORKSHOP #3

FEB. 4, 8:30 AM - 10:30 AM

FEB. 5, 11:30 AM - 1:30 PM

Note: only need to attend one

Topics covered: Internal and external testing, business

process modifications, technical modifications

To register, contact Heidi Kistler at

(231) 935-5873

or

physicianliaison@mhc.net

. Space is limited.

Should be working on now: Vendor inventory

Process remediation plan A technology strategy Review of business processes Staff: continue education FY15 Budget

NEW PHYSICIANS: MHC RECRUITS 39 IN 2013

Munson Healthcare recruited 39 physicians in 14 different specialties during 2013. We’ve had an outstanding year recruiting system wide, and northern Michigan continues to be a highly desirable place to practice and live. Specialties include Cardiology, Emergency Medicine, Family Practice, General Surgery, Hospital Medicine, Internal Medicine, Nephrology, Obstetrics and Gynecology, Oncology/Hematology, Ophthalmology, Orthopedic Surgery, Psychiatry, Urology, and Vitreoretinal Surgery.

Enclosed is a brochure listing the new Munson Healthcare physicians. Recruiting, retaining, and building relationships amongst physicians throughout northern Michigan are priorities for Munson Healthcare. We look forward to continuing to work together to provide close to home care in the communities we serve.

Physicians with colleagues interested in northern Michigan can call Physician Recruitment at (231) 935-5890 or

1-866-637-6128. You can also direct them to munsonhealthcare.org/physicianopportunities to learn about current physician opportunities. They can also join us on Facebook (MunsonHealthcareRecruitment) and Twitter (MHCRecruitment).

A patient portal is a special, secure, website that allows patients to access their personal medical information from the convenience of a computer or smart phone. Starting in the spring, Munson Medical Center, Kalkaska Memorial Health Center, and Paul Oliver patients will be given an opportunity to sign up for their own “patient portal” plus many physician practices now provide web portals for their patients.

Do patient portals meet HIPAA requirements? Yes. Patient portals are easy, safe, private, and secure. Patient portals allow patients to be advocates in their health because they are more aware of, and involved in their care. Patient privacy is protected in the following ways:

• Participation is voluntary. All patients must sign a consent agreement to participate, and must use their own, individual email account. Patients can suspend or terminate participation at any time. Each patient will have their own unique user name, password, and security question(s).

• All communication between the physician and patient, sent via the portal, become part of the patient’s medical record, and continues to be protected by strict HIPAA Privacy laws. Messages are also encrypted in transmission, meaning that they cannot be “hacked” into.

• The portal site is secure, meaning that no unauthorized persons can read any message. Messages can only be read by someone who knows the correct user name and password to log into site.

• Patients bear the responsibility for giving the doctor’s office the correct email address to use.

• Patients are also responsible for keeping their password to themselves, or, may share it with a family member or friend that they authorize to review their medical information. This is the patient’s choice.

• Patients may also print out parts of their record, or download their record to a file that may or not be secure, on their computer or thumb drive. This is the patient’s choice and responsibility.

In summary, this new technology will be safe to use, and patient information will be secure. However, patients must protect their password to prevent unauthorized people from accessing their patient portal account. Patients who suspect that their password has been compromised can reset their password by logging into the patient portal.

If you have any HIPAA questions, please contact Rochelle Steimel, Privacy Officer, at (231) 935-5765 or rsteimel@mhc.net.

PATIENT PORTALS MEET HIPAA PRIVACY REQUIREMENTS

Rochelle Steimel, OTR, MPH Privacy Officer

Munson’s patient portal will launch for

patients on Feb. 17. For more information, go

to

munsonhealthcare.org/myhealthinfo

.

Wednesday, February 12 | 6 - 8 pm | Traverse City Golf & Country Club | Traverse City

Physicians and practice managers are invited to attend this seminar which is aimed at helping physicians and office practices improve work flow and efficiency through an introduction to Lean principles. A light dinner and refreshments will be served. Physicians will receive 2.0 hours of CME for attending. For CME information, go to: munsonhealthcare.org/news/toolsfortransformation. There is no charge to attend.

To RSVP, please contact the Northern Physicians Organization at (231) 421-8505 by February 7.

Tools for Transformation: Leading Your Practice Through the Perfect Work Day

Kevin L. Rogols

KALKASKA MEMORIAL MEDICAL CENTER NAMES NEW ADMINISTRATOR

Kevin L. Rogols will succeed the retiring Jim Austin as administrator of

Kalkaska Memorial Health Center.

Rogols, currently the president and chief executive officer of Sandoval Regional Medical

Center in Rio Rancho, New Mexico, will join Kalkaska Memorial Health Center on

Feb. 3. In addition to several hospital executive positions, he was a former vice president

at Munson Medical Center, serving there from 1986 - 1991. Austin, who has led the

hospital for 24 years, will retire at the end of February 2014.

“Kevin will bring a wealth of leadership experience to Kalkaska Memorial Health Center

in addition to his past experience in northern Michigan,” Munson Healthcare President

and CEO Ed Ness said.

National Wear Red Day

|

FEBRUARY 7

The American Heart Association has designated Feb. 7 as National Wear Red Day to raise awareness about the fight

against heart disease in women. Wear red to work, to play, or wherever else your day takes you.

Heart to Heart for Women and Men

|

WEEKS OF FEBRUARY 10 AND 17

Participants will receive a one-on-one screening, assessment, and education. Tests include blood pressure, body mass

index, blood sugar and cholesterol, stress and depression levels, nutrition review, smoking and alcohol assessments,

and review of family medical history. Participants will leave with a personalized action plan including risk factor

reduction materials and steps for improving heart health. Cost is $55 (grants are available).

È

Munson Community Health Center | 550 Munson Ave., Traverse City

To make an appointment, call

(231) 935-8561

.

FEBRUARY IS HEART MONTH

You should have received an updated Physician by Specialty listing (a.k.a. Green Sheet), which includes contact information for physicians on-staff at Munson Medical Center, Kalkaska Memorial Health Center, and Paul Oliver Memorial Hospital. The Green Sheet is also available online at munsonhealthcare.org > For Physicians > Resources > Directories.

To update your providers’ information, please contact HealthLink at (231) 935-5886, 1-800-533-5520, or healthlink@mhc.net.

Updated Green Sheet Now Available

1105 Sixth Street

Traverse City, MI 49684-2386

Judy C. Liu, MD

Judy C. Liu, MD, has joined the staff of Munson Medical Center as a specialist in vitreoretinal surgery, and is accepting new patients. Associated Retinal Consultants 860 E. Front St.

Traverse City

(231) 938-0710 phone (231) 938-0264 fax

For additional information, call HealthLink at (231) 935-5886or 1-800-533-5520.

For additional information, call HealthLink at (231) 935-5886or 1-800-533-5520.

Peter K. Shireman, MD Peter K. Shireman, MD, has joined the staff of Munson Medical Center as a specialist in pathology. Grand Traverse Pathology 1105 Sixth St. Traverse City

(231) 935-6100 phone (231) 935-7528 fax Nancy L. Reye, MD

Nancy L. Reye, MD, Family Practice, has relocated her practice to Partners In Health and is accepting new patients. Dr. Reye can be reached at:

Partners In Health 3074 N. US 31 S. Traverse City, MI 49684 (231) 935-0535 phone (231) 935-0984 fax